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Rates of prescriptions of antidepressants and suicide are inversely correlated at an epidemiological level. Less attention has been paid to relationships between other drugs used in mental health and suicide rates. Here we tested relationships between prescriptions of anxiolytics and antipsychotics and suicide rates in Scotland.
Results
Suicide rates were inversely correlated with prescriptions of antidepressants and antipsychotics over 14 years (2004–2018), and positively with prescriptions of anxiolytics.
Clinical implications
This illustrates the role of medications used in mental health in suicide prevention, and highlights the importance of identifying causal mechanisms that link anxiolytics with suicide.
Consciousness concerns awareness and how we experience the world. How does awareness, a feature of the mental world, arise from the physical brain? Is a dog conscious, or a jellyfish, and what explains the difference? How is consciousness related to psychological processes such as perception and cognition? The Science of Consciousness covers the psychology, philosophy, and neuroscience of consciousness. Written for introductory courses in psychology and philosophy, this text examines consciousness with a special emphasis on current neuroscience research as well as comparisons of normal and damaged brains. The full range of normal and altered states of consciousness, including sleep and dreams, hypnotic and meditative states, anesthesia, and drug-induced states, as well as parapsychological phenomena and their importance for the science of consciousness is covered, as well as the 'higher' states and how we can attain them. Throughout the text attempts to relate consciousness to the brain.
This chapter examines the process of introspection and examining our own minds. It looks at different types of introspection. it examines the philosophical process and discipline of phenomenology, particularly the work of Husserl. We look at psychological methods of examining the contents of our thoughts, particularly using experience sampling. We then look at the reliability of our own beliefs, and how we can be misled by illusions and delusions. The chapter looks at examples such as schizophrenia, mass hysteria, confabulation and the neurological disorder denial, all of which make us question the reliability of our beliefs. We ask to what extent we could be wrong about the nature of our experience. The chapter moves on to consider what is outside consciousness, and the Freudian concept of the unconscious, and the Jungian concept of the collective unconscious and its contents. The chapter concludes by examining subliminal processing.
This chapter looks at meditation and mindfulness and other forms of heightened awareness. It first looks at the evidence that meditation leads to both temporary and permanent changes in the brain, and has both short- and long-term benefits for physical and mental health. It asks: what then is the relation between mind and brain, and what is the direction of flow of causality? The chapter then looks at transcendental consciousness, and ‘better than normal states’. We focus in particular on religious experiences, and the involvement of the temporal lobes and other structures, as well as evaluating the evidence for the efficacy of Persinger’s ‘god helmet’. It mentions again entheogens, drugs that give religious-like experiences. The chapter concludes with a discussion of Buddhism, particularly Zen.
This chapter looks at the state of sleep and its biology. it begins by looking at what comprises the state of sleep, and examines comparatively which, and how, other animals sleep. It looks at circadian rhythms, and how the sleep--wake cycle is controlled, with melatonin manufactured by the pineal gland. There is emphasis on the electrophysiology of sleep (sleep EEG), and a description of the stages of sleep and how they are characterised by different EEG profiles, particularly the distinction between REM and non-REM sleep. The neurology of sleep looks at the role of structures such as the brainstem and reticular activating system, and the effect of damage at different levels of the brain on sleeping behaviour. The psychopharmacology of sleep looks at the changing role of neurotransmitters throughout the day and night, and in dreaming and dreamless sleep. The chapter then examines the range of sleep disorders, including problems getting to sleep, as well as sleep walking and sleep talking. It then looks at the effects of sleep deprivation. The chapter concludes with a discussion of why we sleep, covering the possible evolutionary functions of sleep, with focus on the role of sleep in learning and memory consolidation.
This chapter looks at the cognitive correlates of consciousness, and how consciousness is related to the ideas of selection and limitation. It begins by looking at how cognitive processes such as attention, particularly visual attention, language, thought, mental imagery and inner speech involve consciousness. It looks at cross-cultural differences in cognition. We then look at the neuroscience of the default-mode network. The chapter then looks at a number of models of consciousness based in cognition, including the global workspace theory of Baars, and the multiple drafts model of Dennett. We consider the underlying neuroscience. The chapter then considers how cognition enables us to construct a model or representation of the world, and the way in which consciousness might emerge from that representation. We consider again emergence and complexity. Finally the chapter examines the possible role of quantum mechanics as a basis for understanding consciousness.
This chapter examines altered states of consciousness (ASCs) and how the the phenomenology of the experience is linked to the changes that give rise to the altered state. The chapter begins by asking what an ASC is, and what is altered in it. I’m It introduces the psychonaut, who tries to explore human experience in part with conscious states. The chapter describes several altered states, including sensory deprivation (and mentions its use as torture), sensory habituation and out-of-body experiences (OBEs). It emphasises that OBEs arise from brain-related changes and do not need to be explained in terms of a soul or astral travel. The chapter similarly examines near-death experiences (NDEs) and how they can be explained in physical terms, without recourse to an afterlife. The chapter also examines migraine prodrome and aura, epilepsy and the sleeping sickness Encephalitis lethargica, as portrayed in Oliver Sacks’s book Awakenings, and the film of the same name.
This chapter looks at dreams. We first examine the definition of a dream and ask how we can be sure that they are real experiences, rather than constructed on awakening, and we ask how reliable is our memory for them. It then looks at lucid dreaming - dreams in which we know we are dreaming - and methods of inducing lucid dreams. The chapter then looks at dream content, including different types of dream, such as nightmares and recurring dreams. It then moves on to the question of why we dream, and whether dreams have any meaning. We examine the biology of dreaming in terms of the default-mode network and the activation--synthesis model. The chapter concludes by looking at why we dream, including accounts such as dealing with threats, and the relationship between dreaming and learning. In particular, we look at psychoanalytic theories, particularly those of Freud, Jung and Adler, and the idea that dreams are a result of a struggle between the ego and the repressed unconscious, and the use of mechanisms such as dream symbols.
This chapter examines the concept of free will. it commences with an examination of determinism, and the idea of a ‘clockwork universe’. It extends the idea of a clockwork universe to the determination of human thought and behaviour. It examines ideas from quantum mechanics, asking whether uncertainty and probability provide any relief for the problem of free will, and we conclude that they probably don’t. The chapter then examines the possibility that dualism provides free will. It further asks whether there are benefits in believing in the illusion of free will. It examines compatabilism -- attempts to reconcile determinism with free will. The chapter discusses crime and punishment in the light of free will, and the idea of moral responsibility. Should psychopaths be punished or treated (or both)? The chapter then examines the literature on deciding to act, including Libet’s experiments on timing, and brain imaging of decision making. It then looks at involuntary action and the alien hand syndrome. It concludes by looking at psychological compulsions, asking how they relate to free will.
This chapter examines machine consciousness. It begins by looking at artificial life, and simulations such as BOIDS that model flocking behaviour. It introduces the concepts of complexity and emergence. It then examines artificial intelligence (AI) in detail. It looks at the idea of computer intelligence, and computers playing games, particularly chess and Deep Blue. The chapter discusses the Turing test and asks what would be an appropriate Turing two for consciousness. It looks at technological advance and asks when, if ever, we are likely to see a conscious computer. It discusses Kurzweil’s notion of the singularity. The chapter then discusses robotics, including different types of robot, and swarm intelligence and evolutionary robotics. The chapter examines attempts to build a brain, and enhancing cognition and consciousness through prosthetics. The chapter concludes by asking whether AI will be a threat.
This chapter examines hypnosis. It begins with a description of the history of hypnosis, including Mesmer, Charcot and Freud. It then examines the process of hypnotic induction, including stage hypnosis. The chapter examines the hypnotic trance, asking what makes good hypnotic subjects (and good hypnotists), and at the construct of suggestibility. It then asks if the hypnotic trance is indeed a special state involving dissociation and a ‘hidden observer’, or whether it is mediated by compliance, as the non-state theorists propose. The chapter then discusses particular uses of hypnosis, such as hypnotherapy - for example in the cessation of smoking - recovering memories, hypnotic amnesia and hypnotic anaesthesia. The chapter considers whether hypnosis is dangerous and whether, under hypnosis, people can be made to do things they don’t really want to do. It examines the neuroscience of hypnosis, considering the implications of neural markers of hypnotism for non-state theories of the hypnotic trance. We conclude with a discussion of self-hypnosis, and finally with what hypnosis tells us about cognitive processing.