Teaching with symbols tangentially related to topic: using a linked multimedia approach to enhance learning.

40 undergraduate students, none of whom were history or literature majors, attended a lecture on Medieval literature. For half the students the lecture was supplemented by two sets of slides. One set summarized course content while the second set contained slides of paintings or other forms of visual art which were only tangentially related to the topic. For the other half of the student-group, the lecture was supplemented by course content slides only. Students viewing symbolic slides had significantly higher test scores on a written 20-question multiple-choice test given immediately after the lecture.

Measurement of nonverbal receptive abilities in medical students.

Physicians have been reported to have difficulty in communicating with their patients. An element of this communication gap is proposed be related to the educational curriculum and the selection process of medical schools, in particular, with the emphasis on scientific methodology reducing exposure to humanistic values. This hypothesis was tested by measuring nonverbal receptive abilities in two groups. 30 medical students were compared with 30 college students who were not science majors but were age-, sex- and race-matched. The nonscience majors were better at perceiving nonverbal cues than medical students. Male nonscience majors had higher scores than male medical students while similar results were seen when female nonscience majors were compared with female medical students. Finally, medical students planning to practice as primary care specialists had higher scores than those interested in specialties which do not involve direct or prolonged patient care.

Use of tangential visual symbols to increase the long-term learning process: applications of linkage in teaching pharmacological principles of addiction.

Medieval and Renaissance teaching techniques using linkage between course content and tangentially related visual symbols were applied to the teaching of the pharmacological principles of addiction. Forty medical students randomly divided into two blinded groups viewed a lecture. One lecture was supplemented by symbolic slides, and the second was not. Students who viewed symbolic slides had significantly higher scores in a written 15-question multiple-choice test 30 days after the lecture. These results were consistent with learning and semiotic models. These models hypothesize a linkage between conceptual content and perception of visual symbols that thereby increases conceptual retention. Recent neurochemical research supports the existence of a linkage between two chemically distinct memory systems. Simultaneous stimulation of both chemical systems by teaching formats similar to those employed in the study can augment neurochemical signaling in the neocortex.

An approach to drug abuse, intoxication and withdrawal.

The symptomatic effects of drug abuse are a result of alterations in the functioning of the following neurotransmitters or their receptors: acetylcholine, dopamine, gamma-aminobutyric acid, norepinephrine, opioids and serotonin. Anticholinergic drugs antagonize acetylcholine receptors. Dissociative drugs affect all transmitter sites. Opiates act on both opioid and adrenergic receptor sites. Psychedelic drugs stimulate serotonin release, and sedative-hypnotic drugs potentiate the gamma-aminobutyric acid receptor. Specific signs and symptoms are associated with the neurotransmitters and receptors affected by each drug class. By recognizing symptomatic changes related to particular neurotransmitters and their receptors, family physicians can accurately determine the drug class and intervene appropriately to counteract drug-induced effects.

Magnesium oxide augmentation of verapamil maintenance therapy in mania.

The authors compared the antimanic effects of a verapamil-magnesium oxide (V-M) combination with a verapamil-placebo combination (V-P) in patients pretreated with verapamil. BPRS scores and serum magnesium levels were compared. The V-M combination was found to be significantly more effective than V-P in reducing manic symptoms (P=0.015). Serum magnesium levels were significantly higher in the V-M group (P<0.04). These data suggest that magnesium may increase antimanic efficacy of verapamil by mechanisms which may operate at the intracellular level. The magnesium-verapamil combination may have clinical application as an adjunct to verapamil in the maintenance therapy of mania.

Acute ketamine intoxication treated by haloperidol: a preliminary study.

In an open, double-blind study of phencyclidine intoxication, 21 white male subjects were later found to have instead ingested ketamine. These subjects were divided into two cohorts, one treated with 5 mg intramuscular haloperidol and the second with an active placebo. Assessment with the Brief Psychiatric Rating Scale revealed significant reduction in symptoms with haloperidol.

Perception of nonverbal facial cues in chronic phencyclidine abusers.

The ability to interpret nonverbal facial cues was tested in 10 young white male chronic phencyclidine (PCP) abusers. When their responses were compared with those of age-matched controls, abusers were significantly more accurate in interpreting the facial cues of videotaped medical interns. Phencyclidine abusers tend to form a socially maladroit and downwardly mobile group. However, previous studies of similar maladroit populations such as heroin addicts have indicated that they are less accurate in interpretation of nonverbal facial cues. The complex action of multiple affected neurotransmitters in PCP abusers was examined. Dopamine and serotonin were thought to be the relevant transmitters.

Sexualization of the female foot as a response to sexually transmitted epidemics: a preliminary study.

The authors reviewed historical literature and hypothesized a relationship between epidemics of sexually transmitted diseases and foot fetishism. They tested this hypothesis by quantifying foot-fetish depictions in the mass-circulation pornographic literature during a 30-yr. interval. An exponential increase was noted during the period of the current AIDS epidemic. The authors offer reasons for this possible relationship.

Comparison of alternative treatment techniques in bulimia: the chemical dependency approach.

Bulimia and chemical dependency are thought to be mediated by the nucleus accumbens, the primary pleasure center in the brain. These disorders consequently share biological, behavioral, and demographic characteristics. Also, earlier researchers have reported similar responses to different types of pharmacological intervention. There has, however, been little investigation of comparative nonpharmacological treatment modalities. The authors treated 10 white bulimic females in an eating-disorders program and a similar group in a 12-step chemical dependency center. Outcomes were similar for the weight-management program and for scores on the Brief Psychiatric Rating Scale. Implications are discussed.

Visual symbolization as a learning tool: teaching pharmacology to international audiences.

Medieval and Renaissance teaching techniques used linkage between course content and tangentially related visual symbols to reinforce lectures. This technique was adopted in teaching pharmacologic principles of addiction to international audiences. It produced significant results with non-English-speaking audiences using concurrent or consecutive translation. This technique may be useful for non-English-speaking audiences because of enhancement of all three areas of memory: attention, storage, and retrieval.

Alexithymia, affective disorders and substance abuse: possible cross-relationships.

Alexithymia is a syndrome manifesting affective, cognitive, and perceptual social defects, which include diminished affective-interpretive abilities. These abilities have been observed to be decreased in opiate abuse, major depression, and premenstrual depressive disorder, but increased in cocaine abuse and manic states. Conditions associated with decreased affective-interpretive abilities are also associated with decreased central catecholamine levels. Conversely, conditions associated with increased interpretive abilities have increased central catecholamine levels. Central catecholamine may be hypothesized as an etiological factor in the development of alexithymia.

Suggestions for studies of substance abusers' responses to nonverbal facial cues.

A study of drug abusers relating scores on measures of alexithymia and personality with affect recognition is reviewed. While the design is novel and provides useful data, multiple types of substance abusers were aggregated into one group. An averaging effect may have thus occurred rendering the results difficult to interpret. Duration of abstinence may have also provided a variable due to catecholamine rebound, which affects nonverbal encoding abilities.

Depressed men's lower ability to interpret nonverbal cues: a preliminary study.

The ability to interpret nonverbal facial cues was tested with 20 depressed males prior to treatment. Each subject and matched control was asked to interpret videotaped facial cues of individuals engaged in a gambling task. Interpretive ability was significantly lower for the nontreated depressed white men than for their matched controls.

The admissibility of scientific evidence in psychiatric malpractice: junk science and the Daubert case.

The defence in malpractice cases has traditionally relied upon a commonly accepted body of knowledge. According to the American 'Frye rule', this knowledge could either have been accepted generally or by a 'respectable minority' of physicians. The US Supreme Court, however, has recently ruled in the Daubert case that conclusions not subject to peer review are acceptable in malpractice cases. The authors analyse the implications of the Daubert decision using the case-study method. Two alternative-scenarios of a hypothetical case are analysed. The potential effect of Daubert places the US psychiatrist-defendant in an untenable position. Either use or non-use of non-peer-reviewed studies in clinical practice could produce a finding of negligence. Furthermore, the responsibility to assess scientific acceptability in US courts has shifted from expert witnesses to judges who are usually without scientific training.

Symptoms of premenstrual syndrome as a function of beta-endorphin: two subtypes.

1. Forty six women presenting with symptoms of premenstrual syndrome (PMS) were studied. Ages ranged from 21 to 32. All women answered a questionnaire based on DSM-III-R criteria. They then had serum beta-endorphin levels drawn on day 1 and day 20 of their menstrual Cycle. 2. Beta-endorphin levels were compared with symptom presentation. Such symptoms as anxiety, food cravings and physical discomfort were associated with significant decline in beta-endorphin. Other symptoms were found equally distributed in both groups. The existence or absence of beta-endorphin decline in specific PMS subgroup was postulated.

Tangential symbols: using visual symbolization to teach pharmacological principles of drug addiction to international audiences.

Visual art was used to teach the biopsychiatric model of addiction to audiences in the Caribbean, Europe and Mideast. Art slides were tangentially linked to slides of pharmacological data. Stylistically dense art was processed by the intuitive right brain while spare notational pharmacological data was processed by the intellectual (rationalistic) left brain. Simultaneous presentation of these data enhanced attention and retention. This teaching paradigm was based on the nonliterate methods developed by Medieval architects and refined by Italian Renaissance philosopher, Marsilio Ficino.

Behavioral response to buspirone in cocaine and phencyclidine withdrawal.

The effects of buspirone in treating cocaine and phencyclidine (PCP) withdrawal were studied. Withdrawal symptoms of these two street-drugs are thought to be due to norepinephrine, dopamine and possibly serotonin depletion. Buspirone acts by enhancing dopaminergic and noradrenergic firing as well by suppressing serotonergic activity. Thirty-two cocaine abusers and 24 PCP abusers were withdrawn over a 30-day period. Half of each group received buspirone 10 mg t.i.d. and the other half 10 mg placebo t.i.d. In the cocaine group, buspirone was significantly more effective from the fifth day onward. In the PCP group, significant improvement was seen on the thirtieth day. Delayed effectiveness in PCP is thought due to its actions at other neurotransmitter sites.