10 Rare Health Conditions - Part II

Fields Disease

Fields disease is one of the rarest known diseases in the world. There are only two known cases so far; they are identical twins known as Catherine and Kirstie Fields, from Wales. The disease is named after them.

Fields disease was first noticed when the twins were 4 years old. Doctors haven’t been able to identify or match it to any known disease. The twins have undergone many tests with no definitive reasons for the condition and no available treatment, making doctors conclude that the twins were born with it.

Chances of getting this disease are one in 3.75 billion, but since the disease was diagnosed in identical twins, the actual frequency is 1 in approximately 7.5 billion. The disease has no medical name other than ‘Fields disease’. Doctors call it a neuromuscular disease as the muscles in the body tend to slowly deteriorate, causing limited movement.

The twins have been examined by doctors all over and the disease has been so rare and unknown that it has made it unable for them to predict what would happen next. Fields disease has made the twins wheelchair-bound. It has made it hard for them to perform even a simple task such as writing.

Hutchinson-Gilford Progeria Syndrome

Progeria is an autosomal dominant condition—which means one copy of the altered gene in each cell is sufficient to cause this condition. Mutation in the LMNA gene causes this condition, which almost always happens with no family history of the disorder.

Progeria affects 1 in around 4 million newborn children worldwide. According to scientific literature, more than 130 cases have been reported since the condition's discovery in 1886. Progeria is a genetic condition, but it is rarely passed through the family.

Rarely does more than one child inherit it. The condition occurs due to a new mutation causing a rapid appearance of ageing which occurs at the beginning of childhood. Causing the child to develop an abnormally-small face with prominent bulging eyes, a thin beak-tipped nose, thin lips, a small chin, protruding ears, an underdeveloped jaw, hair loss (alopecia), aged appearance, and joint abnormalities.

At last, the child loses the layer of fat beneath the skin and the elasticity in the arterial walls, causing a heart attack or stroke in 90% of cases. Death from this condition happens on an average age of 13. This condition doesn’t affect intellectual and motor skills and there is no cure for it; doctors focus on reducing complications caused by the disorder.

Water Allergy Syndrome (Aquagenic Urticaria)

Aquagenic Urticaria (hives) is an extremely rare condition where the person affected breaks out in a rash when coming into contact with water at any given temperature. Symptoms usually start during the onset of puberty and they mostly affect women.

People affected by this condition appear to be allergic to water. The water causes a painful burning and itching rash. The hives associated with Aquagenic Urticaria are typically small (1-3mm) red or skin-coloured welts. The rash mostly develops on the arms neck and upper trunk, although it is possible to develop on other parts of the body. When the water source is removed, the rash gradually fades within 30-60 minutes.

The exact cause for this condition is unknown, but scientists believe it to be caused by a substance dissolved in the water which enters the skin causing an immune response. According to this theory, the allergy is not caused by water, but by an allergen in the water.

Further, it’s stated that interaction between water and an allergen on the skin generates a toxic substance causing the rash. This condition is known to be sporadic with no family history, but there have been familial cases. In a family, three generations have been known to be affected by this condition. In some cases, reported there have been other conditions associated with this. Due to the rarity of this condition, the effectiveness of treatment data is limited.

Alice in Wonderland Syndrome (AIWS)

This condition, also known as dysmetropsia, is a disorienting neuropsychological condition that affects visual perception. A person with this condition experiences alteration of body image. Alteration of visual perception causes the person to see body parts and other objects incorrectly. The head and hands are mostly disproportionate and the effect is worse at night.

It affects vision, touch, and hearing. This can make the person lose their sense of time. They may feel the time passing slower or faster than it actually is. This condition primarily affects children and young adults. With age, most grow out of this condition, but some tend to continue to experience this in adulthood as well.

This condition was identified by British psychiatrist Dr. John Todd in the 1950s. This condition can present many symptoms; it can be associated with migraines, brain tumours, temporal lobe epilepsy, psychoactive drug use, or Epstein Bar virus.

AIWS has no proven treatment, but treatment programmes are used for relief from the probable cause of AIWS. Chronic cases of AIWS are untreatable and have to be left to wear off on their own. The probable treatment is migraine prophylaxis (antidepressants, anti-convulsion medication, beta-blockers, and calcium channel blockers) and a migraine diet; anecdotal reports suggest that symptoms are common during childhood.

Signs and symptoms are migraines, size distortion, time distortion, sound distortion, and hallucinations A person with this condition can have hallucinations and distortions several times during the day and it may take longer to subside, causing the person to get terrified, anxious and panic-stricken.

The manifestations aren't life-threatening and will in all likelihood, fade off in time. Alice in Wonderland Syndrome was named after famous author Lewis Carroll’s 19th-century novel Alice’s Adventures in Wonderland. In the novel, the character faces numerous situations close to this condition.

Moebius Syndrome

Moebius Syndrome is a rare neurological condition that primarily affects facial expressions and eye movement characterised by weakness or paralysis of facial muscles, causing problems such as trouble eating, swallowing; as well as choking, eye sensitivity, hearing problems, high or cleft palate, drooling dental abnormalities, cross eyes, speech difficulties, and bone abnormalities in the limbs.

Children with this condition have delayed motor skills such as crawling or walking, but most eventually succeed. This condition is caused by the underdevelopment or absence of the 6th and 7th cranial nerves that control facial expression and eye movement. Other cranial nerves could be affected too.

It’s not a progressive condition and the exact cause of the condition is not known. It appears to be mostly sporadical; but in some cases, it occurs in families, suggesting the possibility of a genetic component. The severity and abnormalities of this condition are different from person to person.

With proper medical care, a person with this condition who doesn’t have life-threatening complications in the first year of life usually has a normal life expectancy. There is no cure for Moebius Syndrome, but proper care and treatment can help many individuals live a normal life. 

10 Rare Health Conditions - Part I

Morgellons disease

Morgellons disease is an infectious skin condition that is linked to spirochetal (bacterial) infection and tick-borne illness disfiguring and disabling patients. The name came from an unrelated condition in France in 1674, in a letter written by English physician Sir Thomas Brown; he mentioned black hairs emerging on the backs of children in Languedoc. He called it Morgellons and said it cured their coughs and convulsions. A matching description was first reported in the US in 2002.

Morgellons patients suffer from feelings of itching, biting, and crawling sensations in the skin; microscopic filaments resembling textile fibers of colours black, white, blue or red growing from the skin; skin lesions, cognitive functions such as memory loss, poor concentration, joint pains, depressed moods, and fatigue.

The skin filaments have been identified as compressed cellular proteins such as keratin and collagen; an overproduction of these filaments is in response to a spirochetal infection. This infection affects humans, cattle, cats, and dogs. There were 14,000 reports in 2009; since then, there has been an increase in patients with Morgellons disease.

Research shows that skin afflictions were due to a psychological response to the presence of an infection. There is no known cure for Morgellons disease. Some doctors believe Morgellons to be a psychological condition and treat it with cognitive behavioral therapy, antidepressants, antipsychotics, and counseling. Other doctors believe it to be biological. Further studies are required to properly understand the condition.

Paraneoplastic pemphigus

Paraneoplastic Pemphigus (PNP) is a rare autoimmune skin disorder linked to the group of blistering skin diseases. It is a neoplasm. The first symptoms of PNP are usually oral, skin and mucosal lesions. The pathogenesis of pemphigus is still not completely understood, although some immunological characteristics have been recently reported.

Since it’s rare, several diagnostic criteria have been proposed and many diagnostic procedures have been used for diagnosis; they are indirect immunofluorescence and direct immunofluorescence, which are antibody tests using fluorescent dyes and ELISA, which is a test for detecting and quantifying antibodies and hormones.

PNP causes cancers in the stomach, lungs, and colon. B-cell Lymphoma and haematological malignancies are constantly associated with PNP. Patients can show multi-organ involvement and a subset of autoantibodies to several tissues.

Early diagnosis of PNP is difficult, but it’s the best option. Usually, a neoplasm is detected before the onset of PNP, however, PNP is the first clinical manifestation that leads to the discovery of underlying tumors and also that causes secretion of functional peptides and hormone which causes blisters on the skin and mucous membranes.

The blisters fill with fluid and peel off, leaving the skin raw and open and making it susceptible to infection. The disease is extremely fatal, causing death in 90% of patients diagnosed due to sepsis, cancer or multi-organ failure.

PNP usually affects people between ages of 45 and 70, but children and adolescents can be affected too. The disease is hard to treat; removal of tumors and treatment with steroids are the best options until a cure is possibly found. During the past few years, medical advances have improved the understanding of PNP pathogenesis and enhanced diagnosis. Effective diagnosis and treatment may affect the overall clinical outcome. Further research needs to be done.

Microcephaly

Microcephaly is defined by the circumference of the head being much smaller than usual, according to the gender and age of the child. There are two types of microcephaly: one is congenital microcephaly diagnosed at birth, while the other is postnatal microcephaly which appears later in life.
Genetic abnormalities, metabolic disorders, infections, teratogens, as well as prenatal, perinatal and postnatal injuries can cause congenital and postnatal microcephaly. Patients are evaluated with a thorough history and physical examination. Neuroimaging, metabolic, or genetic testing should be done in case of aggravation of microcephaly. Further diagnosis should be done owing to the underlying symptoms pointing to an underlying diagnosis.

Often the first tests for diagnosing microcephaly are Magnetic Resonance imaging (MRI) and neuroimaging. Genetic testing is becoming more common as a follow-up to neuroimaging when the physical examination has no successful diagnosis. Microcephaly is a lifelong illness with no known cure; the prognosis is usually worse for children with intrauterine infection, or metabolic or chromosomal abnormality.

Maternal infections and the Zika virus are associated with microcephaly and other serious brain abnormalities. Children affected by microcephaly end up with less or no brain development while in the womb due to genetic abnormalities and interference in the growth of the cerebral cortex. This causes the child to develop a smaller-than-usual head at birth, which usually remain the same during growth.

Many believe the reasons to be genetic or exposure to harmful substances like radiation, drugs, alcohol, or certain viruses like the Zika virus, rubella, (German measles), varicella (chickenpox), the cytomegalic virus while in the womb, or untreated phenylketonuria (PKU).

The disease is usually paired with Down syndrome. A person affected by Microcephaly ends up with issues of intellectual disability, delayed development, cerebral palsy, seizures, as well as hearing and visual issues. Rubella and Varicella are other serious conditions known to cause genetic microcephaly and intellectual deficits. Maternal immunization for rubella and varicella and have known to prevent microcephaly.

There is no cure to get the child’s head to return to the correct size or shape, but treatment focuses on decreasing the impact associated with the deformities and neurological difficulties. Medicine is used to control seizures, hyperactivity, and neuromuscular symptoms. Genetic testing may help families in future pregnancies.

Von Hippel-Lindau Syndrome (VHL)

Von Hippel-Lindau Syndrome (VHL) is an extremely rare genetic condition which more frequently appears in young adulthood, but symptoms may persist throughout life as well. VHL causes cancerous or non-cancerous tumors or cysts (fluid-filled sacs) to grow in different parts of the body. These tumors are medically known as haemangioblastomas. They are made of newly-formed blood vessels which are more often benign.

These tumors grow in the retina of the eye (retinal angiomas), causing vision loss; as well as the brain and spinal cord, causing weakness, headaches, vomiting, and muscle coordination (ataxia). Cysts tend to grow in the pancreas, kidneys, and genital tract. They are at increased risk of developing kidney cancer called Clear Cell Renal Cell Carcinoma as well as pancreatic cancer called a Pancreatic Neuroendocrine Tumor.

VHL is also associated with a tumor known as pheochromocytoma, which is most commonly associated with adrenal glands (small glands located on top of each kidney which produces hormones). Pheochromocytomas are mostly benign. These tumors rarely show symptoms, but in some cases, they cause panic attacks, excessive sweating, headaches, and dangerously high blood pressure, which may not respond to medication.

Pheochromocytomas can be really dangerous in times of stress and trauma, like when associated with pregnancy, accidents, or surgery. Around 10% of people with HPL develop endolymphatic sac tumors; non-cancerous inner ear tumors. These tumors can cause hearing loss in one or both ears, causing ringing in the ears (Tinnitus) and balance issues. Left untreated, these tumors can cause sudden and profound deafness.

There is a chance of non-cancerous tumors developing in the lungs or liver with people who have VHL, but they may not show any symptoms.

Fibrodysplasia Ossificans Progressiva (FOP)

FOP is a progressive disorder in which muscle tissue and connective tissue such as tendons and ligaments are replaced by bones (ossified), forming bones outside the skeleton (extraskeletal or heterotopic bones) that affect bone movement.

FOP affects the joints, causing loss of mobility, as well as inability to open the mouth (making it impossible to eat or speak, which leads to malnutrition). Extra bone formation around the rib cage can also cause breathing difficulties.

This condition is so rare that it said to affect one in two million people worldwide. There have been several hundred cases reported. FOP is first noticed at early childhood, which starts at the neck and shoulders and then proceeds down to the body and limbs.

Injury or invasive muscle procedures can aggravate the process, causing episodes of inflammation and muscle swelling, which speeds up ossification in the injured area. Flare-ups can also occur due to viral infections such as influenza.

At birth, there is a classic symptom known as malformation of the big toes. This condition can cause short thumbs and other skeletal abnormalities too. There is no known treatment for FOP as surgery to remove the bone can cause the body to produce even more.

The Hmong Sudden Death Syndrome

Vang was a former Hmong (Laotian) soldier who settled in Chicago in 1980, as an escapee of the war in Laos. Lang suffered from traumatic memories of wartime destruction, including severe guilt of leaving his brothers and sisters behind when he fled with his wife and child. According to a mental health team, the culture shock created due to moving from a rural Laos to urban Chicago increased Vang's stress even further. He experienced problems almost immediately.

Vang suffered from sleep issues; he was unable to sleep from the first night in his apartment in Chicago. This continued for the next two days, causing him to visit his resettlement worker, Moua Lee, and confess his problems. He confessed that on the first night, he had woken up suddenly, feeling short of breath from a dream in which a cat was sitting on his chest; and that on the second night, a figure which resembled a black dog came to his bed and sat on his chest, causing him to go out of breath quickly and dangerously. On the third night, a tall, white-skinned female appeared in his bedroom and lay on top of him. Her weight caused difficulty in his breathing, and after 15 minutes, the spirit left and he woke up screaming.

Trauma & Culture

Vang's report attracted scientific interest due to around 25 Laotian refugees in the United States dying of what was termed as the Hmong Sudden Death Syndrome. The victims in those cases also experienced symptoms similar to those Vang did: an exhibition of laboured breathing, screaming, and frantic movements. The US Center for Disease Control investigated these deaths and was unable to find a physical cause. They concluded that the deaths were triggered by a combination of the stress of resentment, guilt over having to abandon families in Laos, and Hmong's cultural beliefs of angry spirits.

The authors of Vang's case study concluded that he might have been a survivor of Sudden Death Syndrome. The role of cultural beliefs is suggested by what happened next. Vang went for treatment to a Hmong woman regarded as a shaman. She told him his problems were caused by unhappy spirits and performed ceremonies to release them. Vang's nightmares and breathing problems during sleep ceased afterwards.

Like the cases of voodoo deaths, Vang's case study suggests that cultural stress and beliefs may have a profound influence on physical well-being. This work was followed by other studies on Hmong immigrants and stimulated interest in the relationship between cultural beliefs and health.

Case Studies

The major limitation of a case study is that it is a poor method for determining cause-effect relations. in most case studies, explanations of behaviour occur after the fact, and there is little opportunity to rule out alternative explanations. The fact that Vang's symptoms ended after seeing a shaman might not have anything to do with his cultural beliefs; it could have been pure coincidence, or other changes in his life could have been responsible.

A second potential drawback concerns on the generalisation of findings: will the principles uncovered in a case study hold true for other people or other situations? The question of generalisability pertains to all research methods, but drawing broad conclusions from a case study can be particularly risky. The key issue is the degree to which the case under study is representative of other people or situations.

A third drawback is the possible lack of objectivity in the way data is gathered and interpreted. Such bias can occur in any type of research, but case studies can be particularly worrisome due to them often being based largely on the researcher's subjective impressions. In science, a skeptical attitude is required for claims based on case studies to be followed up by more comprehensive research methods before being accepted. We should adopt similar skeptical views in our daily lives, too.

Announcement: New Short Story Blog

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I just finished making my blog and posting the first chapter of my first story there. Here's the link:https://the-omniscrolls.blogspot.com/2019/09/the-unseen-part-i-paralysed.html

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Hypnosis and Memory

In TV shows or movies, there are scenes in which people are given a suggestion that they would not remember a certain thing (such as a person's name or an incident, either during the session itself (hypnotic amnesia) or at the end of hypnosis (posthypnotic amnesia). A reversal cue could also be given, a phrase such as "You will now remember everything"; once the person hears this, their state of amnesia ends.

According to research, around 25% of hypnotised college students could be led to experience amnesia. Although researchers agree that hypnotic and posthypnotic amnesia occur, they do still debate the causes. Some feel that it's a result of voluntary attempts in avoidance of thought on certain information, while others believe it to be caused by an altered state of conscientiousness which weakens normal memory systems.

Memory Enhancement

In contrast to producing the effect of forgetting, can hypnosis enhance memory?

Law enforcement agencies sometimes use hypnosis in aid of eyewitnesses to a crime. In a famous case in California which occurred in 1977, a bus carrying 26 children and its driver disappeared without a trace. The victims, buried underground in an abandoned trailer truck by three kidnappers, were later found alive. After the rescue, an expert hypnotised the bus driver and asked him to recall the ordeal. The driver formed a vivid image of the kidnappers' white van and could "read" all but one digit of the vans licence plate. The information helped track down the kidnappers.

Despite occasional success stories such as this, controlled experiments find that hypnosis is unable to improve memory. In some experiments, participants watch videotapes of simulated bank robberies or other crimes. Next, while hypnotised or not, they are questioned by police investigators or criminal lawyers. Hypnotised individuals tend to remember better than non-hypnotised individuals in some studies, but not all. There have been experiments where hypnotised participants had performed much poorly than non-hypnotised people; they had recalled more information, but much of it was inaccurate.

Another concern regarding this is that some memories recalled under hypnosis maybe pseudomemories—false memories created during hypnosis by statements or leading suggestions made by the examiner. In some experiments, hypnotised and non-hypnotised participants are intentionally exposed to false information about an event (e.g.: about a bank robbery). Later, once the hypnotised subjects are brought out of their hypnosis, they are questioned. Highly suggestible individuals that have been hypnotised are the ones most likely to report the false information as being a true memory and often tend to be confident of the accuracy of their memories.

Although some psychologists are exploring ways to minimise hypnosis-induced memory errors, at present, many courts have banned or limited testimonies obtained under the influence of hypnosis. The increased suggestibility of hypnotised individuals makes them particularly susceptible to memory distortion caused by leading questions, and they may come to believe things that never occurred in the first place. Similarly, if a therapist uses hypnosis to help patients recall long-forgotten memories of sexual abuse, what shall we conclude? Are the memories real, or are they pseudomemories created during therapy sessions?

Disassociation

What is hypnosis ad how does it produce its effects?

Several researchers propose theories that view hypnosis as an altered state involving a disassociation of consciousness. Ernest Hilgard proposed that hypnosis creates a division of awareness in which the person simultaneously experiences two streams of consciousness that are cut off from each another. One stream responds to hypnotic suggestions, while the other—the part of consciousness which monitors behaviour—remains in the background, but is aware of everything that goes on. Hilgard reefers to this second part of consciousness as the Hidden Observer.

Suppose a hypnotised subject is given a suggestion that she wouldn't feel pain. Her arm is lowered into a tub of ice-cold water for 45 seconds and every few minutes, she reports the amount of pain. In contrast to unhypnotised subjects, who find this experience moderately painful, she would probably report feeling less pain. But suppose the procedure is done differently. Before lowering the subject's arm, the hypnotist says, "Perhaps there is another part of you that is more aware than your hypnotised part. If so, would that part of you report the amount of pain."

In this case, the subject's other stream of consciousness, the Hidden Observer, would report a higher level of pain.

For Hilgard, this disassociation explained the reason behind the involuntary automatic behaviour that occurs under hypnosis. Given the suggestion "Your arm will start to feel lighter and will begin to rise," the subject intentionally raises his or her arm, but only the Hidden Observer is aware of this. The mainstream of consciousness that responds to the command is blocked from this awareness and perceives that the arm is rising all by itself.

Studies on Hypnosis

Hypnosis is a state of heightened suggestibility, in which certain individuals can experience imagined situations that seem real. There is great interest in hypnosis several therapists use to treat mental illnesses with it. Some Psychology PhD programmes tend to offer courses in hypnosis. Scientists who explore whether hypnosis is a unique state of altered consciousness tend to put the claims about it through several tests.

Hypnotic Behaviour

Hypnotic Induction is the process by which a person (a researcher or a hypnotist) leads another, the subject, into a state of hypnosis. A hypnotist may request the subject to sit down and gaze at an object on the wall, or something like a pendant in his hand. He then may suggest that the subject's eyes are getting heavy. The goal of this test is to relax the subject while increasing their concentration.

Contrary to popular belief, a person can't be hypnotised against their will. Even when people want to be hypnotized, they differ in susceptibility to hypnotic suggestions. Hypnotic susceptibility scales contain a standard series of pass/fail suggestions being read to a subject after hypnotic induction. The subject's score is based on the number of passes. Some subjects tend to be completely non-responsive; some pass all while the rest fall in between.

Does hypnosis alter one's behaviour and psychological function? Some claim it does.

Involuntary Control

Hypnotised individuals subjectively experience their actions as involuntary ones; they believe they're controlled by a mysterious force rather than their conscious control.

If behaviour seems to be involuntary under hypnosis, can it be used to perform harmful acts? According to Martin Orne and Fredrick Evans, hypnotised subjects were able to be made to dip their hands briefly in a solution of foaming liquid, which as made to believe was acid, and throw on another person's face.

This might be an example of the power of hypnosis in getting people to act against their will. However, in another controlled group that Orne and Fredrick tested on, the subjects were asked to simply pretend to be hypnotised. These subjects were just as likely as the earlier group to dip their hands in the solution and throw it at another.

In another experiment, researchers induced hundreds of adults to keep giving what they believed to be hundreds of  painful electric shocks to an innocent man with a heart condition, while he begged them to stop. None of the subjects were hypnotised; they were simply following the researchers' orders. This shows that contrary to popular beliefs, hypnosis does not involve a unique power to get people to behave against their will. A legitimate authority figure can induce people to commit out of character, dangerous acts with or without being hypnotised.

Amazing Feats

Have you seen or heard of stage hypnotists who gets an audience member to perform an amazing physical feat such as the 'human plank'? The subject, usually a male, is hypnotised and lies  outstretched between two chairs. He is told that his body is rigid and then, amazingly, another person stands on his legs and chest.

Similarly, psychology can have striking effects. Consider the classic experiment which involved 13 people allergic to the toxic leaves of a certain tree. Five of the test subjects were hypnotised while being blindfolded and were told that a leaf from a harmless tree they weren't allergic to was touching one of their arms, when, in fact, it was toxic. But four of five hypnotised subjects had no allergic reaction. For the next  step, the other arm of the hypnotised subjects were rubbed with a leaf from a harmless tree and he or she was falsely informed of the leaf being toxic. All five of them reacted to the harmless leaf with an allergic reaction.

Should the human plank, as well as the unusual responses of the allergic subjects, be attributed to the unique powers of hypnosis? Here is why a healthy dose of critical thinking may be of importance.

Pain Tolerance

Scottish surgeon James Esdaile performed more than 300 major operations in the mid-1800s using  hypnosis as the sole anaesthetic. According to experiments, an increase in pain tolerance, which wasn't due to the Placebo Effect, was confirmed.

For patients who experience chronic pain, hypnosis can produce relief lasting for months, or even years. Brain imaging research has revealed that hypnosis modifies a person's neural activity in areas that process painful stimuli, but non-hypnotic techniques such as mental imagery and performing distracting cognitive tasks also alter neural functioning and reduce pain.

We do not know exactly how hypnosis produces painkilling effects. It may influence the release of endorphins, decrease a patient's fear of pain, distract patients of their pain, or somehow help them in separating the pain from the conscious experience.

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Sleepwalking and Consciousness

What is sleepwalking, and how can people do things that are impossible to do while being asleep? Some people sleepwalk to their kitchen to eat food and go back to sleep with no recollection of it in the morning.

Sleepwalking and Crime

There was a case where a man had driven to his mother-in-law's house and killed her and her husband. While driving back home, he had woken up in the car with a bloody knife. Realizing that something had badly gone wrong, he handed himself to the police with the knife, but with no recollection of what had happened—or maybe he did and used sleepwalking as a defence. He was acquitted of murder.

In another case, a man killed a prostitute and set fire to a brothel. Later, he was acquitted on grounds of sleepwalking. Sleepwalking may be real in some cases, but it’s the perfect defence for murder. There were other incidences, one where a couple would sleepwalk to the kitchen and eat raw bacon. In another, a woman would consume salted sandwiches, buttered cigarettes, and large quantities of peanut butter, butter, salt, and sugar. Once, she had woken up while trying to open a bottle of cleaning agent to drink. These individuals usually have no recollection of what happened while they were asleep. The empty packages and half-eaten food, though, made it obvious that something was amiss.

According to my mother, two of my brothers used to sleepwalk when they were very young. Once, one of them had even almost walked off the balcony. If my mother hadn't woken up, he would have fallen. My son used to sit on the bed and talk in his sleep, and sometimes even try to walk out. On a few occasions, he spoke of the One Ring (from The Lord of The Rings) and even looked for it under his pillow—though he didn’t really recall anything in the morning. As I was a light sleeper since my son was born, I would always wake up for the slightest sound, preventing him from walking out.

How can a person sleepwalk to the kitchen and prepare food and eat in their sleep, and how can a person drive while they are asleep and then commit murder, too? Why don't you fall off your bed at night as you are unaware of your many postural shifts as you sleep? Maybe it's because part of you knows where the edge of the bed is. Have you ever been engulfed in thought and spaced out while driving and suddenly snapped out with no recollection of the number of miles you have driven? This means that though you were conscious, you were still focused inward, and a part of you without conscious awareness kept track of the road, controlling your hand movements at the wheel.

The Puzzle of Consciousness

According to philosopher David Charmer, consciousness "is, at once, the most familiar and most mysterious thing in the world. These mysteries range from a normal state of awakening, sleep and dreams, drug-induced experiences, and beyond.”

But what exactly is consciousness, and how does it arise in our brain? In the 1800s, when psychology was founded, it’s “great project” was to unravel some of the puzzles of consciousness. This interest waned in the mid 20th century due to the dominance of Behaviourism, but the resurgence of cognitive and biological perspectives has led us to rethink the longstanding conceptions of the mind.

In psychology, consciousness is often defined as a moment-to-moment awareness of ourselves and our environment. Among its characteristics, consciousness is subjective and private: others cannot directly know what reality is for you, nor can you directly enter into their experience.

Dynamic throughout each day, we drift in and out of various states. Moreover, through stimuli, we are aware of constant change; we typically experience consciousness as a continuously flowing stream of mental activity, rather than as disjointed perceptions and thoughts. Self-reflective and central to our sense of self, the mind is aware of its consciousness. Thus, no matter what your awareness is focused on, a lovely sunset or an itch on your back, you can reflect on the fact that you are the one conscious of it.

Finally, consciousness is intimately connected with the selective attention process. It consists of the selection of some details and the suppression of the rest due to the urgency of attention. Selective attention is the process which focuses on the awareness of some stimuli to the exclusion of others. For example, if the mind is a theatre of mental activity, the consciousness reflects what’s illuminated at the moment; such as the bright spot on the stage, and the selective attention in the spotlight, or the mechanism behind it.

States of Consciousness

Scientists studying consciousness must operationally define private inner states in terms of measurable responses. Self-report measures ask people to describe their inner experiences—they offer the most direct insight into a person's subjective experiences, but aren't always variable or possible to obtain. Most of us do not speak while we sleep; nor can we fill our self-report questionnaires. Much of what occurs within our brains is beyond conscious access. You don't consciously perceive the brain process which lulls you to sleep, awakens you, or regulates your body temperature; and, although you are aware of your thoughts, you're unaware of the brain’s process of creating them.

According to Freud's proposal a century ago, the human mind consists of three levels of awareness. The conscious mind contains thoughts and perceptions of current awareness. Preconscious mental events are outside current awareness, but can be easily recalled under certain conditions. For instance, when someone mentions a friend you haven't thought about for years, you become aware of pleasant memories.

Unconscious events cannot be brought into conscious awareness under ordinary circumstances. Freud proposed that some unconscious content, such as unacceptable sexual and aggressive urges, traumatic memories, and threatening emotional conflicts, are repressed—kept out of conscious awareness due to the possibility of it arousing anxiety, guilt, or other negative emotions.

Behaviourists criticized Freud's ideas as they sought to explain behaviour without invoking conscious mental processes, much less unconscious ones. Cognitive psychologists and many contemporary psychodynamic psychologists, too, take issue with specific aspects of Freud's theory. According to psychodynamic psychologist Drew Westen, many aspects of Freud's theory are, indeed, out of date, and should be. Freud died in 1939, and he was slow to undertake further revisions. However, research supports Freud's general premise: that unconscious processes can affect behaviour.

The Science of Psychology

Why are some people shy while others are outgoing? What sometimes causes opposites to be attracted to each other and fall in love? Why can we remember a first date which happened long ago while forgetting information necessary for a test which we studied only hours ago? Psychology studies all these and countless other scenarios and subjects alike.

Behaviour and Mind

The definition of psychology is the scientific study of behaviour and of the mind. The term behaviour refers to directly observable actions and responses, while the term mind refers to internal states and processes, such as thoughts and feelings, which cannot be seen directly and need to be inferred from observable, measurable responses.

The complexity of behaviour poses special challenges for scientific studies. As we become familiar with the kind of evidence needed to validate scientific conclusions, we become better informed about the many claims made in the name of psychology. For one thing, this teaches us that many widely-held beliefs are inaccurate, but the most important thing we learn is the habit of critical thinking.

Critical Thinking

Critical thinking involves taking an active role in understanding the world around us, rather than merely receiving information. It's important to reflect upon the meaning of the information, how it fits with our experiences, and its implication on our lives and society. Critical thinking also means evaluating something present to us as fact. For example, when someone tells you a new fact, ask yourself the following questions:

Exactly what do you want me to believe?
How do you know this, and what evidence have you got?
Could there be other possible explanations?
What is the most reasonable conclusion?

This helps us understand to be cautious in accepting psychological claims, making us less likely to form simplistic judgement on the behaviours and thoughts of other people. Thus, critical thinking would help serve us in many areas of our lives.

Psychology as an Applied Science

Science involves two types of research: basic research, which requires the quest for knowledge purely for its own sake; and applied science, which is designed to solve specific problems. For psychologists, the most basic of research is centred around the reasons behind people's behaviour, thoughts, and feelings. Basic research can be carried out in laboratories or outdoors, with participants being either human or from other species.

Psychologists studying other species usually do so in an attempt to discover principles which ultimately would shed light on human behaviour, but some study animal behaviour for its own sake. In the field of applied research, psychologists often use basic scientific knowledge in order to design, implement, and assess intervention programmes.

Robbers Cave Study

How do hostility and prejudice develop between groups, and what can be done to reduce it? In the multicultural world we live in today, where clashes erupt between various religious and ethnic groups, there is great importance in this question.

In order to provide an answer, psychologists have conducted research on factors which increase and reduce inter-group hostility. In one experiment, 11-year-old boys were divided into two groups upon arrival at a summer camp in Robbers Cave, Oklahoma. The groups were named the Eagles and the Rattlers and were put in separate cabins, but took part in all the other activities together. Initially, both teams got along well.

In order to test the hypothesis that competition could breed inter-group hostility, the researchers began to pit the two teams against each other in athletic and other contests. As predicted, hostility soon grew between the two groups. Next, the researchers examined if the conflict could be reduced between the teams by having them share enjoyable activities such as watching movies together, but surprisingly, it caused more taunting and fighting among them.

The researchers then created several small emergencies to test a final hypothesis, placing the hostile groups in situations that required cooperation between one another in order to attain common goals, hoping it would reduce their hostility towards each other. In one emergency, the truck transporting food for the hungry boys supposedly stalled, forcing the two groups to pool their strength and tow it with a rope to get it started. This, as well as other cooperative experiences, gradually reduced the hostility among the boys, causing the development of many new friendships.

Since then, the Robbers Cave Study has become a classic, which is an older but widely-known influential study. It represents basic research as its goal was to discover the general principles of inter-group conflicts and not to solve an existing problem. The prejudice between the two groups did not exist from the outset; rather, it was created by the researchers, which showed that hostility could be bred by competition and reduced by making them dependent on each other to reach a common goal.

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Personality and Crime

On the surface, Charles Whitman seemed as solid and as the University of Texas tower from which he rained death on unsuspecting strangers. He was the son of a wealthy family in Florida. Whitman was an outstanding student, an accomplished pianist, one of the youngest eagle scouts in state history, and a former US marine who was awarded the Medal of Good Conduct, as well as the Marine Corps expeditionary medal. He wedded the woman of his dreams, and the couple was even seen as an ideal couple. Whitman became a student of the University of Texas when he was selected for an engineering scholarship by the marines. In his spare time, he served as a scoutmaster in Austin.

So, what caused such a seemingly exemplary person to commit such horrific acts of violence? On December 18, 2001, the Austin History Centre opened its records on Charles Whitman to public scrutiny. The records provide important insight into the complexities of Whitman's personality and the turmoil which existed within him. Although the Whitman incident had happened decades ago, it has a sad reminiscence to more recent acts of violence in schools, workplaces, and communities across the United States.

Whitman's Confession Letter

On a summer evening in 1966, Whitman wrote the following letter:

I don't understand myself these days. I am supposed to be an average, reasonable, and intelligent young man. However, since of late (I am unable to recall the specific day it all started), I have become the victim of many unusual and irrational thoughts. These thoughts tend to recur constantly, and it requires a tremendous mental effort to concentrate on useful and progressive tasks.

In March, when my parents made a physical break, I noticed a great deal of stress. I consulted a doctor, Cochrum, at the university health centre and requested him to recommend someone that I could consult with about some psychiatric disorders that I felt I had. Once I talked with a doctor for about two hours as I tried to convey my fears that I have been feeling overcome by overwhelming violent impulses. After the first session, I never saw that doctor again. And since then, I have been fighting my mental turmoil by myself, and it seems to be to no avail. I wish an autopsy to be done on me when I am dead to find out if there is any visible physical disorder in me. I have had some tremendous headaches in the past and I have consumed two large bottles of Excedrin (Painkiller for migraine headaches) in the past three months.

Later that night, Whitman murdered his wife and mother, both who was loving and supportive of him. The next morning, he carried a high-powered hunting rifle to the top of a 307-foot tower on the busy University of Texas campus in Austin and opened fire on the persons passing below. Within 90 horrifying minutes, he murdered 16 people and wounded 30 others before he was killed by the police.

What is Personality

The concept of personality derives from the fascinating spectrum of human individuality. According to observations, people differ meaningfully according to the ways they customarily think, feel, and act. These distinctive behaviour patterns help in defining one's identity as an individual. According to the noting of one theoretical group, each of us is, in some respects, like all other people, like some others, and like no other person who lived in the past or will exist in the future.

The concept of personality also rests on the observation that any given person seems to behave somewhat consistently over time, and across different situations. From this perceived consistency comes the notion of personality traits that characterizes an individual's customary ways of responding to his or her world. Although only a modest consistency is found from childhood personality to adult personality, consistency becomes greater as we enter adulthood. Nonetheless, even in adulthood, a capacity for meaningful personality change remains.

With the combination of these notions of individuality and consistency, we can define personality as the distinctive and relatively enduring ways of thinking, feeling, and acting that characterize a person's response to life situations.

The thoughts, feelings, and actions that are seen as reflecting an individual's personality typically have three characteristics. First, they are seen as behavioural components of identity that distinguish that person from others; second, the behaviours are viewed as being caused primarily internal rather than environmental factors; and third, the person's behaviour seems to have organization and structure—they seem to fit together in a meaningful fashion, suggesting an inner personality that guides and directs behaviour.

Studies on personality have been guided by psychodynamic, humanistic, biological, behavioural, cognitive, and sociocultural perspectives. These perspectives provide different conceptions of what a personality is and how it functions. Yet this diversity of viewpoints arises from the fact that theorists have their own personalities, which influence their perception and understanding of themselves and the world.

Dementia & Alzheimer's Disease

Dementia is a reference to impaired memory and other cognitive deficits that accompany brain degeneration, as well as interference with normal functioning. There are more than a dozen types and causes of dementia.

Dementia is more prevalent among the elderly. However, it can occur at any point in life. In dementia, cognitive abilities are gradually lost, accompanied by brain degeneration. In people with dementia, there is an occurrence of abnormal progressive degeneration of brain tissue as a result of disease or injury.

Dementia is most common in late adulthood. The term Senile Dementia refers to dementia that begins after the age of 65. Alzheimer's Disease is the most common cause of senile dementia, but Parkinson’s Disease, Huntington Disease and Creutzfeldt-Jakob Disease are other common causes. Complications from high blood pressure and strokes may also cause it.

Scientific Studies

A large Canadian study has found an overall rate of senile dementia of around 8 percent, as well as a female-to-male ratio of about 2:1. Whereas 2 percent of 65- to 74-year-olds are estimated to have dementia, there is an increase in rate to 11 for 75- to 84-year-olds, as well as 34 percent for people who are 85 and above.

Impaired memory, in particular, for very recent events, is typically one of the first symptoms of dementia. Poor judgement, language problems and disorientation may appear gradually or sporadically, and people who develop dementia typically have distress episodes due to confusion. Their behaviour may become uninhibited, they may lose the ability to perform familiar tasks, and they may experience a significant physical decline in addition to cognitive impairments.

Comparing with adults aged 65 and older, those who are more frequently engaged in activities that stimulate cognitive functioning show a lower risk of subsequently developing Alzheimer's disease; but whether this truly reflects a causal relationship remains to be seen. However, one thing is certain: as people live longer lives, the need to find a cure for Alzheimer’s disease and other forms of senile dementia becomes a matter of urgency. Until then, many of us can expect our family members to become Alzheimer’s patients.

Caregiving

Being a caregiver for a spouse or elderly parent with dementia can, unfortunately, be a stressful and psychologically painful experience. Over half of the patients diagnosed with senile dementia show a combination of depression, anxiety, agitation, paranoid reactions, as well as disordered thinking, which may resemble schizophrenia. Ultimately, it could result in the inability to walk, talk, or recognise family members or close friends.

In-depth studies done in Finland, the United States, and Germany, have found that among adults above the age of 65 not suffering from dementia, 20 to 25 percent do have mild cognitive impairment. Combining cases of mild impairment and dementia, some experts have estimated that 79 percent of 65- to 74-year-olds; and 45 percent of people aged 85 and older, remain cognitively normal.

Though these are not pleasant statistics, they make it clear that even well into old age, cognitive impairment isn’t inevitable; and that even with the decrease of some mental abilities with age, more knowledge and wisdom could still be accumulated.        

Alzheimer's Disease (AD)

Alzheimer's disease is a progressive brain disorder which is the most common cause of dementia among adults over the age of 65, according to around 50 to 60 percent of such cases. An overall of 2 to 4 percent of the elderly is estimated to have AD.

The early symptoms AD, which worsen gradually over a period of years, include forgetfulness, poor judgement, confusion, and disorientation. Often, memory of recent events and new information is especially impaired. Forgetfulness by itself is not necessarily a sign of a person developing AD; however, memory happens to be the first psychological function that is affected, as AD initially attacks the subcortical temporal lobe regions—areas near the hippocampus, as well as the hippocampus itself—that help in the conversion of short-term memory into long-term memory.

Alzheimer's disease spreads across a person’s temporal lobes and then to the frontal lobes, as well as to other cortical regions. According to a German physician Alois Alzheimer, who first noticed the disease a century ago, patients afflicted with this disease have an abnormal amount of plaques and tangles in their brains. Plaques happen to be clumps of protein fragments which happen to build up on the outside of the neurons, whereas tangles are fibres that get twisted and wound up together within the neurons.

Neurotransmitter Systems

Neurons tend to become damaged and die, brain tissues shrink, and communication between the neurons is impaired as AD disrupts several neurotransmitter systems, especially the acetylcholine system. Acetylcholine plays a key role in synaptic transmission in several brain areas involved in memory, and drugs that help maintain acetylcholine functioning have had some temporary success in improving cognitive functioning in AD patients.

As AD progresses, working memory and long-term memory worsen. For example, if you read a list of just three words to a healthy 80-year-old and test his recall after a brief time delay, they tend to typically remember at least 2 words if not all three. On the other hand, a patient with AD will recall 1 or none.

Anterograde and retrograde amnesia become more severe and procedural, semantic, episodic, and prospective memory can all be affected. Patients may lose the ability to learn new tasks or remembering new information or experiences, as well as forget how to perform familiar tasks and have trouble recognising even close family members.

Genetic Causes

What causes AD and its characteristic plaques and tangles? According to scientific identification, several genes contribute to early-onset AD; an inherited form of the disease which develops before the age of 65 and as early as 30, but only accounts to about 5 to 10 percent of AD cases.

However, the precise cause of the more typical, late-onset AD remains elusive; but researchers have identified one genetic risk factor. This gene helps direct the production of proteins which carry cholesterol in the blood plasma, and high cholesterol and other risk factors for cardiovascular disease may likewise increase the risk of developing AD. A recent study found that even healthy elderly adults who carried this particular gene, as compared to peers that did not, performed more poorly on prospective memory tasks.

If you know anyone with AD, you are aware that it involves much more than memory loss. These patients experience language issues, disorganised thinking, and changes in mood as well as personality. Ultimately, they may lose the ability to speak and walk, and may also lose control over bladder and bowel functioning.