Quantum Units Continuing Education

Cutting

The notion that cutting or burning oneself could provide relief from emotional distress is difficult to understand for most people, but it is an experience reported commonly among people who compulsively hurt themselves.

Individuals with borderline personality disorder experience intense emotions and often show a deficiency of emotion regulation skills. This group of people also displays high prevalence rates of self-injurious behavior, which may help them to reduce negative emotional states.

Niedtfeld and colleagues studied the effects of emotional stimuli and a thermal stimulus in people either with or without borderline personality disorder. They conducted an imaging study using picture stimuli to induce negative, positive, or neutral affect and thermal stimuli to induce heat pain or warmth perception. The painful heat stimuli were administered at an individually-set temperature threshold for each subject.

In patients with borderline personality disorder, they found evidence of heightened activation of limbic circuitry in response to pictures evocative of positive and negative emotions, consistent with their reported emotion regulation problems. Amygdala activation also correlated with self-reported deficits in emotion regulation. However, the thermal stimuli inhibited the activation of the amygdala in these patients and also in healthy controls, presumably suppressing emotional reactivity.

Dr. John Krystal, Editor of Biological Psychiatry, commented, “These data are consistent with the hypothesis that physically painful stimuli provide some relief from emotional distress for some patients with borderline personality disorder because they paradoxically inhibit brain regions involved in emotion. This process may help them to compensate for deficient emotional regulation mechanisms.”

The authors note that these results are in line with previous findings on emotional hyperactivity in borderline personality disorder and suggest that these individuals process pain stimuli differently depending on their arousal status.

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Elsevier: http://www.elsevier.com/wps/find/authored_newsitem.cws_home/companynews05_01647

Cannabis

The medicinal use of cannabis has been debated by clinicians, researchers, legislators and the public at large for many years as an alternative to standard pharmaceutical treatments for pain, which may not always be effective and may have unwanted side effects. A new study by McGill University Health Centre (MUHC) and McGill University researchers provides evidence that cannabis may offer relief to patients suffering from chronic neuropathic pain. The results of the groundbreaking study are published in the latest issue of theCanadian Medical Association Journal.

“This is the first trial to be conducted where patients have been allowed to smoke cannabis at home and to monitor their responses, daily,” says Dr. Mark Ware, lead author of the study, who is also Director of Clinical Research at the Alan Edwards Pain Management Unit at the MUHC and an assistant professor of anesthesia in McGill University’s Faculty of Medicine, and neuroscience researcher at the Research Institute of the MUHC.

In this study, low doses (25mg) of inhaled cannabis containing approximately 10% THC (the active ingredient in cannabis), smoked as a single inhalation using a pipe three times daily over a period of five days, offered modest pain reduction in patients suffering from chronic neuropathic pain (pain associated with nerve injury) within the first few days. The results also suggest that cannabis improved moods and helped patients sleep better. The effects were less pronounced in cannabis strains containing less than 10% THC.

“The patients we followed suffered from pain caused by injuries to the nervous system from post-traumatic (e.g. traffic accidents) or post-surgical (e.g. cut nerves) events, and which was not controlled using standard therapies” explains Dr. Ware. “This kind of pain occurs more frequently than many people recognize, and there are few effective treatments available. For these patients, medical cannabis is sometimes seen as their last hope.”

“This study marks an important step forward because it demonstrates the analgesic effects of cannabis at a low dose over a shot period of time for patients suffering from chronic neuropathic pain,” adds Dr. Ware. The study used herbal cannabis from Prairie Plant Systems (under contract to Health Canada to provide cannabis for research and medical purposes), and a 0% THC ‘placebo’ cannabis from the USA.

However, larger-scale studies with a longer time frame and higher doses of THC are needed to further evaluate the efficacy and long-term safety of medical cannabis. “Our challenge as researchers is to continue to conduct rigorous clinical studies on the medical use of cannabis with strict attention to details such as quality and dosage,” says Dr. Ware. “This will allow us to move the debate forward by providing reliable scientific clinical data.”

Complicated Grief
Standard CEU Hours: 5 CEU Cost: $15.00
NBCC CEU Hours: 4 CEU Cost: $12.00

This course provides personal and professional information, testimonies and time-tested tools for healthy ways to cope and adjust to life after sudden and/or violent loss. It looks at the reality of sudden loss with perspective and insight, including the author’s (Dr. Gabriel Constans) personal experiences, as well as his clients and colleagues, who have been walking, crawling and sometimes running in the midst of sudden, unexpected, often horrific circumstances.

Grief and Depression
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This short course discusses the differences and interrelationships between Grief and Depression according to the DSM-IV. This is another course in a series on Grief and Loss by Dr. Gabriel Constans.

Men and Grief
Standard CEU Hours: 2 CEU Cost: $6.00
NBCC CEU Hours: 2 CEU Cost: $6.00

This course explores the different ways in which men react to and heal from grief and sadness. The course weaves in the complex web of biology and environment to illuminate how and why men may respond differently than women, as well as how their responses are similar. By exploring some of the different and similar emotional responses and their roots, the hope is to be better able to support one another through painful times.

Behind Bars II: Prison Population and Substance Abuse
Standard CEU Hours: 12 CEU Cost: $36.00
NBCC CEU Hours: 15 CEU Cost: $45.00

This report constitutes the most exhaustive analysis ever undertaken to identify the extent to which alcohol and other drugs are implicated in the crimes and incarceration of America’s prison population. Any individual interested in this issue or working with inmates who abused substances prior to incarceration will benefit from this course.

Good Grief: Love, Loss and Laughter
Standard CEU Hours: 16  CEU Cost: $64.00 Exam Only / $96.00 with Book
NBCC CEU Hours: 12  CEU Cost: $48.00  Exam Only / $72.00 with Book

This course was developed from the book, Good Grief: Love, Loss and Laughter by Gabriel Constans, PhD, which was written for professionals and everyday people who face death and grief. The writing is complete with real situations and honest stories to help bring love and hope to this difficult situation. Those in the mental health, medical, or social work field as well as parents, teachers, students, friends, or anyone else dealing with death and grief could benefit from the practical and compassionate information presented.

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Underage Drinking

Italian youths whose parents allowed them to have alcohol with meals while they were growing up are less likely to develop harmful drinking patterns in the future, according to a new study led by a Boston University School of Public Health (BUSPH) researcher.

In a paper published in the journal Addiction, Research and Theory,a research team led by Lee Strunin, PhD, a professor of community health sciences at BUSPH, detailed their study of the drinking patterns and histories of 160 Italian adolescents and young adults who identified themselves as regular or heavy drinkers. The authors concluded that the introduction of a moderate amount of alcohol in a family setting could prevent young people from binge drinking and nurture healthier drinking behaviors.

“Young people allowed alcohol with meals when growing up were more likely to never drink 5 [or more drinks] or get drunk,” the authors wrote. If they did drink more heavily, it was typically at a “later age than participants who weren’t allowed alcohol in a family setting.”

The researchers interviewed two groups of young people in the Italian regions of Abruzzo and Umbria. One consisted of 80 young adults aged 25-30; the second consisted of 80 adolescents, 16 to18 years old. “We were fortunate to be able to have such a large study sample to interview to help us understand this phenomenon,” said Strunin.

Although the results focused on Italy, Strunin said they could be applied to different countries and could “assist in the design of policies to reduce alcohol problems and harmful behavior among young people.”

Other reports have also suggested that alcohol introduced in a family setting may reduce alcohol-related risk behavior among young people, according to Strunin. Part of the reason, she said, could be that when alcohol is allowed, it is in a context in which there is openness about drinking, and moderate drinking with meals is considered normal.

“Youths in these cultures learn to drink more responsibly than their U.S. counterparts because drinking is culturally normative, exposure occurs at a younger age, and alcohol is part of the fabric of family mores,” said the report.

It is important to note, the authors wrote, that the study focused on youths and young adults who drank wine during a meal with their family. “In talking about drinking in the family, we are talking about meal drinking, not sitting down with your child watching the football or baseball game with a six-pack,” Strunin said. “The wine drinking is part of the meal.

In addition to Strunin, co-authors of the study are: Kirstin Lindeman of BUSPH; Enrico Tempesta and Simona Anav of Osservatorio Permanente sui Giovani e l’Alcool, Rome, Italy; and Pierluigi Ascani and Luza Parisi of Format Research, Rome, Italy.

Funding for this study came from a grant from the National Institute of Alcohol Abuse and Alcoholism.

Story originally published at: http://www.sciencedaily.com/releases/2010/08/100819112224.htm

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