Command hallucinations (CH) are a distressing and high-risk group of symptoms that have long been recognized but little understood, with few effective treatments. Research shows that cognitive behavior therapy (CBT) is a promising treatment for hallucinations in general and therefore has a potential role in the treatment of CH. We propose that the development of an effective CBT for CH would be enhanced by a theory specific to this uniquely problematic symptom. In this article we describe and apply such a theory from evolutionary psychology, namely social rank theory, and review recent evidence for its application to hallucinations in general. Second, we present a treatment protocol developed in accordance with the principles of the theory specifically for CH, and describe an illustrative case. Finally, we outline the design and methodology of a new, randomized, controlled trial currently being undertaken to test the efficacy of the treatment. Further developments both in the protocol and in its evaluation are discussed.
Microglia, the innate immune cells of the central nervous system, play a pivotal role in the modulation of neuroinflammation. Neuroinflammation has been implicated in many diseases of the CNS, including Alzheimer’s disease and Parkinson’s disease. It is well documented that microglial activation, initiated by a variety of stressors, can trigger a potentially destructive neuroinflammatory response via the release of pro-inflammatory molecules, and reactive oxygen and nitrogen species. However, the potential anti-inflammatory and neuroprotective effects that microglia are also thought to exhibit have been under-investigated. The application of ionising radiation at different doses and dose schedules may reveal novel methods for the control of microglial response to stressors, potentially highlighting avenues for treatment of neuroinflammation associated CNS disorders, such as Alzheimer’s disease and Parkinson’s disease. There remains a need to characterise the response of microglia to radiation, particularly low dose ionising radiation.
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