We found a higher prevalence of depression in first-generation migrants aged 50 years or older, together with relevant geographical variation. This difference was not due to other known predictors of depression in older age.
Objectives: The present study in hypomanic and manic patients explored how amygdala responses to affective stimuli depend on the valence of the stimuli presented. Methods:We compared 10 patients with 10 matched healthy control subjects. We measured blood oxygen level-dependent (BOLD) responses in the amygdala while subjects passively viewed photographs taken from the International Affective Picture System. After the fMRI session, subjects saw the pictures again and subjectively rated the emotional valence and intensity of each picture.Results: Compared to healthy individuals, hypomanic or manic patients showed higher valence ratings in positive pictures and associated larger BOLD responses in the left amygdala during positive versus neutral picture viewing. This enhanced amygdala activation was correlated with Young Mania Rating Scale scores and with euphoric as opposed to irritable symptom presentation. Conclusions:Increased valence ratings and amygdala responses to positive affective stimuli may reflect a positive processing bias contributing to elevated mood states characteristic for euphoric mania.
The present work critically examines two assumptions frequently stated by supporters of cognitive neuroenhancement. The first, explicitly methodological, assumption is the supposition of effective and side effect-free neuroenhancers. However, there is an evidence-based concern that the most promising drugs currently used for cognitive enhancement can be addictive. Furthermore, this work describes why the neuronal correlates of key cognitive concepts, such as learning and memory, are so deeply connected with mechanisms implicated in the development and maintenance of addictive behaviour so that modification of these systems may inevitably run the risk of addiction to the enhancing drugs. Such a potential risk of addiction could only be falsified by in-depth empirical research. The second, implicit, assumption is that research on neuroenhancement does not pose a serious moral problem. However, the potential for addiction, along with arguments related to research ethics and the potential social impact of neuroenhancement, could invalidate this assumption. It is suggested that ethical evaluation needs to consider the empirical data as well as the question of whether and how such empirical knowledge can be obtained.
In Germany, the public system of addiction treatment is used less by migrants with addictive disorders than by their non-migrant counterparts. To date, the literature has focused primarily on language, sociocultural factors, and residence status when discussing access barriers to this part of the health care system. However, little attention has been paid to cultural differences in explanatory models of addictive behaviour. This is surprising when we consider the important role played by popular knowledge in a population's perceptions of and responses to illnesses, including their causes, symptoms, and treatment. In the present study, we examined explanatory models of addictive behaviour and of mental disorders in 124 native German und Russian-German youth and compared these models to those observed in an earlier study of 144 German and Turkish youth. We employed the free listing technique German and to compile the terms that participating subjects used to describe addictive behaviour. Subsequently, we examined how a subset of our study population assigned these terms to the respective disorders by means of the pile sort method. Although the explanatory models used by the German and Russian-German youth in our study were surprisingly similar, those employed by Turkish youth did not make any fundamental distinction between illegal and legal drugs (e.g. alcohol and nicotine). German and Russian-German youth regarded eating disorders as "embarrassing" or "disgraceful", but Turkish youth did not. Unlike our German and Russian-German subjects, the Turkish youth did not classify eating disorders as being addictive in nature. Moreover, medical concepts crucial to a proper understanding of dependence disorders (e.g. the term "physical dependence") were characterised by almost half of our Turkish subjects as useless in describing addictions. These findings show that it is impossible to translate medical or everyday concepts of disease and treatment properly into a different language without considering the connotations and implications of each term as it relates to the respective culture. Terms that are central to Western medical models of disease may otherwise be misunderstood, misinterpreted, or simply rejected.
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