The problem of which cues, internal or external, permit a person to label and identify his own emotional state has been with us since the days that James (1890) first tendered his doctrine that \"the bodily changes follow directly the perception of the exciting fact, and that our feeling of the same changes as they occur is the emotion\" (p. 449). Since we are aware of a variety of feeling and emotion states, it should follow from James' proposition that the various emotions will be accompanied by a variety of differentiable bodily states. Following James' pronouncement, a formidable number of studies were undertaken in search of the physiological differentiators of the emotions. The results, in these early days, were almost uniformly negative. All of the emotional states experi-

"Cognitive, social, and physiological determinants of emotional state": Erratum

Objectives:Simulation methodologies are integral to health professional education at all levels of training and across all disciplines. This article reviews the literature on simulation in psychiatric education and explores recent innovations and emerging ethical considerations related to teaching and evaluation.Method:The authors searched the MEDLINE, ERIC, and PsycINFO databases from 1986 to 2006 using multiple search terms. A detailed manual search was conducted of Academic Psychiatry, Academic Medicine, and Medical Education. Literature indirectly relevant to the search parameter was also included.Results:Of the more than 5000 articles retrieved from the literature on simulation and health professional education, 72 articles and books used the terms simulation and standardized patients or role play and psychiatry education. Of the more than 900 articles on objective structured clinical examinations (OSCE), 24 articles related specifically to psychiatry OSCEs.Conclusions:Live simulation is used in teac...

Psychiatric Education and Simulation: A Review of the Literature

Abuse of amphetamines-methamphetamines has increased worldwide. Profiles of abusers, effects of different methods of administration, and research on amphetamine psychosis are reviewed, along with research on psychophysiological mechanisms, addictive potential, and psychotherapeutic strategies.

Psychophysiological Aspects of Amphetamine-Methamphetamine Abuse

A review of the relevant literature is followed by an exploration of the complex relationship, especially for women, between homelessness and mental health. Various mental health and gender-related concerns that have implications for the design of interventions for homeless women are explored.

Mental health issues affecting homeless women: implications for intervention.

Lysergic acid diethylamide (LSD) was studied from the 1950s to the 1970s to evaluate behavioral and personality changes, as well as remission of psychiatric symptoms in various disorders. LSD was used in the treatment of anxiety, depression, psychosomatic diseases and addiction. However, most of the studies were not performed under contemporary standards, and it has taken several decades for a resurgence of interest in LSD research and its therapeutic potential for psychiatry. The aim of this review is to identify controlled and randomized clinical trials that assess the potential use of LSD in psychiatry. PRISMA guidelines for systematic review were followed. A literature search of PubMed and Psychedelic bibliography from Multidisciplinary Association for Psychedelic Studies (MAPS) databases was performed as well as a manual search of references from evaluated studies. Only randomized-controlled clinical trials were included. Study quality was systematically calculated by using the Cochrane Collaboration Tool for assessing risk of bias. A final selection of 11 articles was made after considering inclusion and exclusion criteria. LSD was administered to 567 patients in a dose ranging from 20 to 800 mcg. Despite the design heterogeneity of clinical trials, positive results were observed, thus revealing the therapeutic potential of LSD to reduce psychiatric symptomatology, mainly in alcoholism. The vast majority of authors describe significant and positive short-term changes in patients, despite the fact that in some studies an important homogenization was observed between the LSD treatment group and control group at long-term follow-up. Multiple variables regarding LSD treatment therapeutic approach and quality of experience were revealed and related to therapeutic outcomes. LSD is revealed as a potential therapeutic agent in psychiatry; the evidence to date is strongest for the use of LSD in the treatment of alcoholism. Despite the difficulty of designing proper double blind clinical trials with this substance, new studies that conform to modern standards are necessary in order to strengthen our knowledge on its use and open new doors in the future.

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Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials.

This chapter presents the clinician’s view of homelessness and related mental health issues based on the experiences of a mental health outreach team (the “team”), which operates in the shelters, the meal programs, and the jail of a high-density homeless area in a coastal suburb of Los Angeles County. The beach cities of Santa Monica and Venice differ from downtown Los Angeles’s skid row, New York’s Harlem, and Boston’s “combat zone” in that they are largely residential areas, are easily accessible by bus from downtown, border on the Pacific Ocean, and contain many public parks.1 Violence is less than in downtown skid row, but there are fewer shelters and social service facilities.

Mental Health and Homelessness

Any discussion of the therapeutic uses of the drugs of abuse requires careful attention both to definitions and to terminology. First of all, by therapeutic, we are here referring to a drug which is used in “modern” medicine rather than in folk medicine, and a drug which demonstrates more than a placebo effect. Time constraints preclude consideration of the therapeutic uses of all the drugs of abuse and even of all psychoactive drugs, those which affect the mind and behavior. Therefore, we will discuss selected drugs of abuse, particularly those drugs about which some controversy currently exists. We will make our selection from among those drugs which are in the Controlled Substances Act (C.S.A.), particularly in Schedule 1. The Controlled Substances Act of 1970, a Federal act which has been adopted by many states, imposes nine kinds of controls on scheduled or abusable substances. These drugs are here divided into five schedules according to the dual criteria of abuse potential and therapeutic usefulness. Severity of penalties for drug related offenses is partially related to these schedules. Those drugs which are in Schedule 1 have, by definition, a high drug abuse potential, are unsafe even when given under medical supervision, and have no therapeutic usefulness. We will attempt to discuss only briefly policy and political issues, placing emphasis o n scientific concerns. Thus, three of the four drugs selected for discussion are from Schedule 1 . They include: LSD, marijuana, and heroin. Heroin has been covered in the previous presentation and so the material we will present about it will be somewhat abbreviated. We will also include, from Schedule 2, the amphetamines, currently the center of heated controversy in this country as far as the legal regulation of the indications for which they may be prescribed.

Therapeutic uses of the drugs of abuse

The authors present an innovative approach for providing freshman and sophomore medical students with their initial exposure to the problems of alcohol and other drug abuse. Students in small interactive group seminars teach each other about the major areas of substance abuse: treatment, prevention/education, research, and law enforcement. They are aided by group moderators, by resource professionals, and by recovery teachers as they make field trips, attend 12-step meetings, and get background material. They utilize audiovisuals, role-plays, and programmed patients in a report/debate format. Effects of this seminar on their attitudes have been measured and are presented.

Interactive teaching, medical students, and substance abuse : university and community come together in a new endeavor.

This report focuses on several aspects of the "drug" cannabis in our society: the historical notion of a chemical as a moral issue (i.e., good and evil) rather than a pharmacological one; the scientist as a human being as well as a witting or unwitting influencer of social policy; the statistical design and manipulation of research consciously or unconsciously for fame and fortune (grants); the research treatment "connection" as part of our drug abuse industrial complex, a billion dollar a year industry; and the covert governmental manipulation and distortion of cannabis (and other drug) data.

Bias and the Cannabis Researcher

The “drug scene” in the United States has evolved very dramatically in the period from prior to 1965 to the present. The sociology of drug use patterns was rather constant prior to 1965. In the mid 1960s “fashionable trends” in drug use took shape, starting with use of psychedelics for consciousness expansion. This led to poly-drug use, where the quality of the drugs taken deteriorated leading to present availability of “look alikes” which are manufactured to resemble original drug products but are counterfeit controlled substances. Several special current drug problems currently exist including freebasing cocaine, phencyclidine use and methaqualone use. The potential behavioral meanings of drug use are discussed, which may be multiple and multi-determined in nature. The interface of adolescent development issues and family dynamics are important to consider in regard to potential underlying reasons for adolescent drug abuse.

J. Thomas Ungerleider

Papers

Mental Health and Homelessness

Therapeutic uses of the drugs of abuse

Interactive teaching, medical students, and substance abuse : university and community come together in a new endeavor.

Bias and the Cannabis Researcher

Changes in the Drug Scene: Drug Use Trends and Behavioral Patterns