“There is nothing that art cannot express” ~ Oscar Wilde

What would you like to express with art?

The Wall Street Journal and The New York Times, two of the most puissant media outlets, informed us of the new experimental HIV Vaccine that inflamed the hopes of many.

“An experimental vaccine regimen has shown a modest ability to protect people exposed to the HIV virus, the first time an investigational HIV vaccine has been shown to have this effect. The results from the trial, which involved more than 16,000 adult participants in Thailand, indicated that the vaccine regimen lowered the rate of contracting HIV by 31% compared with those taking a placebo, according to the U.S. National Institute of Health, which helped fund the study” (Gautam Naik, WSJ).

Out of the 8,198 people who received a placebo drug, 74 became infected with HIV.
Out of the other 8,198 people who received the real vaccine, 51 got affected.

The numbers might not be impressive or compelling, but the difference suggests a statistical difference of 31%.
This really is a “piece of good news” and gives hope in the battle against HIV. Yet, why is it that the press does not cite the actual scientific article? I find this deeply flawed. The scientific method relies on methodological and well documented studies in a strictly controlled environment. A scientific article has to be peer reviewed and approved in order to be published. Evidence for none of this was provided in either of the newspapers. This makes me wonder if the study has been peer reviewed and published in a scientific journal. It makes me question the authenticity of the results and the validity and reliability of the whole experiment.

It is worth acknowledging the limitations that researchers face when attempting to experiment with people. When people’s lives are being affected, we cannot really apply the scientific method and conduct a true empirical experiment. There is a moral code that scientists ought to follow. We cannot divide the participants in two groups and infect one of them with HIV in order to test the vaccine. In this sense, it is impossible to have completely manipulated experimental setting. Still, scientists are trying to do the best they can and control the conditions of the experiment as much as possible. This is not the subject of my concerns. My concerns are that such experiments have a lot of limitations and possible alternative explanations that might explain the observed results. An experiment of this sort does not, by any means, imply a cause and effect relationship. My fear is that such data can be simply be interpreted the wrong way. If a pharmaceutical company sees opportunity for profit and starts to sell such vaccine, typing the warnings in small font, hidden in a corner, people might be in danger. A single wrong message from the powerful media empire can convince many that a successful vaccine has been found and scientists have the results to prove it. Yet, no one is quoting the scientific study.

In this particular case, the statistically significant results can be explained by a number of unmentioned reasons. Possibly, the participants, who took the experimental vaccine did not have as many (or any) sexual relationships. Perhaps, the people who had the placebo had unprotected sex with people who were infected, whereas most participants in the other group did not. These are only a few examples of alternative explanations for the results. However, we cannot know for sure if researchers have considered these, because the media is not providing the scientific information. Unsubstantiated by the scientific facts, such reports and statements could be very equivocal or even misleading.

Commercials tell us: “Ask your doctor about … Cymbalta, Ambien, Lunesta… Ask your doctor it it’s right for your”. The easiest thing for your doctor would be to give you the prescription you are looking for. That is probably why we are on the way of becoming an overmedicated nation, if we are not one already.

I encourage each and every one of you to be more skeptical. Ask the right questions and demand an answer. Beware the small font warnings hidden in the bottom. Whenever someone tells you a ‘fact’ and makes a promise, ask him/her to state her source. Know what is in the product that you are consuming, from the prescription drugs you’re taking, to the dinner you’re having.

]]> http://mindforums.com/be-on-the-alert-for-unscientific-media-reports/feed/ 1 http://mindforums.com/835/ http://mindforums.com/835/#comments Wed, 16 Sep 2009 16:50:56 +0000 Dima http://mindforums.com/?p=835 I rejoiced to see the following article in CNN’s Health Care in America commentary: “Drinking age of 21 doesn’t work.” Finally a sensible statement about the issue. The 21-year-old drinking age has not been an effective solution to the problem of drunk driving, or alcohol-related deaths among young adults. Not only is it ineffective, it might actually pose more risks for young people.

The National Minimum Drinking Age Act was passed by the Congress in 1984 and signed by the president. This Act raised the drinking age to 21. This was government’s reaction to the threatening and growing problem with drunken driving accidents and fatalities. However, this is probably the only preventative measure that the government took and it wasn’t nearly enough. Simply raising, or lowering the drinking age does not deal with the real problem. Young people need to be educated on the effects of alcohol (on behavior and driving), the importance of personal decisions and potential risks. Psychologists attest the truth of the old saying that ‘the forbidden fruit tastes the sweetest’. This is especially true for young people, who often need to resist control and authority to declare their autonomy. The author of the article makes an excellent point: “The law does not say drink responsibly or drink in moderation. It says don’t drink. To those affected by it, those who in the eyes of the law are, in every other aspect legal adults, it is Prohibition. And it is incomprehensible”(John M. McCardell, Jr). This can further aggravate the rebellious spirits. In addition, young Americans are aware that almost all other countries (except Indonesia, Mongolia and Palau) either have no minimum drinking age, or have a lower age limit (usually 18, but sometimes even 16).

It is no longer 1984. “Now, 25 years later, we are in a much different, and better, place. Thanks to the effective public advocacy of organizations like Mothers Against Drunk Driving, we are far more aware of the risks of drinking and driving. Automobiles are much safer. Seatbelts and airbags are mandatory. The “designated driver” is now a part of our vocabulary” (John M. McCardell, Jr).

Alcohol-related fatalities have declined in the past 25 years, in all age groups. Yet, the greatest number still involves people at age 21, followed by 22 and 23. “The problem today is different. The problem today is reckless, goal-oriented alcohol consumption that all too often takes place in clandestine locations, where enforcement has proven frustratingly difficult. Alcohol consumption among young adults is not taking place in public places or public view or in the presence of other adults who might help model responsible behavior. But we know it is taking place.” It is taking place in dorm rooms, off-campus apartments or remote fields (that involve driving). Drinking in such remote and isolated places hides greater risks than ordering drinks in a bar, where the bartender can refuse to serve at any point the individual appears intoxicated. If drinking is taking place in a public setting, there are many mediators and people who can react in case of emergency and call 911. This is not the case in locked and secret places where all of the drinkers can be underage and therefore be hesitant to call the police, because they don’t want to get in trouble. The CNN article explains that “of the 5,000 lives lost to alcohol each year by those under 21, more than 60% are lost OFF the roadways, according to the National Institute of Alcoholism and Alcohol Abuse.”

The main problem today in not drunken driving. It is “clandestine binge drinking” “A study published in the Journal of the American Academy of Child and Adolescent Psychiatry revealed that, among college-age males, binge drinking is unchanged from its levels of 1979; that among non-college women it has increased by 20%; and that among college women it has increased by 40%” (John M. McCardell).

The bottom line is that the drinking age of 21 does not eliminate the problems or change the fact that young adults and teenagers ARE drinking, even if it is considered illegal. Then, we need to be thinking how we can create the most safe environment possible, so that young people can explore drinking with minimal risks.

Almost all cable channels are adulterated with at least one ‘Reality show’ which portrays a reality that cannot be further from the actual world. And even if the portrayal is realistic, don’t we have enough reality in out lives – every minute of every day?! Come on, do you really have to hurry to your TV set in order to see ‘The Real Housewives’? If you are not one yourself, talk to your neighbor. She has 6 kids, too and she is a real housewife! Ask about her life. Ask her what it all feels like. It doesn’t get any more real that that.

I assume that the initial idea behind reality shows was to reveal the life of worthy individuals, who do have an incredible story to tell and who can inspire us, or bolster our spirit. At least I hope this was the idea. Maybe it was just good math for profit, because it is shockingly popular TV that will continue to bloom as long as there are people more enthused about the season finale than their real life. Today, reality TV is not about worthy individuals – not always anyway. It is about Megan, who apparently “wants a millionaire”, Bret Michaels who has been looking for true love on “Rock of Love” for three seasons already. Do not feel bad for him though – he finds it at the end of every season. And these are just a couple of examples in a swarm of many more.

The American reality television dating game shows have turned into a popular and acceptable way to date and have sex with many people in the same time, all of whom are conveniently located in the same house. Yes, I admit, it could be funny to watch. What is not funny about adult and, supposedly, mature successful men (millionaires) who fight foolishly for Megan’s heart and would go through all sorts of absurd challenges to win a date? What is not comical around a house full of wild girls who drink, curse, scream, fight, strip and pass out (all of this while they try to prove Bret Michaels they are his true love). All of this could be funny if I saw it in a movie that was labeled as a Parody and Comedy. It is a bit scary when I find it in Reality TV.

Reality shows set very unrealistic expectations among the members of a society who have become addicted to them. The people who are chosen after casting are being prep-ed and treated with a serious amount of make-up. They do not represent the average person who holds a job, has a home and family to support. The excessive drinking, partying, cursing and so on are not the characteristics of a person who effectively functions in society and the life of most of us does not unfold on an epicurean set. Reality TV is not real, it’s an arranged scenery – produced and carefully directed.

So, please, turn off the TV – reality awaits! Attend to your real life – it is probably the only thing worth your attention.

About 50% of first marriages for men under age 45 may end in divorce, and between 44 and 52% of women’s first marriages may end in divorce for these age groups.

Rose M. Kreider and Jason M. Fields, “Number, Timing, and Duration of Marriages and Divorces: 1996″, U.S. Census Bureau Current Population Reports, February 2002, p. 18.

What do these numbers tell us?
My interpretation is that marriage is no longer the rock-solid and unyielding sacrament it was invented to be. Yes – invented. Holy matrimony and monogamy, for that matter, are human creations that made a lot a sense in a brutish and nasty world, where one faced a myriad of enemies and hardships. However, that was a totally different time: in 1900 the average lifespan was 47 years; in 2000 it is 77. In the past, many men lost their wives to childbirth and getting remarried was very common. Fortunately, short life and perilous delivery are no longer the norm. So, are we unreasonable in expecting monogamy to work for all of us, all the way through our long life?

Does monogamy work? Statistics show that Americans, at least, are not very good at it, and the divorce rate wavers around 50% (just compare it with Japan’s 2% divorce rate).

We can ask: “Why are so many people getting divorced?” We can also ask: “Why are people getting married in the first place?” I am not trying to disacknowledge the institution of marriage, but I am afraid many people have unrealistic expectations, or simply get married because it is the norm. Just like so many other things, getting married and having children is what is expected of you, at one point in your life. If one enjoys a ’single life’ for ‘too long’, or relishes polygamy, people start asking, ‘What’s wrong with you? When are you gonna come to your senses and settle down?’ Well, maybe it is worth considering not everyone is the marrying kind. Marriage and monogamy certainly work for many, but not all people. The sooner we realize this, the better. In our western society, getting married is still a very sensible practice (tax benefits for marriage, joined savings accounts and so on), but it makes no sense whatsoever if it doesn’t involve an exclusive, committed relationship. Yet, some people manage to save their marriage while being engaged in polyamory or swinging. Still, it is very rare, because this peculiar lifestyle cannot be stomached by all. The alternative for those who cannot abide monogamy, but do get married, is cheating and/or divorce. Hence, the 50% divorce rate and we are still asking: “Why are people getting married in the first place?”

Another problem for marriage, monogamy and relationships in general is the unrealistic portrayal of romance in the media. Many people are enthralled with the myth that they are going to meet one special person (or maybe a soul-mate) who is going to share their dreams and ideals, and satisfy them on every level (emotional, intellectual, sexual). It would be wonderful if you meet this truly special someone, but, realistically, isn’t this too much to ask from one person? Is it really plausible to expect your spouse or partner to be your best friend, your fervent supporter, to share your hobbies, interests and goals, but also to be gorgeous and, umm of course, the best sex you’ve ever had?

Wild and passionate love that conquers all is commonplace in Hollywood. The message in most movies is that romance, passion, love and happiness are the key components to a relationship. Commitment, friendship, cooperation and forgiveness sink in the background.

Many, I’m afraid, begin to believe that romance and passion are supposed to rule and define a relationship. However, when you are caught up in a stressful routine, overwhelmed with duties and worries, there is very little room left for romance. All of a sudden, your heart is not racing when you see your significant other. All of a sudden, you don’t wish to cuddle until noon on Saturday. At this point many people grow worried that the love is dying, because the passion and romance are gone. Many people think that it is probably time to move on – the marriage is not working. Don’t get me wrong, I am a big fan of passion and romance, but it is fallacious to expect them to last very long, they are just the ephemeral joys of young love. They might be what brought two people together, but are not what will keep them together. Naturally, over time, your significant other is no longer new, exotic and unfamiliar and you cannot expect your hearts to race every time you see each other. You have adapted. It is not necessarily a herald for dying love or a failing relationship. It is evidence that we are creatures who adapt to their surroundings. The contrary would be unhealthy.

We have become love junkies with serious commitment problems. This is not surprising, considering we are a consumerist society that is used to satisfying its every craving. Leased cars are only good until the next model is available. Presents come with gift receipts. Goods can be returned, or exchanged. You can enjoy a free trial of most games, programs, services, massage chairs, mattresses and most other products. Imperfectly, there is no free trial in marriage. There are no guarantees, or your money back. No option for return, or exchange and nothing is risk free. On the contrary, you have a lot to risk and a lot to compromise. Have we lost grasp of these concepts? The overabundance of products makes us capricious and easily bored, and explains our commitment issues.

Does monogamy work? Does marriage work?

Don’t expect to find a single right answer, just keep an open mind and , possibly, understand that one lifestyle is not for all.

]]> http://mindforums.com/662/feed/ 3 http://mindforums.com/light-pollution/ http://mindforums.com/light-pollution/#comments Fri, 14 Aug 2009 00:47:00 +0000 Dima http://mindforums.com/?p=617 When was the last time you stood under the naked skies and gazed at the stars? How often does this happen to you? Let me guess, not too often? Why?

When was the last time you stood under the naked skies and gazed at the stars? How often does this happen to you? Let me guess, not too often? Why?

Among other reasons,our skies have turned into a haze of light. And the stars? We don’t see them anymore, at least not so often.

This is due to Light Pollution – any type of artificial light that shines outward and upward instead of downward, where it is actually needed. One might wonder how could this be pollution and how serious could it be, but it is an increasingly growing problem, whose real consequences we are only beginning to understand.

Nowadays, the night skies over most of the developed world, especially the USA, Europe and Japan, are a cloud of light. In fact, people in about a third of the USA, half of Europe and all of Japan cannot see the Milky Way at night.

Clearly, humans are not nocturnal creatures, but our desire to modify our surroundings and transform the natural state of things is a little frightening. By altering the natural day-night circle, we are changing more than we initially wanted.

Light pollution is greatly affecting animals’ reproduction, feeding and migration.

Birds, for example, react to light as metal to magnet. They tend to gather around light objects and fly in circle around them. This has become an issue, since we have thousands of brightly lit skyscrapers, that attract birds in a flying circle until they drop down with exhaustion. In addition, birds use light and darkness for guidance in their migration. Normally, longer days are associated with opportunity for feeding and longer nights are associated with winter time. When we light up the night sky, we fool the populations of birds into thinking there is a longer day. Consequently, they are able to feed more and reach the needed amount of body fat quicker. Thus, they leave for they migration route sooner than required for their survival. The real problem is that birds would leave before cold weather has set in and come back the following year before the warm weather has created good living conditions for their populations.

Yet another example, of how light pollution affects birds is their singing in unusual times.

Sea turtles also suffer the effects of light pollution. The female sea turtles naturally look for dark beaches to lay their eggs. Their hatchlings are then born with the instinct to move towards the reflective (therefore, brighter) surface of the water. However, the brightly lit cities and/or highways behind the beach line confuse the little hatchlings, who end up traveling towards that brightness and never reach the water, their natural habitat. In Florida, alone, the number of hatchlings that survive decreases with hundreds of thousands each year.

Frogs and toads are species with nighttime breeding rituals. Very often, the ponds and swamps they inhabit are located near bright lit highways or cities, so that these little earthlings never have the darkness necessary for their breeding practices.

Other examples of how our light pollution affects living forms are the many nocturnal creatures that feed in the darkness of the night. For those, it is increasingly difficult to find the darkness, so crucial for their survival. Insects, we all have notices, tend to cluster around streetlights. Therefore, it is increasingly difficult for nocturnal bats to feed and their populations suffer.

While one might not be particularly worried about the life of a frog, or a bat, in this case we are talking about whole populations of specie, whose numbers are decreasing because we have decided to modify the natural world and order of things. Needless to say, change in a single species can initiate a number of other changes in the biosphere. These changes might eventually affect us in a way we would not like. Maybe we ought to consider the big picture. After all, we are earthlings as well and we are also affected by the same natural principles that guide birds and toads.

The change and constant rotation of the day and the night governs our Circadian rhythms. In humans, the Circadian rhythm lasts approximately 24 hours and directs sleep and waking, core body temperature and hormonal levels.

Recent research (Kloog et al.) indicates that excessive exposure to artificial light at night may be a risk factor for breast cancer in women. These studies do not imply causation, only correlation, but they certainly demonstrate there are many things we do not understand yet. Our human species has evolved in a world where a day was followed by a night. All of a sudden, people were forced to work night shifts or simply live amidst the bright neon cities. Who knows how our bodies will react to this sudden change? What are we experimenting with? Is it not ourselves?

I would be an advocate of the bright night if we actually needed the light. Most of the time, however, this is not the case. Often, it is simply useless, aimless lighting! Office buildings with no businesses open during the night certainly do not need all their cubicles brightly lit, do they? The office building right next to my apartment building shines bright 24 hours, every day of the year, without a single soul inside. Who needs all of this light? And why waste all of this electricity? This is not only useless, this is bothering me and all the other people who cannot make their bedrooms dark enough to get a good night’s sleep.

One would think that in these hard times of economic and environmental challenges we would be more cautious not to waste as much energy. Yet, we indulge in our wasteful habits and cast light where we don’t even need it. The International Dark-Sky Association claims that about a third of outdoor lighting is wasted due to ineffective light fixtures. In the USA alone, the annual cost for wasted/ misdirected light costs $10 billion. This is a very simple equation – wasted light is wasted energy and money.

Replacing the fixtures in public spaces with dark-sky-friendly fixtures can surely be a strain on the budget. Between 2002 and 2005 the Canadian city of Calgary has replaced its older, drop-lens streetlights with flat-lens night-sky friendly fixtures (Brad Scriber, Nightlight Savings Time). This enormous project of replacing 37, 000 lights was a major investment. But with $1.7 million in annual energy savings, the project is expected to pay for itself by 2012.

“Of all the pollutions we face, light pollution is perhaps the most easily remedied”

~Verlyn Klinkenborg, The National Geographic

There is a lot we can do!

We can update existing fixtures with new designs that reduce glare and focus light on the ground, instead of outwards and upwards. When buying light fixtures we can look for the light-fixture seal of approval by the International Dark-Sky Association. We can install motion-activated lights for parks, parking lots, building and so on. Switch off the lights when we don’t need them! Try to eliminate aimless lighting! Care! Begin to change our habits and not waste! And step by step we might all be able to see the stars again.

Until then, starry nights will be “rare and exotic skyscapes for many” (Tamie R. Smith). If you would like to plan a dark-sky vacation, these are the spots that offer excellent conditions for stargazing: Death Valley National Park, California and Nevada; Natural Bridges National Monument, Utah; Cherry Springs State Park, Pennsylvania; Acadia National Park, Maine.

That is correct, these days, we need a National Park with its laws and regulations in order to gaze at the stars. I am quite sure, our ancestors did not envision the problems we are having today.

Have a starry night!

About 963 million people across the world suffer hunger (The Food Secutity Statistics, 2008), which is recognized as the most severe form of poverty (Hunger Report, 2004). This strikingly big number may sound unreal to those of us who have just enjoyed our delicious Starbucks treat. Even worse, we might have been desensitized to numbers ranging in the millions, or even billions, as we see them in the same sentence with bailout, debt, loan, equity, and so forth. In this case however, the number is as real as can be. 963 million people – each of these lives as important and meaningful as the next one. To begin to understand these statistics better, let’s break the numbers down: each day, about 16,000 children die from hunger-related causes (Black, Robert, Morris, Saul, & Jennifer Bryce. “Where and Why Are 10 Million Children Dying Every Year?” 2003). This means, one child perishes every five seconds, due to hunger. The more specific causes for these deaths might be chronic undernourishment, vitamin or mineral deficiencies, which, in turn, lead to heightened susceptibility to illness (Hunger Report, 2004).

The United Nations Office on Drugs and Crime (UNODC) starts its 2008 Annual Report with the following sentence: “Drugs, crime and terrorism remain three of the greatest threats to the peace, security and well-being of humanity”. Sadly, there is little place to argue the opposite. The number of inmates, in the US alone, is compelling: 2,310,984 (U.S. Department of Justice, Bureau of Justice Statistics, 2008). This is a 0.8% increase from the number of 2007. However, the average annual growth from 2000 until 2007 was 2.4%. This means we have an estimated 509 sentenced prisoners per every 100,000 US residents. The number of female inmates is also rising, with numerous cases of pregnant inmates, whose inborn child never stood a chance of starting a ‘normal’ life.

When issues like these continue to describe our modern reality, i cannot help but wonder: Why do people have children? What is a good reason to have a child?

We addressed these question to students in an Introductory Psychology class. The responses were truly puzzling: “To have someone carry your name”, “To have a part of you stay after you’re gone”, “To keep a guy”, “To make your marriage work” and so on.

I stood there, in disbelief, shocked to hear what these young and smart people identified as the ‘reasons’ to have a child. Are these really good reasons for a commitment of this magnitude? If we are so desperate to have someone carry our name, aren’t we being purely egoistic? If we need to carry our genotype forward, we are certainly guided by evolutionary principles, but is this a good enough reason? If it takes a baby to make any guy stay with you, you might want to wonder if this guy is worth keeping, to begin with. If anything, a baby can be a strain on any happy marriage and is rarely prescribed as a remedial for a bad one. So, are these the right reasons? If college students, who thought about the issue, considered these their reasons, I am petrified to know what other people might say. Or do people even think about it? Has it just become the ‘normal’ thing to do – a routine of sorts – find a relationship, build a home, have children? Is it merely what our society considers appropriate? Is it something we do to feel good about ourselves? I hear parents taking such pride in the fact they have given life to another human being; people who think giving life is enough of itself and fail to look for their flaws when it comes to parenting. Is this mature and is it fair to the little person who is yet to come into this world and become part of the statistics (which statistics, we could not know yet)?

I happen to think that a good reason to have a child is the desire and possibility to raise a person of quality, who will contribute to society and might as well make the world a better place. I don’t find it trendy and I don’t think it’s cute either.  It is a serious matter of life and the greatest of all responsibilities. For this to be a success, one has to have a good game-plan. All of this, of course, has to be backed up by sincere love, commitment and stability. I do not mean to sound grotesque, or oversimplify complicated situations, but I sincerely believe this is an issue that each of us needs to consider very seriously and make a conscious decision. It would be sad, if something wonderful like a child would be something unwanted and unwelcome. As a professor of mine said: Imagine what a different place this world would be, if in order for a woman to conceive, both parents had to hold hands, look each other in the eyes and repeat thee times ‘I want to have a baby. I want to have a baby. I want to have a baby’ (M.J. Grant). What a different place that would be, indeed. Also, I do not think it is simply enough to give life (any living form can do this). More important is what we do to the life we have given. Do we abuse, or empower? Do we nurture, or neglect? Do we practice effective parenting, or do we fail miserably to connect?

Roger McIntire remarks: “We already license pilots, salesmen, scuba divers, plumbers, electricians, teachers, veterinarians, cab drivers, soil testers and television repairmen. … Are our TV sets and toilets more important to us than our children?” We even need marriage licenses! Then, why do we assume that our right to be parents is absolute and why do we take it so lightly? It is not an absolute right, it ought to be a privilege. Roger McIntire suggests further that licensing parents could be as simple as when you turn 18, you get the book and study it or take the course, then you take the written test, and the eye test, and if you pass, you get a beginner’s license, then you do some hands-on child care for maybe six months under the guidance of a licensed parent, and if you pass that part, you get your license, and if you don’t, maybe you try again in a while. We do it for almost anything else, why should this serious matter be any different?

There are millions of people in this world, who suffer starvation, diseases, low quality of life; millions of people who are being killed, abused or otherwise traumatized. If we are going to bring one more such life into the world, we have plenty already – why not try to take care of one of those.

The creation of life is a moral matter and requires serious moral examination, so ask yourself: Why have children?

]]> http://mindforums.com/why-have-children/feed/ 3 http://mindforums.com/reactive-attachment-disorder-etiology-symptoms-affected-brain-areas-and-treatment/ http://mindforums.com/reactive-attachment-disorder-etiology-symptoms-affected-brain-areas-and-treatment/#comments Tue, 26 May 2009 20:44:06 +0000 Dima http://mindforums.com/?p=347

Reactive Attachment Disorder:

Etiology, Symptoms, Affected Brain Areas and Treatment

Reactive Attachment Disorder (RAD) is characterized by considerably disturbed and inappropriate social interaction, across situations, that is manifested before the age of five (DSM-IV-R). Evidence for the disorder is usually seen in continuous failure to respond appropriately in social situations (being hypervigilant, inhibited, or ambivalent) and/or inability to develop and exhibit selective attachment to primary caregiver(s) (DSM-IV-R). The causes for the disturbed behavior in Reactive Attachment are associated with the developmental stages of Infancy and Early childhood, when pathogenic care can have profound and lasting effects. DSM-IV outlines three aspects of pathogenic care that explain the disturbance in normal development and behavior: persistent disregard for the child’s physical and emotional needs, as well as repeated changes of primary caregiver and/or surroundings. The connection between pathogenic care and disrupted behavior is compelling and reminds of the critical importance of nurture and effective parenting. Many psychologists have studied in depth child development during the first years of life and reveal that this is an extremely sensitive period for both physical and emotional development and maturation. It is a critical time for cultivating attachment, social skills, developing empathy and understanding basic values.

Maltreatment, no matter whether it is abuse, neglect, abandonment, or witnessing violence, can lead to enduring negative changes in the still developing brain of a child. Each time there is some sort of traumatic experience, the brain suffers a particular change. Many of the brain abnormalities that have been studied in abused and neglected children are located in the left hemisphere. Very often, in children, victims of abuse, there were fewer dendritic connections between different areas in the left hemisphere (Gunnar & Vazquez, 2001). Children that had showed such abnormal results demonstrated self-destructive or aggressive behavior, as well as certain disturbances in behavior, thinking and physiology (higher blood pressure, heart rates temperature, hyper vigilance) (Gunnar & Vazquez, 2001). Studies of neglected children found that their cortex was about 20 percent smaller than that of a control group of subjects (children) who have not suffered neglect (Gunnar & Vazquez, 2001). The data is compelling and reveals that providing stable environment of nurture is of utmost importance. About 1% of children who have developed insecure-ambivalent attachment develop RAD (Lehman and Jegtvig, 2004) and without intervention, support and help, many of these children might grow up to develop Antisocial Personality Disorder and live a disruptive life. Eventually, many of these individuals end up in correctional facilities. This compels helping professionals to promote and teach effective parenting and explain the implications of early childhood stress. In addition, the issue has to be considered within the context of adoption and foster care where, very often, children would be moved often and are being exposed to very different/inconsistent treatment and living conditions.

The non-pharmaceutical treatment of RAD appears to be more successful and beneficial than the behavioral medical model (Lehman and Jegtvig, 2004). It utilizes the attachment model as described by Dr. Daniel Hughes in his book “Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children.” The emphasis is on effective parenting - nurturing holding, eye-contact, providing opportunities for enjoyment, encouragement, unconditional love and being a model for self-regulation abilities (Daniel Hughes). Parents and caregivers are to love, nurture, accept and respect the child, so that he/she can grow healthy and happy. Also, professionals in the helping field need to unite their efforts in attempt to educate people and advocate affective parenting and children’s well-being.

Prozak (fluoxetine) is among the Selective Serotonin Reuptake Inhibitors (SSRIs), aka. second-generation antidepressants. As all SSRIs, Prozak blocks the reuptake transporter for serotonin, preventing it from being taken back to the axon terminal. Since this transporter is blocked, serotonin remains in the synaptic cleft for long periods, continuing to have its effect on the postsynaptic neuron. Although this effect takes place very quickly, depression symptoms take long periods to be alleviated. This phenomenon is not fully understood, but it’s interesting to note that Prozak increases the production of new neurons in the hippocampus – a limbic structure that is very vulnerable to stress-induced damage. Therefore, it is suspected that this renewal in the hippocampus is exactly the reason behind this antidepressant’s effect.