Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol

Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia.     

Making Space for Community Critical Methodology: Stories from the Australian Context

Our collective account considers the ways community critical methodologies can inform academic endeavors. Methodology is understood to be the theorizing of methods that produce and legitimate knowledge claims. For us, community critical approaches incorporate poststructural and other forms of critical theory in the questioning of taken for granted assumptions. This forms a valuable foundation for community praxis as it focuses not just on social issues outside, but on an examination within; on the institution of psychology itself. We find “examining within” a vital process for our research, teaching, and community engagement. Above all it is important to ask whose interests are served by the construction and presentation of knowledge in particular ways. We present three pieces of practice which engaged with critical methodologies. The first examines collaborative research methodologies developed with young people in rural Australia who are primary carers for a family member. The second examines tensions involved in trying to employ critical methodologies in multi‐stakeholder work between community organizations, communities, and researchers. The third examines opportunities and barriers when employing critical methodologies in learning and teaching with undergraduate students. We reflect upon the intersecting threads of commonality and difference between them and consider the implications for practice.     

The Mediating Effects of Spiritual Bypass on Depression,Anxiety, and Stress

Spiritual bypass is a defensive psychological posture that prevents people from feeling the pain of difficult emotions or experiences through 2 primary pathways: (a) Psychological Avoidance and (b) Spiritualizing. The authors collected a sample (783 participants) from the general population and tested a parallel mediation model in which 2 factors of spiritual bypass mediated the effect of spirituality on depression, anxiety, and stress. The results demonstrated that Psychological Avoidance and Spiritualizing partially mediated the effect of spirituality on depression and anxiety, whereas they completely mediated the effect of spirituality on stress. The findings are presented in the context of the study's limitations, and implications for clinical practice and research are provided.     

The Effect of modality specific interference on working memory in recalling aversive auditory and visual memories*

Both auditory and visual emotional memories can be made less emotional by loading working memory (WM) during memory recall. Taxing WM during recall can be modality specific (giving an auditory [visuospatial] load during recall of an auditory [visual] memory) or cross modal (an auditory load during visual recall or vice versa). We tested whether modality specific loading taxes WM to a larger extent than cross modal loading. Ninety-six participants undertook a visual and auditory baseline Random Interval Repetition task (i.e. responding as fast as possible to a visual or auditory stimulus by pressing a button). Then, participants recalled a distressing visual and auditory memory, while performing the same visual and auditory Random Interval Repetition task. Increased reaction times (compared to baseline) were indicative of WM loading. Using Bayesian statistics, we compared five models in terms of general and modality specific taxation. There was support for the model describing the effect on WM of dual tasking in general, irrespective of modality specificity, and for the model describing the effect of modality specific loading. Both models combined gained the most support. The results suggest a general effect of dual tasking on taxing WM and a superimposed effect of taxing in matched modality.     

Examining the Clinical Efficacy of Core Transformation: A Randomized Clinical Trial

This randomized clinical trial with a sample of adults (N = 129) from India explored the effects of a single core‐transformation session on symptom experience and psychological growth. The results over the total 8‐week study period indicated significant, moderate overall effect sizes (ds = 0.63 and 0.52) for symptom experience, emotional stability, affect balance, global well‐being, and purpose in life. Implications for research and clinical practice are discussed.     

Working memory for language is not special: Evidence for an articulatory loop for novel stimuli

The “articulatory loop” for rehearsal of verbal materials in working memory has been shown not to be a unique hard-wired structure associated with spoken language. Specifically, a parallel rehearsal process for sign language occurs in fluent signers. Here we show that the same rehearsal process can occur for unfamiliar, nonmeaningful body movements. We conclude that working memory maintenance does not rely on a dedicated architecture, but instead involves the strategic recruitment of resources as needed for the task demands.     

Recycling,evolution and the structure of human personality

Lower childhood cognitive ability may be a risk factor for greater cognitive decline in late life and progression to dementia. To assess variation in age-related cognitive change, it is helpful to have valid measures of cognitive ability from early life. Here, we examine the relation between childhood intelligence and cognitive change in later life in two samples, one born in 1921 and the other in 1936. All participants completed the same test of mental ability (one of the Moray House Test series) at age about 11 years, and were re-examined on Raven’s Progressive Matrices at age 77 (1921-born) or age 64 (1936-born). Where possible, the 1921 sample was re-tested at the age of about 80 years old and the 1936 sample re-tested at about 66 years. After taking into account various covariates, including sex, education and occupation, childhood intelligence was a significant predictor of cognitive change in later life. Results were in the direction that participants with lower childhood mental ability experienced relatively greater cognitive decline, whereas those of higher childhood mental ability showed improved performance. This result suggests that higher premorbid cognitive ability is protective of decline in later life.     

The impact of childhood intelligence on later life: following up the Scottish mental surveys of 1932 and 1947

The Scottish Mental Surveys of 1932 and 1947 collected valid IQ-type test scores for almost everyone born in 1921 and 1936 and attending school on June 1, 1932 (N=89,498) and June 4, 1947 (N=70,805). These surveys are described. This research, using the surveys' data, examined (a) the stability of intelligence differences across the life span, (b) the determinants of cognitive change from childhood to old age, and (c) the impact of childhood intelligence on survival and health in old age. Surviving participants of the Scottish Mental Surveys were tested, and the surveys' data were linked with public and health records. Novel findings on the stability of IQ scores from age 11 to age 80; sex differences in cognitive aging; the dedifferentiation hypothesis of cognitive aging; and the effect of childhood IQ on all-cause and specific mortality, morbidity, and frailty in old age are presented.