Brain

Introduction

The nervous system is involved in the transmission of signals for communication and for coordination of body systems. The principle cell of the nervous system is a neuron, the neuron components are a cell body, dendrites, axon, synaptic terminals and myelin sheath (not always). The cell body component of the neuron integrates signals and coordinates metabolic activities. Dendrites are the branched projections of a neuron that act to conduct the electrochemical stimulation. The axon in the neuron conducts the signal and the synaptic terminals transmit the signals. The myelin sheath is the coating on some neurons that that acts as an insulator to speed the conduction of nerve impulses, usually around only the axon of a neuron.

The transmission of a nerve impulse along a neuron from one end to the other occurs as a result of chemical changes across the membrane of the neuron. The membrane of an unstimulated neuron is polarized—that is, there is a difference in electrical charge between the outside and inside of the membrane. The inside is negative with respect to the outside. Such polarization is established by maintaining an excess of sodium ions (Na+) on the outside and an excess of potassium ions (K+) on the inside. Na+/K+ pumps in the membrane actively restore the ions to the appropriate side.

Other ions, such as large, negatively charged proteins and nucleic acids, reside within the cell. It is these large, negatively charged ions that contribute to the overall negative charge on the inside of the cell membrane as compared to the outside. In addition to crossing the membrane through leakage channels, ions may also cross through gated channels. Gated channels open in response to neurotransmitters, changes in membrane potential, or other stimuli. The following events characterize the transmission of a nerve impulse.

Resting potential: The resting potential describes the unstimulated, polarized state of a neuron.

Graded potential: A graded potential is a change in the resting potential. A graded potential occurs when the stimulus causes Na+ or K+ gated channels to open. Na+ channels open, positive sodium ions enter, and the membrane depolarizes (becomes more positive).

If the stimulus opens K+ channels, then positive potassium ions exit across the membrane and the membrane hyperpolarizes (becomes more negative).

Action potential: An action potential is capable of traveling long distances. If a depolarizing graded potential is sufficiently large, Na+ channels in the trigger zone open. In response, Na+ on the outside of the membrane becomes depolarized (as in a graded potential).

Repolarization: In response to the inflow of Na+, K+ channels open, this time allowing K+ on the inside to rush out of the cell. The movement of K+ out of the cell causes repolarization by restoring the original membrane polarization. Soon after the K+ gates open, the Na+ gates close.

Hyperpolarization: This is when K+ channels closes and more K+ has moved out of the cell. As a result, the membrane becomes hyperpolarized.

Refractory period: The membrane is polarized, but the Na+ and K+ are on the wrong sides of the membrane. During this refractory period, the axon will not respond to a new stimulus. To re-establish the original distribution of these ions, the Na+ and K+ are returned to their resting potential location by Na+/K+ pumps in the cell membrane. Once these ions are returned to their resting potential the neuron is ready for another stimulus.

Transmission of Nerve Impulses between Neurons:

The nerve impulse (action potential) travels down the presynaptic axon towards the synapse, where it activates voltage-gated calcium channels leading to calcium influx, which triggers the simultaneous release of neurotransmitter molecules from many synaptic vesicles by fusing the membranes of the vesicles to that of the nerve terminal. The neurotransmitter molecules diffuse across the synaptic cleft, bind briefly to receptors on the postsynaptic neuron to activate them, causing physiological responses that may be excitatory or inhibitory depending on the receptor.

The central nervous system (CNS) is that part of the nervous system that consists of the brain and spinal cord. The central nervous system is one of the two major divisions of the nervous system. The other is the peripheral nervous system (PNS) which is outside the brain and spinal cord.

The peripheral nervous system (PNS) connects the central nervous system (CNS) to sensory organs (such as the eye and ear), other organs of the body, muscles, blood vessels and glands.

The hippocampus is one of the first regions of the brain to suffer damage; memory problems and disorientation appear among the first symptoms. Damage to the hippocampus can also result from oxygen starvation (hypoxia), encephalitis, or medial temporal lobe epilepsy. People with extensive, bilateral hippocampal damage may experience anterograde amnesia—the inability to form or retain new memories.

Cholinesterase is a family of enzymes that catalyze the hydrolysis of the neurotransmitter acetylcholine into choline and acetic acid, a reaction necessary to allow a cholinergic neuron to return to its resting state after activation.

Cholinesterase inhibitors work by increasing levels of acetylcholine, a chemical messenger involved in memory, judgment and other thought processes. Certain brain cells release acetylcholine, which helps deliver messages to other cells. After a message reaches the receiving cell, various other chemicals, including an enzyme called acetylcholinesterase, break acetylcholine down so it can be recycled.

Alzheimer’s disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception. Alzheimer’s disease is a result from an increase in the production of beta-amyloid protein in the brain that leads to nerve cell death. The only way to know for certain that someone has AD is to examine a sample of their brain tissue after death. The following changes are more common in the brain tissue of people with AD: Neurofibrillary tangles which are twisted fragments of protein within nerve cells that clog up the cell. Another change which is common in brain tissue of a patient with AD is neuritic plaques (containing beta-amyloid protein) mentioned above. This results in abnormal clusters of dead and dying nerve cells, other brain cells, and aberrant protein deposits. When nerve cells are destroyed, there is a decrease in the chemicals/electrical signal that helps nerve cells send messages to one another, which are called neurotransmitters. As a result, areas of the brain that normally work together become disconnected.

The probability of having Alzheimer’s disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85. However Alzheimer’s disease is not a normal part of aging and is not something that certainly happens in later life, many people live to over 100 years of age and never develop Alzheimer’s disease.

Fig 1 (http://www.alz.org/brain/images/09a.jpg)

In fig 1 above is a view of how massive cell loss changes the whole brain in advanced Alzheimer’s disease. This illustration shows a crosswise “slice” through the middle of the brain between the ears. In the Alzheimer’s brain, the cortex shrivels up, damaging areas involved in thinking, planning and remembering. Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories. The ventricles spaces grow larger.

The risks factors implicated in Alzheimer’s disease are age, ApoE4, Down’s syndrome, head injury, low education and also family history i.e. genes. The main risk factor for Alzheimer’s disease is increased age. As a population ages, the frequency of Alzheimer’s disease continues to increase. Studies show that 10% of people over 65 years of age and 50% of those over 85 years of age have Alzheimer’s disease. There are also genetic risk factors for Alzheimer’s disease. Most patients develop Alzheimer’s disease after age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of life (40s or 50s). At least half of these early onset patients have inherited gene mutations associated with their Alzheimer’s disease. Also a child of a patient with early onset Alzheimer’s disease who has one of these gene mutations has a 50% risk of developing Alzheimer’s disease. Other risk factors for Alzheimer’s disease include high blood pressure (hypertension), coronary artery disease, diabetes, and possibly elevated blood cholesterol. Individuals who have completed less than eight years of education also have an increased risk for Alzheimer’s disease. These factors increase the risk of Alzheimer’s disease, but this does not mean Alzheimer’s disease is necessarily expected in persons with these factors.

The onset of Alzheimer’s disease is usually gradual, and it is slowly progressive. Problems of memory, particularly for recent events (short-term memory) are common early in the course of Alzheimer’s disease. Mild personality changes, such as less spontaneity, apathy, and a tendency to withdraw from social interactions, may occur early in the illness. As the disease progresses, problems in abstract thinking and in other intellectual functions develop. Further disturbances in behaviour and appearance may also be seen at this point, such as agitation, irritability and a deteriorating ability to dress appropriately. Later in the course of the disorder, affected individuals may become confused or disoriented. Eventually, patients will be unable to engage in conversation, become erratic in mood, uncooperative, and lose bladder and bowel control. In late stages of the disease, persons may become totally incapable of caring for themselves, and a result of this could be death. Those who develop the disorder later in life more often die from other illnesses (i.e. heart disease).

Fig 2 – Deaths from Alzheimer’s disease: (http://www.alz.org/downloads/Facts_Figures_2011.pdf)

From Fig 2 Alzheimer’s disease is the sixth-leading cause of death in the country and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed. From the data in the graph, death rates have declined for most major diseases while deaths from Alzheimer’s disease have risen 66 percent during the same period.

Unfortunately, there is no cure for AD. However there are goals in treating AD, these goals are to slow the progression of the disease (although this is difficult to do), manage behaviour problems, confusion, sleep problems, and agitation, modify the home environment and support family members and other caregivers.

Cholinesterase blockers are one of the main treatments of AD. Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes. The different cholinesterase inhibitors are Donepezil, Rivastigmine, Galanthamine, Tacrine and Memantine. The three main drugs currently licensed for the treatment of AD are Donepezil, Rivastigmine and Galanthamine.

Donepezil is the generic name and the brand name is Aricept. Donepezil is approved at all stages of Alzheimer’s disease. However the side effects of this drug are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Galanthamine, brand name Razadyne, is approved for the mild to moderate stages of AD. The side effects of Galanthamine are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Memantine (brand name Namenda), is approved for moderate to severe stages of AD, The side effects of this drug are headache, constipation, confusion and dizziness. Rivastigmine (brand name Exelon), approved for mild to moderate Alzheimer’s, the side effects of Rivastigmine are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Tacrine (also known as Cognex), this was the first cholinesterase inhibitor and was approved in 1993 but is rarely prescribed today; this is because of associated side effects which include possible liver damage.

Cholinesterase inhibitors work by increasing levels of acetylcholine, a chemical messenger involved in memory, judgment and other thought processes. Certain brain cells release acetylcholine, which helps deliver messages to other cells. After a message reaches the receiving cell, various other chemicals, including an enzyme called acetylcholinesterase, break acetylcholine down so it can be recycled.

But Alzheimer’s disease damages or destroys cells that produce and use acetylcholine, thereby reducing the amount available to carry messages. A cholinesterase inhibitor slows the breakdown of acetylcholine by blocking the activity of acetylcholinesterase. By maintaining acetylcholine levels, the drug may help compensate for the loss of functioning brain cells.

The benefits of cholinesterase inhibitors are that people taking the cholinesterase inhibitor medications performed better on memory and thinking tests than those taking a placebo, or inactive substance. In terms of overall effect, most experts believe cholinesterase inhibitors may delay or slow worsening of symptoms for about six months to a year; although some people may benefit more dramatically or for a longer time.

Namenda is approved to treat moderate-to-severe Alzheimer’s disease. Namenda works by a different mechanism than other Alzheimer’s treatments; it is thought to play a protective role in the brain by regulating the activity of a different brain chemical called glutamate. Glutamate also plays a role in learning and memory. Brain cells in people with Alzheimer’s disease release too much glutamate (Alzheimer’s Association 2007). Namenda helps regulate glutamate activity. Namenda works by blocking the receptors for the neurotransmitter glutamate. It is believed that glutamate plays an important role in the neural pathways associated with learning and memory. In brain disorders such as Alzheimer’s disease, overexcitation of neurons produced by abnormal levels of glutamate may be associated with neuronal cell dysfunction (resulting in cognitive and memory deficits) and eventual cell death (leading to deterioration and collapse of intellectual functioning). By selectively blocking a type of glutamate receptor (NMDA receptor) while allowing for normal neurotransmission, Namenda may help reduce the excitotoxic effects associated with abnormal transmission of glutamate. (psychatlanta.com)

Namenda may have increased benefit when used with Aricept, Exelon, Razadyne, or Cognex. Memantine, a voltagegated and uncompetitive NMDA antagonist with moderate affinity, can protect neurons from excitotoxicity. It was approved for treatment of the patients with moderate to severe AD. (Alzheimer’s Association 2007)

A growing body of evidence suggest that drugs indicated for other conditions may also possess preventive efficacy for AD. Among the most promising are antioxidants, nonsteroidal, statins, certain anti hypertensive agents, alcohol, fish oil and possibly estrogen. Antioxidants have been recommended for prevention of dementia. The use of natural antioxidants may inhibit damage to the muscarinic receptors caused by free radicals, possibly by preventing or treating AD. High dietary intake of vitamins C and E lower the risk of AD. Estrogen is a weak antioxidant, it is biologically plausible that hormone replacement therapy (HRT) could protect against AD (Zandi PP et al 2002). AD is more likely to develop in a person with atherosclerotic cerebrovascular disease (Postiglione 1995). Antiatheroscleotic pharmacotherapies are used to treat atherosclerotic cerebrovascular disease, which then prevents AD from occurring (John B et al 2004). Folic acid is a AD preventer and is effective against AD. Folic acid is effective because it reduces homocysteine concentration, increased levels of homocysteine concentration increases the risk of AD. Statins is very effective at reducing the risk of AD. Statins reduce the risk of AD by reducing the cholesterol levels by interfering with the activity of enzyme. Moderate take of alcohol and intake of N-3 fatty acids reduces the risk of AD. Studies have shown that intake of N-3 fatty acids and weekly consumption of fish can decrease the risk of AD by 60 %.

Pharmacological treatments of Alzheimer’s disease are limited. Recent observational studies have shown that use of non-steroidal anti-inflammatory drugs (NSAIDs) may protect against the development of the disease, possibly through their anti-inflammatory properties.(Mahyar et al 2007)

The results from research which has been carried out has been varied. Caffeine can be used as a treatment in Alzheimer’s disease (Chuanhai et al 2009). Caffeine causes most of its biological effects via antagonizing all types of adenosine receptors (ARs), as does adenosine, exerts effects on neurons and glial cells of all brain areas. In consequence, caffeine, when acting as an AR antagonist, is doing the opposite of activation of adenosine receptors due to removal of endogenous adenosinergic tonus. Caffeine, through antagonism of ARs, affects brain functions such as sleep, cognition, learning, and memory, and modifies brain dysfunctions and diseases i.e. Alzheimer’s disease. (Gary W et al 2009).

Studies shows that people that take regular supplements decrease the risk of AD. Many people take folate (vitamin B9), vitamin B12, and vitamin E. However, there is no strong evidence that taking these vitamins prevents AD or slows the disease once it occurs. Recent studies have shown that people believe that the herb ginkgo biloba prevents or slows the development of dementia. However, high-quality studies have failed to show that this herb lowers the chance of developing dementia. Treatment of ancillary symptoms of Alzheimer disease has improved as well. Techniques have evolved to treat depression, sleeplessness, agitation, paranoia. Also family support is a cure in its own why which gives the patient a feel good feeling to overcome AD.

References

Volume 20, Supplement 1, 2010 – “Therapeutic Opportunities for Caffeine in Alzheimer’s Disease and Other Neurodegenerative Diseases” (Guest Editors: Alexandre de Mendonca and Rodrigo A. Cunha) Pages 3-15

Volume 20, Number 3, June 2010 – Special Issue “Basics of Alzheimer’s Disease Prevention” (Editor: Jack de la Torre) Pages 687-688

Supplement 3, November 2010 – “Anesthetics and Alzheimer’s Disease” (Guest Editors: Pravat K. Mandal and Vincenzo Fodale) – November 2010 Pages 1-3

Recommendations for the diagnosis and management of Alzheimer’s disease and other disorders associated with dementia: EFNS guideline

Volume 14, Issue 1, pages 1–26, January 2007, From mild cognitive impairment to prodromal Alzheimer disease: A nosological evolution J.L. Molinuevo, C. Valls-Pedret, L. Rami, Volume 1, Issue 3, June 2010, Pages 146-154

G. Waldemar; B. Dubois; M. Emre; J. Georges; I. G. McKeith ; M. Rossor; P. Scheltens; P. Tariska; B. Winblad, Article first published online: 9 JAN 2007, European Journal of Neurology

Mahyar Etminan et al 2003,Effect of non-steroidal anti-inflammatory drugs on risk of Alzheimer’s disease: systematic review and meta-analysis of observational studies doi: 10.1136/bmj.327.7407.128, BMJ. 2003 July 19; 327(7407): 128.

Gary W Arendash, Takashi Mori, Chuanhai Cao, Malgorzata Mamcarz, Melissa Runfeldt, Alexander Dickson, Kavon Rezai-Zadeh, Jun Tan, Bruce A Citron, Xiaoyang Lin, Valentina Echeverria, and Huntington Potter. Caffeine Reverses Cognitive Impairment and Decreases Brain Amyloid-%u03B2 Levels in Aged Alzheimer’s Disease Mice. Journal of Alzheimer’s Disease, Volume 17:3 (July 2009)

Chuanhai Cao, John R Cirrito, Xiaoyang Lin, Lilly Wang, Deborah K Verges, Alexander Dickson, Malgorzata Mamcarz, Chi Zhang, Takashi Mori, Gary W Arendash, David M Holzman, and Huntington Potter. Caffeine Suppresses Amyloid-%u03B2 Levels in Plasma and Brain of Alzheimer’s Disease Transgenic Mice. Journal of Alzheimer’s Disease, Volume 17:3 (July 2009)

John B. Standridge MD (2004) Pharmacotherapeutic approaches to the prevention of Alzheimer’s disease, Department of Family Medicine, University of Tennessee Health Science Center College of Medicine, Chattanooga Unit, Chattanooga, Tennessee, USA.

Zandi PP et al (2002 Nov 6), Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study, JAMA. 288(17):2123-9.

Postiglione A, Napoli C, (1995 Aug 6), Curr Opin Lipidol. Hyperlipidaemia and atherosclerotic cerebrovascular disease. (4):236-42

http://www.alz.org/national/documents/topicsheet_treatments.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC165707/?tool=pubmed

http://www.webmd.com/alzheimers/guide/treatment-overview

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http://www.ncbi.nlm.nih.gov/pubmed/21213151

http://www.alz.org/downloads/Facts_Figures_2011.pdf

http://www.cliffsnotes.com/study_guide/Transmission-of-Nerve-Impulses.topicArticleId-22032,articleId-21935.html

http://www.psychatlanta.com/documents/namenda.pdf

INTRODUCTION

Daily, the number of children diagnosed with Obsessive Compulsive Disorder (OCD) is on the increase. OCD has been shown to affect at least 2% of young people (OCF 2009). As defined by the NHS clinical guide 2005, “obsessive compulsive disorder (OCD) is characterized by the presence of either obsessions or compulsions and most commonly both” The NHS further describe an obsession as any thoughts, imagery or urge which is unwanted and intrusive, repeatedly bogging someone’s mind. Also compulsion, are behaviors or mental activities repetitive in nature which a person feels need or is driven to perform. These definitions embody the reality encompassing people suffering with OCD. The symptoms which cause significant functional impairment and distress coupled with the fact that it can either be overt and observable by others (for example, checking that a door is locked repeatedly) or covert mental act like repeating a particular phrase in ones mind tend to affect sufferers, physically, psychologically, socially and academically as would be expounded in this study. Obsessions or compulsions can negatively impact on the lives of young people within their family environment, school and with friends. Nearly all children have little worries or fears as a normal part of growing up (Pridmore, 2010). This then makes OCD in children difficult to diagnose thus removing early identification and treatment in effect leading to a more developed situation in adult hood. Research into the early diagnosis forms the crux of this study.

AIMS AND OBJECTIVES

RESEARCH AIMS

This research is aimed at scaling more light on ways of early detection of OCD in children with a view to early diagnosis and early treatment by way of research to investigate the relationship between OCD in children, adolescents and adult, thus ensuring translating the cognitive processing of threat across age groups, magnitude of symptom and how this is usually shown by sufferers with age.

Furthermore it also aims to add knowledge to what is currently known about the import of age on OCD and the best approach in detecting and treating OCD early in life.

OBJECTIVES

Interpret how OCD symptoms begin and are displayed across age groups.
Assess level of symptom in sufferers across different age groups.
Analyze critically the best practice for early detection and best approach to treatment.
Make recommendation based on research finding into OCD across varied age groups.

RESEARCH QUESTIONS

Important to this research are the following questions, which make up the body of the research:

How are the symptoms of OCD exhibited in children
What role does age play in the repression or otherwise of OCD in children
How does comparism of OCD symptoms across age groups affect current knowledge of OCD in Children
What conditions affect the repression of OCD symptoms across the test age groups
Can the success of repression across any of the age groups be used as tool to treat OCD in children

These questions would form the building blocks of the research, as the findings would formulate points of discussion.

LITERATURE REVIEW

UNDERSTANDING OCD

Previously, OCD was thought to be a rare psychiatric illness (Paige, 2007), however, research into the causes and symptoms into the condition, points out that the condition or disorder clearly characterized by cycles of obsessions and ‘rituals’ or compulsions causing extreme malfunction, fear and distress to its sufferers.

It is proposed and more likely that in the near distant future, OCD would be grouped in a field of disorders with various treatments. The proposed OC spectrum disorders might include OCD, body dysmorphic disorder (Bjornsson et al, 2010), hoarding (Pertusa et al, 2010), pathological gambling (Black et al, 2010), certain eating disorders, and autism. The current position of OCD differs in the two major diagnostic systems. OCD is perceived as an anxiety disorder In the DSM-IV, while ICD-10 lists it as an entity, which is separate from the anxiety, disorders. As stated above, proposals for the removal of OCD from the anxiety disorders and placed in an independent grouping of “OC spectrum disorders” is currently under discussion (Bartz & Hollander, 2006).

OCD is yet to be fully understood thus various theories flourish which link it to different conditions such as a connection to disgust which is a basic human emotion, which may have an evolutionary function that encourages the avoidance of contamination and disease. Husted et al, (2006), explained that functional imaging indicates that the neurocircuitry of OCD and disgust are similar conceiving OCD as a malfunction in an appraisal process. This would fit with OCD in which there are contamination concerns. However, this ideology does not tally with another theory that observes indecision as a feature of OCD and proposes the disorder is a result of disturbed decision-making strategies, which has been discussed by (Sachdev, et al, 2005). In another instance, functional imaging supports the theory that decision making involves the dorsolateral, orbitofrontal and anterior cingulate cortices (CHANGE THE WORDS) which interact with limbic structures to retain memory of emotional rewards, and the basal ganglia which is involved in behavioral execution, the same structures that appear to be involved in OCD. These are shrouded with other theories that include “not just right experiences” (Coles et al, 2010), inability to terminate improbable but grave danger concerns (Woody and Szechtman, 2010) and “an inflated sense of responsibility” (Smari et al, 2010)

OCD involves obsession that are involuntary, leading up to thoughts that are unwanted and recurring result in feelings of anxiety and many at times dread hence they are not simply cases of meticulousness or over worry. There tend to be much worse, they make the sufferer seem irrational, interfere with normal thinking and are time consuming in some cases taking up to two hours per day (Fruehling J, 1999).

They compel sufferers to make repeated attempts to try and control arising obsessive thoughts all to no avail. The ‘rituals’ performed by sufferers tend to bring temporary relief from the anxiety brought about by the thoughts as there exist a clear the relationship between most obsessions and the compulsions that follow. for example, contamination and washing. Sometimes the opposite is the case as not clear relationship can be attributed to (WHAT)for example, counting behaviors in a bid to prevent harm to others (Paige, 2007). The symptoms of OCD have been shown to grow stronger over time in cases where certain performed compulsions appear less effective in bringing relief. More elaborate measures could be taken to provide a sense of relief effectively ensuring that these become time consuming and thus interfering with everyday functioning. There have been cases of delayed indulgence so as not to appear abnormal socially, but this is nearly very difficult and the urge to perform the rituals always tends to grow. For example, students who tend to and are able to delay their compulsions while in class often tend to go to private places later on to perform set rituals during school hours. The concept of delusion cannot be attributed to sufferers of OCD, more adult sufferers often tend to recognize that such thoughts and behaviors that follow are unreasonable, however, that lack the will or ability to control them. In the face of illness or stress, OCD symptoms worsen.

The causes of OCD border around three major areas, psychological, biological and the roles of neurotransmitters.

Biologically – Studies have linked patients with childhood onset OCD to first-degree relatives, than among patients with later onsets to first-degree relatives (Starcevic, 2005). However, statistical inconsistencies have been shown to exist among twins demonstrating a higher concordance among dizygotic pairs. Upon statistical analysis further more, Grootheest et al, 2005 explained that if a dimensional approach is employed, studies amongst twins suggest heritability of obsessive compulsive symptoms. Early onset of OCD is traceable to strong genetical contributions however, this is not definitive (Pridmore, 2010).

Role of Transmitters – In another study, neurological images implicate disturbances in pathways between the cerebral cortex and thalamus as pathogenesis of obsessions while pathogenesis of compulsion along with repetitive motor acts results from abnormalities in the striatum (Insel, 1992). When comparing sufferers of OCD and other anxiety disorders, Ruda et al, (2010) observed common and distinct neural substrates as both showed a decreased level of bilateral grey matter volume in the brain. OCD like disorders caused by childhood streptococcal infections has been termed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It has been observed that a large percentage of children who have suffered this complication of rheumatic fever have antibodies directed against the caudate (Swedo et al, 1994).

Psychologically – OCD are shown by the symptoms explained upon earlier in this study.

OCD UK STATISTICS

Torres et al reported in 2006 that the survey of British National Psychiatric Morbidity revealed the prevalence within the general population of OCD was 1.1%. The same statistics also showed that the percentage decreased with increasing age (1.4% within 16-26years and 0.2% within 65-74 years). These statistics also revealed that the condition was slightly higher in females than males. Amongst sufferers of the condition, it has been identified that 55% suffer from only obsessions while 11% have only compulsions with 34% having both obsessions and compulsions (Pridmore, 2010). Further statistics show that 62% patients suffer from mental disorder in particular depression and anxiety, with 20% having alcohol dependence, 13% on drug dependence and 25% with a history of attempted suicide. The above statistics points to the prevalence of OCD in children who very often are ignorant of the existence of the condition and or where conscious are often very afraid to inform parents. In a 9 year survey where 142 adolescents and children where followed, Heyman et al, 2010 revealed that 41% of this population had persistent OCD, a very considerable number of those without the condition showed signs of other psychiatric conditions. This reveals that OCD is a chronic disorder amongst the younger generation with a guided prognosis.

CHILDREN LIVING WITH OCD

Childhood onset of OCD may result in children demonstrating washing; checking rituals, and preoccupation with disease, danger, and doubts inter alia (Swedo et al 1989), with an approximate 2%–3% of people (including adolescents) having OCD. Notwithstanding this may be an underestimate because many symptoms are kept secret, OCD can emerge as early as preschool. During puberty and early adulthood, the number of children who develop the disorder peaks (National Institutes of Mental Health, Pediatric Obsessive- Compulsive Disorder Research, 2006). Studies by Paige, 2007 show that one-third of adults have OCD developed from childhood. As stated earlier, children and adolescents often tend to hide the symptoms of OCD for fear of being tagged ‘crazy or weird’ this often takes its toll on the severity of the condition in sufferers later on in life. The stigma often associated with OCD come to the full understanding of most adolescents who go through extreme lengths to avoid showing the symptoms. These steps could see them seek ways to avoid situations, which tend to trigger symptoms or young sufferers become clever in devising explanations for their behaviors. Snider et al, 2000 preach that compulsive behavior begins very often gradually and the trend is inadvertently supported by unsuspecting parents at the outset, for example, in cases where children and adolescents show rituals or compulsions that tend to be developmentally appropriate such as wearing a lucky shirt to a game or lining up stuffed animals in a particular way or show healthy behavior such as appear healthy washing of hands after bathroom use, parents may not initially be concerned by such OCD symptoms thus resulting in not seeking medical treatment at the outset until behaviors have become disruptive. Study by Zohar (1999) reveal that following childhood onset, OCD has a complete remission rate of 10 to 50 percent by late adolescence and without treatment tends to become chronic affecting normal function adversely. Considerable effects on adolescents include decreased performance qualities, impaired relationships, depression, problems associated with poor academic performance and so on (Paige, 2004). Expounding further on the effect of OCD on child or adolescent school performance, OCD often at times has a considerable and significant effect on child or adolescent learning; this tends to worsen if left untreated at the earlier stages. Academic problems associated with OCD in children or adolescent include poor attendance often similar to school avoidance, perceived weird behavior as young sufferers tend to avoid situations and places that increase obsessive thoughts as they may spend more time in secret places where rituals or compulsions are performed, this often results in increased social isolation and missed learning. Other problems may include loss of concentration, which is similar to symptoms associated with Attention Deficit Disorder (ADD) as a direct result of obsessive. The consequences of such behaviors often result in victimization or bullying of students suffering from OCD while obsessive thoughts create social problems.

COMPARISON OF CHILDREN AND ADULTS LIVING WITH OCD

In a study to unearth the developmental differences in the cognitive processing of threat across children, adolescent and adult groups of individual sufferers of OCD by Farrell et al in 2006, some evidence showed that age accounted for differences in the cognitive processing of threat associated with OCD. As this study was the first to examine this relationship, it demonstrated that children suffering from OCD experienced lower anxious and intrusive thoughts in direct comparism to both adolescents and adults. Children experienced lower levels of sadness, worry, disapproval and removal strategies associated with OCD as determined by Farrell et al, (2006) when compared to adolescents and adults. The research also pointed that the intrusive and depressive thoughts experienced by children with OCD was less distressing and less difficult to resist in comparison to the other two groups. These finding where consistent with reports by Salkovskis (1985, 1989) and others (Freeston et al., 1996; Rachman, 1993). Similar results were obtained when responsibility was the factor being tested for. The results showed that children report significantly less responsibility on a self-report responsibility attitude measurement in comparison to the other two groups. This suggested effectively that by adolescent, sufferers ten to have increased attitudes regarding personal blame for harm as is also in the case of adults suffering with OCD.

RESEARCH METHODOLOGY

CONCLUSION AND RECOMMENDATION

The cognitive theory of OCD has in the past been heralded as the most widely accepted account of maintenance of the disorder in adults however; it remained to be seen if evaluation across children, adolescent and adult comparison portends any trend. To this end, research was undertaken to investigate developmental differences in symptoms displayed by OCD sufferers across the age range, the results obtained demonstrated that symptoms evinced increased across the grouping (children – adolescent – adult). This therefore suggests adoption of strategies for treatment of the condition. Importance is placed of the early discovery of the condition in an individual so as to ensure that whatever treatment is required is provided to stem increased conditions as the individual matures. Furthermore, in managing and ensuring recovery from OCD, early identification and requisite treatment remain imperative. Various strategies to manage and control the condition amongst children within the school environment and at home have to be employed. At schools, staff should be alert as to the symptoms of the disorder in any pupil and to achieve this there is need for adequate enlightenment of staff about the disorder. Advice should the sought from the school counselor as unexplained agitation in pupil, prolonged and or frequent absence from class etc could be pointers to the condition in a pupil. Also, indirect observation such as raw or bleeding hands could give required clues. Stigmatization should also be eliminated. Conclusively, parental involvement remains utmost in the management and recovery process. Some parents may require education on how to identify and support children suffering with OCD.

More research is required to fully grasp the role of responsibility, life experiences and exposures on the display and repression of OCD symptoms. This research study however, recommends a more details research into the symptoms showed by sufferers across different age groups and the roles which various factors would play.

REFERENCES

Bartz J., and Hollander E., (2006) ‘Is obsessive-compulsive disorder an anxiety disorder?’ Progress in Neuropsychopharmacology and Biological Psychiatry, vol. 30. pp. 338-352.

Bjornsson A, Didie E, Phillips K., (2010) ‘Body dysmorphic disorder’ Dialogues in Clinical

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In a recent with my friend and mentor Dr. Robert Cooper, he shared something that really hit home with me: “We live in a tiny corner of our possibility as human beings,” he told me. “The good news is, the brain doesn’t get it. The brain tends to only compare itself to the best of what’s common, not the best of what’s possible.”

My first thought was that this is a bit tragic — imagine all that we could accomplish as a species if we actually realized our potential. Think of all the great discoveries and human achievements that remain to be unlocked simply because we don’t fully utilize the amazing brains we’ve been given.

But this feeling soon gave way to excitement and optimism. Because our ability to change and step up our game is completely within our control.

Cooper is a neuroscientist, bestselling author and whose teachings have impacted my life probably more than anyone else’s. He takes incredibly complex, nuanced neuroscience principles and distills them into dead-simple, actionable advice.

In our conversation, he went in depth about “upwiring” — the idea that we can hack our brains and remake them in a directed, purposeful way, and more fully realize our potential as human beings in the process.

Related:

Here are the secret brain hacks that Cooper and his colleagues have discovered. Practice them in order to , become a better leader, have better relationships and build lasting value in your business.

Our brains are working against us.

The first step is acknowledging our neurobiology isn’t designed for success in modern business — or modern life in general, for that matter. In fact, our default tendencies actually stand in the way of our growth.

Through tens of thousands of years of evolution, our brains have evolved certain “hardwired” proclivities. We’re prone to crave continuity, tranquility, safety, and abundance. On the flip side, we’re programmed to avoid situations that are hectic, dynamic or where we’re pushed to our limit.

From an evolutionary standpoint, this makes sense. These fixed traits helped us survive the treacherous tundras, savannahs and forests of our prehistoric ancestors. But they do little to serve us now. If we’re not careful, our brains default to these hardwired tendencies and we retreat into behaviors and mindsets that inhibit our growth.

So what can we do?

The good news is that while our brains default to modes that work against us, they also contain within them an enormous potential for growth and change. Luckily for us, there’s a strategy for tapping into the vast possibility of our brains. It’s called upwiring.

The magic of upwiring.

A well-established law in biology states that it’s impossible for living organisms to stay the same — we’re always either rising and growing or we’re fading and falling. This law applies to our brains as well. Each one of our 100 billion neurons is faced with a choice to grow or die. This result is phenomenon known as “livewiring.”

Cooper explains: “Every single day… every one of your neurons is remaking you – you’re reforming the structure and function of your entire nervous system in real time. That’s livewiring.”

For Cooper and his colleagues, this begged the question: If we’re always remaking our brains in real time, in which direction? Are we crafting better brains or worse ones? Are we downwiring or upwiring?

Cooper and his colleagues discovered that with practice, we can harness the livewiring phenomenon in a directed, purposeful way. The concept of upwiring was born.

Sounds simple enough. But how exactly do you go from awareness to action? It’s actually a lot easier than you think. Here’s how to do it:

1. Lead with curiosity.

Curiosity, according to and his colleagues, is essential in this process.

In neuroscience, this is known as the “Need for Cognition,” or NFC. In order to realize the benefits of upwiring, we have to approach everything we do with a desire to know more about ourselves and how we react given certain stimuli.

One simple strategy is to visualize your behavior from a third person perspective.

Related:

“Imagine a small version of yourself on your own shoulder, observing what you would normally do,” Cooper says. “That observation power will allow you to start to override what you automatically do.”

It might sound like a strange practice, but this outsider awareness frees us from our internal biases, and empowers us to choose how — and who — we want to be.

2. Learn to employ the split-second pause.

This is probably the single most important strategy I’ve learned from Cooper’s research, and the one that has impacted my own life the most.

In order to override our hard-wired default tendencies, you have to insert a split-second pause before you react to challenges, setbacks or opportunities. This pause empowers you to do is take control of your reactions, rather than be a slave to the hardwired tendencies of your brain.

“Before you react, insert an instance of delay,” Cooper explains. “You’ll get your bearings and choose your response.”

It’s lightning quick — within a split second — but this pause will make all the difference. Suddenly, you’ll be in control of how you respond to external stimuli from people and events.

In order to make use of this technique, you have to first determine the areas in your life that you want to improve (something you can identify through the third person visualization exercise above).

The next step is visualizing what it will look like when you pause during these events. Imagine the look your significant other gives you that raises your defenses or the email subject line you dread getting from your boss — the one that causes negative emotions to spiral out of control.

Related:

Now imagine pausing before you react to those situations. It’s as easy as that. Practicing this visualization will enable you to insert these pauses instinctively in the moment, and you will be able to choose how you react.

3. Understand what it’s for.

This might be the more abstract side of the strategy, but a reminder of what you want achieve through upwiring will do wonders.

In other words, you have to remember your purpose.

In a culture in which social media has artificially elevated the opinions of others, and where so many of us — including business leaders — judge their self-worth against these opinions, it’s important to remember that life isn’t a popularity contest. Life is about something much greater.

Cooper reminds us: “The bigger game beneath all of that is this drive to create the most valuable, enduring imprint on the world that lives after you’re gone.”

It’s so simple, yet so powerful. Sure, you can play the game of likes, page views and retweets, but if you’re not making a real, tangible impact on the world, what is at all worth? Keeping this in mind will serve you will both in life and in business.

This really only the tip of the iceberg uncovered by Cooper’s research. To hear more, check out out my full-length interview .

September 24, 2010 • Volume 20, Issue 33| Is the Web changing the way we think? | | By Alan Greenblatt OverviewRecently at lunch, Eric Wohlschlegel announced, “I have to take a BlackBerry pause. ”Plenty of people interrupt social and business meetings to check messages on their mobile devices. There was a time just a few years ago, Wohlschlegel recalls, when his employer didn’t require him to have a BlackBerry. Now, as a spokesman for the influential American Petroleum Institute, Wohlschlegel is expected to be in constant contact with the world at large, fielding some 200 work e-mails a day.

He doesn’t have the option of tuning them out. But when circumstances forced him to, he had a hard time adjusting. His BlackBerry stopped working at just the same time that his home computer crashed, leaving him disconnected, and disoriented. “You always fantasize about that one day when you sit back and go golfing,” he says. “But then when you have a moment without being connected, you realize how significant it is and what you’re missing. ”Meanwhile, Wohlschlegel kept checking the empty holster on his hip, out of habit.Many people describe feeling “phantom vibrations” signaling incoming messages after their smartphones have gone bust.

People today are more connected than ever, visiting social-media sites, checking headlines on the Web and texting, e-mailing and instant-messaging. The Internet has become the focus of many people’s lives — the place where they socialize, shop, do their work and view and listen to entertainment. Mobile phones, with their instant-messaging, Web-surfing and online-shopping capabilities, can link people to the Internet and to each other at just about anytime, anywhere. Texting and IMing my friends gives me a constant feeling of comfort,” a student wrote. Some researchers worry the Internet might even be addictive like substances such as alcohol and tobacco. (AFP/Getty Images/Lakruwan Wanniarachchi) | “Texting and IMing my friends gives me a constant feeling of comfort,” a University of Maryland student wrote after being asked to refrain from using electronic media for a day. “When I did not have those two luxuries, I felt quite alone and secluded from my life.

There’s no question that Americans are engaging more than ever with electronic media. According to a Ball State University study conducted last year, most Americans spent at least 8. 5 hours per day looking at screens — a television, computer monitor or mobile phone, and frequently two or three at once. Television viewing has not gone down in the Age of the Internet — but reading printed works has. Near-constant use of the Internet can not only be habit forming but also something that comes to be expected by others.Because text-messaging and Twitter allow people to respond instantly, friends may expect you to respond instantly. Noting that one teen in California had sent 300,000 texts in a month, William Powers writes in Hamlet’s BlackBerry, his 2010 book about the impact of technology on contemporary life, “The goal is no longer to be ‘in touch,’ but to erase the possibility of ever being out of touch.

”Use of the Internet and handheld devices while driving can also be deadly, Transportation Secretary Ray LaHood warned Sept. 21, calling for a crackdown on distracted driving.More than 5,000 deaths and nearly half a million accidents were caused last year by distracted driving, he said, citing National Highway Safety Administration figures. Automakers have supported bans on text-messaging and using handheld cell phones while driving, but they have introduced other distractions, he said. “In recent days and weeks, we’ve seen news stories about carmakers adding technology in vehicles that lets drivers update Facebook, surf the Web or do any number of other things instead of ,” he said.Technology is also creating expectations that people will be available to work at virtually any time of the night or day. A Chicago police sergeant has filed a federal lawsuit, arguing that his availability during off hours via BlackBerry entitles him to overtime pay.

“Giving a workaholic a laptop is like giving an alcoholic a bottle of gin,” says E. Jeffrey Hill, a sociologist at Brigham Young University. “It enables just that kind of compulsive behavior. There’s now a serious debate going on within therapeutic circles about whether people can become addicted to the Internet in the way that they might become addicted to chemical substances. And there’s a broader debate taking place about whether the Internet is changing the way people think. Much of that debate has been triggered by journalist Nicholas Carr, author of the controversial 2008 Atlantic article “ ” He has since expanded his ideas into a book called The Shallows: What the Internet Is Doing to Our Brains.Carr says the Internet is an unmatched tool for communications and information but argues that it can have bad effects on our brains.

The Internet, he says, speaks to the parts of our brain that are attracted to movement, visual imagery and novelty — primitive parts of the brain that do not lend themselves to deep thought and contemplation. “There’s a whole realm of thought that I think is very important to the richness of our personal intellectual lives, and also very important to the building of culture, that requires an attentive mind,” Carr said. We don’t want to sit alone in a dark room thinking about one thing all day long, but neither do we want to be processing a constant influx of texts and messages and doing Google searches and clicking on links all day long. And yet, that is where I think as a society we’re headed. ”The advent of each new communications medium launches a debate about whether it will help to democratize culture, or dumb it down. The question of whether popular taste is being ruined or cheapened has come up with many new forms of communication, including movies, television, paperback books, comic books, video games and blogs.Jonah Lehrer, the author of How We Decide, a book about the brain and decision-making, and a blogger for Wired, the technology publication, argues that Carr’s concerns are overstated.

Sure, people need to put down their devices once in a while to allow themselves to daydream, he says, but he argues that the Internet provides far more than enough information to justify the distractions that come along with its use. | “There’s no doubt that we’ve come to depend on these tools radically in the last five to 10 years,” Lehrer says. When an iPhone gets dropped and smashed and we have to wait for it to be fixed — we’ve all had that anxiety. But I would frame that anxiety as a sign of how useful these tools are for us, not how they’re corrupting our Pliocene brain. ”Some people have compared the Internet to an outboard brain or separate hard drive, capable of remembering far more than a human brain can — or needs to. “It’s no longer terribly efficient to use our brains to store information,” according to Peter Suderman, a writer for the American Scene, an online magazine. Rather than memorizing information, we now store it digitally and just remember what we stored.

”It may be that having to remember information such as friends’ phone numbers was just a “frozen accident” of history, something that we won’t miss, as New York University technology professor Clay Shirky writes. But Carr argues that the Internet makes it harder to remember anything, that the influx of competing messages interferes with the physical mechanics of the brain that move information into long-term memory. “Almost ertainly, downtime lets the brain go over experiences it’s had, solidify them and turn them into permanent long-term memories,” says Loren Frank, a psychologist at the University of California, San Francisco. When the brain is constantly stimulated, he said, “you prevent this learning process. ”Carr cites studies that suggest that the Internet can change the way the brain acts. One, by Gary Small, a psychiatrist at the University of California, Los Angeles, and coauthor of the book iBrain: Surviving the Technological Alteration of the Modern Mind, found that people’s brains changed in response to Internet use.Experienced Google users displayed different neurons on brain imaging scans than novices — but the novices’ brains reacted the same way after just a few days of limited Web surfing.

“You can change the brain relatively quickly,” Small says. Small isn’t worried the Internet is “going to rot our brains. ” But he does say it’s having profound effects on our lives that we’re only starting to grapple with. “It’s created a whole new age, or stage of human development,” Small says. “You think of the printing press or the development of agriculture,” he continues. This is up there, or even beyond it. ”As people grapple with the idea that the Internet may be changing thought and behavior, here are some of the questions they’re debating:Does the Internet make us smarter? The Pew Internet & American Life Project put a variation of Nicholas Carr’s question — “? ” — to hundreds of technology experts.

A majority disagreed with Carr’s premise, but their ideas about how intelligence had been reshaped by the Internet ranged widely. Some felt that people were freed up from rote tasks such as memorization of facts.That could end up meaning that we have to redefine what we mean by intelligence, as machines take up a greater share of the tasks once left to the human mind. Some stated their belief that the Internet had helped create a “hive brain” that allows people to share thoughts and come to collective solutions to complex problems together. “There’s a pretty broad feeling among lots of technology users that these tools can serve their needs in new ways,” says Lee Rainie, who directs the Pew project. “You can gather up information quickly and easily, which might have taken you enormous amounts of time in an earlier age,” he says. At the same time, people will moan and groan about the distractions that these devices bring into their lives.

”No one disputes that the Internet has made much more information readily available to just about anyone. “It’s been a boon in that it gives access to all kinds of stuff that a crummy high-school library wouldn’t have even come close to having,” says Robert Thompson, a professor of popular culture at Syracuse University. But Thompson worries that the way Google filters information makes it potentially less useful, in certain respects.He jokes that good students will cite material from the third page of links that a Google search calls up, while bad students will not look past the first page. “The problem is that so much of the stuff that would really be a boon is not used, because it’s not on the first page of a Google search,” he says. The narrowing of information — necessary given the glut that’s now available — can cause problems even among serious researchers. Lehrer, the author of How We Decide, cites a study indicating that since scientific papers have been widely available online, fewer of them are being cited.

Even though we have access to all sorts of information, we seem to be citing the same texts,” Lehrer says. “The Internet allows us to filter our world, to cherry-pick our facts. It’s just human nature writ large. ”David Levy, a professor at the University of Washington’s Information School, says that the rapid transmission and accumulation of knowledge made possible by technology is helpful, but he worries that information overload can have some ill effects. Namely, he’s concerned that the flood of information leaves people with no time to think. There’s another piece of the process of learning and growing and getting information further assimilated, and that’s the time for contemplation,” he says. “We’re just not allowing ourselves sufficiently the time to do deeper reflection.

”Paul Saffo, managing director for Discern Analytics, a Silicon Valley forecasting firm, says there’s a case to be made that the Internet is helping to make individuals smarter. There have been studies showing that not just Web searches but also at stimulating and strengthening parts of the brain. Video games turn out to be amazing for the brain,” Lehrer says. “They’re like doing pushups for the brain. ”But Saffo worries, too, that the Internet ethos of instant and ever-changing information can have its deleterious effects on society as a whole. “The collective impact of this technology causes more people to look at and concentrate on the immediate at the expense of the long-term,” he says. This effect of everyone concentrating solely on the moment can lead to catastrophic mistakes and have an ill effect on democracy, Saffo suggests.

This is the dark side of the eternal present,” he says. “There’s no capacity to step back and frame things in different ways. Anyone who dares think long-term will be taken down. ”In his Atlantic article and follow-up book The Shallows, Carr is careful to state that the Internet has been enormously beneficial in a number of ways. Critics of his book nevertheless contend that he has overstated the extent of the problems of concentration and deep thought created or exacerbated by technology. To the extent that people skim, get distracted or fail to think deeply about the words and images flitting across their screens — well, people have always found ways to avoid thinking too deeply. Long before Twitter, there were television sitcoms, Lehrer points out.

And long before people could waste time playing Minesweeper and Scrabble online, there were plenty of games made out of cardboard and plastic. But Carr argues that the Internet is not simply a tool for distraction and time wasting. He says it affects how the brain processes information.In his book, Carr cites studies showing that people reading short stories with hyperlinks embedded in them retain a good deal less of the content than people who read them on the printed page, because the need to make decisions about whether to click on the links keeps them from concentrating on the text at hand. “Dozens of studies by psychologists, neurobiologists, educators and Web designers point to the same conclusion: When we go online, we enter an environment that promotes cursory reading, hurried and distracted thinking and superficial learning,” Carr writes in The Shallows. It’s possible to think deeply while surfing the Net, just as it’s possible to think shallowly while reading a book,” Carr continues, “but that’s not the type of thinking that technology encourages and rewards. ”Getting used to technological distraction can cause problems in social settings, suggests Small, the UCLA psychiatrist.

“We have a generation of digital natives with very strong techno-skills and very strong neuro pathways for multitasking and experiencing partial continuous attention and other wonderful adaptive skills,” Small says. But they’re not developing the face-to-face human contact skills. ”There isn’t strong data about this, Small says, but the idea that young people, especially, have more difficulty interacting with people in person when they are texting other people with near-constancy is evident all around us, he suggests. “The Internet’s not making us stupid or smarter — it’s changing the way we’re processing information,” Small says. “You cannot stop the technology train,” he adds. “It’s way out of the station, coming down the tracks. You have to adapt.

”Does the Web shorten attention ps?Human beings have always had a hard time sitting alone and staying quietly focused. The Internet has made this problem worse for many. It’s become common for people to complain that they no longer seem able to concentrate on one thing for very long. Most participants in a 2003 San Jose State University study said that they were reading more online but had difficulty giving “sustained attention” to the material. “I find that my patience with really long documents is decreasing,” a study participant said. “I want to skip ahead to the end of long articles. There are millions, if not billions, of Web pages and tens of thousands of smartphone applications, or “apps.

” On any given screen, demands for a user’s attention may come from text, audio, video, competing graphics and hyperlinks to yet more pages.Viewing a busy Web page may be interrupted by e-mail alerts and status updates from social-media sites. “I love the iPad,” said Nicholas Negroponte, founder of MIT’s Media Lab, “but my ability to read any long-form narrative has more or less disappeared, as I am constantly tempted to check e-mail, look up words or click through. Not everyone thinks the Internet and mobile devices are shortening their attention ps. A May New York Times/CBS News survey found that less than 30 percent of those under age 45 believed the use of such technology made it more difficult for them to focus, while fewer than 10 percent of older users agreed. “People who do need to focus find the time to focus,” says Tim O’Reilly, president of O’Reilly Media, a technology research firm. “There’s plenty of focused thinking going on.

Even apparent distractions — getting pulled every which way by various stimuli — are not necessarily evidence that people are having a harder time paying attention, says Thompson, the professor of popular culture. “It’s a different kind of attention p than a Victorian gentleman sitting down with a leather-bound book for two hours,” he says. “When I look at an 8-year-old playing these complex video games with other people, I’m not sure what’s going on there, but it’s sure not a lack of attention p.They’re completely focused with all these multiple inputs. ” | But a recent study showed that young children and college students who exceeded a two-hour-per-day limit on watching television and playing video games had a harder time paying attention in class. “In just one year, we would see attention problems in the classroom getting worse related to how much time kids are in front of television and video games,” said study coauthor Douglas Gentile, an associate professor of psychology at Iowa State University.And, Thompson concedes, playing video games and surfing the Net — a term that itself suggests skimming the surface — may lead only to facile thinking and not any great depth.

To get at something valuable on the Web, often a user will have to dig through a great deal of extraneous material — a task from which many people are distracted by the constant possibility of interruption. And other media are coming to resemble Web pages. Magazine designs now include multiple fonts, myriad graphics and shorter stories than used to be the case.Television news channels have also reformatted their presentations, including more than one video presentation at a time, lots of graphics and scroll bars of texts — “a ton of competing information everywhere,” says Larry D. Rosen, a psychologist at California State University-Dominguez Hills and author of two books about young people’s use of technology. “Our attention p basically has diminished,” he says. “Our ability to focus on a task without switching to another task has diminished.

It’s not an inherent change in the way we’re thinking.It’s a change in technology that forces us to change focus often. ”But some studies suggest that the Internet may, in fact, be changing the way we’re thinking. “There is research that suggests the traits of attention deficit disorder are higher than they were a few years ago,” says Elias Aboujaoude, a professor of psychiatry and behavioral science at Stanford University. There’s not yet good data showing a causal effect, he points out, noting it’s possible that people who already had attention-p problems may be more drawn to technology. But there’s a lot of correlational research that, at any point in time, people who spend a lot of time online have shorter attention ps,” Aboujaoude says. The amount of distractions now available to people is taking its toll, Aboujaoude argues.

“The price we pay for all this is that we live in a sound-bite culture now,” he says. “Anything that requires concentration, deliberation, pondering, deep, entrenched difficult thought, we don’t have the attention for. ”It’s easy to make such claims and “to write scare stories about attention ps,” says Lehrer, the Wired blogger. But there’s value to the distractedness, too.Paying attention to a variety of things is a skill the Internet helps foster, Lehrer says. He compares it to the difference between walking for two miles through a busy city and walking through a quiet park. There’s a big supply of studies that walking through a city puts a “cognitive burden” on people because there are so many more things that compete for attention, he says.

But there’s real value to being in cities, which afford people all kinds of interactions and access to more commerce and culture — much like a few of the benefits of the Internet. “The Internet is just like a city,” Lehrer says. It’s a trade-off, but in the end we’re willing to make the trade-off because it allows all sorts of new connections. ”Are people addicted to the Internet? California entrepreneur Kord Campbell uses technology — a lot. Not only is he running an Internet startup company, but he plays video games, follows 1,100 people on Twitter and often falls asleep with a laptop or an iPhone cradled on his chest. He has a hard time putting his devices away, whether on family vacations or commuting by subway to San Francisco. He knows that one tunnel will cost him exactly 221 seconds of time online.

Just before an important meeting is about to begin, Campbell can’t resist clicking on a link on Twitter to a story about a corpse. He finds himself annoyed that the article wasn’t interesting and gets distracted by a pop-up ad for jeans. “It’s some article about something somewhere,” he said. Campbell looks at so many screens so much that he sometimes misses important e-mails, makes costly mistakes in online stores, burns hamburgers on the grill and forgets to pick up his children. His difficulty with the concept of logging off may be extreme, but it’s not unusual. I have friends and relatives that carry BlackBerrys with them 24 hours a day, fully prepared to drop anything in their lives and work at a moment’s notice,” said Tim O’Leary, the head of a marketing firm. “I’m tethered to my laptop as if it were an oxygen machine I must cart around to keep me breathing.

” | For Hilarie Cash, the problems people describe in trying to stay away from their computers and smartphones — such as poor nutrition, anxiety, irritability and the costs their habits impose on their relationships and work or schoolwork — are signs of “classic addiction. Cash runs a treatment center for Internet and video game addiction in Redmond, Wash. She notes that both China and South Korea have named Internet addiction as primary public-health concerns. It doesn’t matter, she says, whether people are addicted to pornography, games or simply the small thrill of getting a new message in their e-mail in-box. “If you’re Facebooking, you’re chatting, you’re doing something sexual that’s a lot of fun, then those reward pathways in the brain are lighting up and you’re in danger of getting addicted,” Cash says.The hit-and-miss nature of the Internet — with some websites being interesting, while many are not — may make it an especially seductive medium. People talk about the “dopamine squirt,” the little bit of chemical excitement that occurs in the brain when something of interest pops up on the computer screen.

Surfing the net or opening up e-mail, in this sense, is just like playing slot machines — you never know when you’re going to hit a winner, a state of uncertainty that leads sometimes to the strongest habits. That means that rather than reward an action every time it is performed, you reward it sometimes, but not in a predictable way,” said Tom Stafford, a lecturer in psychology at England’s University of Sheffield. “So with e-mail, usually when I check it there is nothing interesting, but every so often there’s something wonderful — an invite out, or maybe some juicy gossip — and I get a reward. ”The standard diagnostic manual for mental disorders does not refer to excessive Internet use as an addiction. I like to save ‘addiction’ for obsessions that are rooted in a chemical basis,” such as drug and alcohol use, says John M. Staudenmaier, the editor of Technology and Culture. Many other technology experts shy away from the term addiction, which they think is a term too lightly used in media accounts.

Most people under the age of 20 may be clutching some kind of handheld device, says Syracuse University’s Thompson, but that has more to do with an expectation of availability to communicate at any given time than with a true compulsion.“We have to be careful not to slip into generational nostalgia about this,” he says. Someone from 1870 looking at us before the Internet would have thought our lives were insanely complicated — allowing movie theaters into our homes with television, with constant music in the background. ”Rosen, the Cal State psychologist, says it’s not the amount of time you spend doing something that defines addiction, but its impact on other parts of your life. “If you can’t be on vacation and not check your e-mail, then it’s disrupting your family life,” he says. “If your wife is always complaining that she can’t get you off the computer to go to bed, then we’re talking about addiction. Others argue that, while people may spend excessive amounts of time browsing the Internet or texting, they can also spend too much time doing lots of other things.

“If you applied these criteria to all kinds of behavior, it’s true about a lot of activities,” says Rainie, at the Pew Internet & American Life Project. “If you’re a passionate user, you lose sleep, it takes away from other parts of your life. ”But kicking the Internet habit may take more than just a bit of self-discipline, says the University of Washington’s Levy.Just as doctors concerned with obesity talk about a “toxic food environment” in which it’s easy to make bad choices about food, the ubiquity of the Internet makes it especially hard for some people to shut it off. “The culture is making available and selling to us all kinds of things,” Levy says. “It would be a hell of a lot easier to exercise personal discipline if we weren’t constantly being exposed to things. ”The term “addiction” itself may not be clinically accurate, suggests Aboujaoude, the Stanford psychiatrist, but certainly there is something tempting for many people about Internet use.

It’s only a matter of time before we isolate those parts of the brain that light up when we’re browsing or killing time on an app,” he says. For many observers, the question of whether people can truly be said to be addicted to the Internet is a matter of semantics. For millions of people, like California entrepreneur Campbell, it’s the first thing they turn to when they wake up and the last thing they do at night. “Call it addiction, call it human nature,” says Silicon Valley consultant Saffo. Samuel Johnson [the renowned 18th-century British author] observed that too often we go from anticipation to anticipation, and not from satisfaction to satisfaction. “The problem is, we have more and more media temptations. With ever more capable technologies comes a greater burden to choose wisely and well.

”| About the Author | Alan Greenblatt is a freelance writer living in St. Louis. Currently, he writes about national and international news for NPR’s website. He has been a staff writer at Governing and Congressional Quarterly, where he won a National Press Club award for political journalism.

I will try to show how these factors can have an influence on the brain and might lead to violent behavior, they are: head injuries, malnutrition, and exposure to chemicals or poison at a young age. What do serial killers, Leonard Lake, David Borrowers, Kenneth Blanch, John Wayne Gay, and Carl Panorama, all have in common? They all suffered childhood head trauma, In fact 70% of serial killers received extensive head injuries as children or adolescents (Freeman, 1998).

Scientists believe that brain damage to the frontal lobe causes lack of self- control, planning, Judgment, and make it impossible to develop stable and social relationships. There has also been debate that serial killers are deficient in the limbic system In the brain. The limbic system controls humans emotions and motivation. Some scientists have suggested that If the limbic system Is missing, It could cause uncontrollable anger and aggression. Damage to the limbic brain, hypothalamus or temporal lobe may cause bouts of spontaneous aggression.

These areas are involved with hormones, aggression, emotion and motivation; injuries to them may also result in seizures and forms of amnesia. When the frontal cortex is damaged in a Traumatic brain injury a person’s capacity to control aggressive behavior is often reduced or taken away completely. If a child suffers a severe TAB they may never develop an ability to understand and control their behaviors, even an adult who has understand the difference between good behavior and bad may lose this after a TAB.

Along with the cortex there is a chance that the magical might be damaged because of a TAB. The magical is located between the emotional center of the brain and the cerebral cortex, and if damaged it can cause a loss of inhibitions towards dangerous activities including violence and aggression. We all understand how being hungry can make us feel cranky, but does nutrition have any effect on the ability to control behaviors? According to Derrick Allendale, MD “high calorie malnutrition contributes to crime and violence”.

In his study “Crime and Violence: A Hypothetical Explanation of Its Relationship With High Calorie Malnutrition,” it is stated that High calorie malnutrition can create “irritable brainstem”. This “irritable brainstem” can increase response and in the worst scenario create temporary Insanity and take over the complete behavior of the individual. Orphan, 2002) He also addresses the fact that not only the lack of lead to an imbalance in the brain which results in aggressive and violent activities that may follow them into adulthood.

Thiamin deficiency can cause irritability, magnesium help control the sensitivity to stress and a deficiency of it may promote aggressive behavior, and vitamin 812 deficiency is linked to paranoia, violence and depression. Many studies acknowledge the human risk to certain toxins such as lead, mercury, manganese and polycarbonate phenyl. They are shown to cause nonrepresentational disorders and substantial brain dysfunction. Due to their size and rapid growth children are a more sensitive population than adults and can absorb 40% more toxins then an adult.

Lead poisoning in infancy, even at very low levels, impairs the development of the parts of the brain that regulate behavior and mood (Mobbing, 2013). A number of environmental exposures are documented to result in a common pattern of neurologically effects, including lowered ‘Q, shortened attention p, and increased frequency of antisocial behavior. The American Medical Association has reported that heavy metals are linked to aggressive behaviors, at least seven studies have shown that violent criminals have elevated levels of lead, cadmium, mercury, and other chemicals compared to people who were not violent.

Though there are many contributing factors that may make a person act out in violence, there are scientific studies have shown that a disruption or lack of development in the frontal cortex, magical, or the limbic system in the brain is to blame in most cases. If a child suffers from a head injury due to an accident or abuse they might not develop the understanding of right and wrong, or e able to understand and deal with emotional outburst.

It is very important that anybody suffering from TAB been seen by a doctor, and if aggressive behaviors develop a clinical team will need to work with the person to help them develop an understanding of what they are feeling and how to positively deal with emotions. It is equally important that a child has a healthy diet and is monitored to assure that they are receiving the proper nutrition when it comes to not only calories but vitamins and minerals.

I honestly feel that in poor locations, such as intercity and rural areas, the Tate government should work through WICK programs and the schools to test children for deficiency and help educate the parents on proper nutrition. We all need to work together to eliminate the exposure that adults and children have with toxins. The government has worked hard to eliminate lead paint however we have a long way to go to eliminate pesticides and other chemicals that are on our clothing, in our water, and applied to our foods. I feel that if these areas are addressed then the understanding of some violent behaviors in certain people can be recognized.

There are 3 biological rhythms in the body. Circadian, which is our body clock which works to a 24-hour cycle and regulates our bodies biochemical, physiological and behavioural processes. Ultradian processes, which are smaller processes that happen inside our 24-hour circadian cycle. These Ultradian cycles are the sleep stages lasting 90-120 minutes, however some other ultradian cycles include hormone release, heart rate, nostril dilation and appetite. Lastly there is Infradian which are outside our circadian 24-hour cycle such as the menstrual cycle and hibernation.

These cycles are endogenously controlled, however can be tainted or ‘entrained’ to the environment by exogenous factors. Endogenous pacemakers are biological pacemakers inside us that regulate our cycles. An endogenous pacemaker is the Suprachiasmatic nucleus located in the hypothalamus. It is situated directly above the optic chiasm (allowing it to respond to light) and it responsible for controlling circadian rhythms. At the presence of light, it stimulates the pineal gland to release melatonin. Melatonin is a naturally occurring hormone that promotes sleep.

A higher level of melatonin will promote sleep, and thus a lower level will help us wake up and stay alert. It’s this process that endogenously regulates our circadian sleep-wake cycle. The SCN’s influence on our bodies has been demonstrated in Morgans animal study. He bred ‘mutant’ hamsters with entrained ’20-hour’ circadian rhythms. When their SCN was transplanted into their ‘normal’ hamsters they exhibited the mutant rhythm. This shows the role the SCN plays in our circadian cycles, showing it regulates our sleep patterns and that rhythm entraining is done through the SCN.

However, this argument can be deeply flawed. The SCN affects other circadian rhythms such as hormone release and these could affect sleep itself as well as individual differences; therefore it may be deterministic to conclude that the SCN is the regulator of sleep. Methodological issues are thrown into the research also. Is the research ethical justifiable? In my opinion, in groundbreaking findings drawing the link between the SCN and sleep it is justifiable to use rats however rats are not similar to humans and therefore cannot be well generalised.

Every day, and in every way, we consciously and unconsciously analyze everything about everyone. This is part of being social; it is part survival; and it is how we size people up to establish some level of predictability about who and how people are. This is a natural and nonstop process we experience with everyone we come in contact with. As business leaders, managers and colleagues, we pay attention to everything about a person, to gauge who is successful and driven, whom we want on our teams and whom we would prefer to avoid. Here is a list of 10 subtle things we get judged on:

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1. Appearance

The very first thing to notice about anyone is his or her overall appearance — in a bigger picture sense, before we pay attention to detail. The first things others notice is gender, race, height, weight, hair and clothing, all of which create deep psychological assessments about us in others. Meeting someone for the first time is like going through a TSA checkpoint: We are immediately sized up from the second we come in contact. To make a good first impression, make sure you’re well-kept, nicely dressed and clean, and that you smell good and smile.

2. Handshake

Many believe handshakes reveal everything about a person. Through a handshake, people can sense if we are confident or insecure. Those with a natural confidence shake hands with a balanced and kind sense of authority. Too strong a handshake, however, reveals the need to dominate, while a weak or limp handshake reveals insecurity and/or frailness of personality.

When making a first impression in an interview, or meeting a new customer or salesperson, we need to recognize that our handshake is often a litmus test right from the start. No one wants to start a new relationship with a weak future. Find a balance among the factors of intelligence, elegance and confidence when shaking someone else’s hand.

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3. Teeth

Our teeth function like our business card. Teeth reveal everything, from social status, income level and hygiene, to our overall state of health. Attractive, successful people are associated with pearly white Hollywood smiles. Teeth expose things such as our age and gender and the type of personality we have, all of which have a huge impact on the first impression we give.

Bright, white teeth make people look more successful, more employable and appealing. Pretty, white, straight teeth also make people appear five years younger, so head off to get that whitening treatment to improve the first impression you give.

4. Nail-biting

As a psychologist, one of the first things I look for is the condition of a patient’s fingernails. Nail-biters, or those who pick and chew the skin around their nails tend to have anxiety issues and issues with perfectionism. Perfectionistic, nervous people are viewed as having difficulty relaxing and performing tasks at a normal pace.

Nail-biters tend to have lower levels of frustration tolerance when they do not meet their goals. They also experience higher levels of boredom when not deeply involved in a task. To avoid showing your nerves, work on staying busy to avoid chewing on those nails. Nail-biting is essentially a form of self-soothing. Taking a little natural GABA supplement (GABA being gamma-aminobutyric acid, a neuro-transmitter in the brain) can help calm that nervous energy.

5. Posture

Posture communicates a physical and emotional response to positive and negative stress. When we feel confident, the chemicals in our brains prompt us to stand up straight and arch our back. The more confident we are in ourselves, the taller we stand the major portion of the time. However, when we feel timid, nervous or fearful, or don’t want to be the center of attention, our brains react with the impulse to withdrawal into a fetal-like position.

To make a better impression, keep in mind that we can use our posture to get us out of negative stress by holding ourselves as if we have all the confidence in the world.

6. Laughter

Laughter is judged and experienced as relaxing, natural and lighthearted, or as annoying, overcompensating and nervous. When laughter is natural and appropriate to the situation, it eliminates tension and boosts morale. However, when it comes from a disingenuous place, it creates annoyance and division between people. 

Annoying, needy or attention-seeking laughter may be judged by others as off-putting. So, be sure to laugh naturally, and with a sense of composure, so people enjoy your company.

7. Tone of voice

When it comes to communication, it is not just our words which have an impact, but also our tone of voice. Whether one’s voice is booming, screechy, mousy, raspy or demure, it speaks volumes about our personality. Our voices subtly communicate our true emotional state, even when we’d rather it not. The subtle wavers in our voice communicate that we’re sad or nervous.

When our voices get louder, our words more blunted or pointed, that communicates that we’re angry. This deeply impacts how other people perceive us, maybe even more so than our physical appearance. That is why it is often said that, it is not what you say but how you say it that makes all the difference in communication.  For this reason, think about how you’re speaking before you actually do.

8. Eye contact

When there is too much eye contact it can make others feel they are being stared or glared at, making things awkward or threatening. Too little eye contact is interpreted as insecurity or a lack of honesty. Natural, healthy, well-received eye contact lasts no more than six seconds.

It is important to break contact occasionally and look away — to pause as we express something. It’s also important, when listening, to look at the person speaking with consistency, as that shows that we’re engaged and listening. The most important thing to do when we converse is smile. Smiling changes our eyes in a positive way.

9. Punctuality

Being on time communicates responsibility. We spend a considerable amount of time keeping track of other people’s time, judging them to be early, on time or late. We use units of time to describe ourselves and others. For example, describing someone as “always late” may imply a judgment, that we see that person as disorganized, flaky, disrespectful or immature.

To be punctual is a positive attribute and a reflection of many admirable personality qualities, such as responsibility. For this reason, be on time and/or actively communicate your ETA. Others will appreciate the gesture.

10. Handwriting

If we have to write something by hand at work, or we ask that of a prospective employee, the handwriting that results will give us some great insight into who we or they are. It is believed that the size of our letters reveal whether we are shy or outgoing. Small letters which do not reach the top line are indicative of a timid or introverted personality.

When we write with large letters which go over the top line, we are seen as more outgoing and confident. Those who put a lot of space between words are seen as preferring to have more freedom and independence, while those who put very little space between letters are seen as preferring to be around others and disliking being alone. When we dot our I’s and cross our T’s, we are seen as detail oriented, and if we apply a lot of pressure to our pen, we are seen as confident, whereas if we write lightly, we are viewed as more sensitive and empathic.

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Because it is natural to judge and be judged, use this list to understand how others may be perceiving you and your personality. These subtle things are oftentimes the make-it-or-break-it factors that determine your receiving future opportunities over others. So, pay attention.