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Olympics and Boxing: A Painful Disconnect

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OLYMPICS AND BOXING: A PAINFUL DISCONNECT

By Alen J. Salerian, MD

   How is it possible for neuroscience to know that the prefrontal cortex (the brain region right beneath our forehead) is the king of human intelligence and yet for Olympics not only to promote boxing but to consider the inclusion of women boxing by the next Olympics in Rio? Today's science says:

-    -Prefrontal cortex is the boss of human brain function and behavior.

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-    -Any decline of prefrontal-cortex function from injury or illness may impair judgment, logical thinking, impulse control, and mood.

-   -A single or multiple jolts of prefrontal cortex may have catastrophic consequences.

-    -Organized sports such as soccer, boxing, football, rugby, and diving consistently expose prefrontal cortex to violent jolts.

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-    -The great majority of psychiatric disorders are because of impairment of prefrontal-cortex function.

-   - Drug addiction and depression are complications of untreated brain disorders. In essence it is impossible for anyone to be an addict unless he or she has an abnormal prefrontal cortex.

   It is also true that modern society vilifies people with psychiatric disabilities caused by prefrontal-cortex injuries as victims of self-inflicted injuries. And worse, the current treatments are empowered by erroneous assumptions rooted in DSM-IV (the diagnostic statistical manual of psychiatric disorders).

   Why does it matter? It matters because DSM-IV is our compass to guide the treatment of millions with mental illness, and DSM-IV is unscientific.

   The difference between a cat and a tiger is huge: to confuse one with the other can be fatal, so as to confuse a disease with a disease complication. Medical sciences suggest untreated diabetes may lead to diabetic retinopathy, kidney disease, and premature death. Surprisingly this is not what current DSM-based standards of neuropsychiatric disorders suggest.  

   It seems the great majority of current psychiatric disorders are complications or disease progression from other brain dysfunctions. In other words, these are all phantom disorders created by an artifact of DSM-IV's inability to distinguish an illness from its pathophysiologically predictable complications.

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   During the past decade, in study after study, one image at a time, neuroimaging technologies have been projecting a vibrant brain map. The new image is profoundly different from what we have been taught. The paradigm shift is rooted in a major discovery: the pathophysiology of medical and neuropsychiatric disorders is the same.

   Also of importance is evidence that addictive behaviors are greatly influenced by neurobiology and thus effective treatment depends on identifying and targeting the underlying abnormalities. For instance, someone with social phobia or shyness might rely on alcohol for its anti-anxiety properties, and develop a problem with alcohol. Not recognizing the pathophysiology of phobia and appropriately treating it will often complicate and even hinder successful treatment.

   Thanks to neuroimaging advances, we now have a dynamic brain map to offer more effective treatments for people with neuropsychiatric disorders. This includes not only psychosis or depression but also addictive disorders. In essence, all the scientific news is good news, but the same cannot be said about public knowledge of what harms us.

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Alen J. Salerian, MD is a Washington, DC based physician, author, and historian who has been practicing psychiatry and psychopharmacology for 35 years. He is the former chief psychiatrist of the FBI's mobile psychiatric unit. He has authored (more...)
 

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