49 research outputs found

    Evolution of the human fear-circuitry and acute sociogenic pseudoneurological symptoms: The Neolithic balanced-polymorphism hypothesis

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    In light of the increasing threat of large-scale massacres such as terrorism against non-combatants (civilians), more attention is warranted not only to posttraumatic stress disorder (PTSD) but also to acute sociogenic pseudoneurological ("conversion") symptoms, especially epidemic sociogenic symptoms. We posit that conversion disorders are etiologically related to specific evolutionary pressures (inescapable threats to life) in the late stage of the human environment of evolutionary adaptedness (EEA). Bracha et al. have recently argued that from the neuroevolutionary perspective, medically unexplained efferent vasovagal syncope and medically unexplained craniofacial musculoskeletal pain in young otherwise healthy individuals, may be taxonomized as stress and fear-circuitry disorders. In the present article, we extend neuroevolutionary perspectives to acute pseudoneurological sociogenic ("conversive") symptoms: psychogenic non-epileptic attacks ("pseudoseizures"), epidemic sociogenic disorders (DSM-IV-TR Epidemic "Hysteria"), conversive motor deficits (pseudo-paralysis and pseudo-cerebellar symptoms), and psychogenic blindness. We hypothesize that these perplexing pseudoneurological stress-triggered symptoms, which constitute psychopathology in extant humans, are traceable to allele-variant polymorphisms which spread during the Neolithic EEA. During Neolithic warfare, conversive symptoms may have increased the survival odds for some non-combatants by visually (i.e., "non-verbally") signaling to predatory conspecifics that one does not present a danger. This is consistent with the age and sex pattern of conversive disorders. Testable and falsifiable predictions are presented; e.g., at the genome-transcriptome interface, one of the major oligogenic loci involved in conversive spectrum disorders may carry a developmentally sensitive allele in a stable polymorphism (balanced polymorphism) in which the gene expression mechanism is gradually suppressed by pleiotropic androgens especially dehydroxyepiandrosterone sulfate (DHEA-S). Taxonomic implications for the much-needed rapprochement between the forthcoming Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-V) and the International Classification of Diseases (ICD) are discussed

    The ‘Ajuda Paralyses': history of a neuropsychiatric debate in mid-19th-century Portugal

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    The second half of the 19th century witnessed an increasing interest in neurology and psychiatry by Portuguese physicians, in parallel with the overall development of these disciplines in other countries. This process is reflected in the numerous case report publications as well as in debates taking place at the Lisbon Society of Medical Sciences, the major scientific forum of that time. The ‘Ajuda Paralyses' were a mysterious succession of epidemics that occurred during 1860-64 in the Ajuda asylum for cholera and yellow fever orphans, which were extensively discussed during 1865-66 by Bernardino Antonio Gomes, Antonio Maria Barbosa, Abel Jordão and Eduardo Motta. Studying this debate helps understand the initial stages of development and the great interest that ‘nervous diseases' had for Portuguese clinicians in the mid-19th century and possibly provides one of the first modern descriptions of nutrition-related polyradiculoneuropathy and the ocular findings associated with avitaminosis A. This debate took place at a decisive time for the scientific development of neurology and psychiatry, concurrent with the widespread application of the clinical-anatomical method and neuropathology to the study of diseases of the nervous system, which would set the foundations for our own modern pathophysiological framework. Therefore, the ‘Ajuda paralyses' debate also provides a good basis for a discussion on the evolution of the concepts of hysteria and psychosomatic disease and the description of peripheral neuropathy from among a wealth of other entities that did not withstand the test of scienc

    HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia.

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    We report the case of multiple adverse reactions following HPV vaccination in Colombian adolescents in Carmen de Bolivar. In August 2012, the country introduced a school-based HPV immunization programme which successfully reached over 90% of the target population in the first year. In 2014, between May 29th and June 2nd,15 adolescent girls in one school presented adverse reactions after vaccination and were admitted to the local hospital. Soon, videos of girls fainting, twitching, and arriving unconscious at emergency rooms started to appear in national news media as well as on social media platforms such as YouTube. The viral spread of these videos and disturbing images were followed by the viral spread of symptoms, with over 600 cases reported across Colombia. Thorough epidemiological investigation by Colombian health authorities found no organic association between the teenagers' symptoms and the HPV vaccine, concluding this was a case of mass psychogenic reaction to vaccination. Scientific evidence did not appease the anxious public whose confidence in HPV immunization dropped dramatically. By 2016, HPV vaccine uptake among eligible girls declined to 14% for the first dose and 5% for the complete course, down from 98% and 88%, respectively, in 2012. We document this case and discuss the role of news and social media, particularly YouTube, as a driver of contagious psychogenic reactions. We also discuss the role of health authorities and government, and the importance of acting rapidly and appropriately to contain the spread of such symptoms and maintain public confidence in vaccines

    The Pros and Cons of Fearing Fear: Examples from Venezuela and New York State

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    This article describes consequences of fear for security-related public policy

    Faktor gangguan emosi dalam fenomena histeria massa remaja Muslim

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    Gejala histeria beramai-ramai atau histeria massa adalah satu permasalahan sosial yang telah lama wujud di Malaysia. Histeria massa kebanyakannya terjadi di komuniti sekolah, asrama dan kilang. Di Malaysia, gejala ini lebih kerap ditemui dalam kalangan remaja Muslim di sekolah. Impak histeria massa mengakibatkan pelbagai kesan negatif terutama pada emosi dan keharmonian sosial. Epidemik yang berlaku menyebabkan suasana panik dan tegang serta merencatkan perjalanan aktiviti persekolahan. Oleh itu kajian ini bertujuan mengenal pasti faktor gangguan emosi dalam gejala histeria massa remaja Muslim di sekolah. Kajian menggunakan kaedah kajian tinjauan (survey) dengan penggunaan soal selidik sebagai sebagai alat kajian. Sampel kajian terdiri daripada 105 orang pelajar yang pernah mengalami histeria daripada beberapa buah sekolah sekitar negeri Selangor. Hasil kajian menunjukkan kejadian histeria massa adalah berpunca dari tekanan dan gangguan emosi yang berada pada tahap sederhana tinggi iaitu apabila ledakan tingkah laku histerikal muncul. Simptom histeria yang ditunjukkan menggambarkan unsur kecelaruan dan gangguan pada fungsi afektif. Di samping itu, kajian juga telah mengenalpasti beberapa jenis gangguan emosi yang boleh menjadi pencetus epidemik histeria dalam kalangan remaja muslim iaitu rasa bersalah atas kesilapan lalu, memendam rasa, membayangkan sesuatu yang menakutkan, kesedihan, kebimbangan, tekanan, panik dan takut. Implikasi daripada kajian ini dapat membantu pihak sekolah dalam menangani histeria massa dari terus berlaku dengan mengenal pasti faktor gangguan emosi tersebut

    The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees

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    Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government’s treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticizing the Australian Government’s policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees. The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession. The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity

    PLoS One

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    BackgroundIn 2010, an acute illness outbreak was reported in school students eating high-energy biscuits supplied by the school feeding programme in northwest Bangladesh. We investigated this outbreak to describe the illness in terms of person, place and time, develop the timeline of events, and determine the cause and community perceptions regarding the outbreak.MethodsWe defined case-patients as students from affected schools reporting any two symptoms including abdominal pain, heartburn, bitter taste, and headache after eating biscuits on the day of illness. We conducted in-depth interviews and group discussions with students, teachers, parents and community members to explore symptoms, exposures, and community perceptions. We conducted a questionnaire survey among case-patients to determine the symptoms and ascertain food items eaten 12 hours before illness onset, and microbiological and environmental investigations.ResultsAmong 142 students seeking hospital care, 44 students from four schools qualified as case-patients. Of these, we surveyed 30 who had a mean age of 9 years; 70% (21/30) were females. Predominant symptoms included abdominal pain (93%), heartburn (90%), and bitter taste (57%). All students recovered within a few hours. No pathogenic Vibrio cholerae, Shigella or Salmonellaspp. were isolated from collected stool samples. We found no rancid biscuits in schools and storage sites. The female index case perceived the unusually darker packet label as a \u201cdevil\u2019s deed\u201d that made the biscuits poisonous. Many students, parents and community members reported concerns about rumors of students dying from biscuit poisoning.ConclusionsRapid onset, followed by rapid recovery of symptoms; female preponderance; inconsistent physical, microbiological and environmental findings suggested mass sociogenic illness rather than a foodborne or toxic cause. Rumours of student deaths heightening community anxiety apparently propagated this outbreak. Sharing investigation results and reassuring students and parents through health communication campaigns could limit similar future outbreaks and help retain beneficiaries\u2019 trust on nutrition supplementation initiatives.2013690

    Medieval Thinking in the 21st Century: Crystal Balls, Black Swans, and Darwin\u27s Finches in the Time of Corona

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    Twenty years into the 21st Century, a sizable swath of the world populace thinks, makes decisions, and defines itself in a conflicted and contradictory chimera. Millions of individuals make use of cutting-edge technologies while simultaneously throwing salt over their shoulders and consulting with the local ‘healer’ about any number of illnesses--to caricaturize, a sort of medieval-thinker-tech-savvy orientation. It is here affirmed that the practical consequences of this agentic amalgamation, modes of thinking, and “being in the world” are counterproductive at best and self-defeating at worst, resulting in much uncertainty and leading to, for example, mixed messages in public health approaches and responses with respect to Covid-19. If this was a case of a simple anachronism, a back-to-the-land movement without technology, it would not be disturbing at all. This agentic amalgamation may be important in formulating what it means to be ‘human’ in rapidly changing contemporary societies long after the Coronavirus pandemic slows or stops

    Coupled Contagion Dynamics of Fear and Disease: Mathematical and Computational Explorations

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    Background: In classical mathematical epidemiology, individuals do not adapt their contact behavior during epidemics. They do not endogenously engage, for example, in social distancing based on fear. Yet, adaptive behavior is welldocumented in true epidemics. We explore the effect of including such behavior in models of epidemic dynamics. Methodology/Principal Findings: Using both nonlinear dynamical systems and agent-based computation, we model two interacting contagion processes: one of disease and one of fear of the disease. Individuals can ‘‘contract’ ’ fear through contact with individuals who are infected with the disease (the sick), infected with fear only (the scared), and infected with both fear and disease (the sick and scared). Scared individuals–whether sick or not–may remove themselves from circulation with some probability, which affects the contact dynamic, and thus the disease epidemic proper. If we allow individuals to recover from fear and return to circulation, the coupled dynamics become quite rich, and can include multiple waves of infection. We also study flight as a behavioral response. Conclusions/Significance: In a spatially extended setting, even relatively small levels of fear-inspired flight can have a dramatic impact on spatio-temporal epidemic dynamics. Self-isolation and spatial flight are only two of many possible actions that fear-infected individuals may take. Our main point is that behavioral adaptation of some sort must b
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