12 tips to hear the voices of introverts in medical education and to improve the learning climate for everyone.

This article was migrated. The article was marked as recommended. Small group, highly interactive teaching is growing in popularity, making medical school stacked in favor of the extraverted student. The resulting discomfort experienced by introverted students is well documented and troubling. Not just for their wellbeing, but also for the educational climate as a whole. Everyone misses out on learning opportunities when a group of students is not heard or feels uncomfortable to speak up. In this piece, we offer twelve tips to create a safe and comfortable learning environment for all students, regardless of where they find themselves on the introvert-extravert continuum. In these tips we will focus on self-knowledge and perceptions of silence, didactic strategies and learning activities, starting a conversation to become more aware of differences and reflect on them, training for introverted students and fair assessment.

Fear-potentiated startle, but not light-enhanced startle, is enhanced by anxiogenic drugs.

RATIONALE AND OBJECTIVES: The light-enhanced startle paradigm (LES) is suggested to model anxiety, because of the non-specific cue and the long-term effect. In contrast, the fear-potentiated startle (FPS) is suggested to model conditioned fear. However, the pharmacological profiles of these two paradigms are very similar. The present study investigated the effects of putative anxiogenic drugs on LES and FPS and aimed at determining the sensitivity of LES for anxiogenic drugs and to potentially showing a pharmacological differentiation between these two paradigms. METHODS: Male Wistar rats received each dose of the alpha(2)-adrenoceptor antagonist yohimbine (0.25-1.0mg/kg), the 5-HT(2C) receptor agonist m-chlorophenylpiperazine (mCPP, 0.5-2.0mg/kg) or the GABA(A) inverse receptor agonist pentylenetetrazole (PTZ, 3-30mg/kg) and were subsequently tested in either LES or FPS. RESULTS: None of the drugs enhanced LES, whereas mCPP increased percentage FPS and yohimbine increased absolute FPS values. Furthermore, yohimbine increased baseline startle amplitude in the LES, while mCPP suppressed baseline startle in both the LES and FPS and PTZ suppressed baseline startle in the FPS. CONCLUSIONS: In contrast to findings in the FPS paradigm, none of the drugs were able to exacerbate the LES response. Thus, a clear pharmacological differentiation was found between LES and FPS.

Botox for the brain: enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories.

It has been suggested that the recent rapid developments in the fields of neuroscience and psychopharmacology have increased the possibilities for pharmacological enhancement of mental functioning. Here, evidence is reviewed which shows that drugs acting on a variety of neurotransmitter systems can indeed enhance cognition, and to a lesser extent mood and pro-social behavior. Moreover, it seems possible to interfere with the (re)consolidation of traumatic memories. There are, however, a number of caveats: first, as cognition-enhancing drugs can simultaneously exert both linear and quadratic (U-shaped) effects, doses most effective in facilitating one behavior could at the same time exert null or even detrimental effects on other cognitive domains. Second, individuals with a 'low memory span' might benefit from cognition-enhancing drugs, whereas 'high span subjects' are 'overdosed'. And finally, evidence suggests that a number of trade-offs could occur. For example, increases of cognitive stability might come at the cost of a decreased capacity to flexibly alter behavior. A short overview of ethical issues raised by the use of cognition and mood enhancing drugs demonstrates the tremendous variety in views and opinions regarding the subject.

The effects of sex and neonatal maternal separation on fear-potentiated and light-enhanced startle.

This study was based on the higher prevalence of anxiety disorders in women than in men, and on the finding that early adverse experiences are a major risk factor for the development of anxiety disorders later in life. The object of this study was to investigate in rats, the sensitivities of the light-enhanced startle (LES) and fear-potentiated startle (FPS) paradigms to sex differences and to determine the effects of maternal separation (MS) on the baseline startle magnitude and potentiated startle response in these paradigms. Pups in the MS group were separated daily from their mother for 180 min/day from postnatal day 2 (PND2) to PND14. Control litters remained undisturbed. The adult male and female progeny were tested in the FPS and LES. As predicted, females showed a significantly greater potentiation of startle than males in the FPS, and a strong trend towards greater startle potentiation in the LES. Contrary to predictions, MS had no effect on startle potentiation in the FPS and severely disrupted LES in female, but not male rats. The observed sex differences add to the validity of the FPS and LES as animal paradigms of fear and anxiety. The findings indicate that these paradigms can be used to study the biological basis of sex differences in fear and anxiety. In contrast, the effects of MS on startle potentiation argue against the idea that MS provides a robust model for the predicted influences of early adverse effects on these startle potentiation measures of fear and anxiety.

Light-enhanced and fear-potentiated startle: temporal characteristics and effects of alpha-helical corticotropin-releasing hormone.

BACKGROUND: It has been suggested that the light-enhanced startle paradigm (LES) is an animal model for anxiety, because of the unconditioned and nonspecific cue and the long-term effect. In contrast, the fear-potentiated startle (FPS) is suggested to model fear. In the present study, we assessed in detail the time course of LES and FPS and investigated whether corticotropin-releasing hormone (CRH) is differentially involved in these two models. METHODS: In experiment 1, the amplitude of the startle response was tracked in the presence of the light and after light offset, in both models. In experiment 2, the effects of intracerebroventricular administration of the CRH-receptor antagonist alpha-helical CRH (0, 1, 5, and 25 microg) on LES and FPS were studied. RESULTS: In LES, light onset resulted in a long-lasting potentiation of the startle response and a slow return to baseline after light offset. In FPS, the potentiation of the startle response returned to baseline almost immediately after light offset. Alpha-helical CRH reduced the potentiation in LES at the 5-microg dose but not at 25 microg. In FPS, alpha-helical CRH had no effect. CONCLUSIONS: The results show that the time course of LES is markedly different from that of FPS, which together with the differences in eliciting stimuli suggest that they model anxiety and fear, respectively. Moreover, the results suggest that CRH is involved in LES and not in FPS.

5-HT1A receptor knockout mice and mice overexpressing corticotropin-releasing hormone in models of anxiety.

Pharmacological experiments have implicated a role for serotonin (5-HT)(1A) receptors in the modulation of anxiety. More recent is the interest in corticotropin-releasing hormone (CRH) system as a potential target for the treatment of anxiety disorders. However, selective pharmacological tools for the CRH system are limited, hampering research in this field. Gene targeting is a relatively new approach to study mechanisms underlying anxiety disorders. 5-HT(1A) receptor knockout (1AKO) mice have been created on three different background strains, and two different lines of mice, overexpressing CRH (CRH-OE), have been generated. In the present review, behavioural and physiological findings reported for 1AKO mice and CRH-OE mice will be reviewed. As behavioural phenotyping is often limited to one or two approach avoidance paradigms, we extended these observations and also tested 1AKO and CRH-OE mice in a conditioned fear paradigm. This paradigm reflects essentially different aspect of anxiety than approach avoidance paradigms. 1AKO mice on a 129/Sv background strain showed similar freezing as wild-type (WT) mice. In CRH-OE mice, less freezing was observed than in the corresponding wild-type mice. The fact that the anxious phenotype of these genetically altered mice seems less clear than initially reported will be discussed. Rather than studying the direct consequences of alterations in the targeted gene, 1AKO and CRH-OE mice seem very valuable to study compensatory processes that seem to have taken place in reaction to life-long changes in gene expression.

The light-enhanced startle paradigm as a putative animal model for anxiety: effects of chlordiazepoxide, flesinoxan and fluvoxamine.

RATIONALE: Recently, a new putative animal model of anxiety, "light-enhanced startle" was introduced. By placing a rat in a brightly lit environment, which is a naturally aversive stimulus to rats, the amplitude of the startle response to a startle-eliciting noise burst is increased. OBJECTIVES: The present study aimed to determine the predictive validity of the light-enhanced startle as a putative model for anxiety. METHODS: The effects of the GABA(A)-benzodiazepine receptor agonist chlordiazepoxide (CDP), the 5-HT1A receptor agonist flesinoxan and the specific 5-HT reuptake inhibitor fluvoxamine on light-enhanced startle were studied. RESULTS: Both CDP and flesinoxan decreased startle potentiation, whereas fluvoxamine was devoid of any effects on potentiation. Effects on baseline startle amplitude were only seen after CDP administration. CONCLUSIONS: The present experiment provides evidence for the predictive validity of the light-enhanced startle as an animal model for anxiety. Due to the use of an unconditioned anxiogenic stimulus, the light-enhanced startle offers several benefits over animal models that depend on conditioning. Drug effects can be ascribed more directly to effects on anxiety, as opposed to memory retrieval and, as shown in this study, non-specific drug effects can easily be detected without the interference of contextual fear.