Following the people and events that make up the research community at Duke

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Author: Jeannie Chung

Self-Injury as a Pathway to Relief

By Jeannie Chung

The concept of pain usually reminds us of agony, scowls, and terror. Yet, to some, it is a pathway for relief and salvation.

Clinical Social Worker Carolyn O. Lee from Raleigh presented the subject of self-injury at the Psychiatry and Behavioral Sciences Grand Rounds at the Duke Hospital on Jan. 19. She provided a clear image of what motivates “cutting” and other self-injury, and who it may affect. She also suggested solutions.

Self-injury is counterintuitive to most, but a comfort to some. (iStock photo)

People who damage their body tissue to experience jolting pain receive a “natural high,” Lee said. These injuries are intentional and non-life threatening and occur generally in socially outcasted people. Cutting, self-burning, pin-sticking, scratching, and self –hitting, interference with wound healing, and bone breaking are the common methods used. The tools used for such actions are analogous to security blankets of young children, and are deemed very precious to the inflictor.

The most prevalent question is “Why?,” since the concept of self-injury goes against most people’s natural instinct for survival. People seek self-injury to cope, to regulate mood, affect, and consciousness, to relieve anxiety and depression, discharge anger, to inflict punishment, and induce pleasure, feel alive, and have a sense of control, Lee said. The injuries on their body are their voices, she said.

The general thought is “How will you know I am hurting if you cannot see my pain? I wear it on my body, and it shows what words cannot explain,” Lee said.

Before the self-abuse happens, the patient feels a sense of tension, worthlessness and anxiety. During the abuse, they may experience pleasure, exhilaration, relief and numbness. And afterwards they lapse into a pool of guilt, shame, disgust, sorrow, and intrigue, feeling out of control.

Self-abuse continues because it can differentiate inner and outer body boundaries or bring attentiveness to a mistreated body, Lee said. It may identify with the aggressor, displace rage, and regulate states of hyperarousal and dissociation.

Psychiatrists also suspect autism spectrum disorders or defects in theory-of-mind to be major factors for the emergence of such behavior. Physiologically, deficits in serotonin play a large part as well.

To treat self-abuse, Dr. Lee recommends a combination of psychoanalytic therapy and medication. She believes the relationship between the patient and the psychotherapist plays a significant role in mitigating the behavior. However, she added that if a patient shows signs of addictive behavior to self-injury, she would consider prescribing medications.

Is He Conscious? Does He Want To Be?

Terri Schiavo of Florida, whose vegetative state and right to life became a national issue in 2005

By Jeannie Chung

The difference between a dead man and a man in a vegetative state used to be a thin line of whether
or not the body was still functioning. But what if the vegetative man is still conscious? That brings
the distinction into a whole new level.

Philosopher Walter Sinnott-Armstrong gave a talk titled “Is he conscious? Does he want to be?” at the Trent Center for Bioethics on Friday, Dec. 9. He discussed clinical studies which have shown that despite the unresponsive display, patients in vegetative state may be still conscious. With assistance from an fMRI or an EEG scan, doctors can tap into the patient’s brain activity and “read their thoughts.”

The scanning study’s control was patients who received severe brain trauma and were confirmed to be in a vegetative state. The studies focused on the specific brain activity when the patient was commanded to “think about tennis” and the brain activity that occurred when the patient was commanded to “imagine anything other than tennis.” The distinctive brain activities were then coupled with a series of yes or no questions. If their answer was yes, the patient was told to think about tennis and if their answer was no, the patient was told to think about navigating through a house. In one case study, the patient answered five out of seven questions right by showing brain activity associated with tennis to questions for which an affirmative was the correct answer. The other two questions showed no response, and the doctors assumed the patient had gone to sleep.

This confirmation of consciousness in some vegetative patients brings up an ethical issue. Those at the bedside can now ask questions, including “do you want to live?” The vegetative patient’s answer to such a question may inform the ethical issue that arises each time we worry about “pulling the plug” on a clearly “living” person.



OP Effects on Developing Zebrafish Nervous System

Jeannie Chung

Organophosphates were some of the most widely used pesticides before mounting evidence of harm to ecosystems caused the U.S. and Europe to ban them. Unfortunately, OPs are still being used in China, India and other developing countries, causing water pollution that may have far-reaching effects.

Jerry Yen,  a doctoral candidate, presented his talk on OP(organophosphate compound) effects on the Zebrafish’s nervous system as part of the series sponsored by the Integrated Toxicology and Environmental Health Program Seminar.

Yen said Zebrafish are useful for study because they are relatively fast developing, exhibit high fecundity (lots of embryos to work with) and mostly transparent, allowing visualization of the anatomy through early development.

Early exposures to organophosphates can lead to alterations in adult phenotypes, Yen said.  Specifically, he studied the possible effects of OPs in a specific gene, Kcc2, expressed only in the nervous system.

Kcc2 is the gene for a potassium chloride transporter responsible for lowering Cl- neurons in the system. 86% of the zebrafish Kcc2 gene matches with the human gene, so the effects it shows can be related to the effect OP doses will have on humans. At two days development of the Zebrafish, OP exposure causes the spinal cord to lose all of its Kcc2 expression.

Yen said the different variations of the expression of Kcc2 may affect muscle movement. An audience member suggested studying the variations of the speed the Zebrafish swims at depending on the Kcc2 expression.

Here is a short video that was played in the seminar. The embryo was studied under the microscope. Note how specific parts of the spinal cord are very clear despite being under development. Zebrafish egg development

Astroplanets: What we can now see.

Dr.Ronald Walesworth lecturing about the two methods

By Jeannie Chung

Duke Physics hosted Ronald Walsworth of Harvard last week to hear about his use of something called an “astrocomb,” a tool that could help astronomers make more precise measurements of distant astronomical objects, including planets like Earth.

An astrocomb uses a a laser and an atomic clock to improve the calibrations on the instruments astronomers use to measure tiny shifts in the spectra of a star. The shifts can indicate if a star has a planet.

Currently, astrophysicists cannot measure the minute shifts of planets the size of Earth, or other cosmological phenomena, with these spectrographs. The shifts are too tiny. But this laser calibration astrocomb could be seen as the sunrise on a bright future.

Walsworth said that in five years, discovery and characterization of Earth-like planets would be possible, and that in 10-20 years, direct measurement of cosmological dynamics —  the change and characteristics of celestial bodies – may be possible. He said the laser frequency comb will allow us to see a live feed of the expansion of the universe, instead of looking at hindsight and making inferences from snapshots of a past universe.


Newbie has Arrived!

Contest for the cutest face with my friends.

Drumroll Please.
And it is . . . Jeannie Chung.

Hello Everyone! I am a new blogger for the Duke Research Blog. My name is Jeannie Chung and I am a freshmen currently enrolled in the Pratt School of Engineering as a prospective Mechanical Engineering and Electrical Engineering double major. But as I said, it is “prospective” since I have too many interests to keep me confined in a narrow-minded decision.

One of my biggest excitements about college is that I am invited to listen and share the ingenious ideas of others! Duke University is one of the biggest research schools out there and thus more ideas, ingenuity, and mind-blowing opportunities!

I like taking photos, going to art exhibitions and movies. I’m an avid lover of coffee and tea (no sugar and milk ruining the taste, please!), a music lover (playing and listening), dancer (I try), and an experimental cook.

I am not so fond of sweets, but I do sometimes seek after them. If I have to choose an ice cream I would always go with lemon sherbet gelato, or the classic mint. I love having conversations with people and am always excited to make new friendships.

My family is my number one treasure, and that includes my golden retriever, Dian, and my tuxedo cat, Secret. There are stories that go with those names, but perhaps we can talk about them later. My current goal is to be able to speak all three oriental languages when I graduate and to build a transformer in the future, preferably one from a Yellow Camerro.

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