Consciousness

Chapter 5Consciousness1Locked inErik Ramsey is locked inSuffered traumatic injury to his brain as the result of an automobile accidentHe can see, hear and feel, but he cannot move or communicate with the outside worldat least not yet

Students may not have a clear conception of what consciousness is and will have different notions of what it means to be conscious.

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3FIGURE 5.1 Conscious but Locked In Erik Ramsey (right, with his father, Eddie) suffers from locked-in syndrome. He has total awareness, but his condition leaves him almost completely unable to communicate.

ConsciousnessIn a coma, but awarePatterns of brain activity in a coma sufferer were similar to patterns found in those not in a coma (Owen et al., 2006)4FIGURE 5.2 In a Coma but Aware The brain images on the top are from the patient, a young woman in a coma who showed no outward signs of awareness. The images on the bottom are a composite from the control group, which consisted of healthy volunteers. Both the patient and the control group were told to visualize playing tennis and walking around. Right after the directions were given, the neural activity in the patients brain appeared similar to the neural activity in the control groups brains.

ConsciousnessCommunication may be possible with coma patients previously believed to be unreachable 55.1 What Is Consciousness?Learning Objectives Define consciousness.Identify varied states of consciousness.Summarize research findings on consciousness and the interpreter among individuals with split brain.Discuss how unconscious processes influence thought and behavior.5.1 What Is Consciousness?Consciousness Is a Subjective ExperienceThere Are Variations in Conscious ExperienceBrain Activity Gives Rise to ConsciousnessThe Global Workspace ModelThe Split BrainThe InterpreterThe Interpreter SpeculatesUnconscious Processing Influences BehaviorThe Smart Unconscious6

7What Is Consciousness?People can be conscious even when they appear not to beAll conscious experience is associated with brain activityVariations in consciousness occur naturallyConsciousness can be manipulatedConscious experience varies from person to person8Consciousness Is a Subjective ExperienceConsciousness: The subjective experience of the world, resulting from brain activityThe brain and the mind are inseparableEach of us experiences consciousness personally We cannot know if two people experience the world in exactly the same way

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10FIGURE 5.3 Seeing Red One difficult question related to consciousness is whether peoples subjective experiences of the world are similar. For instance, does red look the same to everyone who has normal color vision?There Are Variations in Conscious ExperienceSleep/wake cycleAutomatic tasksDriving, walking, catching a baseballControlled processing Helps us perform in complex or novel situationsExtreme StatesConditions of impaired consciousness provide useful points of contrast to normal (fully-functioning) consciousnessPersistent vegetative state Full coma that lasts more than a monthTerri Schiavo Minimally conscious state Deliberate movement and communication are possible Jan Grzebski

Students will very likely not have heard of these cases prior to doing the reading. For religious, ethical and other reasons, they may have mixed beliefs and sentiments concerning pulling the plug on someone who is in a full coma vs. someone who is minimally conscious. Where to draw the line may be ambiguous particularly if brain activity is indicative of some level of awareness. 12

13FIGURE 5.4 Persistent Vegetative State versus Minimally Conscious State (a) Terry Schiavo spent more than 15 years in a persistent vegetative state before she was taken off life support. Her parents and their supporters believed she showed some awareness. As the dark areas of the brain scan on the left indicate, however, there was no activity in Schiavos brain because her cortex had deteriorated beyond recovery. By using imaging to examine the brain of a person in an apparent coma, doctors can determine whether the patient is a good candidate for treatment.

14FIGURE 5.4 Persistent Vegetative State versus Minimally Conscious State (b) Jan Grzebski was in a minimally conscious state for 19 years before he awoke and reported that he had in fact been aware of events around him. Suppose you were trapped in a minimally conscious state for even half that time. How might you respond to the world after regaining full consciousness?Brain Activity Gives Rise to ConsciousnessPsychologists can examine and measure consciousness (e.g., fMRI) Consciousness arises from brain circuits activity

16FIGURE 5.5 Scientific Method: The Relationship between Consciousness and Neural Responses in the BrainThe Global Workplace ModelIn some cases brain-injured patients are unaware of their deficits (hemineglect)Consciousness arises through brain processes that are active at any point in timeNo single area of the brain responsible for general awareness

18FIGURE 5.6 Areas of Awareness A central theme emerging from cognitive neuroscience is that awareness of different aspects of the world is associated with functioning in different parts of the brain. This simplified diagram indicates major areas of awareness.The Split Brain()Awareness of the world is associated with functioning in different parts of the brain

The Split BrainCorpus callosum removedTwo halves of the brain cannot receive information directly from each otherStudies show the relation between specific brain regions and conscious experienceEarly observations were that split-brain patients had no discernable problemsSperry & Gazannigas (1960s) research proved otherwise

FIGURE 3.20 The Corpus Callosum In this top view of the brain, the right cerebral hemisphere has been pulled away to expose the corpus callosum. This fibrous structure connects the two hemispheres of the cerebral cortex.

22FIGURE 5.7 Split Brain (a) This image shows the brain of a normal person whose corpus callosum is intact. (b) This image shows the brain of a patient whose corpus callosum has been removed (as indicated by the red outline). With the corpus callosum removed, the two hemispheres of the brain are almost completely separated.The Split BrainBrain Lateralization()Language center located in left hemisphere

FIGURE 5.8 Visual Input Images from the left side go to the brains right hemisphere. Images from the right side go to the left hemisphere.

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24FIGURE 5.9 Split-Brain Experiment: The Left Hemisphere versus the Right HemisphereThe Split BrainSplit brain patients cannot report on an object presented in their left visual fieldThey could correctly choose the object (with their left hand)Right hemisphere handles spatial tasksSplit-brain patients could not arrange blocks correctly when using their right hand Left-handed, the task was effortless 25The InterpreterThe left hemisphere attempts to make sense of right-hemisphere actions

27FIGURE 5.10 The Left Hemisphere Interpreter On the basis of limited information, the left hemisphere attempts to explain behavior governed by the right hemisphere.The Interpreter SpeculatesThe left hemisphere tries to make sense of the world (e.g., imposing narrative structure, seeking patterns)The right hemisphere simply experiences the world Brain hemispheres work together to construct our experience of the worldStudents understanding of hemispheric specialization may be based on popularized notions of left and right brained traits, which are, essentially overstatements of cerebral localization of function. 28Unconscious Processing Influences BehaviorWe are aware of some mental processes and unaware of othersSubliminal perception(): Processing information by sensory systems without conscious awarenessFreudian slip (): : An unconscious thought expressed at an inappropriate moment

Students may believe that prejudicial stereotypes and discriminatory actions arise consciously. This is not always the case. Even though we may claim to be unprejudiced we may in some cases think, feel and act as though we are. 29

Unconscious Processing Influences BehaviorWe are aware of some mental processes and unaware of othersStereotype activation(): Is it automatic?Bargh et al. (1996) found research participants primed with stereotypes about the elderly unconsciously behaved in ways consistent with those stereotype Students may believe that prejudicial stereotypes and discriminatory actions arise consciously. This is not always the case. Even though we may claim to be unprejudiced we may in some cases think, feel and act as though we are. 31Implicit Association Test(IAT)

The Smart UnconsciousGood advice: Youd better sleep on it.Unconscious processing of problems can lead to superior solutions (Dijksterhuis, 2004)Even conscious thinking can undermine good decision- making (Wilson & Schooler, 1991)

Students may think that problems are best solved by effortful though. This is not always the case. 335.2 What Is Sleep?Learning Objectives Describe the stages of sleep.Identify common sleep disorders.Discuss the functions of sleep and dreaming. 5.2 What Is Sleep?Sleep Is an Altered State of ConsciousnessStages of SleepREM SleepSleep DisordersSleep Is an Adaptive BehaviorRestoration and Sleep DeprivationCircadian RhythmsFacilitation of LearningPeople Dream while SleepingREM Dreams and Non-REM DreamsWhat Do Dreams Mean?Activation-Synthesis TheoryEvolved Threat-Rehearsal Theory34What Is Sleep?Sleep is biologically regulatedCircadian rhythms() 24Melatonin secretion linked to light-dark cyclesSome adults report needing 7-9 hours a night70-year-old Miss M. gets by on one hour per night! 35

37FIGURE 5.12 The Pineal Gland and the Sleep/Wake Cycle Changes in light register in the suprachiasmatic nucleus of the hypothalamus. In response, this region signals the pineal gland when the time for sleep or the time for wakefulness has come.

Sleep Is an Altered State of ConsciousnessSleep: Awareness of the outside world is turned off (mostly) So why dont we fall out of bed? EEG: The brain is active in sleep

Students may believe that the brain is switched off during sleep. This is not the case. The brain is very active, with some regions (brain stem, occipital lobe during dreaming) more active in sleep than during waking. 38Stages of SleepUltradian rhythms(Sleep is not an on-off eventSleep stagesHistorically: 5 distinct stagesCurrently: Stages 3 & 4 are now joined Measure of sleepEEG: EOG: (REM sleep)EMG:

41FIGURE 5.13 Brain Activity during Sleep Using an EEG, researchers measured these examples of the patterns of electrical brain activity during different stages of normal sleep.REM SleepOne ultradian cycle : I-II-III-IV-III-II-REM-II-III-IV-III-II-REM-. about 90 minsThere are about 5 ultradian cycles during a normal nights sleep (about 2 hrs for REM).Enter REM (paradoxical) stageMost dreaming occurs in REM sleepAmount of time spent in REM increases

I-II-III-IV-III-II-REM-II-III-IV-III-II-REM-.43FIGURE 5.14 Stages of Sleep This chart illustrates the normal stages of sleep over the course of the night.Sleep DisordersInsomnia: Difficulty falling or staying asleepObstructive Sleep Apnea: Breathing may stop hundreds of times per nightNarcolepsy: Sufferers unexpectedly fall asleepREM Behavior Disorder: Sufferers act out their dreamsSomnambulism: Sleep walkingStudents may mistakenly believe that its dangerous to wake a sleepwalker. This is not the case. The best strategy is to gently awaken the sleepwalker and/or guide the person back to where they were sleeping.

(narcolepsy)15

cataplexysleep paralysis

Ruth M. Benca. (J Clin Psychiatry 2007;68[suppl 13]:58)

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Seiji Nishino. (J Clin Psychiatry 2007;68[suppl 13]:915)

orexin/hypocretinMultiple Sleep Latency Test, MSLT

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modafinil( )methylphenidate()modafinil methylphenidate MSLT

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45FIGURE 5.15 Obstructive Sleep Apnea This man suffers from obstructive sleep apnea. Throughout the night, a continuous positive airway pressure device blows air into his nose or mouth to keep his throat open.Sleep Is an Adaptive BehaviorSleep serves important biological purposes:RestorationCircadian rhythmsFacilitation of learningRestoration TheoryRestorative Theory: Sleep allows the body to rest and repair itselfThe evidence:Sleep increases after strenuous physical activityGrowth hormones secreted in sleepReplenishes the brains energy stores Strengthens the immune system 47Restoration TheoryEffects of sleep deprivation: Mood problems (e.g., irritability)Decrements in cognitive performance (e.g., attention and short-term memory lapses)May compromise the immune systemFalling asleep for a few seconds to a minute (microsleeps) can impair ability to perform critical tasks (e.g., driving)

Circadian RhythmsCircadian rhythm theory: Many creatures are quiet and inactive during the night because darkness is the time when danger is highest Reduced risk of exposure to predators Humans: Are adapted to sleep at night because our early ancestors were more at risk in the dark

50FIGURE 5.16 Sleeping Predator After a fresh kill, a lion may sleep for days.Facilitation of LearningSleep: Strengthens neural connections needed for learning to occurResearch shows memory in participants who slept was greater than those who didnt (Drosopoulos, Schulze, Fischer, & Born, 2007)REM and slow-wave (stages 3 & 4) important for learning to take place

51Facilitation of LearningSleep: Strengthens neural connections needed for learning to occurParticipants who completed a complex task and later dreamed about it subsequently performed better on the task than non-dreaming participants (Wamsley, Tucker, Payne, Benavides, & Stickgold, 2010)Students spend more time in REM during exam periods

52People Dream while SleepingDreams: Products of an altered state of consciousness in which images and fantasies are confused with realitySome students may feel that they do not dream. The fact is that everybody dreams. Persons who dont dream are simply failing to recall them. 53

54REM Dreams and Non-REM DreamsREM dreams: More likely to be bizarre and include intense emotions, visual and auditory hallucinations, and uncritical acceptance of illogical eventsNon-REM dreams: Relatively dull (e.g., what sweater should I wear?) 55REM Dreams and Non-REM DreamsExplanation: Non-REM: General de-activation of many brain regionsREM: Brain structures associated with motivation, emotion, reward, vision are active; pre-frontal cortex is not

57FIGURE 5.18 Brain Regions and REM Dreams These two views of the brain show the regions that are activated and deactivated during REM sleep. (a) As seen here from the side, the motor cortex, the brain stem, and visual association areas are activated, as are brain regions involved in motivation, emotion, and reward (e.g., the amygdala). The prefrontal cortex is deactivated. (b) As shown here from below, other visual association areas are activated as well. (This view also reveals the full size of the prefrontal cortex.)

58FIGURE 5.18 Brain Regions and REM Dreams These two views of the brain show the regions that are activated and deactivated during REM sleep. (a) As seen here from the side, the motor cortex, the brain stem, and visual association areas are activated, as are brain regions involved in motivation, emotion, and reward (e.g., the amygdala). The prefrontal cortex is deactivated.

59FIGURE 5.18 Brain Regions and REM Dreams These two views of the brain show the regions that are activated and deactivated during REM sleep. (b) As shown here from below, other visual association areas are activated as well. (This view also reveals the full size of the prefrontal cortex.)

What Do Dreams Mean?Freud: Dreams contain hidden content that represents unconscious conflictsManifest content: The plot of a dream; the way the dream is rememberedLatent content: What a dream symbolizes; the material that is disguised in a dream to protect the dreams from confronting direct realityNo scientific evidence that dreams represent hidden conflicts or for the special symbolic meaning of dream images

Many students believe dream images have universal meanings. This is not the case. Whats important is what dream content means to the individual dreamer. 60

Activation-Synthesis Theory-The theory:The brain tries to make sense of random brain activity that occurs during sleep by synthesizing the activity with stored memories (Hobson et al., 2000)

Hobson and McCarley63Activation-Synthesis TheoryThe theory:Emotion centers (limbic system) in the brain are active, which explains the intense emotions; frontal cortices are not active, which explains the uncritical acceptance of illogical events

Hobson and McCarley64Activation-Synthesis TheoryControlling the wake-sleep cycle: Brainstem release different neurotransmitterAminergic system () for wake state: NA (), 5-HT ()Cholinergic system() for sleep and dream: ACH()ACH activate the PGO wave in brainstem that cause some syndrome like delirium tremens PONS () Geniculate body () Occupital cotrex ()65AIM ModelTimeIAM

InputActivityModuleA activation, I input-output gating, and M modulation66IAM

A activation, I input-output gating, and M modulation67IAMA activation, I input-output gating, and M modulation68IAM

A activation, I input-output gating, and M modulation69IAMA activation, I input-output gating, and M modulation70Activation-Synthesis TheoryThe critics: Dreams are not as chaotic as the activation-synthesis theory suggests (Domhoff, 2003)Often similar to everyday life waking experience

Evolved Threat-Rehearsal TheoryThought question: Why do people often dream about threatening events? Answer: Perhaps dreams help us prepare to cope with real waking events.Evolved Threat-Rehearsal TheoryDreams sometimes simulate threatening events so that people can rehearse strategies for coping (Revonsuo, 2000)Dreams may have adaptive value if rehearsal helps us survive and reproduce5.3 What Is Altered Consciousness?Learning ObjectivesDiscuss the effects of hypnosis and mediation on consciousness.Define the concept of flow. Discuss the consequences of escaping the self. 5.3 What Is Altered Consciousness?Hypnosis Is Induced through SuggestionTheories of HypnosisHypnosis for PainMedication Produces RelaxationPeople Can Lose Themselves in ActivitiesExercise, Religious Prayer, and FlowEscaping the Self74What Is Altered Consciousness?Awareness varies naturally over the course of the dayPotentially altered by: hypnosis, meditation, and immersion in an action (i.e., flow) Hypnosis Is Induced through SuggestionHypnosis: A social interaction during which a person, responding to suggestions, experiences changes in memory, perception, and/or voluntary actionStudents may mistakenly believe everyone can be hypnotized and that a hypnotist can control a subjects mind (e.g., get them to involuntarily engage in actions theyd otherwise find objectionable). 76Hypnosis Is Induced through SuggestionInduction: Hypnotist makes a series of suggestionsYou are becoming sleepy. Your eyelids are drooping If all goes well, the subject(s) behave in ways consistent with suggestionsHypnosis works primarily for people who are highly suggestible (1 in 5 persons) Students may mistakenly believe everyone can be hypnotized and that a hypnotist can control a subjects mind (e.g., get them to involuntarily engage in actions theyd otherwise find objectionable). 77

78FIGURE 5.19 Hypnotized? Are hypnotized people merely playing a part? What makes you think so?Theories of HypnosisSociocognitive Theory: Hypnotized subjects are role-playing (i.e., acting how they believe hypnotized subjects are supposed to actTheories of HypnosisDissociation Theory: Hypnosis is a trance-like state where conscious awareness is separated from other aspects of consciousnessStrongest evidence for dissociation theory: Numerous studies show the analgesic effects of hypnotic analgesia Hypnosis for PainHypnotic analgesia: Clinical evidence shows hypnosis can be used to treat immediate (e.g., surgery, burns) and chronic (e.g., arthritis, cancer) pain (Patterson & Jensen, 2003)Self-hypnosis: Also be shown to be effective in improving recovery from surgery Clinical evidence: Hypnosis doesnt reduce the sensation of pain, but rather alters our interpretation (i.e., perception) of it

Meditation Produces RelaxationMeditation: A mental procedure that focuses attention on an external object or on a sense of awarenessMeditation Produces RelaxationEffects of meditation: One study found greater stress reduction and attention among participants who meditated compared to a group that underwent relaxation training (Tang et al., 2007)Another study showed that when participants were made to feel sad, those who received meditation training were less sad than those who had not (Farb et al., 2010)

84FIGURE 5.22 The Brain on Meditation In these fMRI scans, the circles indicate brain areas that typically show less activity when people are sad. After control subjects watched sad clips from movies, these areas of their brains were less active, as expected. In the brains of participants who had received eight weeks of meditation training, these areas remained active, indicating that these participants felt less sadness.People Can Lose Themselves in ActivitiesWe are unaware of most of what we think and doThere are activities in which we can lose ourselves and enter an altered state

Exercise, Religious Prayer, and FlowRunners high: Involves a shift in consciousness away from the self (endorphins too) accompanied by euphoriaReligious ecstasy: Directs attention away from the self and toward spiritual awarenessFlow: Total engagement in an act for its own sake (not focused on reward or on escaping ones problems)

87FIGURE 5.23 Religious Ecstasy During a service at a Baptist church in Beulah, Mississippi, a woman is overcome with religious ecstasy. According to the photographer, the woman was speaking in tongues.Escaping the SelfEscapist behaviors include: drug and alcohol use, excessive television viewing, surfing the Web, texting, playing of video games (e.g., World of Warcraft)Purpose of escapist behavior: Distracts people from their problems; helps them avoid feeling bad about themselves

89FIGURE 5.24 Escapist Entertainment Simple entertainment can veer toward obsession. What would you say are the possible benefits of devoting time to video games? What are the potential negative effects?Escaping the SelfEscapist behavior reduces self-awareness, which can lead to:Lowered long-term planning (e.g., poor foresight)Reduced meaningful thought (e.g., less effective at anticipating consequences of ones actions)Lowered inhibitions 5.4 How Do Drugs Affect Consciousness?Learning ObjectivesDescribe the neurochemical, psychological, and behavioral effects of marijuana, stimulants, MDMA, opiates, and alcoholpsychoactive drugs,.Identify physiological and psychological factors associated with addiction().

91How Do Drugs Affect Consciousness?Drugs have been used throughout history to create altered states Around 250 million people use illicit drugs each year (United Nations Office on Drugs and Crime, 2009)Other widely-used drugs include alcohol, prescription medications, caffeine and nicotine Drugs are a mixed blessing

92(n=17044, aged from 16-64) 0.8%0.3%

People Useand AbuseMany Psychoactive DrugsDrugs are useful in the treatment of many medical conditions, but recreational drug use can have negative consequences

96People Useand AbuseMany Psychoactive DrugsPsychoactive drugs: Mind altering substances that change the brains neurochemistry (marijuana, cocaine, amphetamines, MDMA, opiates)Drug effects: The effects of a particular drug depends on which neurotransmitter system it activates (e.g., methamphetamine acts on the dopamine system)

barbiturates)(opium)(heroin)(morphine)(codeine)(cocaine)(Amphetamine)NicotineCaffeine(ecstasy)

:(marijuana)psilocybinmescaline (lysergic acid diethlamide, LSD ) (phencyclidine, PCP) DMTMarijuanaMost widely used illicit drugNot easily categorized as a stimulant, depressant, or hallucinogenProduces a relaxed, contented mood, more vivid perceptionsExperienced users appreciate the effects more than novices (Kuhn, Swartzwelder, & Wilson, 2003)Psychoactive ingredient: THC Operates at cannabanoid receptorsMedical use is controversial99LSD4-12 LSD block serotonin receptor, reduce the dorsage of 5-HT100() 30

1.2. 1. 2.(Cocaine) Dopamine agnostists1.2.3.101AmphetaminesLong history of use for weight loss, staying awakeSeldom used for legitimate medical purposes

Methamphetamine: Worlds second most commonly used illicit drugIncreases dopamine production; blocks reuptakeDamages brain structures responsible for cognition, memory and emotion (Kim et al., 2006; Thompson et al., 2004)Causes considerable physical damage102

103FIGURE 5.26 Methamphetamines Effects on the Brain This image is a composite of brain scans from 29 methamphetamine addicts. The red and yellow areas represent the brain damage that typically occurs in the frontal cortex as a result of methamphetamine abuse (Kim et al., 2006). Such damage may explain the cognitive problems associated with methamphetamine use.

104FIGURE 5.27 Methamphetamines Effects on the Person These before-and-after photos dramatically illustrate how the physical damage from methamphetamine can affect appearance. When the photo on the left was taken, Theresa Baxter was 42 and not a methamphetamine addict. The photo on the right was taken 2 1/2 years later, after Baxter was arrested for crimes she committed to support her addiction.MDMA()Ecstasy has gained in popularity since the raves of the 1990sHigh school students use increased from 3.7% to 4.7% between 2009 and 2010 (National Institute of Drug Abuse, 2010)

105MDMA()Users feel energized and may hallucinateLowers dopamine; increases/depletes serotonin availabilityMay produce depression, memory loss, difficulty in completing complex tasks (Fischer et al., 1995; Kalechstein et al., 2007)

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107FIGURE 5.28 MDMAs Effects on the Brain (a) This image shows serotonin nerve fibers in the cortex of a normal monkey. (b) This image shows the same brain area of a monkey that received multiple doses of MDMA (ecstasy). Eighteen months after the monkey received the MDMA, the monkeys serotonin nerve fibers remain drastically reduced.OpiatesUsed historically to relieve severe pain DepressantHeroin, morphine, codeineUsers experience analgesia, relaxation, euphoriaHighly addictive due to effects at opiate receptors (pleasure) and dopamine receptors (increased wanting of the drug)Long-term use can lead to attention and memory problems (Gruber, Silveri, & Yurgelun-Todd, 2007)

108 1.Analgesia() (receptors in a part of midbrain known as the periaqueductal gray)2.reward(receptor in nucleus accumben and the ventral tegmental area; activate dopaminergic neuron)3.seduction(receptor in mesencephalic reticulr formation)4.hypothermia (receptor in preoptic area)(opiate receptors: encephalin and -endorphins1.2.3.1)agitated behavior, 2)increasing HR, 3)sweating, 4)insomnia, 5)uncontrollable leg movement Alcohol Is the Most Widely Abused DrugOn the one hand: Moderate drinking is an accepted aspect of social interactionOn the other hand: Alcohol is a major contributor to many social illsSpousal abuseTraffic fatalitiesUnsafe sex Loss of productivity at work110

GABA(+)Glutamate(-)1.;2.;3., (delirium tremens 1111.: (1)steady drinker, who drink virtually every day and find it very hard to abstain() from drinking (2) binge() drinker, who drink only occasionally, but cannot stop drinking and they have started. Far more men than women are alcoholics. Why do people become alcoholics? Cloninger et al (1985) carried out a adoption study to assess the relative importance of heredity and environment. There was a major effect of heredity on steady drinking in men but not in women. Cloninger err al found that binge drinking in males and females depended on both heredity and environment. Binge drinkers tended to have a biological parent who was a binge drinker and one or more heavy drinker in their adoption family. 1. Cirrhosis of the liver() 2. Severe damage by preventing the liver from metabolising the vitamin and thiamine(, B1). Thiamine deficiency leads to the loss of brain neurons and this eventually produces amnesia or memory loss in the form of Korsakoffs syndrome(difficult to learn new knowledge or new personal experience, and poor long-term memory).

2. (agitated behaviors)

Gender Differences in Alcohol Consumption across CulturesAccording to the World Health Organization, when compared to women, men are twice as likely to report: Binge drinking Chronic drinking Recent alcohol intoxicationWhat accounts for observed gender differences? Women metabolize alcohol slower than men and can get the same effects while consuming less Womens drinking may be hidden/unreported

112addiction Psychological dependence Physical dependencetolerancedetoxificationAddiction Has Physical and Psychological AspectsAddiction: Drug use that remains compulsive despite its negative consequencesPhysical dependence involves:Tolerance(): Increasing amounts of a drug is needed to achieve the intended effectWithdrawal(): Physiological and psychological state characterized by feelings of anxiety, tension, and cravings for the addictive substancePsychological dependence involves: Drug cravings without tolerance or withdrawalDrug Addiction DSM-IV Dependence A cluster of cognitive, behavioural, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problemsDrug Addiction DSM-IV SymptomsTolerance Difficult to reduce or control substance Taken in increasingly larger amountsMuch effort is devoted to obtaining access to the substanceImportant social, occupational, or recreational activities are reduced or given up as a result of substance use. Drug Tolerance The effects of a drug tend to decrease with repeated useincreased metabolic rate of its uptakeneurons may become less sensitive to the effects of a drug.Users need to take progressively larger amounts of the drug.Gossop (1997), addicts are typically dependent on more than one drug.

118FIGURE 5.30 Physical Dependence versus Psychological Dependence Both types of dependence can force people to go to extremes. (a) What does this scene, outside a restaurant in Germany, suggest about patrons such as this woman?

119FIGURE 5.30 Physical Dependence versus Psychological Dependence Both types of dependence can force people to go to extremes. (b) How do casinos, such as this one in Las Vegas, encourage patrons addiction to gambling?

Addictions CausesWhy do people become addicted? Physiological: Activation of brain dopamine systems that play a role in the pleasurable experience drugs create and regions (the insula) that govern cravings Heredity may play a role (e.g., alcoholism) Psychological: The sensation-seeking personality traitSocial learning (e.g., modeling of drug use by significant others)

Craving 120

121FIGURE 5.31 Insula This brain region appears to play a role in craving and addiction.

(Insula) (Operculum)(Island of Reil)

opioid Addictions Social ContextWe cannot ignore the effects of social and environment context when explaining addiction Robins, Helzer and Davis (1975) conducted a large-scale study of 898 U.S. soldiers during Vietnam War The researchers found widespread drug use (over 90%) among U.S. soldiers 1 in 5 returned to the United States addicted to drugs Once home, approximately 95% of the addicts quit using drugs Removed from the stress of combat, they no longer needed drugs to escape

123FIGURE 5.32 The Sixties, Drugs, and Vietnam(a) By the late 1960s, youth culture had taken many new forms in the United States and elsewhere. In exploring the boundaries of society and consciousness, many young people experimented with drugs. Here, two people share drugs at the Shiva Fellowship Church Earth Faire at Golden Gate Park, San Francisco, in April 1969.

124FIGURE 5.32 The Sixties, Drugs, and Vietnam(b) Through those years and beyond, the United States played a leading role in the Vietnam War, a military conflict that took place in the faraway lands of Vietnam, Laos, and Cambodia. Perhaps inevitably, the changes and conflicts at home influenced the changes and conflicts away from home. For example, many U.S. soldiers abused drugs. Here, two soldiers exchange vials of heroin in Quang Tri Province, South Vietnam, July 1971.