Amnon Jacob Suissa

Addiction to Cosmetic Surgery: Representations and Medicalization of the Body

Contemporary social transformations of the body are essentially mediated by medical discourse. With the body conceived of as “soft and modifiable,” we are witnessing an unprecedented rise in recourse to medicine in order to validate primarily social conditions. In this context, plastic surgery functions as a modality of social control and management, not only of the physical body as such, but at the social level as well. Physical, because plastic surgery allows one to modify the external and visible organs (face, breasts, legs, nose, etc.), and social, because it proposes a social model of the ideal body that goes beyond the one inherited from the biological parents. If the past sheds light on the present, one might wonder whether there are any representations of the body in history that can help us understand better the contemporary phenomenon of cosmetic surgery. What do we mean by the medicalization of bodies? How does a psychosocial condition change from having a social status to a medical one? How can we explain the extraordinary popularity of plastic surgery as a socially acceptable, and desirable, behavior? To answer these questions, based on a review of the literature, this article analyzes the social trend towards the medicalization of bodies via plastic surgery. To that end, four main aspects will be examined: (1) a brief overview of the body’s representation throughout history; (2) a reminder that medicalization is a mode of social control; (3) psychosocial factors that influence the recourse to plastic surgery; (4) cultural examples that demonstrate how important cultural values are in shaping the different trajectories regarding plastic surgery. In conclusion, the author suggests considering social ties as a major component in the social intervention process.

Suicide and gambling: psychopathology and treatment-seeking.

The aim of this study was to evaluate suicides with a history of problem gambling (PG) and others with no such history (NPG) and to compare the two on mental health problems and service utilization. Data on a sample of 49 PG suicides and 73 NPG suicides were obtained from informants and hospital records. Psychopathology was prevalent in both groups, but problem gamblers were twice as likely to have a personality disorder. Moreover, PG suicides were less in contact with mental health services in their last month, their last year, and their lifetime. NPG suicides consulted specialized services from 3 (last month and last year) to 13 times (lifetime) as often as their PG counterparts. Lower service utilization associated with PG suicides argues in favor of stepping up detection, engagement in care and treatment with respect to problem gambling, especially when comorbidity is present.

Cyberaddictions: Toward a psychosocial perspective

The concept of cyberaddiction is far from being unanimously accepted by scientists (Ko, Yen, Yen, Chen, & Chen, 2012; Pezoa-Jares, Espinoza-Luna & Vasquez-Medina, 2012; Nadeau & et al. 2011; Perraton, Fusaro & Bonenfant, 2011. The same is true of addiction to videogames (Hellman, Schoenmakers, Nordstrom, & Van Holst 2013); Coulombe (2010); or to Facebook (Andreassen et al. 2012; Levard & Soulas, 2010). While certain researchers wished to see this condition included in the DSM-5, others question the operational and practical basis for the diagnostic criteria (Block, 2008). Through a review of litterature and results from research findings; the aim of this article is to propose a psychosocial perspective for the cyberaddiction phenomenon. By a psychosocial perspective, we mean the inclusion of social determinants (weak social ties, social exclusion, hyper individualism, poverty, unemployment, etc) and not only the individual characteristics associated with the disease model in the addiction field. To what extent social conditions and cyberaddiction behaviors constitute a potential pathology ? Can we include a psychosocial approach to gain a more general picture of this contemporary issue? In response to these questions, a contextualization and an attempt to define cyberaddiction will be followed by an analysis of some major issues in the development of this type of addiction. As a conclusion, a demonstration of the cycle of addiction on how people develop addictions, including cyberaddictions, will be done within a psychosocial perspective in order to seize the multifactorial aspects of this addiction.

Alcoholism as a Disease in North America: A Critical Social Analysis

&NA; This article describes the phenomenon of the social construction of alcoholism as a disease in North America. The goal of this study is to explicate the persistence of the view of alcoholism as a permanent disease, despite that for the past three decades opposite scientific evidence has been accumulating. Initially, scientific studies are reviewed that support the dominant paradigm of alcoholism as a disease. To do so, studies are explored that reveal the genetic theories and various significant studies concerning twins, genetic markers, and adoption. Further, this review includes the neuro-biological and neuro-behavioral theories. It concludes with the major ideological role of AA (Alcoholic Anonymous). This review illustrates how the dissemination and socialization of the disease discourse passes through the 12-Step philosophy of AA; specifically the first step that underlies the acceptance of lack of power and control over alcohol. Then, we raise an opposing view of the dominant disease discourse with a discussion on how the addiction process is understood as a multifactorial phenomenon. By questioning these major scientific bases that consider alcoholism a disease, this review succeeds, through significant and concluding studies, to demonstrate that the disease model is, in fact, a medicalization process of alcoholic behaviors. Through a critical analysis that includes philosophy, epistemology, sociology, anthropology, and psychology, the author succeeds in demonstrating the emergence of an alternative paradigm to the disease of alcoholism. This alternative paradigm praises a vision where the individual suffering from addiction is not an object, as in the disease discourse (loss of control on a permanent basis; once an alcoholic always an alcoholic), but instead is a responsible social subject, able to decide to reduce, stop, or continue drinking according to ones own personal and social choices. This study is concluded by noting the importance of questioning ourselves on present and future issues related to the growing social and general medicalization of behaviors, particularly concerning alcohol and other drug addictions.

Gambling, Violence, and Family Dynamics: Some Intervention Markers

The phenomenon of family violence associated with addictions in general, and with gambling in particular, is analyzed by the medical model in North America as being a disorder of impulsion, pathology or a disease. This approach, which permits, socially and legally, to label the gambler as suffering from a disease or pathology has certain consequences for the individual, his family members and the society. From a sociological and systemic perspective, this article attempts to identify some markers in these family dynamics with gambling and family violence issues.

Vulnerability and Gambling Addiction: Psychosocial Benchmarks and Avenues for Intervention.

Defined by researchers as “a silent epidemic” the gambling phenomenon is a social problem that has a negative impact on individuals, families and communities. Among these effects, there is exasperating evidence of comprised community networks, a deterioration of family and social ties, psychiatric co-morbidity, suicides and more recently, homelessness. In this context, individual, structural and social vulnerabilities become important markers in understanding the dynamics involved. From a social critical perspective of the literature review, we will highlight some of the major psychosocial stakes underlining the social construction of gambling as pathology. Following a brief definition of the concept of vulnerability, the focus of this paper will be placed on the following issues: 1- the discourse on individual pathology as a marker for vulnerability, 2- the social and ethical contradictions of governments when managing gambling, 3- the heated debate about youth gambling, suicide and Internet gambling, 4- a cultural vulnerability among Asian communities as a demonstration that addiction is a multi factorial phenomenon versus the disease model. Finally, we propose markers for empowerment that can contribute to transferring some power to individuals and their social networks and advance the debate on the complex issues that gambling represents in our society.

Social Practitioners and Families: A Systemic Perspective

ABSTRACT Given the wide range of possible interactions between families and social practitioners, communication problems, although undesirable, are to some extent unavoidable. How to preserve the social practitioners mental health while being able to accompany the family members toward a psychosocial change in the helping process? How to pass from a logic of control to a logic of collaboration? To these basic questions, and through a psychosocial analysis with a systemic grid, the author suggests some intervention markers leading to activate the therapeutic process. Insofar as intervention is, above all, a meeting of two psychosocial systems, some basic tools for social empowerment of family members in the intervention process are suggested.

Gambling Addiction as an Individual Pathology: A Commentary

Although some form of gambling has always been part of the human condition, the current enthusiasm for this kind of activity is hard for society to understand. Behaviours, once considered sins, vices, and deviances, are understood today as diseases, psychiatric pathologies characterized by feelings of a lack of control or compulsion, where abstinence is the only valid response to “eliminate” the addictions (Echeburua & Fernandez-Montalvo, 2005). Within gambling literature, one widespread reform movement is supported on two main pillars. First, the current dominant North American discourse associates gambling with disease or pathology, which to some extent removes any responsibility from governments since gambling becomes a matter of individual weakness. Second, we see the social and institutional process of legalizing and socializing games of chance, a major instrument of ideological legitimisation for politicians, the private casino industry, and many native communities in North America.

Gambling as a social problem

P memory is critical to everyday remembering, whether it be remembering to meet with friends on time or remembering to take an important medication on a regular basis. Prospective memory has been shown in the past to be compromised by the chronic use of a range of recreational drugs, including ecstasy, cannabis, alcohol and more recently, tobacco smoking. One developing area of research has focused on what impact exposure to second-hand smoke or “passive smoking” (where a non-smoker is exposed another person’s tobacco smoke in public or enclosed spaces) might have upon health and cognitive function. There is now widespread scientific consensus that exposure to second-hand smoke is harmful. Previous research has sug-gested that exposure to second-hand smoke not only has a detrimental effect upon health, but is also associated with poorer cognitive performance and educational achievement in chil¬dren, adolescents and adults. The current review will focus on recent evidence which suggests that prospective memory deficits are also associated with exposure to second-hand smoke in young adults. The review will also consider putative some potential psychopharmacological mechanisms involved, as well considering limitations and future directions within this field of research.Material and Methods: A convenient sample of 41 patients with major depressive disorder and 40 healthy age-matched controls were participants of this study. The patients were interviewed face to face according to DSM-IV diagnostic criteria. Depression score was measured using completed Beck Depression Inventory in both groups. The serum level of the interleukins of IL-21, IL-17, and TGF-β were assessed using ELISA-kits.P memory is critical to everyday remembering, whether it be remembering to meet with friends on time or remembering to take an important medication on a regular basis. Prospective memory has been shown in the past to be compromised by the chronic use of a range of recreational drugs, including ecstasy, cannabis, alcohol and more recently, tobacco smoking. One developing area of research has focused on what impact exposure to second-hand smoke or “passive smoking” (where a non-smoker is exposed another person’s tobacco smoke in public or enclosed spaces) might have upon health and cognitive function. There is now widespread scientific consensus that exposure to second-hand smoke is harmful. Previous research has sug-gested that exposure to second-hand smoke not only has a detrimental effect upon health, but is also associated with poorer cognitive performance and educational achievement in chil¬dren, adolescents and adults. The current review will focus on recent evidence which suggests that prospective memory deficits are also associated with exposure to second-hand smoke in young adults. The review will also consider putative some potential psychopharmacological mechanisms involved, as well considering limitations and future directions within this field of research.Introduction: The depressive disorder in children is a common condition that affects the physical, emotional, social development and often persists into adulthood. Childhood depression is a public health problem affecting, in the world, 2.8% of children under 13 years old. In Brazil, the prevalence of depression in childhood is 0.2% and 7.5% for children under 14 years old. However, the theoretical contributions about the neuroanatomical changes in patients with childhood depression are quite inconsistent. Therefore, the purpose is a systematic review about the neuroanatomical changes present in patients with childhood depression. Methods: Systematic review of the literature January 1, 2010 to January 16, 2014 to the descriptors “Depression” (MeSH), “Child” (MeSH), “Anatomy” (MeSH) and their respective terms in English on the basis data: MEDLINE and SciELO. Results: Neuroimaging studies have shown that the hippocampus is about 4-5% lower in patients with major depression than in healthy controls, and this reduction in hippocampal volume constantly noted in children with a family history of major depressive disorder. In addition, the orbitofrontal cortex, cingulate gyrus, and the basal ganglia were also found reduced in patients with major depression. Conclusion: Taking into account the possible influences and structural and functional brain changes over depressive disorder, longitudinal studies are necessary from the use of neuroimaging methods, in order to understand what the possible variations in the cytoarchitecture of the nervous system that best indicate and /or that are pathognomonic in childhood depression.Objectives: Bipolar disorder is characterised by cognitive deficits and deficits in social functioning both during acute stages and in clinical remission. One concept used to examine the underlying mechanisms of social impairment in neuropsychiatric disorders is social cognition, involving the ability to understand and respond to the thoughts and feelings of others. Thus, Theory of mind (ToM), the ability to represent one’s own and others mental states, has been an important area of research in bipolar affective disorder. Results have been mixed so far, mainly due to possible confounding effects of neurocognition, as well as clinical factors such as stage of illness and current mood. The present study explores ToM in bipolar disorder patients during the stage of clinical remission. Method: 20 patients diagnosed with bipolar disorder according to ICD-10, currently in remission and 20 healthy controls were recruited. Remission was determined by 3 month symptom-free period clinically and with YMRS scores< 4 and HAM-D score < 7. The Faux Pas test was used for ToM assessment. In this test, the subject is read 10 stories containing social faux pas and 10 control stories containing minor conflict, but no faux pas. The subject is required to identify the faux pas by taking perspective of the other person’s mental state. The data was analyzed using the computer software program, Statistical Package for Social Sciences-version 11.5 (SPSS-11.5) for Windows®, with different parametric and nonparametric tests, as indicated. The level of significance was taken as p < 0.05 (two tailed). Results: There was significant difference in performance on faux pas stories in patient population as compared to controls. Bipolar disorder patients failed to recognize the faux pas committed by the characters in the stories. There was no significant difference in performance of the control stories in patient population as compared to controls. There was no correlation of poor performance on faux pas stories and clinical characteristics of patients like age, education, age of onset of illness, duration of illness, duration of remission, positive family history, YMRS and HAM-D scores. Conclusions: The study revealed deficits in recognizing social cues by bipolar patients as compared to normal controls. Similar performance on control stories indicate that there is no difficulty in understanding a regular social context. This deficit seen in remission phase indicates that social cognition remains impaired in bipolar patients even after apparent clinical recovery.D the first part of the lecture the author will discuss the diagnosis and clinical picture of PTSD. She will then briefly present emotional processing theory to help understand why some traumatized individuals recover and others develop chronic PTSD and how we can conceptualize Prolonged Exposure (PE) therapy within this theory. Next, she will provide an overview of the efficacy of different cognitive behavioral programs that have been found helpful in ameliorating PTSD symptoms, with emphasize on PE, illustrating the treatment via video clips of patients. Finally, she will discuss the dissemination of PE in clinical practices of civilian community, veterans, and military in the US, and other countries.A dysfunction of the lateral habenula (LHb) is implicated in several psychiatric disorders including drug abuse, bipolar disorder, alcohol dependence and schizophrenia. Previous work with psychophysically-based studies suggests that electrolytic lesion of the LHb, which lies in the dorsal diencephalic conduction system, degrades the intracranial self-stimulation (ICSS). This experiment was aimed at studying the importance of the LHb in brain reward stimulation, and its connection with other areas that support operant responding for ICSS. For this purpose, rats were trained to receive an electrical stimulation at the lateral hypothalamus (LH), a region in the brain implicated in reward and motivation. The change in reward was measured daily for two weeks, and Fos-like immunoreactivity was quantified at the end of the experiment. The expression of c-fos was measured in several forebrain and midbrain regions in order to visualize the neurons that were activated by the stimulation. The same experiment was done in rats that received a stimulation at the LH following an electrolytic lesion at the LHb. Results show that a lesion at the LHb produced a large and long-lasting attenuation of reward, which was generally associated with reduced c-fos expression. Since an alteration in reward is an important characteristic of several psychiatric disorders, identifying the role of the LHb in the brain reward circuitry will constitute an important step towards a better understanding of the neurobiological bases of these disorders.There is more need in the pharmacotherapeutical treatment, particularly in psychopharmacotherapy, to take into account the psychological factors that influence the effectiveness or ineffectiveness of treatment. It’s important to takes into account the holistic approach to the patient and a “brain-mind” concept is also inevitable in this approach. Inefficiency of pharmacotherapy, treatment-resistence, non-adherence, nocebo etc. are only some of the phenomena that require a psychodynamic approach and the kind of creativity in prescribing drugs. Psychiatry 2015; 12, 2: 85–89 key words: inefficiency of pharmacotherapy, psychodynamic approach, holistic approach Address for correspondence: prof. dr. sc. Mirela Vlastelica Vukasovićeva 10, 21000 Split, Croatia, Tel. 00385 91 410 0091, e-mail: mirela.vlastelica@yahoo.com Mirela Vlastelica Private Psychiatric Office, Split, Croatia; Department of Psychological Medicine, School of Medicine, University of Split, Croatia How to deal with psychopharmacotherapeutic inefficiency Jak radzić sobie z nieskutecznością psychofarmakoterapiD the first part of the lecture the author will discuss the diagnosis and clinical picture of PTSD. She will then briefly present emotional processing theory to help understand why some traumatized individuals recover and others develop chronic PTSD and how we can conceptualize Prolonged Exposure (PE) therapy within this theory. Next, she will provide an overview of the efficacy of different cognitive behavioral programs that have been found helpful in ameliorating PTSD symptoms, with emphasize on PE, illustrating the treatment via video clips of patients. Finally, she will discuss the dissemination of PE in clinical practices of civilian community, veterans, and military in the US, and other countries.

Addictions and Medicalization of Social Conditions: Context and Paths of Reflexion

Addictions and Medicalization of Social Conditions: Context and Paths of Reflexion In the psychosocial management of addictions, different social control modalities coexist. We can think of the penal, therapeutic, medical and “laissez-faire” perspectives. The current redefinition of the addiction concept reveals that no single explanation can validate diverse addiction conditions; a multifactorial approach is necessary to grasp the complexity of this phenomenon: addiction to psychotropic substances, love, the Internet, cosmetic surgery, groups, shopping, work, etc. In dealing with the hurried society and performance at any cost, how can we explain the growing tendency to medicalize social conditions and the explosion of categories? To what extent does contemporary society generate conditions where a person feels less and less capable of keeping up with the social and institutional pace? The author suggests analyzing individual and social control markers and shedding light on the central issue of social ties. Finally, the author illustrates how, for example, the 12-step philosophy contributes directly to the labeling and socializing of pathologies instead of focusing on the hidden strengths of people and their families and social networks.