Lithium As A Neuroscience Approach


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Lithium as a neuroscience approach to reducing antisocial behavior as a public health strategy

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Lithium As A Neuroscience Approach

  1. 1. Lithium as a Neuroscience/Public Health Approach to Reducing Antisocial Behaviors James M. DeCarli, MPH, MPA, CHES University of Southern California Department of Psychology/Neuroscience
  2. 2. Overview Background Antisocial Behavior Ineffective Interventions Gene-Environment Interplay Anosognosia Lithium Nutritional Supplimentation Pharmocokenetics Pharmacodynamics Conclusion Efficacy of Lithium supplementation to reduce antisocial behaviors
  3. 3. Background 20% of people experience victimization by perpetrators of violent and nonviolent illegal behavior per year (U.S. Bureau of Justice Statistics, 2002) Behavioral science needs to achieve an understanding of the causes of ASB to obtain an evidenced-based approach to control and prevent ASB
  4. 4. Background Only about 12%: shown to reduce juvenile offenders’ recidivism (Lipsey & Wilson, 1998) ABS has not been shown to be reduced due from even the best of these programs While programs have not shown to be effective, this review takes a neuroscience approach as lithium supplementation as a potential public health strategy to reduce and control violence.
  5. 5. Heritability MAO-A (Neurotransmitter) Serotonin (HT5) Norepinephrine
  6. 6. Heritability ABS Outcome Environmental Risk Factor Heritability (Genotype) Neural Substrate
  7. 7. Barrier to Seeking Treatment Environmental stimuli might be observed as the problem among both the antisocial parent and the child This becomes a barrier and those are not likely to seek treatment.
  8. 8. Anosognosia As observed with many mood disorders and antisocial behaviors nonadherence to treatment are common, leading to a barrier to being treated as well Some common themes of nonadherance include fear of dependency, side effects, discomfort of psychiatric diagnosis and most importantly denial of illness (Byrne, 2006) or anosognosia Before one is capable of seeking or accepting treatment they first need conscious self-awareness of their illness.
  9. 9. Antisocial Behaviors: Neurological Effects Reduce gray matter (amygdala) emotional regulation While those with antisocial and violence behaviors exhibit reduced gray matter, specifically among the amygdala in emotional dysregulation, low level of serotonin is also common, resulting in an increased risk of conduct disorder among children.
  10. 10. Pharmacokenetics of Lithium Oral Ingestion Absorbed Gastrointestinal Kidneys Excreted in breast milk and insignificant amount in perspiration and feces Organs affected: Thyroid, hematopoietic system, kidneys, and heart.
  11. 11. Pharmacodynamics of Lithium Inhibit inositol phosphatases within the neurons Pathogenesis of Neurotransmitters: Serotonin (5HT) Norepinephrine Increases serotonin and norepinephrine, Shown to increase grey matter (Sassi, 2002).
  12. 12. Lithium: Neurological Effects Antisocial Behavior Gray Matter Serotonin (HT5) (Amygdala)
  13. 13. Aetiology of Anosognosia Dissociable Interactions and Conscious Experience (DICE) Model [McGlynn & Schacter,1989] Lack of awareness Executive System of complex Frontal Lobes impairments in problem solving, retrieving, and integrating information, behaviorally, socially, Conscious Awareness System (CAS) and personality -Inferior Parietal Lobes and Cingulate Cortex changes Memory Language Sensormotor Vision
  14. 14. Efficacy of Lithium Studies have shown that the incidence of rape, homicide, and suicide were significantly higher in areas where the drinking water contained little or no lithium. This has confirmed that low level dose of lithium has a beneficial effect on human behavior (Schrauzer, 1990).
  15. 15. Conclusion Nutritional lithium supplement could help close this gap among those with antisocial behaviors who choose not to seek or accept treatment because of their denial and lack of conscious self-awareness of illness Application Water/Food source Schools (with high levels of community violence) Help meet the Health People 2010 leading health objectives to reduce youth violence