Psychiatry

Xerox In Biology

Circular definitions are a trap. It’s good to avoid traps.

Hence, in simple terms, here are some useful explanations.

Genes are the computer coding for people, because we all know people are actually robots. (Click. Whirr. This is a joke.)

A genotype is the total computer code print-out for a person. It’s relevant to inheritable diseases. A disease is a state of poor health, by the way. It has to be significantly abnormal enough for it to be classed as diagnosable, given these things are based on artificial cut-offs. They can be somewhat arbitrary, but generally there’s a reasonable basis underneath them.

A phenotype is the outside casing of the computer product, which is distinct from its wiring inside. It represents how matters surface in the material world.

A phenocopy is a materialised appearance of things that doesn’t actually have the relevant genotype. That is, it looks like that computer coding output, but the computer coding is different from what it’s expected to be. It resembles a syndrome but without the genetic basis for it.

The phenocopy situation can occur in Huntington’s disease, where the autosomal dominant CAG-repeater mutation isn’t apparent but similar clinical manifestations arise.

References

  1. Moore RC, Xiang F, Monaghan J, Han D, Zhang Z, Edström L, Anvret M, Prusiner SB. Huntington disease phenocopy is a familial prion disease. Am J Hum Genet. 2001 Dec;69(6):1385-8. doi: 10.1086/324414. Epub 2001 Oct 9. PMID: 11593450; PMCID: PMC1235549.

Luria’s Test

Fist, slap, slice! Or fist, cut, slap! Fist, cut, slice?!

It can be tricky to recall the order of Luria’s 3-step test for frontal lobe function.

Here’s a business-minded way to remember it.

GIVE MONEY NOW!

Give

Make a fist.

This represents the aggression of forcing someone to give you something.

Money

Make the slicing motion.

This emulates the handshake of a business deal.

Now!

Slap the hand with the palm facing down.

This is like being a demanding gangster and banging on a table to intimidate your enemy.

References

  1. PsychDB (2021). Luria Sequence (Luria’s Test). [online] PsychDB. Available at: https://www.psychdb.com/neurology/neuro-exam/luria.

Parenting Styles

There are 4 theoretical parenting styles: authoritative, authoritarian, permissive and uninvolved.

Authoritative: the dream. Warm and boundaried.

Authoritarian: overly controlling. Too much discipline.

Permissive: too enabling. Laissez-faire.

Uninvolved: neglectful. Too much freedom.

2 of the above have similar-sounding names. Just as people confuse psychology with psychiatry and optometry with ophthalmology, there must be a way to demystify this likeness. There is!

Here’s how you remember which one is good and which one is bad.

Authoritative: positive.

Authoritarian: barbarian.

Bibliography

  1. Sanvictores T, Mendez MD. Types of Parenting Styles and Effects On Children. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568743/#

There’s A Fancier Name For Fake Niceness

A particular breed of falsified collegiality is siding with the foe of a foe. This has a convenient name: pseudo-altruism.

Pseudo-altruism is a pattern of behavior used by people who have a problem in coping satisfactorily with repressed rage. Observed in both individual and group psychotherapy, it allows the discharge of unacceptable impulses through professed concern about others. This model involves the interaction of at least three people. One individual, A, unable to acknowledge his rage toward a second person, B, comes to the assistance of a third party, C, whom he is convinced has been injured by B. A attacks B or encourages C to do so. In this way A, who experiences difficulty in discharging aggression directly, finds an acceptable means of doing so. He convinces himself that his aggression is warranted by B’s behavior and that he acted solely out of concern for C’s welfare. The pseudo-altruistic pattern thus includes denial, rationalization, and at times projective identification.

Edelson SR. Pseudo-altruism. Psychiatr Q. 1981 Summer;53(2):106-9. doi: 10.1007/BF01064894. PMID: 7330125.

References

  1. Edelson SR. Pseudo-altruism. Psychiatr Q. 1981 Summer;53(2):106-9. doi: 10.1007/BF01064894. PMID: 7330125.

The Poetry Of Pareidolia

Pareidolia is the tendency to see visual meaning where there isn’t any, like a face in toast, because humans evolved to detect patterns. Here is the most poetic pareidolia entry ever.

A 20-year-old woman presented to our emergency department after a cliff-jumping adventure went awry. The ultrasound of the aorta was benign, but a “Darth Vader” sign found off the reflection of the spine was no Jedi mind trick. The ability to detect an aneurysm is insignificant next to the power of the Force!

Pareidolia is a phenomenon of recognizing patterns, shapes and familiar objects — often faces — where they do not actually exist. There are several well-known examples in popular culture, including most recently a perception of Vladimir Putin’s resemblance in a flock of birds, the image of Jesus on toast or the “Face on Mars” captured by the Viking 1 orbiter. Examples achieving popular notoriety are found in medicine as well, particularly with diagnostic imaging.

Pareidolia is recognized in humans as young as eight months old. Compared with other types of illusion, pareidolia is unique in how the illusion often becomes more intense with increased attention to it. Similar neural processes trigger pareidolic illusions and visual hallucinations, which has led to speculation that pareidolia represents a susceptibility to visual hallucinations. Conversely, other studies have shown that the right temporal lobe discriminates between real and illusory faces but is highly suggestible, consistent with a more benign prognosis.

Could there be more to pareidolia than sheer entertainment value? Simply put, pareidolia is perceiving a meaningful pattern in meaningless noise. In medicine, we learn to detect illness patterns in the noise of nonspecific signs and symptoms.

Bibliography

Baylis, J., & Ting, D. K. (2015). Pareidolia and clinical reasoning: the pattern awakens. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 187(18), 1364. https://doi.org/10.1503/cmaj.151079