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States-of-Mind

Brotherly bullying

Much has been said about bullying in recent years. We are all aware of the negative long-term effects childhood bullying can have on its victims.

We know the mean behaviour of other children is not to be taken lightly and most schools have adopted zero tolerance policies when it comes to bullying.

Our children receive instruction on how to identify and handle schoolyard bullies and how to avoid cyber bullies as well.

With all of the increased focus, I hope schools are becoming safer and friendlier places for everyone.

But what about bullying in our homes? Little is said about what happens when brothers and sisters bully and torment one another.

No one likes to acknowledge that nastiness can happen inside our homes and between our beloved children, but if they can bully at school, you can be sure they can and do bully at home too.

A study published in Pediatrics examined the effects of sibling bullying from childhood into middle age. 

Examining longitudinal data from more than 3,000 children in the U.K., Oxford researchers found bullying between siblings can lead to similar outcomes as other forms of childhood bullying.

In this study, children who experienced bullying from a sibling several times a week were roughly twice as likely to be depressed, anxious or harm themselves in early adulthood as those who were not bullied by siblings.

These results are perhaps not altogether surprising. Being bullied at home can be particularly unpleasant as it may not be possible for the child to retreat or get away from a sibling bully.

This study is a good reminder for parents and family members to be involved with our children and help them as they manage their relationships.

We should be working with children to encourage them to be friends rather than competitors or enemies. It helps if parents avoid comparing siblings in negative ways or pitting siblings against one another.

When friendship is not possible between siblings, we can at least play a big role in teaching our children about acceptable and respectful treatment of others and how to tolerate someone with different interests or personality traits.

Sometimes we have the impulse to let children sort out their own differences.

While this can be helpful in some mild circumstances, when bullying is happening we need to help our kids (both bully and victim) find appropriate ways to engage with one another.

The home should be a safe place for children to get away from pressures of school or peers. It should be a space for recharging and relaxing.

When this isn’t happening it is not healthy for anyone involved.





Do you remember...?

If you’re over 40 and struggling to remember where those car keys are, the name of the nice neighbour or what you did last weekend, you may be experiencing age-related memory loss.

This is memory loss associated with getting older, but is not the degenerative and much more serious dementia or Alzheimer’s disease.

Recent work by Eric Kandel, Nobel Prize winning psychiatrist, has turned up interesting findings about this kind of memory loss.

Age-related memory loss typically starts when people are in their 40s whereas Alzheimer’s disease typically begins at 65-70 years of age.

It usually involves difficulty remembering little things like facts, events, objects, people and places.

Mild memory loss is a common phenomenon as we get older. It is difficult to obtain exact figures on its prevalence because many people do not report it to their physician.

It is often thought to be simply a normal part of aging and only when memory loss becomes more serious does it get brought to the attention of a medical professional.

Studies examining brains at autopsy of people who were between the ages of 40-90 and who did not have Alzheimer’s disease found a systematic decrease of mRNA and a particular protein, over time in the part of the brain called the dentate gyrus.

This is the area of the brain where age-related memory loss is thought to begin.

They found this same protein decreased in the dentate gyri of old mice.

When they inhibited that protein in young mice, they replicated some of the age-related behavioral abnormalities of old mice that are thought to model age-related memory problems in humans.

They could reverse this effect by enhancing the expression of the same protein.

This certainly suggests a possible blueprint for a future drug treatment to reverse age-related memory loss. From my own medical practice with the over 40 age group, I can say this would be a popular and much sought after therapy should it ever come to fruition with acceptable side-effects.

On a related topic, Dr Kandel talked about the relationship between bone health and mental health. Osteoblasts in bone release a hormone called osteocalcin that is important for insulin secretion, testosterone production, energy expenditure, brown fat and insulin sensitivity.

It also boosts neurogenesis, serotonin and dopamine while decreasing GABA.

Injection of osteocalcin into the dentate gyrus enhances memory performance of both old and young mice. Given that aging is often associated with bone loss and therefore a decrease in the release of this hormone, it is possible this could contribute to age-related memory loss.

Exercise builds bone mass and this may explain some of the beneficial effects of exercise on cognition.

These findings are interesting. Let’s hope this story continues to evolve in a positive direction and we can all look forward to remembering our lives in our golden years, at least as long as we don’t get Alzheimer’s.

In the meantime, take lots of photos and label them carefully because some day these may be important in helping to retrieve those memories of places, people and events you just can’t retrieve without assistance.

And, of course, exercise regularly. It is good for your bones and your brain.



Loving thyself too much

Narcissism is one of the hallmark conditions of this generation of North Americans.

Or at least we certainly hear more about it than we did in the past.

We do have a generation of kids growing up under a super-celebratory parenting style designed to build and boost self-confidence.

We have had technology beyond the wildest dreams of our grandparents, so people likely has more photos and videos of themselves than they have time to review.

And, of course, the popularity of social media has glorified the idea of the selfie and encouraged all of us to document and share even the most mundane moments of our lives.

It shouldn’t be any wonder that we all love ourselves a bit more than is strictly necessary.

Narcissism, as a personality trait, has four components:

  • leadership/authority
  • superiority/arrogance
  • self-absorption/self-admiration
  • exploitativeness/entitlement.

These dimensions often bear themselves out in obvious self-focus, relationship problems, lack of insight, difficulty with empathy, problems distinguishing self from others, hypersensitivity to insults, flattery toward admirers, detesting critics, using people without considering the cost, pretending self-importance, bragging, and inability to view the world from other perspectives.

Although being confident may help in certain situations, a quick read through of the above list shows how narcissism is really not a positive quality.

People who already believe they are great are not likely to spend a lot of time working at self-improvement.

Add to that a lack of empathy and they are probably not going to be very good for the people in their lives either.

Interestingly, a recent review of literature on narcissism has found that narcissists are quite easy to identify because they are relatively self-aware and also shameless.

Self-report questionnaires that ask simple, straightforward questions work well.

To put it simply – a narcissist will likely answer in the positive if you just ask.

This review of data from more than 2,000 people suggests it is possible to get a rough gage of narcissistic traits simply by including the question asking participants to rate their level of narcissism.

Similar one-question surveys have also been found to be relatively successful at gauging self-esteem.

As with many personality traits, narcissism is a difficult thing to change. In this instance, it is particularly tricky since, by definition, narcissists believe themselves to be superior to most people and will not see a need for change.

When the trait has caused difficulty in job or relationships, it is sometimes possible to work toward being mindful and changing thought patterns, which can help to improve the narcissist’s ability to get along in cooperative settings.



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Addiction's changing face

The face of heroin addiction has changed.

Until fairly recently, the most common demographic for the highly addictive opioid was young men in the big city.

A study from Washington University shows how the face of heroin abuse has changed in the past decade and is now often a drug used after becoming addicted to prescription opioids.

For this study, published in JAMA Psychiatry, 2,800 American heroin users who had entered treatment facilities were surveyed about their past heroin use and how it came to be their drug of choice.

Users who began taking heroin during the 1960s were primarily young men from the inner city using heroin as their first opioid. Both white and non-white individuals were represented equally at this time.

However, for more recent users, the demographics shifted to include older men and women from outside large urban centres who first used prescription opioids. In the last decade, 90 per cent of new heroin users were white. 

Individuals who first used prescription opioid medications often cited cost and availability as reasons for transitioning from prescription drugs to heroin use.

Some believe addicts were compelled to switch after the introduction of abuse-resistant formulations of many opioid medications in 2010.

This may have compelled existing addicts to switch to heroin as a more accessible alternative.

Some good news on opioid addiction is that numbers of youth and young adults using prescription drugs have fallen in the past few years. Also, numbers of people using buprenorphine to treat heroin addiction has gone up 400 percent in recent years.

In Kelowna, I certainly see a lot more heroin addiction now than I did 30 years ago.

It is amazing to see how nonchalantly many people take up heroin use these days. This, then, becomes part of a downward spiral into criminal activity, prostitution and homelessness that is devastating to watch.

The other face of heroin addiction that I see frequently is when parents of addicted women have to raise their grandchildren because of heroin’s effects.

It is difficult enough that these grandparents are trying to raise young children well into their 60s, but they are usually doing it with a lot of opposition from their addicted children who often resent their involvement.

There is usually ministry involvement mandating that the children cannot be with their addicted parent and yet that parent may resist all interference.

The addicted parents lack insight into how ill-equipped they are to look after their children on their own or how inappropriate their addicted partners are to be involved in the raising of children.

The grandparents I see are often depressed. They are in constant conflict, burdened with the extra responsibilities and often financially stressed.

It is hard to abandon your grandchildren to a life of depravation and they usually try everything to help, but often with only limited success.

It is a miserable life for everyone concerned. The parents, children and grandchildren sometimes have other psychiatric issues that complicate their lives beyond the addictions.

The cost of heroin addiction is large when you look at the cumulative costs of medical care, counseling, Ministry involvement, social services, legal, penal and policing costs over at least three generations.

I hope to see more research and strategies that will work to prevent and treat these damaging addictions.



More States of Mind articles

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

Like us on Facebook: facebook.com/oktrials

Follow us on Twitter: @OCT_ca



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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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