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Registered mental health nurse working in community mental health. Runner. Rower.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 The problem in concluding that we don’t know exact causes or change mechanisms is that we enter a world of treatment anarchy where anything goes (like offering ‘depth therapy’ or the carnivore diet for insomnia disorder). The human cost is substantial.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Whilst we don’t have ultimate causes of any mental illness, we have good evidence of things that might be implicated and therefore which treatments are likely to help (eg TFP for BPD or CBTi for insomnia disorder).

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Take the cold press away, the pain returns. It’s a symptomatic tx, like giving paracetamol for fever from pneumonia. CBTi targets the underlying psychobiology that presents w/the symptom of insomnia. It does so w/out treating the whole person or just focusing on the symptom.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Think sports injury. A physio could provide a cold compress for symptom relief, or they could try a whole person intervention involving diet, exercise, lifestyle, etc. A 3rd option is targeted rehab exercises that address the mechanisms maintaining the problem…as with CBTi.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Perhaps Ive misunderstood. I took it that because CBTi doesn’t attempt to treat the whole personality, it is therefore symptom focused. My point is theres a 3rd possibility. A treatment can target the mechanisms maintaining a specific disorder w/out treating the whole person.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 CBTi doesn’t suppress the symptom, it targets the underlying psychobiological processes (often through SRT & SCT) which once resolved, resolve the symptom.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 CBTi doesn’t suppress the symptom, it targets the underlying psychobiological processes (often through SRT & SCT) which once resolved, resolve the symptom.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Correct - it doesnt intend to treat the whole personality. I think you’re setting up a false dichotomy: you can treat the underlying mechanisms of a particular disorder without treating the whole person. Z-drug would be an example of a symptomatic treatment for insomnia disorder.

[checktheavailability @Molyneux100]

@DrLuisACenteno1 Yes, often…and when persistent - even independent of the initial cause - it can become a disorder in its own right with its own underlying psychobiological mechanisms. CBTi does not treat the symptom of insomnia, rather it treats those underlying mechanisms.

[checktheavailability @Molyneux100]

@tylerblack32 @chrisaikenmd An interesting read nonetheless?

[checktheavailability @Molyneux100]

@Alexleaf @FoundationDads Yep, prospective studies are clearly more informative 👍

[checktheavailability @Molyneux100]

@Alexleaf @FoundationDads Could there be reverse causation? Eg if youre already inclined to aggression youre more likely 2 get spanked by a parent? Also, parents who spank may have ⬆️ levels of aggression, mental health difficulties, which could be genetically transmitted to 👦 independent of the spanking

[checktheavailability @Molyneux100]

@sulmoney @tylerblack32 Thank you for the heads up…I’ll avoid water now.

[checktheavailability @Molyneux100]

@RikKhan20 @chrisaikenmd @DrAnnieHickox I understand there’s little evidence that those with social phobia are lacking in social skills. The problem tends to be self-focused attention, a faulty self-image, and safety/avoidance behaviours.

[checktheavailability @Molyneux100]

@phil948 @caloriesproper2 Yep - sleep is a homeostatic process regulated by circadian rhythms and sleep drive (not our choice). A poor nights sleep will usually build up sleep drive which results in longer sleep the following night, or simply deeper sleep within our usual sleep window.

[checktheavailability @Molyneux100]

@caloriesproper2 @phil948 I’m not sure it’s possible to (naturally) ‘get’ 9-10 hours sleep unless this is what one’s biology dictates.

[checktheavailability @Molyneux100]

@cjsnowdon @stuarthelmer @turtmcfly @GilesYeo I think it’s the “easily avoided…” part that might be the issue.

[checktheavailability @Molyneux100]

@Yvonne00322432 @slayerment @Brady_H CICO imbalance drives the adiposity broadly but not necessarily TD2, where an individual’s personal fat threshold is central (see work of prof roy Taylor).