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Joe Pierre, MD

23 Mar, 11 tweets, 9 min read

1/

Was just thinking there were few mass shootings during the pandemic.

Unfortunately, it looks like we're getting "back to normal" now.

This thread has some of my thoughts on mass shootings, #guns , & #GunReform through the years:

#Boulder #Atlanta

aeon.co/essays/does-a-…

2/

psychologytoday.com/us/blog/psych-…

"Guns make gun owners feel safer"

3/

"...while a few mass shooters in history have had serious mental illnesses, the more typical shooter has experienced the kind of milder difficulties with mood, anxiety, and social interactions with which most of us have some personal familiarity."

psychologytoday.com/us/blog/psych-…

4/

"If psychiatric medications were being taken, it might be more accurate to say that they weren't working very well rather than assuming causality in terms of violence."

psychologytoday.com/us/blog/psych-…

5/

"...gun violence among men is sometimes about compensating for feelings of impotence with fantasies of revenge that often end in suicide or the perpetrator being killed by law enforcement. Going out with a bang, if you will."

psychologytoday.com/us/blog/psych-…

6/

"...declarations that all active shooters must simply be mentally ill are misleading & unhelpful.”

"But once again, the lack of a diagnosis of mental illness doesn’t mean that active & mass shooters are mentally healthy. In most cases, they’re not."

psychologytoday.com/us/blog/psych-…

7/

"The Church of the AR-15 is the United States of America. Or half of it.

Is that crazy? Is the love many Americans have for their guns a cultish obsession or a healthy fetish? The answer depends on who you ask. And whether or not they own a gun."

psychologytoday.com/us/blog/psych-…

8/

"The roots of mass murder are much more integral and insidious than that, like cancer that's born within our own bodies of cells gone awry."

psychologytoday.com/us/blog/psych-…

9/

...and finally, an academic paper about how fear can hamper progress despite widespread agreement on "common sense" gun legislation:

nature.com/articles/s4159…

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@amybarnhorst @meganranney @EmmyBetz @JonathanMetzl @sandrogalea @AllenFrancesMD @ViolenceWonks @DrSarteschi @MkRBol @drrichardtaylor @awaisaftab @paulsummergrad @jonathanstea @tylerblack32 @DrWinarick @DebiecJacek @evolutionarypsy @dawso007 @MarkLRuffalo @pash22 @z

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More from @psychunseen

Joe Pierre, MD

@psychunseen

10 Mar

THREAD 1/

Do antipsychotics shrink the brain? No!

At long last, we have RCT data in 1st episode psychosis to disentangle effects of meds vs. disease.

nature.com/articles/s4138…

2/

Here are the striking findings.

At 3 months:

- no grey matter volume change in controls
- volume *loss* w/ placebo/psychosocial tx
- volume *increase* w/ meds

3/

The authors found no evidence to support confounding factors and therefore concluded that antipsychotic medications "prevent or perhaps even reverse" illness-related volume loss, consistent with a possible neuroprotective effect of 2nd generation medications.

Read 13 tweets

Joe Pierre, MD

@psychunseen

2 Mar

THREAD 1/

Harrow et al. have published another study demonstrating an association between antipsychotic treatment and poorer outcomes compared to non-antipsychotic treatment, this time for both schizophrenia and affective psychosis.

2/

To date, no RCT (no, not even Wunderink) exists to address potential causality or more precisely *direction* of causality. The million $$ question is whether antipsychotic discontinuation leads to recovery or whether recovery leads to discontinuation.

psychologytoday.com/us/blog/psych-…

@awaisaftab

3/

Harrow often uses baseline prognosis as a proxy of severity to address this question, but the only thing that really matters is *actual* disease severity. Why were meds stopped?

This is a chicken-egg issue as I discuss w/@awaisaftab here:

psychiatrictimes.com/view/there-bac…

Read 13 tweets

Joe Pierre, MD

@psychunseen

24 Feb

@zivacooper

THREAD 1/

This article on "addiction as a brain disease" is a must-read update on an age-old debate.

IMO, much of it equally applies to "addiction" as other mental disorders.

(thanks to @zivacooper for sending).

2/

A few points worth discussing. First, addiction as disease is a counter-narrative in response to the:

"prevailing nonscientific, moralizing, and stigmatizing attitudes to addiction [that framed it as a] moral failing or weakness of character, rather than a 'real' disease.

3/

"This argument was particularly targeted to the public, policymakers and health care professionals, many of whom held that since addiction was a misery people brought on themselves, it fell beyond the scope of medicine..."

Read 21 tweets

Joe Pierre, MD

@psychunseen

14 Feb

@JasperFeyaerts

THREAD 1/

Finally got around to reading and really enjoyed this new paper by @JasperFeyaerts et al. that offers a critical view of traditional conceptualizations of delusions and the (mis)assumption of a delusional continuum.

pubmed.ncbi.nlm.nih.gov/33485408/

2/

It affirms my view that firmly distinguishing between delusions and delusion-like (and shared) beliefs is ultimately doomed, because we do not have coherent existing definitions of "delusions" nor for that matter "beliefs"

Here are my favorite quotations from this paper:

3/

"Jaspers... points towards the experiential context within which primary delusions originate. Whereas delusion-like ideas arise in intelligible ways from everyday experience, primary delusions develop... as "a transformation in our total awareness of reality."

Read 10 tweets

Joe Pierre, MD

@psychunseen

2 Dec 20

@JoeBiden

THREAD 1/10

I've been enjoying a moment of political apathy, resting on the laurels of a @JoeBiden @KamalaHarris victory, while doing my best to ignore Trump's bluster which can't hide the reality that he's been deflated & will be put to rest like so many Halloween decorations.

@StephenAtHome

2/10

Last night @StephenAtHome compared Trump to herpes, suggesting that we'll likely see him "blossom" and reactivate from time to time like an annoying cold sore outbreak.

And yeah, maybe he will actually run for re-election in 2024.

thehill.com/blogs/in-the-k…

3/10

But Trump aside, what will probably not go away is the myth that the election was stolen. Trumpers & GOP pols will likely perpetuate the myth as a rally cry "seeding for future social polarization & division on a scale America has never seen."

nytimes.com/2020/11/30/opi…

Read 12 tweets

Joe Pierre, MD

@psychunseen

5 Nov 20

@TheAtlantic

THREAD 1/12

This @TheAtlantic article by @olgakhazan is a good synopsis of the seemingly unfathomable popularity of Trump and his policies that the left still can't wrap its head around.

theatlantic.com/politics/archi…

2/12

One result of this 50/50 election, whatever its outcome, should be to take hard look at "the other side."

Even if Trump is gone, polarization (and political gridlock) is here to stay—it has been and will continue to be America's undoing.

psychologytoday.com/us/blog/psych-…

@JonathanMetzl

3/12

Arlie Hochschild's quoted words echo @JonathanMetzl (who's also quoted):

"[White men's] economic prospects are bad & American culture tells them that their gender is too. So they’ve turned to Trump as a type of folk hero, one who can restore their sense of former glory."