General Discussion

[Psyga315]

... I've never really have any preference to this show... but for this revelation of Mickey Mouse invading Star Wars, and making Pooh's Adventures of Star Wars a possible nightmarish reality, I have no choice but to whip out my favorite reaction image from that show.

[Roxas]

Thanks for not warning me we were getting cut off today, Plusnet. Really earning that 'beloved customer service' thing or whatever the fuck you pride yourself on.

[Tachi]

Ugh...that's...I have to wonder how a company that screws its customers over so much is still in business...

[Mahou Moerin]

Roxas... Seriously, try and find a new internet provider. Just... Ugh.

[Roxas]

We would, but lack of money is preventing that.

[Tachi]

I'm an idiot. I'd just like to apologise to anyone I've caused any headaches with my stupidity.

[Rain]

You're not. Also haven't caused any headaches. :/

[Mahou Moerin]

You're not. >.< I'm sorry. >.<

[Vinestar]

Tach, stop that. >.<

[dblade26]

Yeah...not sure why Tachi would think that since he never causes problems for anyone...

[Tachi]

Except for when I stalled things for more than a week because of reasons I couldn't be bothered explaining to everyone else, or when I stalled, and eventually just dropped out of that Mindscape mini-RP, or all the screwing around trying to work out a powerset for Tachi...probably got a few more on the list...

[EldritchMermaid]

...

*hugs tightly*

We're not mad at you for it, so...

[Mahou Moerin]

Not upset about any of that. >.< Sorry. >.<

[Tachi]

Not sure why you're apologising...

[Tachi]

Bleh...need something to do. Just sitting around reflecting on stuff is making me feel worse and worse...Stupid lack of anything to do here... >.<

[dblade26]

Umm.. if trying to post in stuff will make you feel better Sis is trying to get Maou going again, You could maybe write your character's reaction to drinking the Elixir of Life in UF, at least some stuff in NR so you could post in that too...

Also, it'd be nice to just talk to you too. I miss ya.

[Vinestar]

Please come back, Tach. No one's holding anything against you. >.<

[Tachi]

Not really sure how to react in UF, might give Rain and Anno another day or two before I post in NR. Could probably try to post something in Maou.

And I'm probably not going to be back in the chatbox for a week or so, because I'm a despicable piece of trash that can't stand seeing his friends enjoy something he has nothing to do with...and even then, I'm expecting a repeat of this when the final battle starts up.

[dblade26]

aww, Tachi...it's okay to be upset when we're doing something and you can't join in. That doesn't make you a bad person. I've felt like that before too, so I mean it when I say it doesn't make you bad and no one should be mad at you for it at all.

Just come back when you feel like you can, okay? Still miss ya.

-hugs-

[Vinestar]

I'm sorry, Tach. >.<

[Deleted]

I'm not angry at you at all, Tachi. I'm sorry if I made you think that at any point...

[dblade26]

I'm sorry too. I wish you were still playing with us. It's not as fun without you around.

[Tachi]

Honestly, even though I think people have every right to, I didn't expect anyone to be mad at me...

And I'm kinda pissed off at myself for getting to the point where people are so used to me dismissing ideas without explaining why that they just assumed I was present when a certain event that would've completely removed the need for me to drop out of season one was planned and that I had some reason for thinking it wouldn't work...

Really though, I'm not sure when I'll be back in the chatbox.

---

-peeks at the chatbox-

A problem of his is that he frequently keeps writing himself out or not responding because of timezones and we all kinda move on ahead. >.<

I'm not sure how it's a difficult thing to deal with. Just try to avoid posting repeatedly during that 6-8 hour part of the day when I'm asleep. I mean, people usually remember to wait for everyone else to post before continuing scenes and between four people, surely at least one of you can remember that I'm in a scene...maybe. Even then, only two of the four times I had to write Tachi out of a scene were because people posted multiple times each while I was sleeping. The other two were because 1)I was going to visit family and wasn't sure if I'd have reliable internet access and 2)I didn't want to hold people up while I was getting back from visiting family.

Hell, if you want a real problem I had, the character's personality basically restricts him to talking to people he already knows and children...except he can't talk to people he knows because I was stupid enough to have him react seriously to Meowrin's comedic perversion, leaving him nigh-incapable of existing in the same scene as the people he already knows. There. Let's throw in the fact that I had to go visit family interstate pretty much as soon as I joined, making me sit out the only arc I was technically part of, the fact that the character has so little presence that Rain's characters haven't had any reason to acknowledge his existence at all, Anno very briefly noticed him in the first scene he was in but not at all since and no one but Grey reacted when he fled from Jenny getting stabbed with Rule Breaker (and no one noticed at all on either of the other occasions I had him abruptly leave a scene) and the fact that I joined too late for the plot to have any real relevance to my character. And of course, to top it all off, we have the fact that my tendency to not explain my reasoning for why I think ideas won't work completely sabotaged the one chance to fix the biggest of those issues in season one.

So yeah, people posting a bunch of times while I'm sleeping was really annoying and, I'm not going to lie, would probably lead to the same outcome (because I know telling people to delete their posts wouldn't go down well) if it happens again in the future, but it's far from my biggest problem.

Also, despite the lack of much of the stuff that made me decide to leave the chatbox showing up today, probably still not going to be there tomorrow, since I expect it'll pick up again when Strat tries to work out his post.

Amusingly, the only thing I can think of that's even close to a solution (which I'm not selfish enough to want people to do) would've completely averted the need for a solution in the first place (either by not filling the chatbox with the RP discussion that led to me flipping out or by putting mention of Moe's plan that would've let me stay in the RP somewhere I might've been able to see it). Said idea that I really don't expect anyone to want to follow is...putting RP discussion in the RP discussion thread.

[Rain]

... we managed to post repeatedly in a day at all?

Apart from that, umm... sorry. Always find it easier to respond to people than start a conversation. >.<

[Tachi]

When April stabbed Jenny with Rule Breaker and then again around the time that the Abyss took control of Grey.

[EldritchMermaid]

*feeling like this is my fault again*

[Tachi]

It's not. Like I said, there were a bunch of people (5-6 by my count, since I can't remember if Anny had left yet by the first time this happened) who could've stopped and thought "hey, Tachi's asleep at the moment, maybe we should wait for him to have a chance to respond".

[Krautman]

My laptop's being repaired, so access will be spotty.

[Rain]

I hate essay writing:

Discuss One Biological and One Psychological Treatment of Schizophrenia
(8 and 12 marks)

Biological theories of mental health emphasise that all disorders have a somatic cause. So, too, do biological treatments emphasise correcting a physical problem. In the case of schizophrenia, the easiest problem to rectify is the vastly elevated levels of dopamine, and it's this that the most common therapy for schizophrenia, chemotherapy, attempts to rectify.

Anti-psychotics can be split into two types based upon how they reduce or modulate levels of dopamine at key sites. The first, and older, type of anti-psychotics are called typical anti-psychotics, and include Chlorpromazine. The more recent developments are called atypical anti-psychotics and include seroquel and clozapine.

Typical anti-psychotics have a simple goal, to reduce the level of dopamine in the brain, and work in a straightforward manner: they bind to D2 receptor sites and prevent dopamine from sending signals. This universally lowers the level of dopamine transmission in the brain and, as a consequence, decreases positive symptoms.

However, they have several flaws. Firstly, they never unbind from receptor sites, which has numerous side effects regardless of the area of the brain affected: D2 is a key neurotransmitter and transmission is needed for normal functioning. Secondly, even if sites aren't permanently blocked, typical anti-psychotics lower dopamine transmission in the entirety of the brain, including key pathways used for movement, which simply aggravates the disorder's negative symptoms.

Atypical anti-psychotics were created to modulate levels of dopamine without worsening negative symptoms. To this end, they have different actions in different regions of the brain.

In the mesolimbic pathway, a region of the brain involved with emotions and sensations of pleasure, atypical anti-psychotics function much like typical anti-psychotics. They bind to D2 receptor sites and prevent transmission. However, if D2 is completely blocked, motor side effects will result. As such, atypical anti-psychotics are designed to rapidly dissociate to enable a period of normal transmission and functioning before the next drug dose. This 'hit and run' action avoids some of the negative motor side effects associated with drug therapy.

In the nigrostriatal system, atypical anti-psychotics instead bind with serotonin receptors. This is because the nigrostriatal system is mostly involved with movement, so lowering the levels of D2 here is undesirable. Instead, serotonin is blocked. Since the presence of serotonin inhibits D2,the levels of dopamine in the nigrostriatal pathway rise when serotonin is blocked. This drastically reduces motor side effects.

In evaluation, there is evidence to support the effectiveness of anti-psychotics. Borison et al (1996) conducted a clinical trial into the effectiveness of seroquel in treating both positive and negative symptoms of schizophrenia. The study contained 54 schizophrenic patients in the experimental condition and 55 in the control group, which was on no anti-psychotic medication at all. Patients were assessed over six weeks, and significant differences were found at the p < 0.05 level, and no aggravation of negative symptoms were reported. This supports the effectiveness of anti-psychotics over both no medication and typical anti-psychotics. However, this study does have one major flaw: the right to protection from harm in the control group was compromised, and it subsequently lost 3/5 of its members before the end of the study.

In 1996, Elesser et al did an investigation into the effectiveness of both typical and atypical anti-psychotics. Typical anti-psychotics resulted in an improvement in 65% of schizophrenic patients, whilst atypical anti-psychotics showed an improvement in an even larger 85% of patients. This once again supports the effectiveness of anti-psychotics for treating schizophrenia.

There is evidence to suggest that the success of anti-psychotics can be improved when combined with more traditional psychological therapies to combat the social and cognitive issues that arise as a complication of the disorder, such as through CBT, as indicated by Kopelowicz & Liberman (1998). This shows that although anti-psychotics are an effective treatment, they aren't perfect.

However, anti-psychotics have many side effects, which presents an ethical dilemma and raises questions about whether anti-psychotics are an appropriate treatment. One side effect is tardive dyskinesia, an irreversible condition that affects 60% of patients and results in involuntary bodily and facial movements such as lip smacking and tongue thrushing. The treatment, by design, also massively diminishes patients' sensory experience of the world and tends to aggravate negative symptoms. It introduces some motor difficulties, such as akathesia, that aren't even part of the original disorder.

Finally, anti-psychotics promote a deterministic view of human nature: people don't get any ability to choose or play an active part in chemotherapy, aside from whether to take the medication or not. It's merely a matter of ingesting chemicals to affect your neurochemistry and waiting for the effects. It completely ignores the possibility of individual differences from behaviour and desires—but the 15% who show no benefit from anti-psychotics suggests there is more to it than simply doping people.

The opposite of biological therapies are psychological therapies. Instead of advocating a somatic cause to the disorder, they instead emphasise some sort of mental fault that can be addressed and improved upon with therapy.

One type of psychological therapy is Cognitive Behavioural Therapy (CBT). This identifies and address both the cognitive (thought based) and behavioural (action based) issues that are part of schizophrenia to improve the patient's situation. There are multiple techniques within CBT. One is Integrated Psychological Therapy (IPT) and another is Coping Strategy Enhancement (CSE).

IPT aims to identify specific cognitive deficits and remedy them, starting with improving attention and concept formation before moving onto social cognition. It also includes reality tests, helping patients to identify delusions, as in the case of Chadwick et al (1996). In this case, a man believed he could make things happen by thinking them; after being shown 50 video clips and being asked to predict what happened next, he accepted that he did not have this ability when he didn't get a single prediction correct.

Firstly, with IPT, interactive exercises in a group and individual format are used to help improve the patient's verbal memory, attention, and concept formation, in order to make the simplest aspects of day to day life easier. Next comes working on social cognition; for instance recognising that a cashier is smiling at you and you should smile back, to combat inappropriate affect. Third comes engaging in more social contact and improved communication skills (to combat alogia and avolition). Finally comes working on straight social skills and strategies for solving interpersonal problems, the part of IPT least geared towards schizophrenic patients and the part with the most potential for benefit in the general populace

CSE exists to make it easier for patients to manage their symptoms and to cope with them, hence the name. Through psychoeducation, they are taught strategies to manage specific symptoms. This can include such things as positive self-talk (for cognitive strategies), whilst behavioural strategies include relaxation techniques and drowning out hallucinations, such as through music. Strategies are practised with the therapist and then the individual is given homework assignments to apply them in real life.

In evaluation, CBT has empirical support. Startup et al (2004) conducted a study using 90 schizophrenic patients. 47 were given up to 25 hour and a half long CBT sessions, whilst the other 43 received only anti-psychotic medication. Patients were assessed on admission, then at six months, then at one year. The experimental group showed 60% improvement compared to the 40% of the anti-psychotic only group and had no deterioration, compared to 17% of the control. This shows that CBT is effective.

Chadwick et al (2000) found CBT to be effective in treating schizophrenia as well, taking 22 patients with auditory hallucinations, voices in particular, in eight group sessions. Pt's showed significant reduction in their beliefs about the power of the voices. This also indicates that CBT is effective for managing symptoms, though patients didn't show any reduction in depression or anxiety.

Tarrier (1987) also found CBT to be effective—in particular, CSE. Using strategies developed in sessions, 73% of schizophrenic patients reported success at managing their symptoms, once again suggesting that CBT is a valuable and effective treatment for schizophrenia.

However, there are indications that CBT might not be appropriate in all cases. Firstly, it relies on a level of cognition that schizophrenia is characterised by a lack of, which impairs its use for therapeutic benefit. Many patients with delusions might not even accept they need the help in the first place. Secondly, many clinicians feel that it is far less suitable for use with older sufferers due to the rigidity of their thoughts, as reported by Kingdon & Kirschen (2006).

Garret (2008) described successfully getting a schizophrenic woman to take her medication using CBT. This shows that, even in instances where using CBT as a direct treatment might not be appropriate, the therapy still has appropriate applications for the treatment of schizophrenia.

Finally, the therapy promotes free will. By encouraging patients to take part in their own treatment and actively involving them, it puts the power to improve their condition back in the patient's hands and removes the emphasis on biochemical puppetry emphasised by chemotherapy.

[fusionman]

Trust me. The only disgusing piece of trash is me. Trust me. It's how I've been treated a lot.

Hell I'm pretty sure I'm the only one of us here with a This Troper video about me.