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Schizophrenia is a mental disorder that makes it difficult to distinguish the difference between what is real and not real.
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SCHIZOPHRENIA/ MENTAL DISORDERS & Cannabis studies completed

also see Narcissistic Personality Disorder

1974 - Letter ~ Radical notion.

1994 - News ~ Study Shows Long Term Marijuana Users Healthy.

2000 - Study ~ Association study of a cannabinoid receptor gene (CNR1) polymorphism and schizophrenia.

2000 - Study ~ Are Cannabinoid Receptor Knockout Mice Animal Models for Schizophrenia?

2002 - Study ~ Cannabis Use is Not Associated with the Development of Psychosis in an 'ultra' High-risk Group.

2002 - Study ~ Tobacco and Cannabis Smoking Cessation Can Lead to Intoxication with Clozapine or Olanzapine.

2002 - Anecdotal/News ~ Recipe For Trouble.

2002 - News ~ Marijuana receptor gene abnormality in schizophrenia.

2002 - News ~ Cannabis may treat psychiatric disorders.

2003 - Study ~ Cannabis and the brain.

2003 - Study ~ Haloperidol, but not clozapine, produces dramatic catalepsy in delta9-THC-treated rats: possible clinical implications.

2004 - Letter ~ Cannabis as a psychotropic medication.

2004 - Study ~ Lower Negative Symptom Scores Among Cannabis-dependent Patients with Schizophrenia-spectrum Disorders: Preliminary Evidence from an African American First-episode Sample.

2004 - Study ~ Aetiology - Review: current evidence does not show a strong causal relation between the use of cannabis in young people and psychosocial harm.

2004 - News ~ How our brains fend off madness, we produce a cannabis like substance.

2004 - News ~ Cannabis does not induce schizophrenia, Dutch scientists say.

2005 - Study ~ On the Cannabinoid Receptor: A Study in Molecular Psychiatry.

2005 - Study ~ Symptoms of schizotypy precede cannabis use.

2005 - Study ~ Cannabidiol as an antipsychotic. A double-blind, controlled clinical trial on cannabidiol vs. amisulpride in acute schizophrenia.

2005 - News ~ Cannabis and schizophrenia link blurs further.

2005 - News ~ Chemicals in Cannabis may help mentally ill.

2006 - Study ~ Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug.

2006 - Study ~ The Mental Health Risks of Adolescent Cannabis Use.

2006 - Letter ~ Cannabis and psychosis.

2006 - Study ~ Increased cannabinoid receptor density in the posterior cingulate cortex in schizophrenia.

2006 - Study ~ An Experimental Study of Catechol-O-Methyltransferase Val(158)Met Moderation of Delta-9-Tetrahydrocannabinol-Induced Effects on Psychosis and Cognition.

2006 - News ~ Cannabis use does not cause schizophrenia.

2006 - News ~ No Increased Schizophrenia Risk With Use Of Cannabis.

2006 - News ~ Cannabis is a First-Line Treatment for Childhood Mental Disorders.

2007 - Letter ~ Reefer Madness Refuted.

2007 - Study ~ A Comparison of Symptoms and Family History in Schizophrenia with and Without Prior Cannabis Use: Implications for the Concept of Cannabis Psychosis.

2007 - Study ~ Anandamide levels in cerebrospinal fluid of first-episode schizophrenic patients: Impact of cannabis use.

2007 - Study ~ Cannabinoids and psychosis.

2008 - Study ~ Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis.

2008 - Study ~ The effects of cannabis abuse on the symptoms of schizophrenia: patient perspectives.

2009 - Study ~ Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring.

2009 - Study ~ Cannabis and suicide: longitudinal study.

2009 - Study ~ Parasitic brain infection, endocannabinoids, and schizophrenia.

2009 - Study ~ The role of cannabis in cognitive functioning of patients with schizophrenia.

2009 - Study ~ Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway.

2009 - Study ~ Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia.

2009 - Study ~ Effects of cannabidiol on amphetamine-induced oxidative stress generation in an animal model of mania.

2009 - Study ~ Synthetic delta-9-tetrahydrocannabinol (dronabinol) can improve the symptoms of schizophrenia.

2009 - Study ~ Can recreational doses of THC produce significant dopamine release in the human striatum?

2009 - Study ~ If cannabis caused schizophrenia-how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations.

2009 - News ~ Minimal Relationship Between Cannabis And Schizophrenia Or Psychosis, Suggested By New Study.

2009 - News ~ Schizophrenia link to cannabis denied.

2009 - News ~ Cannabis and smoking gene links to schizophrenia ‘unfounded’.

2009 - News ~ New study suggests minimal relationship between cannabis and schizophrenia or psychosis.

2009 - News ~ Science: The development of the number of new schizophrenia cases in the UK does not support the hypothesis that cannabis use increases schizophrenia risk.

2009 - News ~ THC can improve symptoms of schizophrenia.

2009 - News ~ Maternal Marijuana use not Associated with Psychotic Symptoms , but Alcohol is.

2010 - Study ~ Endocannabinoids and Schizophrenia.

2010 - Study ~ Do patients think cannabis causes schizophrenia? - A qualitative study on the causal beliefs of cannabis using patients with schizophrenia.

2010 - Study ~ Reasons for illicit drug use in people with schizophrenia: Qualitative study.

2010 - Study ~ Are cannabis use disorders associated with an earlier age at onset of psychosis? A study in first episode schizophrenia.

2010 - Study ~ Therapeutical use of the cannabinoids in psychiatry.

2010 - Study ~ A common polymorphism in the cannabinoid receptor 1 (CNR1) gene is associated with antipsychotic-induced weight gain in Schizophrenia.

2010 - Study ~ Cannabinoid–Dopamine Interaction in the Pathophysiology and Treatment of CNS Disorders.

2010 - Study ~ A behavioural comparison of acute and chronic Delta9-tetrahydrocannabinol and cannabidiol in C57BL/6JArc mice.

2010 - Study ~ Cannabinoid self-administration attenuates PCP-induced schizophrenia-like symptoms in adult rats.

2010 - Study ~ Brain cannabinoid CB2 receptor in schizophrenia.

2010 - Study ~ Does intravenous {triangleup}9-tetrahydrocannabinol increase dopamine release? A SPET study.

2010 - Study ~ The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample.

2010 - Study ~ Attraction to cannabis among men with schizophrenia: a phenomenological study.

2010 - Letter ~ Tardive Dystonia and the Use of Cannabis.

2010 - News ~ Oral THC Reduces Aggressive Behavior In Patients With Refractory Psychosis, Study Says.

2010 - News ~ Risk of suicide spurs rimonabant trial to end.

2011 - Study ~ Deletion of CB2 Cannabinoid Receptor Induces Schizophrenia-Related Behaviors in Mice.

2011 - Study ~ Cannabis use predicts shorter duration of untreated psychosis and lower levels of negative symptoms in first-episode psychosis: a South African study.

2011 - Study ~ Cannabinoids for the Treatment of Schizophrenia? A Balanced Neurochemical Framework for Both Adverse and Therapeutic Effects of Cannabis Use.

2011 - Study ~ Gadolinium-HU-308-incorporated micelles.

2011 - Study ~ Synthetic cannabinoid JWH-018 and psychosis: An explorative study.

2011 - Study ~ Nutritional omega-3 deficiency abolishes endocannabinoid-mediated neuronal functions.

2011 - Study ~ Psychopharmacological comparison of schizophrenia spectrum disorder with and without cannabis dependency.

2011 - Study ~ Endocannabinoid system dysfunction in mood and related disorders.

2011 - Study ~ Sub-chronic impact of cannabinoids in street cannabis on cognition, psychotic-like symptoms and psychological well-being.

2011 - Study ~ The Dopamine and Cannabinoid Interaction in the Modulation of Emotions and Cognition: Assessing the Role of Cannabinoid CB1 Receptor in Neurons Expressing Dopamine D1 Receptors.

2011 - Study ~ History of cannabis use is not associated with alterations in striatal dopamine D2/D3 receptor availability.

2011 - Study ~ Popular intoxicants: what lessons can be learned from the last 40 years of alcohol and cannabis regulation?

2011 - Study ~ The schizophrenia susceptibility gene neuregulin 1 modulates tolerance to the effects of cannabinoids.

2011 - Study ~ Endocannabinoid system and psychiatry: in search of a neurobiological basis for detrimental and potential therapeutic effects.

2011 - Study ~ The endocannabinoid system in the regulation of emotions throughout lifespan: a discussion on therapeutic perspectives.

2011 - Study ~ Cannabinoid receptor 1 gene polymorphisms and marijuana misuse interactions on white matter and cognitive deficits in schizophrenia.

2011 - Study ~ Association between a cannabinoid receptor gene (CNR1) polymorphism and cannabinoid-induced alterations of the auditory event-related P300 potential.

2011 - Study ~ Deletion of CB2 cannabinoid receptor induces schizophrenia-related behaviors in mice.

2011 - News ~ Marijuana Use Associated With 'Superior' Cognitive Performance In Schizophrenic Patients, Study Says.

2011 - News ~ A Brain Wrought Without Omega-3.

2011 - News ~ Debunking the Myth of a Link Between Marijuana and Mental Illness.

2011 - News ~ The Link Between Marijuana and Schizophrenia.

2012 - Study ~ Acute mental disturbance caused by synthetic cannabinoid: a potential emerging substance of abuse in Hong Kong.

2012 - Study ~ Cannabinoid modulation of noradrenergic circuits: Implications for psychiatric disorders.

2012 - Study ~ Cortical basket cell dysfunction in schizophrenia.

2012 - Study ~ Increased gray matter density in patients with schizophrenia and cannabis use: A voxel-based morphometric study using DARTEL.

2012 - Study ~ Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid?

2012 - Study ~ A current overview of cannabinoids and glucocorticoids in facilitating extinction of aversive memories: Potential extinction enhancers.

2012 - Study ~ Antipsychotic Profile of Cannabidiol and Rimonabant in an Animal Model of Emotional Context Processing in Schizophrenia.

2012 - Study ~ Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia.

2012 - Study ~ A critical review of the antipsychotic effects of Cannabidiol: 30 years of a translational investigation.

2012 - Study ~ Neurocognitive functioning and cannabis use in schizophrenia.

2012 - Study ~ Subjective and Physiological Effects of Oromucosal Sprays Containing Cannabinoids (Nabiximols): Potentials and Limitations for Psychosis Research.

2012 - Study ~ Alcohol and cannabis use and mortality in people with schizophrenia and related psychotic disorders.

2012 - Study ~ Nutritional n-3 polyunsaturated fatty acids deficiency alters cannabinoid receptor signaling pathway in the brain and associated anxiety-like behavior in mice.

2012 - News ~ Study: Marijuana Linked to Lower Mortality Rate for Patients with Psychotic Disorders.

Hardcover Schizophrenia Books

Schizophrenia Revealed: From Neurons to Social InteractionsSurviving Schizophrenia: A MemoirBen Behind His Voices: One Family's Journey from the Chaos of Schizophrenia to HopeSchizophreniaSchizophrenia For Dummies Surviving Schizophrenia: A Manual for Families, Patients, and Providers

 
 
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Narcissistic Personality Disorder

How to recognize a narcissist :Never love anything that can't love you back

What is a personality disorder?

 

[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]

An enduring pattern of inner experience and behaviour that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

A personality disorder is a pattern of deviant or abnormal behaviour that the person doesn't change even though it causes emotional upsets and trouble with other people at work and in personal relationships. It is not limited to episodes of mental illness, and it is not caused by drug or alcohol use, head injury, or illness. There are about a dozen different behaviour patterns classified as personality disorders by DSM-IV. All the personality disorders show up as deviations from normal in one or more of the following:
(1) cognition -- i.e., perception, thinking, and interpretation of oneself, other people, and events;
(2) affectivity -- i.e., emotional responses (range, intensity, lability, appropriateness);
(3) interpersonal functions;
(4) impulsive.


Narcissistic Personality Disorder

While grandiosity is the diagnostic hallmark of pathological narcissism, there is research evidence that pathological narcissism occurs in two forms, (a) a grandiose state of mind in young adults that can be corrected by life experiences, and (b) the stable disorder described in DSM-IV, which is defined less by grandiosity than by severely disturbed interpersonal relations.


     The preferred theory seems to be that narcissism is caused by very early affective deprivation, yet the clinical material tends to describe narcissists as unwilling rather than unable, thus treating narcissistic behaviors as volitional -- that is, narcissism is termed a personality disorder, but it tends to be discussed as a character disorder. This distinction is important to prognosis and treatment possibilities. If NPD is caused by infantile damage and consequent developmental short-circuits, it probably represents an irremediable condition. On the other hand, if narcissism is a behavior pattern that's learned, then there is some hope, however tenuous, that it's a behavior pattern that can be unlearned. The clinical literature on NPD is highly theoretical, abstract, and general, with sparse case material, suggesting that clinical writers have little experience with narcissism in the flesh. There are several reasons for this to be so:

  •   The incidence of NPD is estimated at 1% in the general population, though I haven't been able to discover the basis of this estimate.
  •   Narcissists rarely enter treatment and, once in treatment, progress very slowly. We're talking about two or more years of frequent sessions before the narcissist can acknowledge even that the therapist is sometimes helpful. It's difficult to keep narcissists in treatment long enough for improvement to be made -- and few people, narcissists or not, have the motivation or the money to pursue treatment that produces so little so late.
  •   Because of the influence of third-party payers (insurance companies), there has been a strong trend towards short-term therapy that concentrates on ameliorating acute troubles, such as depression, rather than delving into underlying chronic problems. Narcissists are very reluctant to open up and trust, so it's possible that their NPD is not even recognized by therapists in short-term treatment. Purely anecdotal evidence from correspondents and from observations of people I know indicates that selective serotonin inhibitors, such as Prozac, aggravate narcissists' grandiosity and lack of social inhibition. It has also been suggested that self-help literature about bolstering self-esteem and getting what you want out of life or that encourages the feeling of victimization has aggravating effects on NPD thinking and behaviour.
  •   Most clinical writers seem unaware that narcissists' self-reports are unreliable. This is troubling, considering that lying is the most common complaint about narcissists and that, in many instances, defects of empathy lead narcissists to wildly inaccurate misinterpretations of other people's speech and actions, so that they may believe that they are liked and respected despite a history of callous and exploitative personal interactions.
[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.[jma: NPD first appeared in DSM-III in 1980; before that time there had been no formal diagnostic description. Additionally, there is considerable overlap between personality disorders and clinicians tend to diagnose mixes of two or more. Grandiosity is a special case, but lack of empathy and exploitative interpersonal relations are not unique to NPD, nor is the need to be seen as special or unique. The differential diagnosis of NPD is made on the absence of specific gross behaviours. Borderline Personality Disorder has several conspicuous similarities to NPD, but BPD is characterized by self-injury and threatened or attempted suicide, whereas narcissists are rarely self-harming in this way. BPD may include psychotic breaks, and these are uncharacteristic of NPD but not unknown. The need for constant attention is also found in Histrionic Personality Disorder, but HPD and BPD are both strongly oriented towards relationships, whereas NPD is characterized by aloofness and avoidance of intimacy. Grandiosity is unique to NPD among personality disorders, but it is found in other psychiatric illnesses. Psychopaths display pathological narcissism, including grandiosity, but psychopathy is differentiated from NPD by psychopaths' willingness to use physical violence to get what they want, whereas narcissists rarely commit crimes; the narcissists I've known personally are, in fact, averse to physical contact with others, though they will occasionally strike out in an impulse of rage. It has been found that court-ordered psychotherapy for psychopaths actually increases their recidivism rate; apparently treatment teaches psychopaths new ways to exploit other people. Bipolar illness also contains strong elements of grandiosity. See more on grandiosity and empathy and its lack below.]The disorder begins by early adulthood and is indicated by at least five of the following:

Translation: Narcissistic Personality Disorder (NPD) is a pattern of self-centred or egotistical behaviour that shows up in thinking and behaviour in a lot of different situations and activities. People with NPD won't (or can't) change their behaviour even when it causes problems at work or when other people complain about the way they act, or when their behaviour causes a lot of emotional distress to others (or themselves? none of my narcissists ever admit to being distressed by their own behaviour -- they always blame other people for any problems). This pattern of self-centred or egotistical behaviour is not caused by current drug or alcohol use, head injury, acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or early adulthood.


     NPD interferes with people's functioning in their occupations and in their relationships:
Mild impairment when self-centred or egotistical behaviour results in occasional minor problems, but the person is generally doing pretty well.


Moderate impairment when self-centred or egotistical behaviour results in: (a) missing days from work, household duties, or school, (b) significant performance problems as a wage-earner, home-maker, or student, (c) frequently avoiding or alienating friends, (d) significant risk of harming self or others (frequent suicidal preoccupation; often neglecting family, or frequently abusing others or committing criminal acts).


Severe impairment when self-centred or egotistical behaviour results in: (a) staying in bed all day, (b) totally alienating all friends and family, (c) severe risk of harming self or others (failing to maintain personal hygiene; persistent danger of suicide, abuse, or crime).

1. An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

Translation: Grandiosity is the hallmark of narcissism. So what is grandiose?

The simplest everyday way that narcissists show their exaggerated sense of self-importance is by talking about family, work, life in general as if there is nobody else in the picture. Whatever they may be doing, in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit.

They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all; they may inspire your sympathy or admiration for their stoicism in the face of hardship or unstinting self-sacrifice for the good of (undeserving) others. But this everyday grandiosity is an aspect of narcissism that you may never catch on to unless you visit the narcissist's home or workplace and see for yourself that others are involved and are pulling their share of the load and, more often than not, are also pulling the narcissist's share as well. An example is the older woman who told me with a sigh that she knew she hadn't been a perfect mother but she just never had any help at all -- and she said this despite knowing that I knew that she had worn out and discarded two devoted husbands and had lived in her parents' pocket (and pocketbook) as long as they lived, quickly blowing her substantial inheritance on flaky business schemes. Another example is claiming unusual benefits or spectacular results from ordinary effort and investment, giving the impression that somehow the narcissist's time and money are worth more than other people's. [Here is an article about recognizing and coping with narcissism in the workplace; it is rather heavy on management jargon and psycho-babble, but worth reading. "The Impact of Narcissism on Leadership and Sustainability" by Bruce Gregory, Ph.D. "When the narcissistic defence is operating in an interpersonal or group setting, the grandiose part does not show its face in public. In public it presents a front of patience, congeniality, and confident reasonableness."]

In popular usage, the terms narcissism, narcissist, and narcissistic denote absurd vanity and are applied to people whose ambitions and aspirations are much grander than their evident talents. Sometimes these terms are applied to people who are simply full of themselves -- even when their real achievements are spectacular. Outstanding performers are not always modest, but they aren't grandiose if their self-assessments are realistic; e.g., Muhammad Ali, then Cassius Clay, was notorious for boasting "I am the greatest!" and also pointing out that he was the prettiest, but he was the greatest and the prettiest for a number of years, so his self-assessments weren't grandiose. Some narcissists are flamboyantly boastful and self-aggrandizing, but many are inconspicuous in public, saving their conceit and autocratic opinions for their nearest and dearest. Common conspicuous grandiose behaviours include expecting special treatment or admiration on the basis of claiming (a) to know important, powerful or famous people or (b) to be extraordinarily intelligent or talented. As a real-life example, I used to have a neighbour who told his wife that he was the youngest person since Sir Isaac Newton to take a doctorate at Oxford. The neighbour gave no evidence of a world-class education, so I looked up Newton and found out that Newton had completed his baccalaureate at the age of twenty-two (like most people) and spent his entire academic career at Cambridge. The grandiose claims of narcissists are superficially plausible fabrications, readily punctured by a little critical consideration. The test is performance: do they deliver the goods? (There's also the special situation of a genius who's also strongly narcissistic, as perhaps Frank Lloyd Wright. Just remind yourself that the odds are that you'll meet at least 1000 narcissists for every genius you come across.) [More on grandiosity.]

 

2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love

Translation: Narcissists cultivate solipsistic or "autistic" fantasies, which is to say that they live in their own little worlds (and react with affront when reality dares to intrude).

3. Believes he is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)

Translation: Narcissists think that everyone who is not special and superior is worthless. By definition, normal, ordinary, and average aren't special and superior, and so, to narcissists, they are worthless.

4. Requires excessive admiration

Translation: Excessive in two ways: they want praise, compliments, deference, and expressions of envy all the time, and they want to be told that everything they do is better than what others can do. Sincerity is not an issue here; all that matter are frequency and volume.

5. Has a sense of entitlement

Translation: They expect automatic compliance with their wishes or especially favorable treatment, such as thinking that they should always be able to go first and that other people should stop whatever they're doing to do what the narcissists want, and may react with hurt or rage when these expectations are frustrated.

6. Selfishly takes advantage of others to achieve his own ends

 

Translation: Narcissists use other people to get what they want without caring about the cost to the other people.

7. Lacks empathy

Translation: They are unwilling to recognize or sympathize with other people's feelings and needs. They "tune out" when other people want to talk about their own problems.


    In clinical terms, empathy is the ability to recognize and interpret other people's emotions. Lack of empathy may take two different directions: (a) accurate interpretation of others' emotions with no concern for others' distress, which is characteristic of psychopaths; and (b) the inability to recognize and accurately interpret other people's emotions, which is the NPD style. This second form of defective empathy may (rarely) go so far as alexithymia, or no words for emotions, and is found with psychosomatic illnesses, i.e., medical conditions in which emotion is experienced somatically rather than psychically. People with personality disorders don't have the normal body-ego identification and regard their bodies only instrumentally, i.e., as tools to use to get what they want, or, in bad states, as torture chambers that inflict on them meaningless suffering.

Self-described narcissists who've written to me say that they are aware that their feelings are different from other people's, mostly that they feel less, both in strength and variety (and which the narcissists interpret as evidence of their own superiority); some narcissists report "numbness" and the inability to perceive meaning in other people's emotions.

8. Is often envious of others or believes that others are envious of him

Translation: No translation needed.

9. Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes

 

Translation: They treat other people like dirt.

 

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