INTERESTING TIMES

 

“The state of flow, like the path that bears its name, is volatile, unpredictable, and all-consuming.  Flow feels like the meaning of life for good reason.  The neurochemicals that underpin the state are among the most addictive drugs on earth.  Equally powerful is the psychological draw.  scientists who study human motivation have lately learned that after basic survival needs have been met, the combination of autonomy (the desire to direct your own life), mastery (the desire to learn, explore, and be creative), and purpose (the desire to matter, to contribute to the world) are our most powerful intrinsic drivers—the three things that motivate us most.  All three are deeply woven through the fabric of flow.  Thus toying with flow involves tinkering with primal biology: addictive neurochemistry, potent psychology, and hardwired evolutionary behaviors.  Seriously, what could go wrong?”
 

—Steven Kotler in The Rise of Superman; Decoding the Science of Ultimate Human Performance, p158, in Ch10 entitled The Dark Side of Flow.

Americans are broad-minded people. They'll accept the fact that a person can be an alcoholic, a dope fiend, a wife beater, and even a newspaperman, but if a man doesn't drive, there is something wrong with him.
--Art Buchwald

Excellent writeup on a recent study, here: http://phenomena.nationalgeographic.com/2014/07/02/why-do-some-teens-become-binge-drinkers-algorithms-answer/.

"The search for unpolluted drinking water is as old as civilization itself. As soon as there were mass human settlements, waterborne diseases like dysentery became a crucial population bottleneck. For much of human history, the solution to this chronic public-health issue was not purifying the water supply. The solution was to drink alcohol. In a community lacking pure-water supplies, the closest thing to "pure" fluid was alcohol. Whatever health risks were posed by beer (and later wine) in the early days of agrarian settlements were more than offset by alcohol's antibacterial properties. Dying of cirrhosis of the liver in your forties was better than dying of dysentery in your twenties. Many genetically minded historians believe that the confluence of urban living and the discovery of alcohol created a massive selection pressure on the genes of all humans who abandoned the hunter-gatherer lifestyle. Alcohol, after all, is a deadly poison and notoriously addictive. To digest large quantities of it, you need to be able to boost production of enzymes called alcohol dehydrogenases, a trait regulated by a set of genes on chromosome four in human DNA. Many early agrarians lacked that trait, and thus were genetically incapable of "holding their liquor." Consequently, many of them died childless at an early age, either from alcohol abuse or from waterborne diseases. Over generations, the gene pool of the first farmers became increasingly dominated by individuals who could drink beer on a regular basis. Most of the world population today is made up of descendants of those early beer drinkers, and we have largely inherited their genetic tolerance for alcohol. (The same is true of lactose tolerance, which went from a rare genetic trait to the mainstream among descendants of the herders, thanks to domestication of livestock.) The descendants of hunter gatherers--like many Native Americans or Australian Aborigines--were never forced through this genetic bottleneck, and so today they show disproportionate rates of alcoholism. The chronic drinking problem in Native American populations has been blamed on everything from the weak "Indian constitution" to the humiliating abuses of the U.S. reservation system. But their alcohol intolerance most likely has another explanation: their ancestors didn't live in towns."
--Steven Johnson, in The Ghost Map, pages 103-4.

Bruises fade and skin heals, but the mind remembers. Physical punishment is still prevalent among US families. This study found the prevalence of physical punishment without "more severe child maltreatment" was 5.9%. Boys get physically punished more than girls, 59.4% to 40.6%. Blacks get beat more than whites. Asians and Pacific Islanders (including native Hawaiians) were the least likely to get whupped by their own parents.

The harsher the physical (or emotional) punishment was, the higher the odds of an axis I or II diagnosis. Axis I diagnoses include major depression, dysthymia, mania, mood disorders, phobias, anxiety disorders, and drug and alcohol abuse or dependence. Axis II diagnoses include several individual personality disorders and cluster A and B disorder diagnoses. The researchers concluded that 2-7% of all mental disease is attributable to childhood abuse.

SOURCE
http://www.medscape.org/viewarticle/767353?src=cmemp
( the stats )

It's scheduled to come out in May 2013, and this doc (Allen Frances, MD) asks the question: is the APA going to release it because it is needed and helpful and founded for psychiatric treatment? Or because they want the income from the release of a new book?? He has a good grasp on where the system fails and what needs to happen next. He'd like to see changes based in science, and is keenly aware of the degree to which psych diagnosis is inexact and the pathophysiology of these diseases uncertain.

You have to create a login to read here:
http://www.medscape.com/viewarticle/763886?src=mp&spon=38

Here are his concerns that the current DSM-IV does not deal with:
20x autism rates (is everybody really autistic??)
20x childhood bipolar rates
3x ADHD rates
2x adult bipolar rates
"Misuse of the label "paraphilia NOS" to sanction the questionably constitutional involuntary commitment of rapists as a veiled form of preventive detention"

And here are the things he is worried will be stuffed prematurely into the DSM-V:
Disruptive mood dysregulation disorder
Minor neurocognitive disorder
Removing the bereavement exclusion for major depressive disorder (sadness not allowed!)
Lowered ADHD threshold (by raising the allowed age of onset to 12) (how does this work??)
Lowered threshold and poor reliability for generalized anxiety disorder
Combining substance abuse w substance dependence under "addictive disorders" (low reliability and unnecessary stigma)
A category for "behavioral addictions" that will promote "Internet addiction" as a NOS diagnosis. (Next: "addictions" to sex, shopping, work, golf, boating)
Pedophilia criteria wording that tries to sneak in hebephilia (preference for early pubescent teens) and invites forensic abuse
Making binge-eating a mental disorder
An unusable personality section that the APA Assembly voted unanimously to oppose

The inclination to dilute boredom chemically for a while is part of the reason sociopaths tend to be alcohol and drug abusers. A major comorbidity study published in 1990 in the Journal of the American Medical Association estimates that as many as 75 percent of sociopaths are dependent on alcohol, and 50 percent abuse other drugs. And so sociopaths are often addicts in the usual sense, in addition to being figuratively addicted to risk. With its "peak experiences" and its dangers, the drug culture holds more than one form of appeal for the conscienceless, and the drug culture is where many sociopaths feel most at home.

Another study, published in 1993 in the American Journal of Psychiatry, found that 18 percent of intravenous-dug abusers diagnosed with antisocial personality disorder were HIV-positive, while only 8 percent of intravenous-drug abusers without antisocial personality disorder tested positive for HIV. The higher odds ratio of HIV infection among sociopaths is presumably due to their greater risk-taking behaviors.

--Martha South, Ph.D. in The Sociopath Next Door, p187.