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Differential brain activations during intentionally simulated and subjectively experienced paralysis
Distinguishing conversion disorder from malingering presents a significant challenge as the diagnosis ultimately depends on the patient's subjective report and the clinician's suspicion of an intention to deceive. Using hypnosis to manipulate the intentionality of movement inhibition in the same subjects, we used positron emission tomography (PET) to determine whether failure to move during intentionally simulated and subjectively experienced paralysis is mediated by different neural structures. METHODS: Using a within-subject design, 12 normal, hypnotised subjects were tested under two paralysis conditions during the same scanning session. Half of the scans were performed with the suggestion that the left leg was paralysed (subjectively experienced paralysis condition) and half with the leg normal but with the instruction that paralysis should be feigned (intentionally simulated paralysis condition). RESULTS: Relative increases in brain activation were seen in the right orbitofrontal cortex, right cerebellum, left thalamus, and left putamen during subjectively experienced paralysis compared to intentionally simulated paralysis, although a previously reported activation of the right anterior cingulate cortex was not seen. During intentionally simulated paralysis compared to subjectively experienced paralysis relative increases in brain activation were seen in the left ventrolateral prefrontal cortex, and a number of right posterior cortical structures. CONCLUSIONS: Our results suggest that subjectively experienced paralysis has a different neural basis to intentionally simulated paralysis. These findings have theoretical and clinical implications for malingering and related attempts to unravel the neuropsychological basis for conversion hysteria.
Wellcome Department of Imaging Neuroscience, Institute of Neurology, University College, London, London, UK. n-ward@fil.ion.ucl.ac.uk
We’re at the beginning of a new decade. The end of 2009 left many people shell-shocked from the world-wide economic meltdown. Thousands have lost jobs, homes and life savings. But, as with any adversity, humans have the ability to recreate themselves, to create a better future.
However, change – whether on a global scale or personal – starts with thought. To change your weight, your finances, your outlook on life you have to change how you think. There is power in thought. It is where creativity begins. If you cannot perceive of yourself as being slim, it’s unlikely that...
Excessive worry and anxieties are so common in Western society that I sincerely doubt that there are many people who are not adversely affected by them. Do you constantly feel stressed? Do you have problems sleeping? Is your mind always hyperactive and jumping from worry to worry? Yes, you problem are handling your stress and anxieties very well.
Remember that your reactions are most likely part of what psychologists call learned behavior. This means that at some time you reacted – or over-reacted – to a situation. When you perceived it happening again, this recognition...
Cyber bullying seems to be an invention of the Internet era. This form of cowardly bullying involves someone – who is frequently anonymous – communicating through e-mail or social media sites in a very threatening manner. Like bullying that involves the bully being present in person, one cyber bully is almost always joined by others who join in on the frenzy.
As I have written frequently, all bullying is a manifestation of instinctual dominance play in which one or more person’s seek to prey on those who are deemed to be helpless. While this is normally a matter of brawn, in more...
