Amnesia due to Emotional Trauma

                                                                 

Amnesia due to Emotional Trauma

By

Aysha Siddiqui

Walden University

Introduction

Memory is the ability to retain and then recover new information, and amnesia is an impairment of memory (Breedlove & Watson, 2013). Research has shown that amnesia can be caused by head trauma and damage to the hippocampus, mammillary bodies and dorsal thalamus. These regions of the brain are required to form ‘declarative memories’, those memories that can be shown to others. Henry Molaison, known to the world as patient H.M. is probably the most famous subject in the study of amnesia and inability to make new memories due to brain trauma. In 1953, , Henry's neurosurgeon removed most of the ‘anterior temporal lobes’ in his brain to cure Henry’s out of control epilepsy and seizures (Breedlove & Watson, 2013). The surgery helped with the seizures, but Henry lost the ability to make new memories. This condition is called retrograde amnesia when the loss of memory is that of more recent events compared to remote events. Nadel & Moscovitch (1997) found in their research evidence in past studies of retrograde amnesia following damage to the hippocampal complex of humans. They also conclude that the amount of loss of memory depends upon the kind of memory is being assessed.

Research has shown that head trauma and injury can cause amnesia, but there is another controversial theory. Some experts have concluded that emotional trauma can be a reason for amnesia as well. However, this theory is under question as compared to the well established theory of amnesia caused by head trauma.

In this paper, we examine research done on the theory that emotional trauma can be a cause of amnesia. We look at the neurological reasons behind this theory and the pros and cons of this issue.

Amnesia caused by emotional trauma

Emotional trauma or trauma is defined as a response to an appalling event like an accident, rape or natural disaster (American Psychological Association, APA). Behavior of denial and shock is a typical response following the event and in some cases many years after the event. Joseph (1999) after his research on past articles about amnesia argues that memory loss after ‘severe stress and emotional trauma’ are not uncommon. This is usually due to the ‘gluco steroids’ and stress associated with the hippocampus region in the brain that plays a vital role in memory storage. He says that the intensity of amnesia depends upon factors like repetition of the traumatic event, severity and the duration of the trauma.

Post Traumatic Stress Disorder (PTSD) has often been connected to amnesia as a result of emotional trauma. In past studies, there was no substantial mechanism to measure PTSD and neurogenic amnesia. However, contemporary research give an in depth view of memory and have found the basis for dual diagnosis of PTSD combined with amnesia (Layton & Wardi-Zonna, 1995).

Breuer and Freud (1893-1895/1955) affirmed that repression is a ‘cognitive inhibition’ process that the person who faced the trauma uses. This causes amnesia of the traumatic event for the time being, but memory of the event is not eradicated entirely. They argue that these memories move into the ‘unconscious’ and are released through personality disorders, states of hysteria or PTSD (Shobe & Kihlstrom, 2007). The view point of suppressed memories or repression that can cause amnesia is popular among experts helping rape victim war survivors, PTSD sufferers as result of events like 9/11.

Do I believe that amnesia can be caused by emotional trauma?

Yes, I do believe that amnesia can be caused by emotional trauma. However, this can vary depending on the kind of trauma (e.g. amnesia suffered by war survivors or by childhood abuse survivors), duration and most definitely on the coping abilities of the sufferer. Amnesia can be used as a dominant defense mechanism against the emotional trauma. Freyd (1994) made the argument that ‘psychogenic amnesia’ is a tool a child may use to maintain a relationship and attachment to a figure that may have abused them. When these abused children grow older amnesia enables them to cope with the emotional arrests they feel with their abuser who may have violated some basic ethics of human relationships.

If survivors of emotional trauma seek help and it is successful, then the scenario of psychogenic amnesia may possibly change. Coping abilities of individuals who have suffered from emotional trauma can play a role. Some survivors are able to carry on normal life with slight effects on their behavior from the emotional trauma. In this case,  the amnesia is more helpful than being harmful and does not require help. When coping abilities are not sufficient, and PTSD develops and professional help is needed, amnesia maybe treated. The memories of emotional trauma may need revival for successful treatment of behavioral and mental conditions. Amnesia caused by emotional trauma and the continuation of this psychogenic amnesia is subject to change. I understand what Freud and Breuer declared that memories of emotional trauma travel to unconscious but are never completely abolished.

Phenomenon explained in neurologic terms

Gilbertson et al (2002) study showed that in animals exposure to stress regularly causes damage to the hippocampus and effects memory. In human studies also a smaller hippocampal is seen when suffering from posttraumatic stress disorder (PTSD). Their study involved pairs of twins with one group of twins who suffered from PTSD and the other did not. They in fact, did find a negative relation between the severity of PTSD and hippocampal volume, size. Some researchers have suggested that amnesia is a ‘disconnection syndrome’ and impairment is found for that material in memory which requires conscious remembering (Warrington and Weiskrantz, 1982). Some significant researches show that amnesia occurs when there  are severe neurological effects on the mesial temporal lobes.

Doubts cast by researches on the validity of psychological amnesia, some pros and cons

Joseph, R. (1998) proposed in his study that amnesia caused by trauma is ‘secondary to abnormal neocortical and hippocampal arousal’ According to him other factors like age, sex difference and stress in daily life before and after the trauma play a role in how much memory is lost of the event. On the other hand,  some researchers believe that the best mechanism to understand the hippocampal function is to study the amnesia caused by traumatic events (Cohen et al, 1999). In the past researchers have conducted research to show how memory is lost, affected and then retrieved due to emotional trauma. Many studies have also concluded that there is still much room for more research and study on this topic. The doubts expressed are mostly based on the viewpoint that there is a thin line between amnesia and memory loss (Sweet et al, 2008). To understand the amnesia caused by emotional trauma, it is important to understand this distinction.

References

Cohen, N. J., Ryan, J., Hunt, C., Romine, L., Wszalek, T., & Nash, C. (1999). Hippocampal system and declarative (relational) memory: summarizing the data from functional neuroimaging studies. Hippocampus, 9(1), 83-98.

Freyd, J. J. (1994). Betrayal trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics & Behavior, 4(4), 307-329.

Gilbertson, M. W., Shenton, M. E., Ciszewski, A., Kasai, K., Lasko, N. B., Orr, S. P., & Pitman, R. K. (2002). Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nature Neuroscience, 5, 1242–1247. Retrieved from http://www.nature.com/neuro/journal/v5/n11/abs/nn958.html

Hass, D. C., & Ross, G. S. (1986). Transient global amnesia triggered by mild head trauma. Brain, A Journal of Neurology, 109(2), 251-257.

Layton, B. S., & Wardi-Zonna, K. (1995). Posttraumatic stress disorder with neurogenic amnesia for the traumatic event. The Clinical Neuropsychologist,9(1), 2-10.

Joseph, R. (1998). Traumatic amnesia, repression, and hippocampus injury due to emotional stress, corticosteroids and enkephalins. Child Psychiatry and Human Development, 29(2), 169-185.

Joseph, R. (1999). The neurology of traumatic “dissociative” amnesia: Commentary and literature review. Child Abuse Neglect, 23, 715-727.

Nadel, L., & Moscovitch, M. (1997). Memory consolidation, retrograde amnesia and the hippocampal complex. Current Opinion in Neurobiology, 7(2), 217-227.

Shobe, K. K., & Kihlstrom, J. F. (2007). Is traumatic Memory special? Retrieved from http://ist-socrates.berkeley.edu/~kihlstrm/special.htm

Sweet, J. J., Condit, D. C., & Nelson, N. W. (2008). Feigned amnesia and memory loss. Clinical Assessment of Malingering and Deception, 218-236.

Von Cramon, D. Y., Hebel, N., & Schuri, U. (1985). A contribution to the anatomical basis of thalamic amnesia. Brain, 108(4), 993-1008.

Sexually Transmitted Infections (STI) in Youth

Introduction

The young people ages, 15-24 years old represent 25% of the sexually experienced population and account for 88% of all the news cases of sexually transmitted Infections (STIs), according to Weinstock et al, 2004. These numbers show that STIs have an impact on the youth of US that is sexually actively and the risks are much higher as well. The World Health Organization (WHO) reports the same numbers that half of the 14 million people with Human Immunodeficiency Virus (HIV) are between the ages of 15 and 24 years (Hein et al, 1995).  Interventions aimed at specifically controlling the increasing numbers of youths getting STIs are the solution. The primary step in this is to make the youth aware of the risk factors of sexually transmitted Infections (STIs).

Risk factors of sexually transmitted Infections (STIs)

When we talk about youth then the risk factors are higher in this age group compared to the adults and some factors increase the risks of getting STIs. According to the National Institute of Health (NIH) the factors that can increase the risk of STI’s for youth are:

·         If a youth is sexually active then they are instantly at risk for STI.

·         More than one partner increases the risk for getting STI.

·         Young girls are at a higher risk to get STI compared to boys due to changing hormones.

·         Many girls don’t even know where to get a condom or how it is used. This unawareness puts them at a higher risk as well ( In developing countries like Ghana,  Ohene and Akoto, 2009).

·         Youth from Lower Socio Economic neighborhoods are at a higher risk of developing STI and having unprotected sex.

·         Research shows that a strong connection is found between youth with substance and alcohol abuse behavior and risks of getting STI.

·         Psychological distress among  youth has also been connected with higher risk of engaging in risky sexual activities by youth.

Health Promotion Campaign

Promoting sexual health among youth definitely addresses the risk factors of STIs. It is important to create an awareness among the youth instead of creating fear or using parental approach. According to Hein et al (1995) if parents only attach values to sexual activity of their children, then that does not lower the risk of getting STI. Parents have to approach the issue in connection with school and other resources with a view point of accepting sexual desires, activity present in their children. There has to be a recognition of the problem before a solution can be presented.

References

Weinstock, H., Berman, S., & Cates, W. (2004). Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000.Perspectives on sexual and reproductive health, 36(1), 6-10.

Ohene, O., & Akoto, I. O. (2009). Factors associated with sexually transmitted infections among young Ghanaian women. Ghana medical journal, 42(3).

Hein, K., Dell, R., Futterman, D., Rotheram-Borus, M. J., & Shaffer, N. (1995). Comparison of HIV+ and HIV-adolescents: Risk factors and psychosocial determinants. Pediatrics, 95(1), 96-104.

Humoral Immunity Reponse

Humoral Immunity Response                  

       By

              Aysha Siddiqui

Walden University

Introduction

Definition of Humoral Immunity

Humoral immunity response is part of the adaptive immunity and is the primary defense mechanism against extracellular microbes, their toxins (Abbas, Lichtman, Pillai, 2012). Humoral immunity is interceded by antibodies and with capsules rich in ‘polysacchrides and lipids’ it is the main defense. The National Institute of Health (NIH) describes humoral immunity response consisting of a number of components that include the naturally occurring antibodies (NAB), pentraxins (family of plasma proteins), complement and contact cascades.

Description of Humoral Immunity: Humoral immune responses to nonprotein antigens are handled by recognizing the antigens of specific immunoglobulin receptors of naïve B cells (Abbas, Litchman, Pillai, 2012). Humoral immune response to a protein antigen is called ‘T-dependant responses and initiated by binding of the protein to specific Ig receptors of naïve B cells in lymphoid follicles’ (Abba, Litchman, Pillai, 2012).

           

Disease associated with Humoral Immunity Response

Stockert et al., (1998) report that growing evidence shows humoral response to autoimmunogenic tumor antigens and tumors develop an antibody response to NY-ESO-1 (humoral response). Breast cancer has shown to be associated with the humoral immunity response by the fact that malignant tumors show different types of molecules that maybe regarded as foreign antigens by the immunity system (Abbas, Litchman, Pillai, 2012). Research has also shown that chronic inflammation leads to cancer development, while enhanced humoral immunity along with innate immune activation alters risk of cancer (Tan, Coussens, 2007).

Behavioral Intervention to Influence Humoral Immunity

            Segerstrom, Miller (2004) report that there are more than 300 research studies with evidence of a relation between stress and immunity response. They report that humoral immunity is not compromised but cellular immunity is affected in times of acute stress (lasting a few minutes) and with chronic stress, humoral immunity is also compromised.

            Behavioral intervention to influence humoral immunity would need to focus around stress reducing techniques. The reason is because stress has been connected to immunity in lot of research. According to Segerstrom, Miller (2004) age can play a crucial role as well, since they conclude that stressors can have varying affect on immunity among older and younger age groups.  Some researchers argue that how can stress get into the body? The sympathetic fibers travel from the brain to the primary and secondary lymphoid tissues (Ader, Cohen, Felten, 1995).

            Segerstrom, Miller (2004) write that according to Maier and Watkins (1998) a close connection exists between stress and immune function: ‘the immunological changes associated with stress were adapted from the immunological changes in response to infection’. Their study explains a ‘sickness behavior’ which includes behavioral changes like lack of socializing, sexual activity and increase in response to pain, depressing moods. This is when body is working towards reserving energy to fight future infections.

Behavioral intervention would include steps like:

• Identification of stressors
• Observation of bodily response to stressors
• Identification of past history of stress, anxiety or depression
• Recording of family history of physiological conditions and immunity deficient diseases
•  Understanding of regularity, duration and timings of exacerbations
• Coping techniques development that are suitable to the individual and their surroundings,

Complementary/alternative modality or lifestyle change

            Complementary or alternative modality or medicine (CAM) cover a broad spectrum of ancient as well we modern techniques, practices to fight and treat disease (Barnes et al., 2008).People who are using or seeking CAM are usually aiming to improve their health and well being.

            To help a patient with breast cancer whose humoral immunity maybe affected, we could use CAM as a mean to improve health as well. Massage therapy is an effective CAM technique that is also known to reduce pain in cancer patients (Pan et al., 2000). Massage therapy is a technique that involves getting deep tissue or muscle massage with an intention to work towards a healing process. Billhult, Dahlberg (2001) describe that in their controlled study female cancer patients described massage therapy as a ‘relief from suffering’ experience. Cassileth, Deng (2004) highlight the importance of awareness of massage therapy and other CAM techniques used by cancer patients for their care providers.

                                                            References

Abbas, A. K., Lichtman, A. H., & Pillai, S. (2012). Basic immunology: functions and disorders of the immune system. Elsevier Health Sciences.

Ader, R., Cohen, N., & Felten, D. (1995). Psychoneuroimmunology: interactions between the nervous system and the immune system. The Lancet, 345(8942), 99-103.

Barnes, P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative medicine use among adults and children: United States, 2007.

Cassileth, B. R., & Deng, G. (2004). Complementary and alternative therapies for cancer. The Oncologist, 9(1),, 80-89.

Pan, C. X., Morrison, R. S., Ness, J., Fugh-Berman, A., & Leipzig, R. M. (2000). Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life: a systematic review. Journal of pain and symptom management, 20(5), 374-387.

Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological bulletin, 130(4), 601.

Shishido, S. N., Varahan, S., Yuan, K., Li, X., & Fleming, S. D. (2012). Humoral innate immune response and disease. Clinical Immunology, 144(2), 142-158.

Tan, T. T., & Coussens, L. M. (2007). Humoral immunity, inflammation and cancer. Current opinion in immunology, 19(2), 209-216.

Success rate among Immigrants

Success rate among Immigrants

By

Aysha Siddiqui

Walden University

Abstract

This paper explains the rationale and purpose of our research study on success rate among first and second generation immigrants. We have written a past literature review of theories that derive our hypotheses. These include Albert Bandura’s social learning theory and Piaget’s social cognitive learning theory. Our hypothesis is that a relation exists between the success experienced by an individual and his or her origin of family. In the end we list down the spheres of social life that can benefit from our research study. This paper also includes our rationale for using the survey research methods and how they are the right choice for this study.

Success rate among immigrants and their children

‘Finding a home away from home’ is what defines the phenomenon of an immigrant (Hernandez, 2014). An immigrant is defined as a person who leaves his country of birth and moves to another country to make it their new home. Today, first and second generation immigrants are 24% of the total US population (Perkins,Wiley & Deaux, 2014) and the influx of immigrants in other parts of the world is also at a rise. This justifies recent increase in research on immigrant populations in range of corporate settings, human resource, educational and health reforms. From a psychological point of view first and second generation immigrants have a mind set, self image and perception of their surroundings that is unique to this population (Perkins,Wiley & Deaux, 2014).

Unique Psychological Aspects of Immigrants

Adolescence, childhood, young adult and adult: at all ages, immigrants and children of immigrant parents have a unique and specific image of their surroundings (Rumbaut, 1994). Adolescents are observed to struggle with identity, acculturation and peer pressure (Mann, 2004). Brilliant (2000) reports that cultural variations affect the academic and social performance of immigrant students in colleges around the United States. Growing up in a cross cultural home is a unique experience as well that can direct life experiences of second generation immigrants.

Self image, public and private regard, motivation are all factors that can affect an individual’s sense of success in life (Seibert & Kraimer, 2001). This research study aims at understanding if there is a relation between the unique psychological aspects that only immigrants (first and second generation) face and the success in life.

                                                Problem Statement

Research shows that life experiences and perceptions of immigrants, their children are unique and unlike their peers. Are these experiences exceptional and influential to the extent that they can determine the level of success an individual experiences? What is the extent of influence of an individual’s origin, his or her social identity as an immigrant on his life? Our research study aims at collecting date from a specified population of first and second generation immigrants to understand if a relation exists. We question that do immigrants experience higher or lower success because of their origin and condition of being an immigrant.

Theoretical Rationale

For a substantial amount of time diversity consideration has been integral to any economic or industrial human resource reform (Portes & Sensenbrenner, 1993). Life experiences of individuals as immigrants are an outcome of a social interaction. It is the social perspective that gives rise to the concept of immigrants: being a foreigner and unique from a social point of view.

Testable theory related to any research study on immigration and its effects can be taken as parallel to life span development. Our research study is an assessment of an individual’s life span development in light of socio-cultural influences. Further, we aim at understanding the effects of these cultural and social factors on an individual’s ability to succeed in life.

Piaget’s Cognitive Development Theory

Piaget, a Swiss psychologist, who changed the way we understand the development of children’s mind believed in ‘assimilation and accommodation’ (Santrock, 1995). Most of Piaget’s work is on children’s psychological development and how the social aspect interacts to develop a person psychologically. According to Piaget (2013), ‘a universe without objects is a self without knowledge’ and each stage of a child’s development is aimed at understanding the world around.  Piaget (1964 ) also highlights that to know an object we have to understand it’s transformation that takes place. This is a process of operation and this is the ‘essence of knowledge’.

Piaget (Piaget & Inhelder, 2013) reports that intelligent behavior is connected to growth continuum and intelligence has been connected to success (Canterucci, 2005).

 Youniss & Damon (1994) write about the post World War Era when social scientists were involved to develop programs that encourage citizens to accept diversity. In that era Piaget proposes that the modern era social occurrences take place at a new level from what mankind has seen in the past. Piaget further adds that ‘all events in the modern world are international. What happens in one part of the world affects another part and this thing works like a sphere’.   

Bandura’s Social Cognitive Theory

Bandura’s social theory emphasizes that cognitive processes are crucial moderators in between behavior and environment. Bandura believes that people ‘cognitively observe’ others behaviors and then sometimes adopt these behaviors themselves. He belongs to the group of behaviorists who believe that development is highlight influenced by behaviors of others and the environment (Santrock, 1995).

According to Bandura (1994) ‘self-efficacy’ is a person’s belief in his ability to influence events that affect his life. This belief is the core of motivation, performance, accomplishments and emotional well being. Bandura adds that unless this belief is present in a person he or she will not take up any activities in life that give challenge. This aspect of Bandura’s theory derives our dependant variable, success. Another angle of Bandura’s social learning theory is that learning happens through direct experience and by observation of others (Bandura, 1977).

Hypothesis

H0: There is no relation between success and being raised in a cross cultural home by       immigrant parents.

H1: There is a relation between success achieved by an individual and being raised in a cross cultural environment by immigrant parents

H2: The success achieved by an individual who is raised in a cross culture by immigrant parents is not as high as their peers raised in their country of origin.

Rationale for Use of Survey Research Methods Design

Rumbaut (1994) used a multivariate analysis to understand the ethnic identity among eighth and ninth graders in Miami and San Diego. The study used a survey research method to collect data from 5,000 children raised by immigrant parents. In our research study we are not aiming to look at the affect of a specific condition, but aim to understand if a relationship exists. According to Creswell (2009) survey research provides a ‘numeric description’ of trends and attitudes. Keeping this definition in account, we consider the survey research method for our study.

We are trying to establish a relationship that we hypothesize exists and that’s possible by collecting data from cases that already exist.

Utility Statement

There is no denial that globalization and diversity is the trend of the day. Results from our research study can benefit not just one phase of life, but almost every aspect of our surroundings. After review of past literature, the following areas can benefit from our research study:

• Jackson & Ruderman (1995) argue that it is imperative that organizations and corporate structures adjust to the growing diversity in each sector. They insist on the importance of the dynamics, the assets and liabilities that come out of the diverse treasures in any organization. From information technology (IT), financial management to entertainment, education, art: immigrants have become an integral part of any sector.
• Health care and the immigrant population is a very important area that can benefit from our study. Hu et al (1996) report on the emerging diversity in population suffering from human immunodeficiency virus (HIV). Their study shows that the growing diversity among the population suffering from HIV is understood to a minimal level. The studies conducted are limited and further research can be very beneficial.
• Due to legal and immigration laws, health insurance is not as easily accessible to immigrants as to others. Ku & Matani (2001) report that health insurance is very limited to immigrants and their children. Among other reasons, there are also language, cultural beliefs and religious restrictions. Emergency care is also not as easily accessible to this population as to others. Our research study would be able to contribute to this kind of social change as well.
• Last but not the least: education and child development is a field today that can most benefit from any research on immigrants and diversity. Today, the number of immigrant children or children whose parents were immigrants is higher than before (Rumbaut & Portes, 2001) and researchers say we are seeing a ‘new America’ today. Our research study can be a basis for any kind of intervention, program designed for school aged or teenage children.  

   References

Bandura, A. (1994). Self‐efficacy. John Wiley & Sons, Inc..

Bandura, A. (1977). Social learning theory.

Brilliant, J. J. (2000). Issues in counseling immigrant college students.Community College Journal of Research & Practice, 24(7), 577-586.

Canterucci, J. (2005). Personal Brilliance: Mastering the Everyday Habits that Create a    Lifetime of Success. AMACOM Div American Mgmt Assn.

Hernandez, E. (2014). Finding a Home away from Home Effects of Immigrants on Firms’ Foreign Location Choice and Performance. Administrative Science Quarterly, 59(1), 73-108.

Hu, D. J., Dondero, T. J., Rayfield, M. A., George, J. R., Schochetman, G., Jaffe, H. W. & Curran, J. W. (1996). The emerging genetic diversity of HIV: the importance of global surveillance for diagnostics, research, and prevention.Jama, 275(3), 210-216.

Jackson, S. E., & Ruderman, M. N. (1995). Diversity in work teams: Research paradigms for a changing workplace. American Psychological Association.

Ku, L., & Matani, S. (2001). Left out: immigrants’ access to health care and insurance. Health Affairs, 20(1), 247-256.

Mann, M. A. (2004). Immigrant parents and their emigrant adolescents: The tension of inner and outer worlds. The American journal of psychoanalysis,64(2), 143-153.

Perkins, K., Wiley, S., & Deaux, K. (2014). Through which looking glass? Distinct sources of public regard and self-esteem among first-and second-generation immigrants of color. Cultural Diversity and Ethnic Minority Psychology, 20(2), 213.

Piaget, J. (1964). Part I: Cognitive development in children: Piaget development and learning. Journal of research in science teaching, 2(3), 176-186.

Piaget, J. (2013). The construction of reality in the child (Vol. 82). Routledge.

Piaget, J., & Inhelder, B. (2013). The growth of logical thinking from childhood to adolescence: An essay on the construction of formal operational structures(Vol. 84). Routledge.

Portes, A., & Sensenbrenner, J. (1993). Embeddedness and immigration: Notes on the social determinants of economic action. American journal of sociology, 1320-1350.

Rumbaut, R. G. (1994). The crucible within: Ethnic identity, self-esteem, and segmented assimilation among children of immigrants. International Migration Review, 748-794.

Rumbaut, R. G., & Portes, A. (Eds.). (2001). Ethnicities: Children of immigrants in America. Univ of California Press.

Seibert, S. E., & Kraimer, M. L. (2001). The five-factor model of personality and career success. Journal of vocational behavior, 58(1), 1-21.

Youniss, J., & Damon, W. (1994). Social construction and Piaget’s theory.Moral development, 5, 407-426.

Chronic Lower Back Pain (CLBP) and Sleep disorder

I wasn’t exactly sure if my sleep disturbance could be regarded as a sleep disorder, but then some research made me understand the issue better. I am grateful that I have no issue with falling asleep or staying asleep but in the past few weeks I have suffered with lower back pain. In the past I have had the same condition that would follow the time when I had small babies. After consulting with my doctor, it was concluded that my lower back pain early morning right after I wake up or during the night is caused by the physical stress my body takes. It’s been a very stressful fall with kids in new school, a toddler and a workaholic husband. I was prepared for it but not sure if my body was J.  So, in my seven days sleep journal I have recorded lower back complain during the night and a desire to sleep in each morning. For my discussion I have chosen ‘Chronic Lower Back Pain” (CLBP) and sleep disorder.

Past research has shown a link between CBLP and sleep impairment with indications that strategies to manage CBLP can also affect control over quality of life (Kelly et al., 2011). Heffner et al., (2011) conducted a study of sleep disturbance on two groups of adults with one who suffered from CLBP and another that did not. The results showed that adults with CBLP had more sleep disturbance and the sleep disturbance also showed a link to higher ‘interleukin-6(IL-6)’ which is an inflammatory cytokine. The study concluded that IL-6 play a role in the sleep disturbance causes in patients with CLBP. The control group of adults showed no sleep disturbance but IL-6 results were similar to the other group.

What’s interesting is to understand if CLBP affects sleep or sleep impairment aggravates CLBP as research has shown to us that both issues are connected. Moldofsky (2001) highlights that there is a reciprocal relationship between pain and sleep, which I agree with. Their study reviews that sleep disturbances, pain e.g. lower back pain and psychological stress is observed in people who have had injury. Patients with irritable bowel syndrome have shown sleep disturbed and it’s understood that recognition of disturbed sleep can lead to management of ‘painful medical disorders’.

A regular exercise routine would be the optimal behavioral intervention to control sleep disorder as well as CLBP. Research has shown that some specific exercises like yoga, Tai chi or other stretching exercises that relieve muscle tension help with CBLP as well as sleep issues (Penedo,Dahn, 2005). Massage therapy is another technique that can be used as a behavioral intervention to relieve CLBP, stress hormone and sleep disturbances. Hernandez-Reif, Field, Krasnegor, Theakston, H. (2001) study design was aimed at comparing two groups of people with lower back pain with one group being treated with massage therapy and the other with relaxation techniques. After a 5 week study, results showed that massage therapy group compared to the relaxation group experienced improved sleep, less pain, depression and anxiety.

References

Kelly, G. A., Blake, C., Power, C. K., O'Keeffe, D., & Fullen, B. M. (2011). The association between chronic low back pain and sleep: a systematic review. The Clinical journal of pain, 27(2), 169-181.

 Heffner, K. L., France, C. R., Trost, Z., Ng, H. M., & Pigeon, W. R. (2011). Chronic low back pain, sleep disturbance, and interleukin-6. The Clinical journal of pain, 27(1), 35.

Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy.International Journal of Neuroscience, 106(3-4), 131-145.

Penedo, F. J., & Dahn, J. R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry, 18(2), 189-193.

Moldofsky, H. (2001). Sleep and pain. Sleep medicine reviews, 5(5), 385-396

Brain activity and trauma

Leonard (2010) explains that the brain is directly affected by cytokines, chemokines, prostenoids and immune cells, contrary to what some researchers believed until few years ago. Chronic stress causes changes in ‘hypothalamic- pituitary- adrenal axis and in the immune system. Research and past evidence reveals that pro inflammatory cytokines and glucocorticoids are in high concentrations during chronic stress that can lead to depression. When body is attacked by bacteria or virus, cells of the immune system react by secreting proteins called cytokines (National Institute of Health, NIH) and this causes among other signs fatigue and withdrawl. Research has shown that when cancer or hepatitis B patients are treated with cytokines they show signs of depression.

Dowdney (2000) reports that psychological effects of the death of a parent can be heterogeneous. However, statistics show that at least 1 out of 4 children develop some sort of mental disorder in the year after the trauma. As adults, the trauma of loss of parent can cause issues with ego building, forming health relationships and is dependent on the recovery of the whole family after the trauma (Hilgard et al. 1960). Research has shown that traumas like loss of a parent can influence mental as well as physiological health of people as adults, with major affect noted on social behavior (Turner & Lloyd, 1995). Acute stress and chronic stress have shown to affect immune system is varying ways, with chronic stress causing suppression of immune system through the physiological reactions, according to O'Leary, 1990).

References

Dowdney, L. (2000). Annotation: Childhood bereavement following parental death. Journal of Child Psychology and Psychiatry, 41(07), 819-830.

Hilgard, J. R., Newman, M. F., & Fisk, F. (1960). Strength of adult ego following childhood bereavement. American Journal of Orthopsychiatry, 30(4), 788.

Leonard, B. E. (2010). The concept of depression as a dysfunction of the immune system. Current Immunology Reviews, 6(3), 205–212. 

National Institute of Mental Health. (2009). Key molecule in inflammation-related depression confirmed. Retrieved from http://www.nimh.nih.gov/news/science-news/2009/key-molecule-in-inflammation-related-depression-confirmed.shtml

O'Leary, A. (1990). Stress, emotion, and human immune function.Psychological bulletin, 108(3), 363.

Turner, R. J., & Lloyd, D. A. (1995). Lifetime traumas and mental health: The significance of cumulative adversity. Journal of Health and Social Behavior, 360-376.

HPV Cervical Cancer

The National Institute of Health (NIH) reports that the role of inflammation in the human papillomavirus (HPV) infection and disease is complex (Boccardo, Lepique, Villa, 2010). This is because it involves responses that have the ability to prevent initial infections and clear ongoing lesions. The process to avoid the immune response is the crucial point in HPV resistance as that’s what leads to HPV-related Neoplasia (NIH). Trimble (2007) reports that sexually transmitted HPV is one of the leading cause of cervical cancer and still remains the second major cause of death among women globally. The report also highlights that in 25% of the women the immune system actually rejects or heals the HPV virus when it begins. The 75% who do not ‘self heal’ the virus by recognition through the immune system T-cells are inhibited into pre-cancerous lesions. Castle et al. (2001) study worked with women less than 50 years who had been infected with HPV virus or who had experienced high grade lesions. The results suggest that ‘cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV’.

Suggests that the vaccine’ AS04-adjuvanted HPV prophylactic vaccine’ with a new adjustment system has shown to improve the natural immune responses to the HPV virus. Though there is still some debate that exists, but the use of vaccine at an appropriate age maybe an effective strategy to improve immunity against HPV. Another strategy could be DNA testing as research has shown that it’s a great tool in cervical cancer screening (Anhang, Goodman, Goldie, 2004). The three strategies that could help enhance the immunity system more active in HPV patients would include: first, education on the link between sexual activity in women and HPV, second, literacy of parents about HPV vaccine leading to their acceptance of the method for their adolescent girls and third, psychological conditioning of young people about the risks and prevention of the disease.

References

Anhang, R., Goodman, A., & Goldie, S. J. (2004). HPV communication: review of existing research and recommendations for patient education. CA: A Cancer Journal for Clinicians, 54(5), 248-259.

Boccardo, E., Lepique, A. P., & Villa, L. L. (2010). The role of inflammation in HPV carcinogenesis. Carcinogenesis, 31(11), 1905-1912.

Castle, P. E., Hillier, S. L., Rabe, L. K., Hildesheim, A., Herrero, R., Bratti, M. C. & Schiffman, M. (2001). An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV). Cancer Epidemiology Biomarkers & Prevention, 10(10), 1021-1027.

The Dana Foundation. (n. d.). Immune conditioning in premalignant HPV disease. Retrieved fromhttp://www.dana.org/grants/human/detail.aspx?id=8820