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Case in Point: The Biology of Substance Issues Meets "Us vs. Them Thinking" --- & A modern take on Loyalty & Fealty

1/22/2022

We're going to be looking at Substance Abuse and its relationship to Neuro-Endocrine and Neuro-Immune Pathways.

Also, the DISPARITIES with regard to DRUG ENFORCEMENT are fairly well established..

It's hard if not next to impossible to understand what is going on in this Country with regard not only to Criminal Justice BUT ALSO the Society At Large --- if you don't start addressing:

UNCONSCIOUS BIAS
US vs. THEM Thinking
and a Society of Lawyers, Advocates, and At Will Employees in which everyone has taken an OATH of LOYALTY & FEALTY --- and few are really free to speak their minds without fear of losing their jobs.
Further, educated professions such as LAW & Mental Health are making rudimentary logical mistakes --- but it is difficult to address if we're unwilling to address UNDERLYING ASSUMPTIONS that don't look so good anymore.

Tolstoy had an interesting REMEDY for US vs. Them Thinking and it was that God was on the SIDE of the UNDERDOG.

As soon as the UNDERDOG got the upper hand, it switched --- and God was on the SIDE of the NEW UNDERDOG.

I think one of the ways this is borne out in a way is that we are UNAWARE of our UNCONSCIOUS BIASES --- but those on the receiving end are AWARE --- and sooner or later that KNOWLEDGE is going to turn into POWER.

What Is the "Us Against Them" Mentality?

Effects of prenatal immune activation on amphetamine-induced addictive behaviors: Contributions from animal models (2021)

Abstract

Background: Prenatal environmental adversities may affect brain development and are associated with increased risk for schizophrenia, an illness with 50% comorbidity with addiction.

Maternal immune activation by poly-inosinic-citidilic acid (Poly(I:C)) exposure can promote behavioral alterations consistent with schizophrenia symptoms in rodents.

. . .

Conclusions: Prenatal administration of Poly(I:C) is able to potentiate vulnerability to addiction in two animal models, without however modulating stereotyped behavior.

Neuroendocrine and immune pathways from pre- and perinatal stress to substance abuse (2018)

Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities (2021)

Do we have the right profession to address the "Neuro-developmental continuum"---?

1/16/2022

Genetic research supports the hypothesis that ID (Intellectual Disability), ASD (Autism Spectrum Disorder), ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum

There's a lot of "INTEGRATIVE COMPLEXITY" in the statement above from Dialogues in Clinical Neuroscience, and I suspect we will be UN-PACKING IT for the next century if not far beyond.

Much of how we REASON is to take the CAUSAL LINK we've come upon in the MOMENT and try to make sense of it and create a STORY and a NARRATIVE until we can't anymore --- the ANOMALIES have built up to such a degree that we know this STORY --- can't be "RIGHT."

The STORY the MENTAL HEALTH PROFESSION is telling themselves and others regarding PSYCHIATRIC DISORDERS is "NOT RIGHT" in FUNDAMENTAL WAYS that are preventing us from MORE EFFECTIVELY addressing the MENTAL HEALTH CRISIS that we see in most DEVELOPED COUNTRIES and DEVELOPING COUNTRIES.

Is the STORY "WRONG" --- well, it is MISSING KEY ELEMENTS that would DRAMATICALLY CHANGE TREATMENT STRATEGIES in MANY CASES.

On the other hand --- DON'T THROW THE BABY OUT WITH THE BATH WATER --- it is not as if there is nothing of value in our current approaches to treating "PSYCHIATRIC DISORDERS."

Further, many of our current approaches have SAVED LIVES --- even as those approaches are NOT SUFFICIENT to address the CRISIS we're currently facing.

WORK has to be a TWO-WAY STREET and it may be most easily seen in the "EXTREME" of people with NEURO-DEVELOPMENTAL DIFFERENCES and SERVICE PROVIDERS.

You can't just RAM Neuro-Diverse people into any old WORK Environment and think it is going to "work out"
- they often have BIG STRENGTHS that aren't getting SUFFICIENTLY CHALLENGED, and
- EXECUTIVE FUNCTIONING Differences or Deficits that are not receiving SUFFICIENT SUPPORT.

"My New Job Isn't What I Signed Up For" --- Inc.com

It has been HARD to understand how the Profession could:

Blow off the significance of a scientifically invalid DSM, and
Compelling Research of the last 5 to 10 years regarding the relationship between Neuro-Developmental & Psychiatric DIsorders BUT
This isn't necessarily APPEALING to the people who are currently in the Profession.

You can't just add FUNDAMENTAL ELEMENTS to the JOB Description of treating PSYCHIATRIC DISORDERS --- and think everyone who is currently working under the title MENTAL HEALTH PROVIDER --- wants to do or is even well-suited to incorporate those FUNDAMENTAL NEW ELEMENTS.

Are neurodevelopmental disorders discrete conditions? (2018)

There is abundant evidence to indicate that neurodevelopmental disorders tend to co-occur, rather than existing as individual conditions.

Could this ‘comorbidity’ reflect an overall atypical course of neural development, which manifests in various ways?

The NEW PARADIGMS from the RESEARCH view:

Neuro-Developmental Disorders as BLURRED
Psychiatric Disorders as BLURRED, and
Psychiatric Disorders as DISORDERS of the NEURO-DEVELOPMENTAL CONTINUUM

That's a far cry from the DSM and goes a long way to explaining why we are having such a hard time addressing our MENTAL HEALTH CRISIS ---

We've got a bigger problem than we realize, and
Our Systems are not set up to deal with it.
Further, a lot of people who went into Mental Health wanted to do "Mental Health Therapy" --- NOT work with people with DEVELOPMENTAL DISORDERS --- but that is their primary population
- THIS IS A PROBLEM.
- There is a role for therapy, but much of what is needed is DIFFERENT than what is being offered.
- Now, a lot of Mental Health Professionals if they had the TRAINING would be interested in working with people with DEVELOPMENTAL DISORDERS involving EXECUTIVE FUNCTIONING.
- Further, it is not as if Mental Health Professionals don't have some general knowledge, but by and large they are NOT the EXPERTS we need them to be, even if there are EXPERTS within their ranks, not surprisingly in EDUCATIONAL PSYCHOLOGY --- which is focused on more DEVELOPMENTAL ISSUES.

One of the points we've tried to make on this website is that CRIMINAL JUSTICE REFORM often FAILS because what's needed is so UNDER-ESTIMATED.

At least in part, that can be traced to Medical and Educational Under-Estimations of what it actually takes to address DIFFERENCES or DEFICITS in EXECUTIVE FUNCTIONING.

To say this is DISASTROUS sounds like hyperbole --- UNTIL you realize:

Most people with psychiatric disorders started out as people with neuro-developmental disorders involving EXECUTIVE FUNCTIONING, and
Graduated to people with psychiatric disorders and HYPER-CONNECTED BRAINS at least in part I would submit trying to manage those EXECUTIVE FUNCTIONING DIFFERENCES in a largely clueless if not PUNISHING SOCIAL ENVIRONMENT.

Those super sensitive / reactive people are becoming more sensitive and more reactive in attempts to address EXECUTIVE FUNCTIONING and that is DYSREGULATING SYSTEMS of the BODY even more.
Finding BALANCE and SUSTAINABILITY is a much more CHALLENGING PROPOSITION than we've been willing to recognize as a society ---- the more ASYNCHRONOUS the PERSON --- the more of a challenge that can be.

We somehow have this IDEA that DEVELOPMENTAL DIFFERENCE doesn't have any consequences if one has an AVERAGE or ABOVE-AVERAGE IQ.

Of course, our MENTAL HEALTH CRISIS and who it is affecting is telling quite a different story.
Further, that population of NEURO-DIVERSE people is steadily increasing as inflammation in the society and MATERNAL IMMUNE ACTIVATION increase.

It is not fair to say that the SOCIETY is causing ALL the CHALLENGES --- but it is FAIR to say the SOCIETY is EXACERBATING the CHALLENGES by FAILING TO ADEQUATELY APPRECIATE THEM.

Image Credit: VIA Institute on Character

Those NEURO-DIVERSE STRENGTHS that are a NATURAL ATTEMPT to BALANCE what may be MULTIPLE DYREGULATIONS of BODILY SYSTEMS by conventional standards --- may prove INSUFFICIENT ---

but those NEURO-DIVERSE STRENGTHS are still an IMPORTANT COMPONENT to MENTAL & PHYSICAL WELL BEING.

Maternal Immune Activation, DYSREGULATION INCLUDING Metabolic Dysregulation & the Tree of Knowledge

1/14/2022

Psychiatric Disorders appear to be in some to many cases a progression of Neuro-Developmental Disorders.

Further, those Neuro-Developmental disorders often bring with them DYSREGULATIONS of MULTIPLE SYSTEMS of the BODY.

Such DYSREGULATIONS "appear" to be IDIOSYNCRATIC and can tend toward one extreme or another.

Metabolic Dysregulations from Maternal Immune Activation are associated with Neuro-Developmental and Psychiatric Disorders.

This is above and beyond Professor Graham Rook's concerns of the lack of diversity in the HUMAN MICROBIOME that is causing the IMMUNE SYSTEM to be TOO SENSITIVE which might be considered a SOFTWARE CONCERN.

The issues with MATERNAL IMMUNE ACTIVATION --- appear to go to HARDWARE and perhaps more difficult to address.

Do these METABOLIC ABNORMALITES / DYSREGULATIONS represent another type of EXECUTIVE or UNCONSCIOUS FUNCTIONING that now has to be managed more CONSCIOUSLY with ADDITIONAL CHALLENGES?

Interestingly, "BIPOLAR DISORDER":

Bipolar Disorder is being conceptualized by the University of Michigan as a DEVELOPMENTAL DISORDER that includes
Cells that are MORE REACTIIVE
Further, Bipolar Disorder appears to involve DSYREGULATIONS of MULTIPLE SYSTEMS OF THE BODY
And those INTER-CONNECTED DYSREGULATIONS have a LIFE OF THEIR OWN

Tree of Knowledge --- The Art of DionJa'Y

Metabolic Disorders May Contribute to Anorexia
(2019)

Researchers say these metabolic abnormalities may not be symptoms of the eating disorder. They may be part of the cause.

Metabolic abnormalities associated with obesity in children and adolescents in Jordan (2011)

"Obesity was significantly associated with increased odds of individual metabolic abnormalities and their clustering."

Metabolic and behavioral features of acute hyperpurinergia and the maternal immune activation mouse model of autism spectrum disorder (2021)

Tree of Knowledge by Lucas Cranach the Elder

BUT all of those DYSREGULATIONS MAY FORCE a certain partaking of the TREE of KNOWLEDGE --- because you can't rely to the same EXTENT on AUTOMATIC FUNCTIONING.

So you MAY have to develop other skills including LOGIC SKILLS and other ABILILITIES much more than someone else -----

and what you're finding is what a lot of theologians and philosophers and artists found before you ---- YOU DON'T HAVE AN UNLIMITED ABILITY TO DO THAT.
The HYPER-CONNECTED BRAINS and DYSREGULATED SYSTEMS associated with NEURO-DEVELOPMENTAL and PSYCHIATRIC DISODERS are a kind of FORENSIC EVIDENCE that are telling a COMPLICATED TALE --- full of INTEGRATIVE COMPLEXITY.
- Just the kind of Tale that someone who was into the HUMANITIES would understand.

Addressing the failure of SYSTEMS to care for those with the greatest needs

1/4/2022

This person who is "GRAVELY DISABLED" has REFUSED MEDICATION & TALK THERAPY

there are no MENTAL HEALTH BEDS

WHATEVER SHALL WE DO?How does the person feel about:

Hotel Vouchers
Assisted Living
Nursing Homes
- Often Disfavored as Institutions
- Often a Step-Down from the Mental Health Institutions
- Nursing Homes COULD BE a great place to do DISCHARGE Planning for 30 to 90 days--
- BUT it is a TRAP if there is NOWHERE TO GO.

Medication

Is the person open to genetic testing as a way to get quicker and better insight into some Medication selections?
Medication is a complicated issue in Mental Health as it is in Cancer and other major illnesses.
Further, many people with High IQ Neuro-Developmental Differences involving Executive Functioning and/or Psychiatric Disorders:
- Have IDIOSYNCRATIC SYSTEMS --- and if they are on the Street or the Jail, etc. --- they may be OUTLIERS in an OUTLIER POPULATION.

For most people with PSYCHIATRIC DISORDERS it has been an ALICE IN WONDERLAND experience of YEARS of TRIAL & ERROR --- that maybe turned up something that "worked and was better than nothing" and maybe didn't.

Our Society needs the ability to deal with that COMPLEXITY both CONCEPTUALLY & PRACTICALLY.

Marshall Fire --- Photo Credit: AXIOS

The Researchers have been RINGING THE ALARM BELLS for the need for BETTER TREATMENTS for AWHILE --- and it is in their INTERESTS to do so.

In this year's PBS Program on Mental Health funded by the AMERICAN PSYCHIATRIC ASSOCIATION FOUNDATION --- that need for BETTER TREATMENTS was acknowledged.
BUT how many people in the SOCIETY understand the need for BETTER TREATMENTS as opposed to just the need to FORCE SOMETHING DOWN some RECALITRANT PATIENT'S THROAT?

MORE CONJECTURE --- EPIGENETICS

It seems that we should be talking about Neuro-Developmental Disorders such as ADHD and AUTISM with PSYCHIATRIC DISORDERS --- and a lot of the research does that.
What Neuro-Developmental and Psychiatric Disorders often have in common is EXECUTIVE FUNCTONING CHALLENGES.

MORE CONJECTURE: The Epigenetics of the IMMUNE SYSTEM are SENSITIVE because they need to be for our SURVIVAL.

BUT many factors are pushing our IMMUNE SYSTEMS TO THE LIMIT and we need better and more complete understandings of what's going on.
We've tended to fill in the gaps with PRO SOCIAL COMPETENCY RELIGION for people "we judge harshly"
- That "we judge harshly" comes from Stanford Neuro-Biologist Robert Sapolsky and his ADMONITION to be very careful in judging a behavior --- "ESPECIALLY IF IT IS A BEHAVIOR YOU JUDGE HARSHLY."

Doing Therapies

Music Therapy & Something like Britain's Key Changes which provides opportunities for patients to perform and record musical tracks.
Art Therapy
Animal Therapy (Dog, Equine)

Supported Employment

One of the insights of the Dartmouth Supported Employment Model was that if done in an INDIVIDUALIZED manner --- it could often improve Mental Health.
BUT Employment is tricky for people with Psychiatric Disorders or High IQ Neuro-Developmental Difference involving Executive Functioning
- People need to be challenged in their STRENGTHS (which can be HIGHER than EXPECTED), and
- SUPPORTED in areas of Executive Functioning such as Planning, Organization, Emotional Regulation and Short-Term Memory.

The truth is most people want HELP --- BUT the options are meager, especially when what we're doing is in some cases not working and hospital beds haven't gotten any cheaper.

SAMHSA.GOV

The National Registry of Evidence-Based Programs and Practices (NREPP) has been indefinitely suspended by federal health officials.

Since 1997, NREPP has listed effective, science-based interventions for behavioral health issues, including the prevention and treatment of mental illness and substance use disorders (SUD).

Programs included in NREPP were independently audited and regularly updated.

The registry included proven interventions as well as programs to avoid because they had not been shown to work sufficiently.

The White House froze the public database in September 2017 and months later pulled federal funding for NREPP, which was a project of The Substance Abuse and Mental Health Services Administration (SAMHSA).

This defunding of NREPP is more COMPLICATED than it looks --- mainly because CMS, SAMHSA and the STATES have largely failed to address the needs of people with the most serious mental health needs.

So when the conservative organizations like the Mental Illness Policy Organization and the Treatment Advocacy Center saw things like NREPP --- it made their BLOOD BOIL -- these governmental subdivisions had so FAILED at what should be their primary mission --- serving those with the greatest needs.

So we absolutely have to hold CMS, SAMHSA and the STATES' FEET TO THE FIRE on providing for those with the GREATEST NEEDS -- which isn't being done --- and it is INFURIATING.

On the other hand, this is a CONTINUUM and we do need the National Registry of Evidenced-Based Practices and Programs.]

The CATCH-22 for HIGH IQ DEVELOPMENTAL DIFFERENCE --- nobody is expecting or prepared to deal with the need for EXECUTIVE FUNCTIONING SUPPORT.

CONJECTURE: The FAILURE to address EXECUTIVE FUNCTIONING with REASONABLE ACCOMMODATIONS and WORKAROUNDS -- and even just some KNOWLEDGE -- is resulting in an EPIGENETIC CASCADE.

So the person's IMMUNE SYSTEM and SENSORY PROCESSING is RAMPING UP to find PATTERNS to address this CHALLENGE
BUT there are LIMITS which our SOCIETY and our MENTAL HEALTH Profession largely think NEURO-PLASTICITY or COGNITIVE BEHAVIORAL THERAPY ARE going to solve.
What's Happening --- you have a person with a NEURO-DEVELOPMENTAL DISORDER that now has a PSYCHIATRIC DISORDER and an even more HYPER-CONNECTED BRAIN.
- and a Mental Health Profession that is by and large CLUELESS those people with DEVELOPMENTAL DISABILITIES that they didn't want to treat are their PRIMARY POPULATION --- but with HIGHER IQs.

MANY JOB DESCRIPTIONS today read like "NO BLACKS, ASIANS, HISPANICS, LGBTQ NEED APPLY" for people who may have those EXECUTIVE FUNCTIONING CHALLENGES.

Because the knowledge doesn't appear to be there to deal with that on the part of anybody --- certainly the ADULT MENTAL HEALTH SYSTEM.
There are a HANDFUL of EDUCATIONAL PSYCHOLOGISTS and OCCUPATIONAL THERAPISTS who could add a lot to the discussion --- BUT we normally don't think of them for ADULTS.

If we can't discriminate against people because of their skin color or their sexual orientation or preference --

that ODDBALL in the corner who seems so EMOTIONAL or SPEAKING OUT of TURN, has BORING "SPECIAL INTERESTS," or is DISORGANIZED --- surely we can DISCRIMINATE AGAINST them --- that's OBJECTIVE CRITERIA, isn't it?

Translational Medicine Friday

Case in Point: The Biology of Substance Issues Meets "Us vs. Them Thinking" --- & A modern take on Loyalty & Fealty

Do we have the right profession to address the "Neuro-developmental continuum"---?

Maternal Immune Activation, DYSREGULATION INCLUDING Metabolic Dysregulation & the Tree of Knowledge

Addressing the failure of SYSTEMS to care for those with the greatest needs

Translational Medicine Friday

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