Nassir Ghaemi, MD, Psychiatry/Mental Health, 03:17PM Feb 6, 2010
Everyone is writing about Tiger Woods, and I am not at all inclined to join in - but I suppose I will. The casual use of the concept of "sexual addiction" in relation to his recent diagnosis and treatment may warrant some internal dialogue among psychiatrists. I write these notes not to persuade but to raise questions and see if other colleagues are not wondering similarly.
What is sex addiction all about? I understand hypersexuality, and I understand addiction, but I am not sure I understand sex addiction.
As a psychiatrist, I would first want to apply here the concept of a hierarchy of diagnoses. So a high amount of sexual activity could certainly occur with many conditions, and the concept of a sex addiction, if valid, would have to be the last thing one would diagnose - a diagnosis of exclusion since it could happen with so many other things. First on everyone's list of causes of high sexual activity, I would think, should be mania, or bipolar disorder. Next, or right with it, would be obsessive compulsive disorder (OCD), with sexual content; this is quite common. Then perhaps PTSD with sexual trauma (with later hypersexuality in some people), substance abuse (e.g., amphetamine, steroid, or testosterone abuse), and frontal lobe syndrome. Some depressed individuals also appear to engage in sexual activity, not because of aroused libido, but out of a wish to come out of their isolation and engage with others, even if only physically.
Sexual addiction, as a concept, though, would seem to represent nothing but sex: no mania, nor PTSD, nor substance use, nor other causes. Addiction, as a concept, implies an intense feeling of acute pleasure, followed by a wish to repeat, and, often, tolerance and withdrawal. In this context, tolerance would mean that the more one experienced sex, the less pleasurable it would be; and withdrawal would mean that when abstinence occurred, one experienced painful psychological or physical symptoms (perhaps depression and anxiety). Addiction also implies something that perhaps begins as an experiment, later becomes a habit, and then becomes autonomous. Neurobiologically, addictions tend to involve, we think, activation of the dopaminergic pleasure centers of the brain. Can lots of sex take on this pattern?
It seems difficult to me to distinguish OCD from so-called sexual addiction; perhaps the main difference would be that the individual is bothered by his behavior in one case (OCD) and not the other (addiction); yet this single minor subjective difference would seem to be a small feature upon which to base an entire diagnostic entity. Indeed, there appear to exist many cases of OCD without insight, that is, OCD in which the patient is not much bothered by his or her symptoms. OCD is not, traditional teaching notwithstanding, uniformly characterized by presence of insight (better phrasing than the old ego-dystonic term, in my view).
One reputable website defines sexual addiction as "a progressive intimacy disorder characterized by compulsive sexual thoughts and acts." DSM's definition, under paraphilias, as sexual disorders NOS includes the following ideas: "compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship." This kind of definition seems quite hard to distinguish from OCD with sexual content.
The difference in terminology is important; the idea of sexual addiction would seem to imply analogies to substance abuse: 12 step programs, a limited role for medications, Malibu resorts. The OCD concept would put medications central to the treatment, and make the problem more biological in origin and pathogenesis, rather than simply habit gone awry.
Where we are uncertain, I would prefer the term sexual paraphilia, so as to remain neutral as to the addiction versus OCD dichotomy. Dr. Martin Kafka, a specialist in paraphilias, with whom I have shared patients and whose expertise is large, recently suggested a new DSM category of "Hypersexual disorder", which presumes carefully first ruling out other conditions like OCD and bipolar disorder hierarchically. Though I know he practices this way, I fear that the public at large, and the average clinician, will be too democratic, and too little hierarchical, and forget that such a diagnosis, though perhaps not useless, is one of exclusion, and last resort.
If individuals like Tiger Woods have a variety of OCD, it could be that enough serotonergic antidepressant would knock out their libido or their OCD, or both, to keep them from ruining their lives. But 12 step programs might be tenuously utile.
I don't know the right answer, but it seems to me that this is yet another part of psychiatry where the lapidary use of popular phrases hardly clarifies.
Tuesday, February 23, 2010
Monday, February 22, 2010
Definition of Hypertension in Youth
Assessment and Management of Hypertension in Children and Adolescents
The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents[12] provides systolic and diastolic blood pressure levels corresponding to the 50th, 90th, 95th, and 99th percentiles based on the child's sex, age, and height percentile.
The height percentile is plotted from normal growth charts. The blood pressure tables and instructions for using them are available in the report[12] and online.[14]
Blood pressure status can be classified on the basis of systolic and diastolic blood pressure percentiles ( Table 1 ).
Measurements below the 90th percentile are considered normal.
Prehypertension or hypertension are present when measurements of either systolic or diastolic pressure, or both, are at or above the 90th percentile.
Blood pressure should be measured at least twice during the same assessment, and confirmed over at least three separate occasions.
Prehypertension is present when the measurement is at or above the 90th percentile, but less than the 95th percentile, as well as when blood pressure reaches or exceeds 120/80 mmHg in an adolescent.
Hypertension is present when repeated measurements are at or above the 95th percentile.
Hypertension is further classified as either stage 1, in which blood pressure ranges from the 95th to the 99th percentile plus 5 mmHg, or stage 2, where blood pressure is above the 99th percentile plus 5 mmHg.
'White coat' hypertension occurs when the patient's blood pressure remains above the 95th percentile when measured in a clinical setting, but is normal when measured in a familiar setting.
If hypertension is confirmed, blood pressure should be measured in both arms and a leg.
The classification of blood pressure influences decisions on evaluation and management.
Table 1. Classification of Hypertension in Youth*
Category Systolic or diastolic blood pressure percentile
Normal < 90th
Prehypertension 90-95th, or if blood pressure exceeds 120/80 mmHg even if < 90th up to < 95th
Stage 1 hypertension 95-99th plus 5 mmHg
Stage 2 hypertension >99th plus 5 mmHg
*Percentiles are based on normative values related to sex, age, and height percentile. If systolic and diastolic categories are different, classify by the higher category.
The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents[12] provides systolic and diastolic blood pressure levels corresponding to the 50th, 90th, 95th, and 99th percentiles based on the child's sex, age, and height percentile.
The height percentile is plotted from normal growth charts. The blood pressure tables and instructions for using them are available in the report[12] and online.[14]
Blood pressure status can be classified on the basis of systolic and diastolic blood pressure percentiles ( Table 1 ).
Measurements below the 90th percentile are considered normal.
Prehypertension or hypertension are present when measurements of either systolic or diastolic pressure, or both, are at or above the 90th percentile.
Blood pressure should be measured at least twice during the same assessment, and confirmed over at least three separate occasions.
Prehypertension is present when the measurement is at or above the 90th percentile, but less than the 95th percentile, as well as when blood pressure reaches or exceeds 120/80 mmHg in an adolescent.
Hypertension is present when repeated measurements are at or above the 95th percentile.
Hypertension is further classified as either stage 1, in which blood pressure ranges from the 95th to the 99th percentile plus 5 mmHg, or stage 2, where blood pressure is above the 99th percentile plus 5 mmHg.
'White coat' hypertension occurs when the patient's blood pressure remains above the 95th percentile when measured in a clinical setting, but is normal when measured in a familiar setting.
If hypertension is confirmed, blood pressure should be measured in both arms and a leg.
The classification of blood pressure influences decisions on evaluation and management.
Table 1. Classification of Hypertension in Youth*
Category Systolic or diastolic blood pressure percentile
Normal < 90th
Prehypertension 90-95th, or if blood pressure exceeds 120/80 mmHg even if < 90th up to < 95th
Stage 1 hypertension 95-99th plus 5 mmHg
Stage 2 hypertension >99th plus 5 mmHg
*Percentiles are based on normative values related to sex, age, and height percentile. If systolic and diastolic categories are different, classify by the higher category.
Friday, February 19, 2010
10 Brain Tips To Teach and Learn
Jul 3, 2008
By: Laurie Bartels
If you agree that our brains are designed for learning, then as educators it is incumbent upon us to be looking for ways to maximize the learning process for each of our students, as well as for ourselves. Some of what follows is simply common sense, but I’ve learned that all of it has a scientific basis in our brains.
1. Review and 2. Reflection are two means for thinking about what is being learned. Review can be done in the moments after a question is posed, a comment is made, a passage is read, an activity is done, or directions are given, providing ample time to think about what has taken place, process the information and respond accordingly.
Review is also what should be done periodically over the course of the year, so that students have the opportunity to revisit, relearn, clarify and consolidate their learning to memory.
Marilee Sprenger, based upon research by Jeb Schenck, notes that “spacing reviews throughout the learning and increasing the time between them gradually allows long-term networks to be strengthened… the timing between repeated reviews can significantly affect how much information is retained.”
Reflection encompasses not only a response to actual material but also thinking about how one learns.
It is 3. Metacognition, and with each iteration you learn more about yourself as a learner. We empower our students and ourselves when we take the time for reflection, because the more we understand about how we each learn, the better we can become at learning. According to Sprenger, “Metacognition involves two phases. The first is knowledge about cognition or thinking about our thinking. The second is monitoring and regulating cognitive processes.”
For me, blogging has been a continual process of review and reflection. In the course of over 170 posts to date, I continually revisit topics, make connections, and write about my own course of learning. As teachers, ideally we should be reviewing and reflecting on lessons, course materials, and interactions with students, both as a means of improving them as well as learning from what worked or did not work.
4. Sleep is another way to consolidate learning, which is one reason getting a full night of uninterrupted sleep is important. Of course, doing so also helps us the next day to have more energy and patience, which then helps us with our attention control. In fact, couple sufficient sleep with waking up to a healthy breakfast, and you are prepared to tackle the day.
Proper 5. Nutrition keeps our systems functioning closer to their peak by stabilizing various levels of hormones and chemicals. All of this holds equally true for students as well as teachers!
We all have our own life stories, and being exposed to something new tends to stick better if we have something else to associate it with or if it is sufficiently unusual that it stands out on its own. Taking advantage of student
6. Prior Knowledge probably requires minimal effort on the part of the teacher, but yields big returns by engaging student interest as students consider new information as it pertains to them and their experiences.
This, in turn, can 7. Engage Emotions, which is the largest hook into learning. We all tend to remember things that get our blood boiling for better or for worse. The parts of the brain engaged in emotions include the small yet mighty amygdala, the hippocampus and the hypothalamus.
“The amygdala deals with our emotions, helps process our memories, and gets totally absorbed in managing our response to fear and stress. Combined, these are biggies, so the hippocampus and hypothalamus chime in with some assistance. The hippocampus handles factual information, while the hypothalamus monitors how your body is doing internally and directs the pituitary gland to release hormones on the basis of functions such as body temperature, appetite, and sexual functioning.”
8. Novelty is another big hook. As information presentation blends between teachers or stays the same by one teacher, it becomes difficult to see patterns and students may tune out the “sameness”. But change it up a bit, introduce something radically different or in a radically different manner, and all of a sudden it is like a quick-pick-me-up in the middle of a lesson, a “brain snack”. Students refocus their attention, and it can even enliven your presentation and wake you up! One way to incorporate novelty is to add some
9. Movement to reenergize the body and brain cells. Movement can shake the sillies out or wake up sluggish bodies and brains; it can be an antidote to the time of day or the climate. Movement is also a close relative of
10. Exercise, and it has been shown that exercise is especially helpful in keeping our adult brains healthy, so remember to participate in that movement with your students (and they will probably consider your participation a bit novel!).
Novelty and movement can also effectively be used to assist kids with sharpening control of their executive function, which is managed by the frontal lobes in the neocortex. Executive function is how we control our attention, create plans, and carry out those plans.
Too often in school, kids are required to “sit still” and “quiet down”, yet these are the very basics of being a kid! Consider harnessing that natural kid energy to help students manage their own functioning. Indeed, in a recent Newsweek article, Wray Herbert notes that an executive function curriculum has emerged to help students manage “effortful control and cognitive focus but also working memory and mental flexibility–the ability to adjust to change, to think outside the box
Laurie Bartels writes the Neurons Firing blog to create for herself the “the graduate course I’d love to take if it existed as a program”. She is the K-8 Computer Coordinator and Technology Training Coordinator at Rye Country Day School in Rye, New York. She is also the organizer of Digital Wave annual summer professional development, and a frequent attendee of Learning & The Brain conferences.
By: Laurie Bartels
If you agree that our brains are designed for learning, then as educators it is incumbent upon us to be looking for ways to maximize the learning process for each of our students, as well as for ourselves. Some of what follows is simply common sense, but I’ve learned that all of it has a scientific basis in our brains.
1. Review and 2. Reflection are two means for thinking about what is being learned. Review can be done in the moments after a question is posed, a comment is made, a passage is read, an activity is done, or directions are given, providing ample time to think about what has taken place, process the information and respond accordingly.
Review is also what should be done periodically over the course of the year, so that students have the opportunity to revisit, relearn, clarify and consolidate their learning to memory.
Marilee Sprenger, based upon research by Jeb Schenck, notes that “spacing reviews throughout the learning and increasing the time between them gradually allows long-term networks to be strengthened… the timing between repeated reviews can significantly affect how much information is retained.”
Reflection encompasses not only a response to actual material but also thinking about how one learns.
It is 3. Metacognition, and with each iteration you learn more about yourself as a learner. We empower our students and ourselves when we take the time for reflection, because the more we understand about how we each learn, the better we can become at learning. According to Sprenger, “Metacognition involves two phases. The first is knowledge about cognition or thinking about our thinking. The second is monitoring and regulating cognitive processes.”
For me, blogging has been a continual process of review and reflection. In the course of over 170 posts to date, I continually revisit topics, make connections, and write about my own course of learning. As teachers, ideally we should be reviewing and reflecting on lessons, course materials, and interactions with students, both as a means of improving them as well as learning from what worked or did not work.
4. Sleep is another way to consolidate learning, which is one reason getting a full night of uninterrupted sleep is important. Of course, doing so also helps us the next day to have more energy and patience, which then helps us with our attention control. In fact, couple sufficient sleep with waking up to a healthy breakfast, and you are prepared to tackle the day.
Proper 5. Nutrition keeps our systems functioning closer to their peak by stabilizing various levels of hormones and chemicals. All of this holds equally true for students as well as teachers!
We all have our own life stories, and being exposed to something new tends to stick better if we have something else to associate it with or if it is sufficiently unusual that it stands out on its own. Taking advantage of student
6. Prior Knowledge probably requires minimal effort on the part of the teacher, but yields big returns by engaging student interest as students consider new information as it pertains to them and their experiences.
This, in turn, can 7. Engage Emotions, which is the largest hook into learning. We all tend to remember things that get our blood boiling for better or for worse. The parts of the brain engaged in emotions include the small yet mighty amygdala, the hippocampus and the hypothalamus.
“The amygdala deals with our emotions, helps process our memories, and gets totally absorbed in managing our response to fear and stress. Combined, these are biggies, so the hippocampus and hypothalamus chime in with some assistance. The hippocampus handles factual information, while the hypothalamus monitors how your body is doing internally and directs the pituitary gland to release hormones on the basis of functions such as body temperature, appetite, and sexual functioning.”
8. Novelty is another big hook. As information presentation blends between teachers or stays the same by one teacher, it becomes difficult to see patterns and students may tune out the “sameness”. But change it up a bit, introduce something radically different or in a radically different manner, and all of a sudden it is like a quick-pick-me-up in the middle of a lesson, a “brain snack”. Students refocus their attention, and it can even enliven your presentation and wake you up! One way to incorporate novelty is to add some
9. Movement to reenergize the body and brain cells. Movement can shake the sillies out or wake up sluggish bodies and brains; it can be an antidote to the time of day or the climate. Movement is also a close relative of
10. Exercise, and it has been shown that exercise is especially helpful in keeping our adult brains healthy, so remember to participate in that movement with your students (and they will probably consider your participation a bit novel!).
Novelty and movement can also effectively be used to assist kids with sharpening control of their executive function, which is managed by the frontal lobes in the neocortex. Executive function is how we control our attention, create plans, and carry out those plans.
Too often in school, kids are required to “sit still” and “quiet down”, yet these are the very basics of being a kid! Consider harnessing that natural kid energy to help students manage their own functioning. Indeed, in a recent Newsweek article, Wray Herbert notes that an executive function curriculum has emerged to help students manage “effortful control and cognitive focus but also working memory and mental flexibility–the ability to adjust to change, to think outside the box
Laurie Bartels writes the Neurons Firing blog to create for herself the “the graduate course I’d love to take if it existed as a program”. She is the K-8 Computer Coordinator and Technology Training Coordinator at Rye Country Day School in Rye, New York. She is also the organizer of Digital Wave annual summer professional development, and a frequent attendee of Learning & The Brain conferences.
Physical Exercise and Brain Health
Jun 26, 2008
By: Dr. Pascale Michelon
Have you heard of or read John Ratey’s book “Spark: The Revolutionary New Science of Exercise and The Brain”?
According to Harvard Psychiatry Professor John Ratey nothing beats exercise for promoting brain heath.
I am sure you have also heard that exercising your mind promotes brain health.
What is the connection between physical and mental exercises? Do they have additive effects on brain health? Are they redundant?
Let’s start by reviewing what we know about the effects of physical exercise on the brain.
The effect of physical exercise on cognitive performance
Early studies compared groups of people who exercised to groups of people who did not exercise much. Results showed that people who exercised usually had better performance in a range of cognitive tasks compared to non-exercisers.
Laurin and colleagues (2001) even suggested that moderate and high levels of physical activity were associated with lower risk for Alzheimer’s disease and other dementias.
The problem with these studies is that the exercisers and the non-exercisers may differ on other factors than just exercise.
The advantage that exerciser show may not come from exercising but from other factors such as more resources, better brain health to start with, better diet, etc.
The solution to this problem is to randomly assigned people to either an aerobic training group or a control group. If the exerciser group and the non-exerciser group are very similar to start with and if the exerciser group shows less decline or better performance over time than the non-exerciser group, then one can conclude that physical exercise is beneficial for brain health.
In 2003, Colcombe and Kramer, analyzed the results of 18 scientific studies published between 2000 and 2001 that were conducted in the way described above.
The results of this meta-analysis clearly showed that fitness training increases cognitive performance in healthy adults between the ages of 55 and 80.
Another meta-analysis published in 2004 by Heyn and colleagues shows similar beneficial effects of fitness training on people over 65 years old who had cognitive impairment or dementia.
What is the effect of fitness training on the brain itself?
Research with animals has shown that in mice, increased aerobic fitness (running) can increase the number of new cells formed in the hippocampus (the hippocampus is crucial for learning and memory).
Increased exercise also has a beneficial effect on mice’s vascular system.
Only one study has used brain imaging to look at the effect of fitness on the human brain. In 2006, Colcombe and colleagues randomly assigned 59 older adults to either a cardiovascular exercise group, or a nonaerobic exercise control group (stretching and toning exercise). Participants exercised 3h per week for 6 months. Colcombe et al. scanned the participants’ brains before and after the training period.
After 6 months, the brain volume of the aerobic exercising group increased in several areas compared to the other group. Volume increase occurred principally in frontal and temporal areas of the brain involved in executive control and memory processes. The authors do not know what underlying cellular changes might have caused these volume changes. However they suspect, based on animal research, that volume changes may be due to an increased number of blood vessels and an increased number of connections between neurons.
How does physical exercise compare to mental exercise?
Very few studies have tried to compare the effect of physical exercise and mental exercise on cognitive performance.
When looking at each domain of research one notices the following differences:
- The effects of cognitive or mental exercise on performance seem to be very task specific, that is trained tasks benefit from training but the benefits do not transfer very well to tasks in which one was not trained.
- The effects of physical exercise on performance seem broader. However they do not generalize to all tasks. They benefit mostly tasks that involve executive-control components (that is, tasks that require planning, working memory, multitasking, resistance to distraction).
To my knowledge only one study tried to directly compare cognitive and fitness training:
Fabre and colleagues, in 1999, randomly assigned subjects to 4 groups: an aerobic training group (walking or running for 2 h per week for 2 months), a memory training group (one 90 min session a week for 2 months), a combined aerobic and mental training group, or a control group (no training).
Results showed that compared to the control group, the memory performance of all 3 groups increased. The combined group showed greater increase than the other 2 training groups.
This suggests that the effects of cognitive and fitness training may be additive… However this study involved only 8 participants per group! More research is clearly needed before anything can be safely concluded.
In the meantime let’s play it safe and combine fitness and cognitive training for better brain health…!
By: Dr. Pascale Michelon
Have you heard of or read John Ratey’s book “Spark: The Revolutionary New Science of Exercise and The Brain”?
According to Harvard Psychiatry Professor John Ratey nothing beats exercise for promoting brain heath.
I am sure you have also heard that exercising your mind promotes brain health.
What is the connection between physical and mental exercises? Do they have additive effects on brain health? Are they redundant?
Let’s start by reviewing what we know about the effects of physical exercise on the brain.
The effect of physical exercise on cognitive performance
Early studies compared groups of people who exercised to groups of people who did not exercise much. Results showed that people who exercised usually had better performance in a range of cognitive tasks compared to non-exercisers.
Laurin and colleagues (2001) even suggested that moderate and high levels of physical activity were associated with lower risk for Alzheimer’s disease and other dementias.
The problem with these studies is that the exercisers and the non-exercisers may differ on other factors than just exercise.
The advantage that exerciser show may not come from exercising but from other factors such as more resources, better brain health to start with, better diet, etc.
The solution to this problem is to randomly assigned people to either an aerobic training group or a control group. If the exerciser group and the non-exerciser group are very similar to start with and if the exerciser group shows less decline or better performance over time than the non-exerciser group, then one can conclude that physical exercise is beneficial for brain health.
In 2003, Colcombe and Kramer, analyzed the results of 18 scientific studies published between 2000 and 2001 that were conducted in the way described above.
The results of this meta-analysis clearly showed that fitness training increases cognitive performance in healthy adults between the ages of 55 and 80.
Another meta-analysis published in 2004 by Heyn and colleagues shows similar beneficial effects of fitness training on people over 65 years old who had cognitive impairment or dementia.
What is the effect of fitness training on the brain itself?
Research with animals has shown that in mice, increased aerobic fitness (running) can increase the number of new cells formed in the hippocampus (the hippocampus is crucial for learning and memory).
Increased exercise also has a beneficial effect on mice’s vascular system.
Only one study has used brain imaging to look at the effect of fitness on the human brain. In 2006, Colcombe and colleagues randomly assigned 59 older adults to either a cardiovascular exercise group, or a nonaerobic exercise control group (stretching and toning exercise). Participants exercised 3h per week for 6 months. Colcombe et al. scanned the participants’ brains before and after the training period.
After 6 months, the brain volume of the aerobic exercising group increased in several areas compared to the other group. Volume increase occurred principally in frontal and temporal areas of the brain involved in executive control and memory processes. The authors do not know what underlying cellular changes might have caused these volume changes. However they suspect, based on animal research, that volume changes may be due to an increased number of blood vessels and an increased number of connections between neurons.
How does physical exercise compare to mental exercise?
Very few studies have tried to compare the effect of physical exercise and mental exercise on cognitive performance.
When looking at each domain of research one notices the following differences:
- The effects of cognitive or mental exercise on performance seem to be very task specific, that is trained tasks benefit from training but the benefits do not transfer very well to tasks in which one was not trained.
- The effects of physical exercise on performance seem broader. However they do not generalize to all tasks. They benefit mostly tasks that involve executive-control components (that is, tasks that require planning, working memory, multitasking, resistance to distraction).
To my knowledge only one study tried to directly compare cognitive and fitness training:
Fabre and colleagues, in 1999, randomly assigned subjects to 4 groups: an aerobic training group (walking or running for 2 h per week for 2 months), a memory training group (one 90 min session a week for 2 months), a combined aerobic and mental training group, or a control group (no training).
Results showed that compared to the control group, the memory performance of all 3 groups increased. The combined group showed greater increase than the other 2 training groups.
This suggests that the effects of cognitive and fitness training may be additive… However this study involved only 8 participants per group! More research is clearly needed before anything can be safely concluded.
In the meantime let’s play it safe and combine fitness and cognitive training for better brain health…!
How can I improve my short term memory
Nov 6, 2006
Brain Coach Answers: By: Caroline Latham
Q: How can I improve my memory? Is there a daily exercise I can do to improve it?
A: The most important component of memory is attention.
By choosing to attend to something and focus on it, you create a personal interaction with it, which gives it personal meaning, making it easier to remember.
Elaboration and repetition are the most common ways of creating that personal interaction. Elaboration involves creating a rich context for the experience by adding together visual, auditory, and other information about the fact. By weaving a web of information around that fact, you create multiple access points to that piece of information. On the other hand, repetition drills in the same pathway over and over until it is a well-worn path that you can easily find.
One common technique used by students, is actually, not that helpful. Mnemonic techniques of using the first letter of each word in a series won’t help you remember the actual words. It will help you remember the order of words you already know. The phrase My Very Energetic Mother Just Screamed Utter Nonsense can help you remember the order the planets in our solar system, but it won’t help you recall the individual planet names: Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune.
These techniques do help you improve your memory on a behavioral level, but not on a fundamental brain structure level.
The main reason it gets harder for you to learn and remember new things as you age is that your brain’s processing speed slows down as you get older.
It becomes harder to do more than one thing at the same time, so it’s easier to get confused.
Your brain may also become less flexible, so it’s harder to change learning strategies in mid-stream.
All these things mean it becomes harder to focus.
So far, there’s nothing you can do to change your brain’s processing speed, but there are techniques you can use to increase your learning performance, even if your processing speed has slowed.
Focus
Alertness, focus, concentration, motivation, and heightened awareness are largely a matter of attitude. Focus takes effort.
In fact, most memory complaints have nothing to do with the actual ability of the brain to remember things.
They come from a failure to focus properly on the task at hand.
If you want to learn or remember something, concentrate on just that one thing.
Tune out everything else.
The harder the task, the more important it is to tune out distractions.
(If someone tells you they can do their homework better with the TV or radio on, don’t believe it. Any speech or speech-like sounds automatically use up part of your brain’s attention capacity, whether you are aware of it or not.)
In other words, it can be hard to do more than one thing at once, and it naturally gets harder as you get older.
The solution is to make more of an effort not to let yourself get distracted until you’ve finished what you have to do.
Strategy:
When you learn something new, take breaks so that the facts won’t interfere with one another as you study them. If you’ve ever been to a movie double feature, you know that you’ll have a hard time remembering the plot and details of the first movie immediately after seeing the second.
Interference also works the other way.
Sometimes when your friend gets a new telephone number, the old one will still be so familiar to you that it’s hard to remember the new one.
Engage
Your brain remembers things by their meaning.
If you spend a little effort extra up front to create meaning, you’ll need less effort later to recall it.
When you read or hear a word you don’t already know — for example, “phocine” — your brain has to work harder.
First, you have to remember how to spell it long enough to look it up in a dictionary. There, you’ll see it means “seal-like” and it’s pronounced “fo-sine.” Now picture a seal in your mind and repeat the word aloud. Even say “Fo! Fo! Fo!” aloud like a seal barking. The sound of the word, its spelling, the image of a seal, and the barking all work together to form memory links.
The more links the better to help you trigger the word later on, when you want to use it to describe, say, a sunbather in a black one-piece.
Strategy:
Say you’re on vacation in Maui, staying at a beachfront hotel in room #386. How do you remember that? Method number one: Pause for a minute to take a mental snapshot of your room door viewed from an outside vantage point. Then, when you return to that same vantage point, you’ll know which door is yours. Method number two: Stop and think for a minute. You’re on the third floor, which is the top floor of the hotel, so the number 3 is easy. Now for the 8 and the 6. The expression “to eighty-six” comes to mind — as in to get rid of, do away with, or throw out. As in what your boss will do to you if you decide to spend an extra week in Maui. Done.
Brain Coach Answers: By: Caroline Latham
Q: How can I improve my memory? Is there a daily exercise I can do to improve it?
A: The most important component of memory is attention.
By choosing to attend to something and focus on it, you create a personal interaction with it, which gives it personal meaning, making it easier to remember.
Elaboration and repetition are the most common ways of creating that personal interaction. Elaboration involves creating a rich context for the experience by adding together visual, auditory, and other information about the fact. By weaving a web of information around that fact, you create multiple access points to that piece of information. On the other hand, repetition drills in the same pathway over and over until it is a well-worn path that you can easily find.
One common technique used by students, is actually, not that helpful. Mnemonic techniques of using the first letter of each word in a series won’t help you remember the actual words. It will help you remember the order of words you already know. The phrase My Very Energetic Mother Just Screamed Utter Nonsense can help you remember the order the planets in our solar system, but it won’t help you recall the individual planet names: Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus, Neptune.
These techniques do help you improve your memory on a behavioral level, but not on a fundamental brain structure level.
The main reason it gets harder for you to learn and remember new things as you age is that your brain’s processing speed slows down as you get older.
It becomes harder to do more than one thing at the same time, so it’s easier to get confused.
Your brain may also become less flexible, so it’s harder to change learning strategies in mid-stream.
All these things mean it becomes harder to focus.
So far, there’s nothing you can do to change your brain’s processing speed, but there are techniques you can use to increase your learning performance, even if your processing speed has slowed.
Focus
Alertness, focus, concentration, motivation, and heightened awareness are largely a matter of attitude. Focus takes effort.
In fact, most memory complaints have nothing to do with the actual ability of the brain to remember things.
They come from a failure to focus properly on the task at hand.
If you want to learn or remember something, concentrate on just that one thing.
Tune out everything else.
The harder the task, the more important it is to tune out distractions.
(If someone tells you they can do their homework better with the TV or radio on, don’t believe it. Any speech or speech-like sounds automatically use up part of your brain’s attention capacity, whether you are aware of it or not.)
In other words, it can be hard to do more than one thing at once, and it naturally gets harder as you get older.
The solution is to make more of an effort not to let yourself get distracted until you’ve finished what you have to do.
Strategy:
When you learn something new, take breaks so that the facts won’t interfere with one another as you study them. If you’ve ever been to a movie double feature, you know that you’ll have a hard time remembering the plot and details of the first movie immediately after seeing the second.
Interference also works the other way.
Sometimes when your friend gets a new telephone number, the old one will still be so familiar to you that it’s hard to remember the new one.
Engage
Your brain remembers things by their meaning.
If you spend a little effort extra up front to create meaning, you’ll need less effort later to recall it.
When you read or hear a word you don’t already know — for example, “phocine” — your brain has to work harder.
First, you have to remember how to spell it long enough to look it up in a dictionary. There, you’ll see it means “seal-like” and it’s pronounced “fo-sine.” Now picture a seal in your mind and repeat the word aloud. Even say “Fo! Fo! Fo!” aloud like a seal barking. The sound of the word, its spelling, the image of a seal, and the barking all work together to form memory links.
The more links the better to help you trigger the word later on, when you want to use it to describe, say, a sunbather in a black one-piece.
Strategy:
Say you’re on vacation in Maui, staying at a beachfront hotel in room #386. How do you remember that? Method number one: Pause for a minute to take a mental snapshot of your room door viewed from an outside vantage point. Then, when you return to that same vantage point, you’ll know which door is yours. Method number two: Stop and think for a minute. You’re on the third floor, which is the top floor of the hotel, so the number 3 is easy. Now for the 8 and the 6. The expression “to eighty-six” comes to mind — as in to get rid of, do away with, or throw out. As in what your boss will do to you if you decide to spend an extra week in Maui. Done.
The Ten Habits of Highly Effective Brains
Aug 22, 2007
By: Alvaro Fernandez
Let’s review some good lifestyle options we can follow to maintain, and improve, our vibrant brains.
1.Learn what is the “It” in “Use It or Lose It”.
A basic understanding will serve you well to appreciate your brain’s beauty as a living and constantly-developing dense forest with billions of neurons and synapses.
2.Take care of your nutrition. Did you know that the brain only weighs 2% of body mass but consumes over 20% of the oxygen and nutrients we intake?
As a general rule, you don’t need expensive ultra-sophisticated nutritional supplements, just make sure you don’t stuff yourself with the “bad stuff”.
3.Remember that the brain is part of the body. Things that exercise your body can also help sharpen your brain: physical exercise enhances neurogenesis.
4.Practice positive, future-oriented thoughts until they become your default mindset and you look forward to every new day in a constructive way.
Stress and anxiety, no matter whether induced by external events or by your own thoughts, actually kills neurons and prevent the creation of new ones.
You can think of chronic stress as the opposite of exercise: it prevents the creation of new neurons.
5.Thrive on Learning and Mental Challenges. The point of having a brain is precisely to learn and to adapt to challenging new environments. Once new neurons appear in your brain, where they stay in your brain and how long they survive depends on how you use them. “Use It or Lose It” does not mean “do crossword puzzle number 1,234,567″.
It means, “challenge your brain often with fundamentally new activities”.
6.We are (as far as we know) the only self-directed organisms in this planet. Aim high. Once you graduate from college, keep learning.
The brain keeps developing, no matter your age, and it reflects what you do with it.
7.Explore, travel. Adapting to new locations forces you to pay more attention to your environment. Make new decisions, use your brain.
8.Don’t Outsource Your Brain. Not to media personalities, not to politicians, not to your smart neighbour… Make your own decisions, and mistakes. And learn from them. That way, you are training your brain, not your neighbour’s.
9.Develop and maintain stimulating friendships. We are “social animals”, and need social interaction.
Which, by the way, is why ‘Baby Einstein’ has been shown not to be the panacea for children development.
10.Laugh. Often. Especially to cognitively complex humor, full of twists and surprises. Better, try to become the next Jon Stewart
Now, remember that what counts is not reading this article-or any other-, but practicing a bit every day until small steps snowball into unstoppable, internalized habits…so, pick your next battle and try to start improving at least one of these 10 habits today!
By: Alvaro Fernandez
Let’s review some good lifestyle options we can follow to maintain, and improve, our vibrant brains.
1.Learn what is the “It” in “Use It or Lose It”.
A basic understanding will serve you well to appreciate your brain’s beauty as a living and constantly-developing dense forest with billions of neurons and synapses.
2.Take care of your nutrition. Did you know that the brain only weighs 2% of body mass but consumes over 20% of the oxygen and nutrients we intake?
As a general rule, you don’t need expensive ultra-sophisticated nutritional supplements, just make sure you don’t stuff yourself with the “bad stuff”.
3.Remember that the brain is part of the body. Things that exercise your body can also help sharpen your brain: physical exercise enhances neurogenesis.
4.Practice positive, future-oriented thoughts until they become your default mindset and you look forward to every new day in a constructive way.
Stress and anxiety, no matter whether induced by external events or by your own thoughts, actually kills neurons and prevent the creation of new ones.
You can think of chronic stress as the opposite of exercise: it prevents the creation of new neurons.
5.Thrive on Learning and Mental Challenges. The point of having a brain is precisely to learn and to adapt to challenging new environments. Once new neurons appear in your brain, where they stay in your brain and how long they survive depends on how you use them. “Use It or Lose It” does not mean “do crossword puzzle number 1,234,567″.
It means, “challenge your brain often with fundamentally new activities”.
6.We are (as far as we know) the only self-directed organisms in this planet. Aim high. Once you graduate from college, keep learning.
The brain keeps developing, no matter your age, and it reflects what you do with it.
7.Explore, travel. Adapting to new locations forces you to pay more attention to your environment. Make new decisions, use your brain.
8.Don’t Outsource Your Brain. Not to media personalities, not to politicians, not to your smart neighbour… Make your own decisions, and mistakes. And learn from them. That way, you are training your brain, not your neighbour’s.
9.Develop and maintain stimulating friendships. We are “social animals”, and need social interaction.
Which, by the way, is why ‘Baby Einstein’ has been shown not to be the panacea for children development.
10.Laugh. Often. Especially to cognitively complex humor, full of twists and surprises. Better, try to become the next Jon Stewart
Now, remember that what counts is not reading this article-or any other-, but practicing a bit every day until small steps snowball into unstoppable, internalized habits…so, pick your next battle and try to start improving at least one of these 10 habits today!
BMI Not as Effective as Waist-To-Height Ratio in Determining Heart Risks
From Reuters Health Information
NEW YORK (Reuters Health) Feb 12 - Body mass index (BMI) doesn't predict cardiovascular risk as well as waist-to-height ratio and other measures of obesity, new research suggests.
Asked whether physicians should replace BMI as a way of assessing a patient's cardiovascular risk, the study's lead author Dr. Harald J Schneider responded by email, "Probably, yes. However, I would still be cautious."
He pointed out that BMI might still be useful for assessing other risks, such as for orthopedic complications of being overweight or obese, which were not considered in the current study.
Dr. Schneider, of Ludwig-Maximilians University in Munich, Germany, and his colleagues analyzed data from two German cohort studies called DETECT and SHIP. DETECT followed 6,355 patients for more than 3 years, and SHIP followed 4,297 patients for more than 8 years. They reported their findings online February 3rd in the Journal of Clinical Endocrinology and Metabolism.
Overall, 620 people in both studies died, with 181 deaths attributed to cardiovascular causes, and 325 reached the composite endpoint of stroke, heart attack or cardiovascular death.
In both studies, the waist-to-height ratio was the best predictor of cardiovascular mortality, all-cause mortality and the combined endpoint.
The relative risk of cardiovascular mortality in the highest quartile of waist-to-height ratio compared to the lowest quartile was 2.75.
For BMI, the RR in the highest quartile versus the lowest quartile was 0.74.
Both waist-to-height ratio and waist circumference were significant predictors of all-cause mortality, and all measures except BMI were significantly correlated with the composite endpoint.
Results were comparable when subjects were stratified by age and gender.
"BMI does not distinguish between visceral fat, the 'bad' fat that accumulates in the belly, and subcutaneous fat, the 'good' fat that is under the skin," Dr. Schneider told Reuters Health.
He did point out that these studies involved mostly white, European populations, making it difficult to apply the same conclusions to other ethnic groups.
Dr. Cora E. Lewis, of the Division of Preventive Medicine at the University of Alabama at Birmingham, said other research has similarly indicated that it is more useful to know about abdominal fat than BMI when it comes to cardiovascular risk assessment. She was not involved in Dr. Schneider's research.
"There are some limitations to BMI, but it is easy to obtain," she said in an e-mail. "If you really want a measure to be widely used, the staff at the doctor's office needs to be able to do it quickly and reliably without a lot of fuss from the patients."
She added that the National Heart, Lung and Blood Institute's guidelines for assessing obesity and heart risks do advise the use of waist circumference as well as BMI.
In Dr. Schneider's study, waist circumference was not as successful at predicting risk as waist-to-height ratio, but it appeared to be better than BMI.
"Given that BMI does capture a lot of the information, I am not betting against BMI, at least in the near future," Dr. Lewis said.
J Clin Endocrinol Metab 2010.
NEW YORK (Reuters Health) Feb 12 - Body mass index (BMI) doesn't predict cardiovascular risk as well as waist-to-height ratio and other measures of obesity, new research suggests.
Asked whether physicians should replace BMI as a way of assessing a patient's cardiovascular risk, the study's lead author Dr. Harald J Schneider responded by email, "Probably, yes. However, I would still be cautious."
He pointed out that BMI might still be useful for assessing other risks, such as for orthopedic complications of being overweight or obese, which were not considered in the current study.
Dr. Schneider, of Ludwig-Maximilians University in Munich, Germany, and his colleagues analyzed data from two German cohort studies called DETECT and SHIP. DETECT followed 6,355 patients for more than 3 years, and SHIP followed 4,297 patients for more than 8 years. They reported their findings online February 3rd in the Journal of Clinical Endocrinology and Metabolism.
Overall, 620 people in both studies died, with 181 deaths attributed to cardiovascular causes, and 325 reached the composite endpoint of stroke, heart attack or cardiovascular death.
In both studies, the waist-to-height ratio was the best predictor of cardiovascular mortality, all-cause mortality and the combined endpoint.
The relative risk of cardiovascular mortality in the highest quartile of waist-to-height ratio compared to the lowest quartile was 2.75.
For BMI, the RR in the highest quartile versus the lowest quartile was 0.74.
Both waist-to-height ratio and waist circumference were significant predictors of all-cause mortality, and all measures except BMI were significantly correlated with the composite endpoint.
Results were comparable when subjects were stratified by age and gender.
"BMI does not distinguish between visceral fat, the 'bad' fat that accumulates in the belly, and subcutaneous fat, the 'good' fat that is under the skin," Dr. Schneider told Reuters Health.
He did point out that these studies involved mostly white, European populations, making it difficult to apply the same conclusions to other ethnic groups.
Dr. Cora E. Lewis, of the Division of Preventive Medicine at the University of Alabama at Birmingham, said other research has similarly indicated that it is more useful to know about abdominal fat than BMI when it comes to cardiovascular risk assessment. She was not involved in Dr. Schneider's research.
"There are some limitations to BMI, but it is easy to obtain," she said in an e-mail. "If you really want a measure to be widely used, the staff at the doctor's office needs to be able to do it quickly and reliably without a lot of fuss from the patients."
She added that the National Heart, Lung and Blood Institute's guidelines for assessing obesity and heart risks do advise the use of waist circumference as well as BMI.
In Dr. Schneider's study, waist circumference was not as successful at predicting risk as waist-to-height ratio, but it appeared to be better than BMI.
"Given that BMI does capture a lot of the information, I am not betting against BMI, at least in the near future," Dr. Lewis said.
J Clin Endocrinol Metab 2010.
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