text:
Benzphetamine

Benzphetamine (brand name Didrex) is a substituted amphetamine used short-term along with a doctor-approved, reduced-calorie diet, exercise, and behavioral program for weight loss. It is prescribed for obesity to people who have been unable to lose weight through exercise and dieting alone. It is a prodrug to dextroamphetamine and dextromethamphetamine.

Benzphetamine is an anorectic, primarily promoting weight loss through reduced appetite. It also slightly increases metabolism.

Pharmacology
Benzphetamine is a sympathomimetic amine and is classified as an anorectic. The drug's main function is to reduce appetite, which in turn reduces caloric intake.

Although the mechanism of action of the sympathomimetic appetite suppressants in the treatment of obesity is not fully known, these medications have pharmacological effects similar to those of amphetamines. Amphetamine and related sympathomimetic medications (such as benzphetamine) are thought to stimulate the release of norepinephrine and/or dopamine from storage sites in nerve terminals of the lateral hypothalamic feeding center, thereby producing a decrease in appetite. This release is mediated through the binding of benzphetamine to VMAT2 and inhibiting its function, causing a release of these neurotransmitters into the synaptic cleft through their reuptake transporters. Tachyphylaxis and tolerance have been demonstrated with all drugs of this class.

Benzphetamine has a half-life of 4–6 hours.

Contraindications
Benzphetamine is contraindicated in patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyper-thyroidism, known hypersensitivity or idiosyncrasy to sympathomimetic amines, and glaucoma, or who have recently used a MAOI. Benzphetamine should not be given to patients who are in an agitated state or who have a history of drug abuse.

Controlled substance classification
Benzphetamine is unique in its classification as a Schedule III drug in the United States. (Most members of the amphetamine family are classified in the more highly regulated Schedule II.) Benzphetamine is metabolized by the human body into amphetamine and methamphetamine, making it one of a number of drugs to undergo in vivo conversion to a substance of higher addiction and abuse potential.

title: Benzphetamine


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Rorschach test

The Rorschach test is a projective psychological test in which subjects' perceptions of inkblots are recorded and then analyzed using psychological interpretation, complex algorithms, or both. Some psychologists use this test to examine a person's personality characteristics and emotional functioning. It has been employed to detect underlying thought disorder, especially in cases where patients are reluctant to describe their thinking processes openly. The test is named after its creator, Swiss psychologist Hermann Rorschach. The Rorschach can be thought of as a psychometric examination of pareidolia, the active pattern of perceiving objects, shapes, or scenery as meaningful things to the observer's experience, the most common being faces or other pattern of forms that are not present at the time of the observation. In the 1960s, the Rorschach was the most widely used projective test.

Although the Exner Scoring System (developed since the 1960s) claims to have addressed and often refuted many criticisms of the original testing system with an extensive body of research, some researchers continue to raise questions. The areas of dispute include the objectivity of testers, inter-rater reliability, the verifiability and general validity of the test, bias of the test's pathology scales towards greater numbers of responses, the limited number of psychological conditions which it accurately diagnoses, the inability to replicate the test's norms, its use in court-ordered evaluations, and the proliferation of the ten inkblot images, potentially invalidating the test for those who have been exposed to them.

History
The use of interpreting "ambiguous designs" to assess an individual's personality is an idea that goes back to Leonardo da Vinci and Botticelli. Interpretation of inkblots was central to a game, Gobolinks, from the late 19th century. The Rorschach test, however, was the first systematic approach of this kind.

After studying 300 mental patients and 100 control subjects, in 1921 Hermann Rorschach wrote his book Psychodiagnostik, which was to form the basis of the inkblot test. After experimenting with several hundred inkblots which he drew himself, he selected a set of ten for their diagnostic value. Although he had served as Vice President of the Swiss Psychoanalytic Society, Rorschach had difficulty in publishing the book and it attracted little attention when it first appeared. Rorschach died the following year.

It has been suggested that Rorschach's use of inkblots may have been influenced by German doctor Justinus Kerner who, in 1857, had published a popular book of poems, each of which was inspired by an accidental inkblot. French psychologist Alfred Binet had also experimented with inkblots as a creativity test, and, after the turn of the century, psychological experiments where inkblots were utilized multiplied, with aims such as studying imagination and consciousness.

In 1927, the newly founded publishing house purchased Rorschach's book Psychodiagnostik from the inventory of Ernst Bircher. Huber remains the publisher of the test and related book, with Rorschach a registered trademark of Swiss publisher Verlag Hans Huber, Hogrefe AG. The work has been described as "a densely written piece couched in dry, scientific terminology".

After Rorschach's death, the original test scoring system was improved by Samuel Beck, Bruno Klopfer and others. John E. Exner summarized some of these later developments in the comprehensive system, at the same time trying to make the scoring more statistically rigorous. Some systems are based on the psychoanalytic concept of object relations. The Exner system remains very popular in the United States, while in Europe other methods sometimes dominate, such as that described in the textbook by, which is closer to the original Rorschach system and rooted more deeply in the original psychoanalysis principles.

Rorschach never intended the inkblots to be used as a general personality test, but developed them as a tool for the diagnosis of schizophrenia. It was not until 1939 that the test was used as a projective test of personality, a use of which Rorschach had always been skeptical. Interviewed in 2012 for a BBC Radio 4 documentary, Rita Signer, curator of the Rorschach Archives in Bern, Switzerland, suggested that the blots selected by Rorschach were not random, but rather were carefully chosen to be as ambiguous and "conflicted" as possible.

Method
The Rorschach test is appropriate for subjects from the age of five to adulthood. The administrator and subject typically sit next to each other at a table, with the administrator slightly behind the subject. Side-by-side seating of the examiner and the subject is used to reduce any effects of inadvertent cues from the examiner to the subject. In other words, side-by-side seating mitigates the possibility that the examiner will accidentally influence the subject's responses. This is to facilitate a "relaxed but controlled atmosphere".

There are ten official inkblots, each printed on a separate white card, approximately 18 by 24 cm in size. Each of the blots has near perfect bilateral symmetry. Five inkblots are of black ink, two are of black and red ink and three are multicolored, on a white background.

After the test subject has seen and responded to all of the inkblots (free association phase), the tester then presents them again one at a time in a set sequence for the subject to study: the subject is asked to note where they see what they originally saw and what makes it look like that (inquiry phase). The subject is usually asked to hold the cards and may rotate them. Whether the cards are rotated, and other related factors such as whether permission to rotate them is asked, may expose personality traits and normally contributes to the assessment.

As the subject is examining the inkblots, the psychologist writes down everything the subject says or does, no matter how trivial. Analysis of responses is recorded by the test administrator using a tabulation and scoring sheet and, if required, a separate location chart.

The general goal of the test is to provide data about cognition and personality variables such as motivations, response tendencies, cognitive operations, affectivity, and personal/interpersonal perceptions. The underlying assumption is that an individual will class external stimuli based on person-specific perceptual sets, and including needs, base motives, conflicts, and that this clustering process is representative of the process used in real-life situations.

Methods of interpretation differ. Rorschach scoring systems have been described as a system of pegs on which to hang one's knowledge of personality. The most widely used method in the United States is based on the work of Exner. Administration of the test to a group of subjects, by means of projected images, has also occasionally been performed, but mainly for research rather than diagnostic purposes.

Test administration is not to be confused with test interpretation: The interpretation of a Rorschach record is a complex process. It requires a wealth of knowledge concerning personality dynamics generally as well as considerable experience with the Rorschach method specifically. Proficiency as a Rorschach administrator can be gained within a few months. However, even those who are able and qualified to become Rorschach interpreters usually remain in a "learning stage" for a number of years.

Features or categories
The interpretation of the Rorschach test is not based primarily on the contents of the response, i.e., what the individual sees in the inkblot (the content). In fact, the contents of the response are only a comparatively small portion of a broader cluster of variables that are used to interpret the Rorschach data: for instance, information is provided by the time taken before providing a response for a card can be significant (taking a long time can indicate "shock" on the card). As well as by any comments the subject may make in addition to providing a direct response.

In particular, information about determinants (the aspects of the inkblots that triggered the response, such as form and color) and location (which details of the inkblots triggered the response) is often considered more important than content, although there is contrasting evidence. "Popularity" and "originality" of responses can also be considered as basic dimensions in the analysis.

Content
The goal in coding content of the Rorschach is to categorize the objects that the subject describes in response to the inkblot. There are 27 established codes for identifying the name of the descriptive object. The codes are classified and include terms such as "human", "nature", "animal", "abstract", "clothing", "fire", and "x-ray", to name a few. Content described that does not have a code already established should be coded using the code "idiographic contents" with the shorthand code being "Idio." Items are also coded for statistical popularity (or, conversely, originality).

More than any other feature in the test, content response can be controlled consciously by the subject, and may be elicited by very disparate factors, which makes it difficult to use content alone to draw any conclusions about the subject's personality; with certain individuals, content responses may potentially be interpreted directly, and some information can at times be obtained by analyzing thematic trends in the whole set of content responses (which is only feasible when several responses are available), but in general content cannot be analyzed outside of the context of the entire test record.

Location
Identifying the location of the subject's response is another element scored in the Rorschach system. Location refers to how much of the inkblot was used to answer the question. Administrators score the response "W" if the whole inkblot was used to answer the question, "D" if a commonly described part of the blot was used, "Dd" if an uncommonly described or unusual detail was used, or "S" if the white space in the background was used. A score of W is typically associated with the subject's motivation to interact with his or her surrounding environment. D is interpreted as one having efficient or adequate functioning. A high frequency of responses coded Dd indicate some maladjustment within the individual. Responses coded S indicate an oppositional or uncooperative test subject.

Determinants
Systems for Rorschach scoring generally include a concept of "determinants": These are the factors that contribute to establishing the similarity between the inkblot and the subject's content response about it. They can also represent certain basic experiential-perceptual attitudes, showing aspects of the way a subject perceives the world. Rorschach's original work used only form, color and movement as determinants. However currently, another major determinant considered is shading, which was inadvertently introduced by poor printing quality of the inkblots. Rorschach initially disregarded shading, since the inkblots originally featured uniform saturation, but later recognized it as a significant factor.

Form is the most common determinant, and is related to intellectual processes. Color responses often provide direct insight into one's emotional life. Movement and shading have been considered more ambiguously, both in definition and interpretation. Rorschach considered movement only as the experiencing of actual motion, while others have widened the scope of this determinant, taking it to mean that the subject sees something "going on".

More than one determinant can contribute to the formation of the subject's perception. Fusion of two determinants is taken into account, while also assessing which of the two constituted the primary contributor. For example, "form-color" implies a more refined control of impulse than "color-form". It is, indeed, from the relation and balance among determinants that personality can be most readily inferred.

Symmetry of the test items
A characteristic of the Rorschach inkblots is their symmetry. For many, this is unexceptional, but Rorschach, and subsequent researchers, considered the issue. Rorschach experimented with both asymmetric and symmetric images before choosing the latter, giving the explanation:

Asymmetric figures are rejected by many subjects; symmetry supplied part of the necessary artistic composition. It has a disadvantage in that it tends to make answers somewhat stereotyped. On the other hand, symmetry makes conditions the same for right and left handed subjects; furthermore, it facilitates interpretation for certain blocked subjects. Finally, symmetry makes possible the interpretation of whole scenes.

Exner scoring system
The Exner scoring system, also known as the Rorschach Comprehensive System (RCS), is the standard method for interpreting the Rorschach test. It was developed in the 1960s by John E. Exner, as a more rigorous system of analysis. It has been extensively validated and shows high inter-rater reliability. In 1969, Exner published The Rorschach Systems, a concise description of what would be later called "the Exner system". He later published a study in multiple volumes called The Rorschach: A Comprehensive system, the most accepted full description of his system.

Creation of the new system was prompted by the realization that at least five related, but ultimately different methods were in common use at the time, with a sizeable minority of examiners not employing any recognized method at all, basing instead their judgment on subjective assessment, or arbitrarily mixing characteristics of the various standardized systems.

The key components of the Exner system are the clusterization of Rorschach variables and a sequential search strategy to determine the order in which to analyze them, framed in the context of standardized administration, objective, reliable coding and a representative normative database. The system places a lot of emphasis on a cognitive triad of information processing, related to how the subject processes input data, cognitive mediation, referring to the way information is transformed and identified, and ideation.

In the system, responses are scored with reference to their level of vagueness or synthesis of multiple images in the blot, the location of the response, which of a variety of determinants is used to produce the response (i.e., what makes the inkblot look like what it is said to resemble), the form quality of the response (to what extent a response is faithful to how the actual inkblot looks), the contents of the response (what the respondent actually sees in the blot), the degree of mental organizing activity that is involved in producing the response, and any illogical, incongruous, or incoherent aspects of responses. "Bat" is a popular response to the first card.

Using the scores for these categories, the examiner then performs a series of calculations producing a structural summary of the test data. The results of the structural summary are interpreted using existing research data on personality characteristics that have been demonstrated to be associated with different kinds of responses.

With the Rorschach plates (the ten inkblots), the area of each blot which is distinguished by the client is noted and coded—typically as "commonly selected" or "uncommonly selected". There were many different methods for coding the areas of the blots. Exner settled upon the area coding system promoted by S. J. Beck (1944 and 1961). This system was in turn based upon Klopfer's (1942) work.

As pertains to response form, a concept of "form quality" was present from the earliest of Rorschach's works, as a subjective judgment of how well the form of the subject's response matched the inkblots (Rorschach would give a higher form score to more "original" yet good form responses), and this concept was followed by other methods, especially in Europe; in contrast, the Exner system solely defines "good form" as a matter of word occurrence frequency, reducing it to a measure of the subject's distance to the population average.

Performance assessment system (R-PAS)
Rorschach performance assessment system (R-PAS) is a scoring method created by several members of the Rorschach Research Council. They believed that the Exner scoring system was in need of an update, but after Exner's death, the Exner family forbade any changes to be made to the Comprehensive System. Therefore, they established a new system: the R-PAS. It is an attempt at creating a current, empirically based, and internationally focused scoring system that is easier to use than Exner's Comprehensive System. The R-PAS manual is intended to be a comprehensive tool for administering, scoring, and interpreting the Rorschach. The manual consists of two chapters that are basics of scoring and interpretation, aimed for use for novice Rorschach users, followed by numerous chapters containing more detailed and technical information.

In terms of updated scoring, the authors only selected variables that have been empirically supported in the literature. The authors did not create new variables or indices to be coded, but systematically reviewed variables that had been used in past systems. While all of these codes have been used in the past, many have been renamed to be more face valid and readily understood. Scoring of the indices has been updated (e.g. utilizing percentiles and standard scores) to make the Rorschach more in line with other popular personality measures. Preliminary evidence suggests that the R-PAS exhibits good inter-rater reliability.

In addition to providing coding guidelines to score examinee responses, the R-PAS provides a system to code an examinee's behavior during Rorschach administration. These behavioral codes are included as it is believed that the behaviors exhibited during testing are a reflection of someone's task performance and supplements the actual responses given. This allows generalizations to be made between someone's responses to the cards and their actual behavior.

The R-PAS also recognized that scoring on many of the Rorschach variables differed across countries. Therefore, starting in 1997, Rorschach protocols from researchers around the world were compiled. After compiling protocols for over a decade, a total of 15 adult samples were used to provide a normative basis for the R-PAS. The protocols represent data gathered in the United States, Europe, Israel, Argentina and Brazil.

Cultural differences
Comparing North American Exner normative data with data from European and South American subjects showed marked differences in some features, some of which impact important variables, while others (such as the average number of responses) coincide. For instance, texture response is typically zero in European subjects (if interpreted as a need for closeness, in accordance with the system, a European would seem to express it only when it reaches the level of a craving for closeness), and there are fewer "good form" responses, to the point where schizophrenia may be suspected if data were correlated to the North American norms. Form is also often the only determinant expressed by European subjects; while color is less frequent than in American subjects, color-form responses are comparatively frequent in opposition to form-color responses; since the latter tend to be interpreted as indicators of a defensive attitude in processing affect, this difference could stem from a higher value attributed to spontaneous expression of emotions.

The differences in form quality are attributable to purely cultural aspects: different cultures will exhibit different "common" objects (French subjects often identify a chameleon in card VIII, which is normally classed as an "unusual" response, as opposed to other animals like cats and dogs; in Scandinavia, "Christmas elves" (nisser) is a popular response for card II, and "musical instrument" on card VI is popular for Japanese people), and different languages will exhibit semantic differences in naming the same object (the figure of card IV is often called a troll by Scandinavians and an ogre by French people). Many of Exner's "popular" responses (those given by at least one third of the North American sample used) seem to be universally popular, as shown by samples in Europe, Japan and South America, while specifically card IX's "human" response, the crab or spider in card X and one of either the butterfly or the bat in card I appear to be characteristic of North America.

Form quality, popular content responses and locations are the only coded variables in the Exner systems that are based on frequency of occurrence, and thus immediately subject to cultural influences; therefore, cultural-dependent interpretation of test data may not necessarily need to extend beyond these components.

The cited language differences can result in misinterpretation if not administered in the subject's native language or a very well mastered second language, and interpreted by a master speaker of that language. For example, a bow tie is a frequent response for the center detail of card III, but since the equivalent term in French translates to "butterfly tie", an examiner not appreciating this language nuance may code the response differently from what is expected.

Inkblots
Below are the ten inkblots printed in Rorschach Test – Psychodiagnostic Plates, together with the most frequent responses for either the whole image or the most prominent details according to various authors.

{| ! Card ! style="width:30%;"| Popular responses ! Comments
 * [[Image:Rorschach blot 01.jpg|160px]]
 * When seeing card I, subjects often inquire on how they should proceed, and questions on what they are allowed to do with the card (e.g. turning it) are not very significant. Being the first card, it can provide clues about how subjects tackle a new and stressful task. It is not, however, a card that is usually difficult for the subject to handle, having readily available popular responses.
 * [[Image:Rorschach blot 02.jpg|160px]]
 * The red details of card II are often seen as blood, and are the most distinctive features. Responses to them can provide indications about how a subject is likely to manage feelings of anger or physical harm. This card can induce a variety of sexual responses.
 * [[Image:Rorschach blot 03.jpg|160px]]
 * Card III is typically perceived to contain two humans involved in some interaction, and may provide information about how the subject relates with other people (specifically, response latency may reveal struggling social interactions).
 * [[Image:Rorschach blot 04.jpg|160px]]
 * Card IV is notable for its dark color and its shading (posing difficulties for depressed subjects), and is generally perceived as a big and sometimes threatening figure; compounded with the common impression of the subject being in an inferior position ("looking up") to it, this serves to elicit a sense of authority. The human or animal content seen in the card is almost invariably classified as male rather than female, and the qualities expressed by the subject may indicate attitudes toward men and authority. Because of this Card IV is often called "The Father Card".
 * [[Image:Rorschach blot 05.jpg|160px]]
 * Card V is an easily elaborated card that is not usually perceived as threatening, and typically instigates a "change of pace" in the test, after the previous more challenging cards. Containing few features that generate concerns or complicate the elaboration, it is the easiest blot to generate a good quality response about.
 * [[Image:Rorschach blot 06.jpg|160px]]
 * Card III is typically perceived to contain two humans involved in some interaction, and may provide information about how the subject relates with other people (specifically, response latency may reveal struggling social interactions).
 * [[Image:Rorschach blot 04.jpg|160px]]
 * Card IV is notable for its dark color and its shading (posing difficulties for depressed subjects), and is generally perceived as a big and sometimes threatening figure; compounded with the common impression of the subject being in an inferior position ("looking up") to it, this serves to elicit a sense of authority. The human or animal content seen in the card is almost invariably classified as male rather than female, and the qualities expressed by the subject may indicate attitudes toward men and authority. Because of this Card IV is often called "The Father Card".
 * [[Image:Rorschach blot 05.jpg|160px]]
 * Card V is an easily elaborated card that is not usually perceived as threatening, and typically instigates a "change of pace" in the test, after the previous more challenging cards. Containing few features that generate concerns or complicate the elaboration, it is the easiest blot to generate a good quality response about.
 * [[Image:Rorschach blot 06.jpg|160px]]
 * [[Image:Rorschach blot 05.jpg|160px]]
 * Card V is an easily elaborated card that is not usually perceived as threatening, and typically instigates a "change of pace" in the test, after the previous more challenging cards. Containing few features that generate concerns or complicate the elaboration, it is the easiest blot to generate a good quality response about.
 * [[Image:Rorschach blot 06.jpg|160px]]
 * [[Image:Rorschach blot 06.jpg|160px]]
 * [[Image:Rorschach blot 06.jpg|160px]]

 * Texture is the dominant characteristic of card VI, which often elicits association related to interpersonal closeness; it is specifically a "sex card", its likely sexual percepts being reported more frequently than in any other card, even though other cards have a greater variety of commonly seen sexual contents.
 * [[Image:Rorschach blot 07.jpg|160px]]
 * Card VII can be associated with femininity (the human figures commonly seen in it being described as women or children), and function as a "mother card", where difficulties in responding may be related to concerns with the female figures in the subject's life. The center detail is relatively often (though not popularly) identified as a vagina, which makes this card also relate to feminine sexuality in particular.
 * [[Image:Rorschach blot 08.jpg|160px]]
 * People often express relief about card VIII, which lets them relax and respond effectively. Similar to card V, it represents a "change of pace"; however, the card introduces new elaboration difficulties, being complex and the first multi-colored card in the set. Therefore, people who find processing complex situations or emotional stimuli distressing or difficult may be uncomfortable with this card.
 * [[Image:Rorschach blot 09.jpg|160px]]
 * Characteristic of card IX is indistinct form and diffuse, muted chromatic features, creating a general vagueness. There is only one popular response, and it is the least frequent of all cards. Having difficulty with processing this card may indicate trouble dealing with unstructured data, but aside from this there are few particular "pulls" typical of this card.
 * [[Image:Rorschach blot 10.jpg|160px]]
 * Card X is structurally similar to card VIII, but its uncertainty and complexity are reminiscent of card IX: people who find it difficult to deal with many concurrent stimuli may not particularly like this otherwise pleasant card. Being the last card, it may provide an opportunity for the subject to "sign out" by indicating what they feel their situation is like, or what they desire to know.
 * }
 * [[Image:Rorschach blot 09.jpg|160px]]
 * Characteristic of card IX is indistinct form and diffuse, muted chromatic features, creating a general vagueness. There is only one popular response, and it is the least frequent of all cards. Having difficulty with processing this card may indicate trouble dealing with unstructured data, but aside from this there are few particular "pulls" typical of this card.
 * [[Image:Rorschach blot 10.jpg|160px]]
 * Card X is structurally similar to card VIII, but its uncertainty and complexity are reminiscent of card IX: people who find it difficult to deal with many concurrent stimuli may not particularly like this otherwise pleasant card. Being the last card, it may provide an opportunity for the subject to "sign out" by indicating what they feel their situation is like, or what they desire to know.
 * }
 * Card X is structurally similar to card VIII, but its uncertainty and complexity are reminiscent of card IX: people who find it difficult to deal with many concurrent stimuli may not particularly like this otherwise pleasant card. Being the last card, it may provide an opportunity for the subject to "sign out" by indicating what they feel their situation is like, or what they desire to know.
 * }
 * }

United States
The Rorschach test is used almost exclusively by psychologists. Forensic psychologists use the Rorschach 36% of the time. In custody cases, 23% of psychologists use the Rorschach to examine a child. Another survey found that 124 out of 161 (77%) of clinical psychologists engaging in assessment services utilize the Rorschach, and 80% of psychology graduate programs teach its use. Another study found that its use by clinical psychologists was only 43%, while it was used less than 24% of the time by school psychologists.

During World War II, United States Army Medical Corps chief psychiatrist Douglas Kelley and psychologist Gustave Gilbert administered the Rorschach test to the 22 defendants in the Nazi leadership group prior to the first Nuremberg trials, and the test scores were published some decades later.

Because of the large amount of data used to interpret the test, psychologist Zygmunt Piotrowski, began work to computerize ink blot interpretation in the 1950s and 1960s. This work included over 1,000 rules and included no summary nor narrative conclusions. A subsequent computerized interpretation of Rorschach test scores, that included summary and conclusions was developed in the 1970s by psychologists Perline and Cabanski, and marketed internationally. This computerized interpretation of the test was used to interpret the set of scores developed by Gilbert on Nazi Hermann Goering along with several other Nazis while awaiting trial at Nuremberg Prison.

In the 1980s psychologist John Exner developed a computerized interpretation of the Rorschach test, based on his own scoring system, the Exner Comprehensive System. Presently, of the three computerized assessments, only the Exner system is available on the market.

The arguments for or against computerized assessment of the Rorschach is likely to remain unresolved for some time, as there is no absolute correct interpretation against which the different markers (scores) denoting mental health can be compared. Although scores for a theoretically typical healthy adult have been proposed and reasonable attempts to standardize the computer interpretation against these scores have been obtained, more work in this area needs to be done.

United Kingdom
Many psychologists in the United Kingdom do not trust its efficacy and it is rarely used. Although skeptical about its scientific validity, some psychologists use it in therapy and coaching "as a way of encouraging self-reflection and starting a conversation about the person's internal world." It is still used, however, by some mental health organisations such as the Tavistock Clinic. In a survey done in the year 2000, 20% of psychologists in correctional facilities used the Rorschach while 80% used the MMPI.

Japan
Shortly after the publication of Rorschach's book, Japanese psychologist Yuzaburo Uchida came across a copy in a second-hand book shop. His positive reaction created an enduring popularity for the tests in Japan. The Japanese Rorschach Society is the world's largest and the test is "routinely put to a wide range of purposes", being described in 2012 as "more popular than ever".

Controversy
Some skeptics consider the Rorschach inkblot test pseudoscience, as several studies suggested that conclusions reached by test administrators since the 1950s were akin to cold reading. In the 1959 edition of Mental Measurement Yearbook, Lee Cronbach (former President of the Psychometric Society and American Psychological Association) is quoted in a review: "The test has repeatedly failed as a prediction of practical criteria. There is nothing in the literature to encourage reliance on Rorschach interpretations." In addition, major reviewer Raymond J. McCall writes (p. 154): "Though tens of thousands of Rorschach tests have been administered by hundreds of trained professionals since that time (of a previous review), and while many relationships to personality dynamics and behavior have been hypothesized, the vast majority of these relationships have never been validated empirically, despite the appearance of more than 2,000 publications about the test." A moratorium on its use was called for in 1999.

A 2003 report by Wood and colleagues had more mixed views: "More than 50 years of research have confirmed Lee J. Cronbach's (1970) final verdict: that some Rorschach scores, though falling woefully short of the claims made by proponents, nevertheless possess 'validity greater than chance' (p. 636). [...] Its value as a measure of thought disorder in schizophrenia research is well accepted. It is also used regularly in research on dependency, and, less often, in studies on hostility and anxiety.  Furthermore, substantial evidence justifies the use of the Rorschach as a clinical measure of intelligence and thought disorder."

Test materials
The basic premise of the test is that objective meaning can be extracted from responses to blots of ink which are supposedly meaningless. Supporters of the Rorschach inkblot test believe that the subject's response to an ambiguous and meaningless stimulus can provide insight into their thought processes, but it is not clear how this occurs. Also, recent research shows that the blots are not entirely meaningless, and that a patient typically responds to meaningful as well as ambiguous aspects of the blots. Reber (1985) describes the blots as merely "...the vehicle for the interaction..." between client and therapist, concluding: "...the usefulness of the Rorschach will depend upon the sensitivity, empathy and insightfulness of the tester totally independently of the Rorschach itself. An intense dialogue about the wallpaper or the rug would do as well provided that both parties believe."

Illusory and invisible correlations
In the 1960s, research by psychologists Loren and Jean Chapman, at the University of Wisconsin, published in the Journal of Abnormal Psychology, showed that at least some of the apparent validity of the Rorschach was due to an illusion. At that time, the five signs most often interpreted as diagnostic of homosexuality were 1) buttocks and anuses; 2) feminine clothing; 3) male or female sex organs; 4) human figures without male or female features; and 5) human figures with both male and female features. The Chapmans surveyed 32 experienced testers about their use of the Rorschach to diagnose homosexuality. At this time homosexuality was regarded as a psychopathology, and the Rorschach was the most popular projective test. The testers reported that homosexual men had shown the five signs more frequently than heterosexual men. Despite these beliefs, analysis of the results showed that heterosexual men were just as likely to report these signs, which were therefore totally ineffective for determining homosexuality.  The five signs did, however, match the guesses students made about which imagery would be associated with homosexuality.

The Chapmans investigated the source of the testers' false confidence. In one experiment, students read through a stack of cards, each with a Rorschach blot, a sign and a pair of "conditions" (which might include homosexuality). The information on the cards was fictional, although subjects were told it came from case studies of real patients. The students reported that the five invalid signs were associated with homosexuality, even though the cards had been constructed so there was no association at all. The Chapmans repeated this experiment with another set of cards, in which the association was negative; the five signs were never reported by homosexuals. The students still reported seeing a strong positive correlation. These experiments showed that the testers' prejudices could result in them "seeing" non-existent relationships in the data. The Chapmans called this phenomenon "illusory correlation" and it has since been demonstrated in many other contexts.

A related phenomenon called "invisible correlation" applies when people fail to see a strong association between two events because it does not match their expectations. This was also found in clinicians' interpretations of the Rorschach. Homosexual men are more likely to see a monster on Card IV or a part-animal, part-human figure in Card V. Almost all of the experienced clinicians in the Chapmans' survey missed these valid signs. The Chapmans ran an experiment with fake Rorschach responses in which these valid signs were always associated with homosexuality. The subjects missed these perfect associations and instead reported that invalid signs, such as buttocks or feminine clothing, were better indicators.

In 1992, the psychologist Stuart Sutherland argued that these artificial experiments are easier than the real-world use of the Rorschach, and hence they probably underestimated the errors that testers were susceptible to. He described the continuing popularity of the Rorschach after the Chapmans' research as a "glaring example of irrationality among psychologists".

Tester projection
Some critics argue that the testing psychologist must also project onto the patterns. A possible example sometimes attributed to the psychologist's subjective judgement is that responses are coded (among many other things), for "Form Quality": in essence, whether the subject's response fits with how the blot actually looks. Superficially this might be considered a subjective judgment, depending on how the examiner has internalized the categories involved. But with the Exner system of scoring, much of the subjectivity is eliminated or reduced by use of frequency tables that indicate how often a particular response is given by the population in general. Another example is that the response "bra" was considered a "sex" response by male psychologists, but a "clothing" response by females. In Exner's system, however, such a response is always coded as "clothing" unless there is a clear sexual reference in the response.

Third parties could be used to avoid this problem, but the Rorschach's inter-rater reliability has been questioned. That is, in some studies the scores obtained by two independent scorers do not match with great consistency. This conclusion was challenged in studies using large samples reported in 2002.

Validity
When interpreted as a projective test, results are poorly verifiable. The Exner system of scoring (also known as the "Comprehensive System") is meant to address this, and has all but displaced many earlier (and less consistent) scoring systems. It makes heavy use of what factor (shading, color, outline, etc.) of the inkblot leads to each of the tested person's comments. Disagreements about test validity remain: while Exner proposed a rigorous scoring system, latitude remained in the actual interpretation, and the clinician's write-up of the test record is still partly subjective. Reber (1985) comments "...there is essentially no evidence whatsoever that the test has even a shred of validity."

Nevertheless, there is substantial research indicating the utility of the measure for a few scores. Several scores correlate well with general intelligence. One such scale is R, the total number of responses; this reveals the questionable side-effect that more intelligent people tend to be elevated on many pathology scales, since many scales do not correct for high R: if a subject gives twice as many responses overall, it is more likely that some of these will seem "pathological". Also correlated with intelligence are the scales for Organizational Activity, Complexity, Form Quality, and Human Figure responses. The same source reports that validity has also been shown for detecting such conditions as schizophrenia and other psychotic disorders; thought disorders; and personality disorders (including borderline personality disorder). There is some evidence that the Deviant Verbalizations scale relates to bipolar disorder. The authors conclude that "Otherwise, the Comprehensive System doesn't appear to bear a consistent relationship to psychological disorders or symptoms, personality characteristics, potential for violence, or such health problems as cancer". (Cancer is mentioned because a small minority of Rorschach enthusiasts have claimed the test can predict cancer.)

Reliability
It is also thought that the test's reliability can depend substantially on details of the testing procedure, such as where the tester and subject are seated, any introductory words, verbal and nonverbal responses to subjects' questions or comments, and how responses are recorded. Exner has published detailed instructions, but Wood et al. cite many court cases where these had not been followed. Similarly, the procedures for coding responses are fairly well specified but extremely time-consuming leaving them very subject to the author's style and the publisher to the quality of the instructions (such as was noted with one of Bohm's textbooks in the 1950s ) as well as clinic workers (which would include examiners) being encouraged to cut corners.

United States courts have challenged the Rorschach as well. Jones v Apfel (1997) stated (quoting from Attorney's Textbook of Medicine) that Rorschach "results do not meet the requirements of standardization, reliability, or validity of clinical diagnostic tests, and interpretation thus is often controversial". In State ex rel H.H. (1999) where under cross-examination Bogacki stated under oath "many psychologists do not believe much in the validity or effectiveness of the Rorschach test" and US v Battle (2001) ruled that the Rorschach "does not have an objective scoring system."

Population norms
Another controversial aspect of the test is its statistical norms. Exner's system was thought to possess normative scores for various populations. But, beginning in the mid-1990s others began to try to replicate or update these norms and failed. In particular, discrepancies seemed to focus on indices measuring narcissism, disordered thinking, and discomfort in close relationships. Lilienfeld and colleagues, who are critical of the Rorschach, have stated that this proves that the Rorschach tends to "overpathologise normals". Although Rorschach proponents, such as Hibbard, suggest that high rates of pathology detected by the Rorschach accurately reflect increasing psychopathology in society, the Rorschach also identifies half of all test-takers as possessing "distorted thinking", a false positive rate unexplained by current research.

The accusation of "over-pathologising" has also been considered by Meyer et al. (2007). They presented an international collaborative study of 4704 Rorschach protocols, obtained in 21 different samples, across 17 countries, with only 2% showing significant elevations on the index of perceptual and thinking disorder, 12% elevated on indices of depression and hyper-vigilance and 13% elevated on persistent stress overload—all in line with expected frequencies among non-patient populations.

Applications
The test is also controversial because of its common use in court-ordered evaluations. This controversy stems, in part, from the limitations of the Rorschach, with no additional data, in making official diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Irving B. Weiner (co-developer with John Exner of the Comprehensive system) has stated that the Rorschach "is a measure of personality functioning, and it provides information concerning aspects of personality structure and dynamics that make people the kind of people they are. Sometimes such information about personality characteristics is helpful in arriving at a differential diagnosis, if the alternative diagnoses being considered have been well conceptualized with respect to specific or defining personality characteristics". In the vast majority of cases, anyway, the Rorschach test was not singled out but used as one of several in a battery of tests, and despite the criticism of usage of the Rorschach in the courts, out of 8,000 cases in which forensic psychologists used Rorschach-based testimony, the appropriateness of the instrument was challenged only six times, and the testimony was ruled inadmissible in only one of those cases. One study has found that use of the test in courts has increased by three times in the decade between 1996 and 2005, compared to the previous fifty years. Others however have found that its usage by forensic psychologists has decreased.

Exner and others have claimed that the Rorschach test is capable of detecting suicidality.

Protection of test items and ethics
Psychologists object to the publication of psychological test material out of concerns that a patient's test responses will be influenced ("primed") by previous exposure. The Canadian Psychological Association takes the position that, "Publishing the questions and answers to any psychological test compromises its usefulness" and calls for "keeping psychological tests out of the public domain." The same statement quotes their president as saying, "The CPA's concern is not with the publication of the cards and responses to the Rorschach test per se, for which there is some controversy in the psychological literature and disagreement among experts, but with the larger issue of the publication and dissemination of psychological test content".

From a legal standpoint, the Rorschach test images have been in the public domain for many years in most countries, particularly those with a copyright term of up to 70 years post mortem auctoris. They have been in the public domain in Hermann Rorschach's native Switzerland since 1992 (70 years after the author's death, or 50 years after the cut-off date of 1942), according to Swiss copyright law. They are also in the public domain under United States copyright law where all works published before 1923 are considered to be in the public domain. This means that the Rorschach images may be used by anyone for any purpose. William Poundstone was, perhaps, first to make them public in his 1983 book Big Secrets, where he also described the method of administering the test.

The American Psychological Association (APA) has a code of ethics that supports "freedom of inquiry and expression" and helping "the public in developing informed judgments". It claims that its goals include "the welfare and protection of the individuals and groups with whom psychologists work", and it requires that psychologists "make reasonable efforts to maintain the integrity and security of test materials". The APA has also raised concerns that the dissemination of test materials might impose "very concrete harm to the general public". It has not taken a position on publication of the Rorschach plates but noted "there are a limited number of standardized psychological tests considered appropriate for a given purpose". A public statement by the British Psychological Society expresses similar concerns about psychological tests (without mentioning any test by name) and considers the "release of [test] materials to unqualified individuals" to be misuse if it is against the wishes of the test publisher. In his 1998 book Ethics in Psychology, Gerald Koocher notes that some believe "reprinting copies of the Rorschach plates ... and listing common responses represents a serious unethical act" for psychologists and is indicative of "questionable professional judgment". Another association, the Associazione Italiana di Psicoterapia Strategica Integrata (literally: Italian Association of Strategic Psychotherapy), recommend that even information about the purpose of the test or any detail of its administration should be kept from the public, even though "cheating" the test is held to be practically impossible.

On September 9, 2008, Hogrefe attempted to claim copyright over the Rorschach ink blots during filings of a complaint with the World Intellectual Property Organization against the Brazilian psychologist Ney Limonge. These complaints were denied. Further complaints were sent to two other websites that contained information similar to the Rorschach test in May 2009 by legal firm Schluep and Degen of Switzerland.

Psychologists have sometimes refused to disclose tests and test data to courts when asked to do so by the parties, citing ethical reasons; it is argued that such refusals may hinder full understanding of the process by the attorneys, and impede cross-examination of the experts. APA ethical standard 1.23(b) states that the psychologist has a responsibility to document processes in detail and of adequate quality to allow reasonable scrutiny by the court.

Controversy ensued in the psychological community in 2009 when the original Rorschach plates and research results on interpretations were published in the "Rorschach test" article on Wikipedia. Hogrefe & Huber Publishing, a German company that sells editions of the plates, called the publication "unbelievably reckless and even cynical of Wikipedia" and said it was investigating the possibility of legal action. Due to this controversy an was temporarily established on Wikipedia to prevent the removal of the plates.

James Heilman, an emergency room physician involved in the debate, compared it to the publication of the eye test chart: though people are likewise free to memorize the eye chart before an eye test, its general usefulness as a diagnostic tool for eyesight has not diminished. For those opposed to exposure, publication of the inkblots is described as a "particularly painful development", given the tens of thousands of research papers which have, over many years, "tried to link a patient's responses to certain psychological conditions." Controversy over Wikipedia's publication of the inkblots has resulted in the blots being published in other locations, such as The Guardian and The Globe and Mail. Later that year, in August 2009, two psychologists filed a complaint against Heilman with the Saskatchewan medical licensing board, arguing that his uploading of the images constituted unprofessional behavior. In 2012, two articles were published showing consequences of the publication of the images in Wikipedia. The first one studied negative attitudes towards the test generated during the Wikipedia-Rorschach debate, while the second suggested that reading the Wikipedia article could help to fake "good" results in the test.

Publication of the Rorschach images is also welcomed by critics who consider the test to be pseudoscience. Benjamin Radford, editor of Skeptical Inquirer magazine, stated that the Rorschach "has remained in use more out of tradition than good evidence" and was hopeful that publication of the test might finally hasten its demise.

In art and media
Australian artist Ben Quilty has used the Rorschach technique in his paintings, by loading impasto oil paint onto a canvas and then pressing a second, unpainted, canvas onto the first, and proceeding to create an artwork from the shape created by this method.

The mask of the fictional antihero of the same name in the graphic novel limited series Watchmen and its adaptations displays a constantly morphing inkblot based on the designs used in the tests. In the 1999 Sofia Coppola movie The Virgin Suicides the character of Cecilia is given the test and in David Cronenberg's Spider (2002) the Rorschach inkblots are incorporated into the opening of the film.

In 2022, a Malayalam language film titled Rorschach was announced with actor Mammootty in the lead role, inspiring queries and discussion in social media about the test.

The trailer for season 1 of the 2017 TV series Mindhunter features a bloody inkblot.

In Fallout: New Vegas, the character Doc Mitchell uses three cards from the test to give judgment on the player character who is recovering from a bullet to the head. Cards VII, VI, and II are used in that order. The player answers from a premade list of answers which then determine the player's skill bonuses. A community mod for Card II was created due to popular agreement from the community that it looked like "Two bears high fiving". This would inspire a character in the Honest Hearts addon called "Two Bears High Fiving".

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Rorschach test


text:
Orexin

Orexin, also known as hypocretin, is a neuropeptide that regulates arousal, wakefulness, and appetite. It exists in the forms of orexin-A and orexin-B. The most common form of narcolepsy, type 1, in which the individual experiences brief losses of muscle tone ("drop attacks" or cataplexy), is caused by a lack of orexin in the brain due to destruction of the cells that produce it.

There are 50,000–80,000 orexin-producing neurons in the human brain, located predominantly in the perifornical area and lateral hypothalamus. They project widely throughout the central nervous system, regulating wakefulness, feeding, and other behaviours. There are two types of orexin peptide and two types of orexin receptor.

Orexin was discovered in 1998 almost simultaneously by two independent groups of researchers working on the rat brain. One group named it orexin, from orexis, meaning "appetite" in Greek; the other group named it hypocretin, because it is produced in the hypothalamus and bears a weak resemblance to secretin, another peptide. Officially, hypocretin (HCRT) is used to refer to the genes and transcripts, while orexin is used to refer to the encoded peptides. There is considerable similarity between the orexin system in the rat brain and that in the human brain.

Discovery
In 1998, reports of the discovery of orexin/hypocretin were published nearly simultaneously. Luis de Lecea, Thomas Kilduff, and colleagues reported the discovery of the hypocretin system at the same time as Takeshi Sakurai from Masashi Yanagisawa's lab at the University of Texas Southwestern Medical Center at Dallas reported the discovery of the orexins to reflect the orexigenic (appetite-stimulating) activity of these peptides. In their 1998 paper describing these neuropeptides, they also reported discovery of two orexin receptors, dubbed OX1R and OX2R. Masashi Yanagisawa and Emmanuel Mignot were awarded the Breakthrough Prize in 2022 for this discovery.

The two groups also took different approaches towards their discovery. One team was interested in finding new genes that were expressed in the hypothalamus. In 1996, scientists from the Scripps Research Institute reported the discovery of several genes in the rat brain, including one they dubbed "clone 35." Their work showed that clone 35 expression was limited to the lateral hypothalamus. They extracted selective DNA found in the lateral hypothalamus. They cloned this DNA and studied it using electron microscopy. Neurotransmitters found in this area were oddly similar to the gut hormone, secretin, a member of the incretin family, so they named hypocretin to stand for a hypothalamic member of the incretin family. These cells were first thought to reside and work only within the lateral hypothalamus area, but immunocytochemistry techniques revealed the various projections this area truly had to other parts of the brain. A majority of these projections reached the limbic system and structures associated with it (including the amygdala, septum, and basal forebrain area).

On the other hand, Sakurai and colleagues were studying the orexin system as orphan receptors. To this end, they used transgenic cell lines that expressed individual orphan receptors and then exposed them to different potential ligands. They found that the orexin peptides activated the cells expressing the orexin receptors and went on to find orexin peptide expression specifically in the hypothalamus. Additionally, when either orexin peptide was administered to rats it stimulated feeding, giving rise to the name 'orexin'.

The nomenclature of the orexin/hypocretin system now recognizes the history of its discovery. "Hypocretin" refers to the gene or genetic products and "orexin" refers to the protein, reflecting the differing approaches that resulted in its discovery. The use of both terms is also a practical necessity because "HCRT" is the standard gene symbol in databases like GenBank and "OX" is used to refer to the pharmacology of the peptide system by the International Union of Basic and Clinical Pharmacology.

Isoforms
There are two types of orexin: orexin-A and orexin-B (hypocretin-1 and hypocretin-2). They are excitatory neuropeptides with approximately 50% sequence identity, produced by cleavage of a single precursor protein. This precursor protein is known as prepro-orexin (or preprohypocretin) and is a 130 amino acid pre-pro-peptide encoded by the gene HRCT and located on chromosome 17 (17q21). Orexin-A is 33 amino acid residues long and has two intrachain disulfide bonds; orexin-B is a linear 28 amino acid residue peptide. Although these peptides are produced by a very small population of cells in the lateral and posterior hypothalamus, they send projections throughout the brain. The orexin peptides bind to the two G-protein coupled orexin receptors, OX1 and OX2, with orexin-A binding to both OX1 and OX2 with approximately equal affinity while orexin-B binds mainly to OX2 and is 5 times less potent at OX1.

The orexins are strongly conserved peptides, found in all major classes of vertebrates.

Function
The orexin system was initially suggested to be primarily involved in the stimulation of food intake, based on the finding that central administration of orexin-A and -B increased food intake. In addition, it stimulates wakefulness, regulates energy expenditure, and modulates visceral function. The orexin system has been hypothesized function by exciting other neurons that produce neurotransmitters (such as the locus coeruleus), as well as by inhibiting neurons in the ventrolateral preoptic nucleus, which is a region of the brain whose neuronal activity is imperative to proper sleep function.

Brown fat activation
Many studies support that the orexin neurons regulate brown adipose tissue (BAT) activity via the sympathetic nervous system to enhance energy expenditure. Although orexin knockout mice were reported to show maldevelopment of brown adipose tissue (BAT), subsequent report has shown normal development of BAT.

Wakefulness
Orexin seems to promote wakefulness. Studies indicate that a major role of the orexin system is to integrate metabolic, circadian and sleep debt influences to determine whether an animal should be asleep, or awake and active. Orexin neurons strongly excite various brain nuclei with important roles in wakefulness including the dopamine, norepinephrine, histamine and acetylcholine systems and appear to play an important role in stabilizing wakefulness and sleep.

The discovery that an orexin receptor mutation causes the sleep disorder canine narcolepsy in Doberman Pinschers subsequently indicated a major role for this system in sleep regulation. Genetic knockout mice lacking the gene for orexin were also reported to exhibit narcolepsy. Transitioning frequently and rapidly between sleep and wakefulness, these mice display many of the symptoms of narcolepsy. Researchers are using this animal model of narcolepsy to study the disease. Narcolepsy results in excessive daytime sleepiness, inability to consolidate wakefulness in the day (and sleep at night), and cataplexy, which is the loss of muscle tone in response to strong, usually positive, emotions. Dogs that lack a functional receptor for orexin have narcolepsy, while animals and people lacking the orexin neuropeptide itself also have narcolepsy. Organisms with narcolepsy were also found to experience REM sleep at any time of day, suggesting an alteration of function of REM sleep which can lead to hypnagogic hallucinations (hallucinations that occur as an organism goes to sleep).

Central administration of orexin-A strongly promotes wakefulness, increases body temperature and locomotion, and elicits a strong increase in energy expenditure. Sleep deprivation also increases orexin-A transmission. The orexin system may thus be more important in the regulation of energy expenditure than in the regulation of food intake. In fact, orexin-deficient people with narcolepsy have increased obesity rather than decreased BMI, as would be expected if orexin were primarily an appetite stimulating peptide. Another indication that deficits of orexin cause narcolepsy is that depriving monkeys of sleep for 30–36 hours and then injecting them with the neurochemical alleviates the cognitive deficiencies normally seen with such amount of sleep loss.

In humans, narcolepsy is associated with a specific variant of the human leukocyte antigen (HLA) complex. Furthermore, genome-wide analysis shows that, in addition to the HLA variant, people with narcolepsy also exhibit a specific genetic mutation in the T-cell receptor alpha locus. In conjunction, these genetic anomalies cause the immune system to attack and kill the critical orexin neurons. Hence the absence of orexin-producing neurons in people with narcolepsy may be the result of an autoimmune disorder.

Food intake
Orexin increases the craving for food, and correlates with the function of the substances that promote its production. Orexin is also shown to increase meal size by suppressing inhibitory postingestive feedback. However, some studies suggest that the stimulatory effects of orexin on feeding may be due to general arousal without necessarily increasing overall food intake.

Review findings suggest that hyperglycemia that occurs in mice due to a habitual high-fat diet leads to a reduction in signalling by orexin receptor-2, and that orexin receptors may be a future therapeutic target. Leptin is a hormone produced by fat cells and acts as a long-term internal measure of energy state. Ghrelin is a short-term factor secreted by the stomach just before an expected meal, and strongly promotes food intake. Orexin-producing cells have been shown to be inhibited by leptin (through the leptin receptor pathway), but are activated by ghrelin and hypoglycemia (glucose inhibits orexin production). Orexin, as of 2007, is claimed to be a very important link between metabolism and sleep regulation. Such a relationship has been long suspected, based on the observation that long-term sleep deprivation in rodents dramatically increases food intake and energy metabolism, i.e., catabolism, with lethal consequences on a long-term basis. Sleep deprivation then leads to a lack of energy. In order to make up for this lack of energy, many people use high-carbohydrate and high-fat foods that ultimately can lead to poor health and weight gain. Other dietary nutrients, amino acids, also can activate orexin neurons, and they can suppress the glucose response of orexin neurons at physiological concentration, causing the energy balance that orexin maintains to be thrown off its normal cycle.

Addiction
Preliminary research shows potential for orexin blockers in the treatment of cocaine, opioid, and alcohol addiction. For example, lab rats given drugs which targeted the orexin system lost interest in alcohol despite being given free access in experiments. Wild type mice that were treated with morphine were found to be at a higher risk of developing addiction when compared to mice that did not produce orexin.

Studies of orexin involvement in nicotine addiction have had mixed results. For example, blocking the orexin-1 receptor with the selective orexin antagonist SB-334,867 reduced nicotine self-administration in rats and that smokers who sustained damage to the insula, a brain region that regulates cravings and contains orexin-1 receptors, lost the desire to smoke. However, other studies in rats using the dual orexin receptor antagonist TCS 1102 have not found similar effects.

Lipid metabolism
Orexin-A (OXA) has been demonstrated to have a direct effect on an aspect of lipid metabolism. OXA stimulates glucose uptake in 3T3-L1 adipocytes and that increased energy uptake is stored as lipids (triacylglycerol). OXA thus increases lipogenesis. It also inhibits lipolysis and stimulates the secretion of adiponectin. These effects are thought to be mostly conferred via the PI3K pathway because this pathway inhibitor (LY294002) completely blocks OXA effects in adipocytes. The link between OXA and lipid metabolism is currently being studied.

Mood
High levels of orexin-A have been associated with happiness in human subjects, while low levels have been associated with sadness. The finding suggests that boosting levels of orexin-A could elevate mood in humans, being thus a possible future treatment for disorders like depression. Orexins have also been hypothesized to aid in the development of resilience to the stress response, as their activity in the ventral pallidum was found to decrease depressive symptoms by activating GABAergic neurons at that site.

It has been observed that orexin, while implicated in addiction and depression, is also involved in the display of anhedonia in ADHD. Proper functioning of orexin has been shown to have a large degree of control over behaviors that are motivated by a need to survive, such as searching for food when an organism is starving. When orexin does not function as intended, it impairs an organism's ability to feel pleasure from strongly motivated actions.

Neurotransmitters
Orexinergic neurons have been shown to be sensitive to inputs from Group III metabotropic glutamate receptors, cannabinoid receptor 1 and CB1–OX1 receptor heterodimers,  adenosine A1 receptors, muscarinic M3 receptors, serotonin 5-HT1A receptors, neuropeptide Y receptors, cholecystokinin A receptors, and catecholamines,  as well as to ghrelin, leptin, and glucose. Orexinergic neurons themselves regulate release of acetylcholine, serotonin, and noradrenaline.

Orexinergic neurons can be differentiated into two groups based on connectivity and functionality. Orexinergic neurons in the lateral hypothalamic group are closely associated with reward related functions, such as conditioned place preference. These neurons preferentially innervate the ventral tegmental area and the ventromedial prefrontal cortex. The neurons found in the ventral tegmental area, the ventromedial prefrontal cortex, and the nucleus accumbens shell are strongly implicated in addiction and the sensitization of neurons to stimulating drugs (such as amphetamines). Orexin producing neurons in these areas have been found to be primarily indicated in seeking behavior when externally stimulated by environmental signals such as stress. These neurons are in contrast to the lateral hypothalamic neurons, the perifornical-dorsal group of orexinergic neurons are involved in functions related to arousal and autonomic response. These neurons project inter-hypothalamically, as well as to the brainstem, where the release of orexin modulates various autonomic processes.

Orexin system dysfunction
Orexin/hypocretin system dysfunction might be associated with a variety of disorders and medical conditions.

Takotsubo syndrome
Orexin/hypocretin system dysfunction has been proposed as a novel pathophysiological model of Takotsubo syndrome (acute failure syndrome).

ESSENCE
ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) is an umbrella term covering a wide range of neurodevelopmental disorders and difficulties (ADHD, developmental coordination disorder, autism spectrum disorder) as well as ESSENCE-associated conditions (behavioural phenotype syndromes, some neurological conditions and disorders, and severe early-onset mental disorders). Orexin/hypocretin system dysfunction might be associated with many symptoms in a variety of ESSENCE.

Clinical uses
The orexin/hypocretin system is the target of the insomnia medication suvorexant (Belsomra), which works by blocking both orexin receptors. Suvorexant has undergone three phase III trials and was approved in 2014 by the US Food and Drug Administration (FDA) after being denied approval the year before. The other FDA-approved orexin antagonists are lemborexant (Dayvigo) and daridorexant (Quviviq).

In 2016, the University of Texas Health Science Center registered a clinical trial for the use of suvorexant for people with cocaine dependence. They plan to measure cue reactivity, anxiety and stress.

In 2022, the European Medicines Agency authorized the use of daridorexant (Quviviq) for sleep initiation and maintenance disorders.

Other potential uses
Intranasal orexin is able to increase cognition in primates, especially under sleep deprived situations, which may provide an opportunity for the treatment of excessive daytime sleepiness.

A study has reported that transplantation of orexin neurons into the pontine reticular formation in rats is feasible, indicating the development of alternative therapeutic strategies in addition to pharmacological interventions to treat narcolepsy.

Orexins are also thought to have potential implications in learning and aiding in fending off diseases such as dementia and other disorders that impair cognition.

Evolution
The exon architecture of orexin is conserved in all vertebrates.

title: Orexin


text:
Talk:Enigma

dab cypher
Given the debate at WikiProject Cryptography/Cipher vs Cypher, I only dab'ed "cypher" by changing the target of the link without changing the article text. Patrick Bernier 08:48, 2004 Nov 4 (UTC)

What Is
What is the significe of "enigma" in WII, or am I spelling it wrong —The preceding unsigned comment was added by 64.33.155.101 (talk) 15:49, 18 December 2006 (UTC).
 * See ULTRA. A common evaluation in books on the subject is that the decryption of messages from the Enigma machine, and other high-grade cipher systems, hastened the defeat of Germany by a couple of years or so. — Matt Crypto 16:25, 18 December 2006 (UTC)

Whar does Enigma from Salvador Dalis painting The Endless Enigma mean.

— Preceding unsigned comment added by 194.182.166.61 (talk • contribs) 09:17, 23 May 2007 (UTC)

Moved from Enigma
Moved from Enigma

Enigma is also a song performed by the band "Ages of Man". It was composed November of 2007.

--74.13.60.237 (talk) 12:28, 29 November 2007 (UTC)

Bot-generated content
A computerised algorithm has generated a version of this page using data obtained from AlgaeBase. You may be able to incorporate elements into the current article. Alternatively, it may be appropriate to create a new page at Enigma (alga). Anybot ( contact operator) 16:04, 21 February 2009 (UTC)

Clean-up
Tagged becuase of ''Disorganized categories. Multiple spellings and forms. Multiple redlinks.'' The redlinks remaining are OK, but I haven't dealt with the other issues. Boleyn (talk) 07:59, 9 August 2009 (UTC)

Tooth Disease Entry
In a book I read a few years ago that discussed obscure origins of words we use today, "enigma" was explained to originate from the name of a then mysterious tooth disease found in dogs that we now have the cure for. It didn't mention penicillin in there, since it wasn't invented at the time, but I thought I'd add that for modern readers. It also mentions that although enigma's meaning has changed somewhat, the "mystery" part remains although it has long lost the meaning of a tooth disease in dogs (and it only had that meaning for roughly 300 years). However, it also mentions stuff like "rule of thumb" referring to how wide of an object you can beat your wife with, "garbage" originally being a Norman French derrived word for offal from birds, explaining why beef and pork are names for the flesh but the animals are still called cows and pigs, and so on. I can understand if you want to remove the additional usage, because it's not cited, but I will look for that book and attempt to cite it for all of you. MVillani1985 (talk) 02:42, 2 September 2009 (UTC)

Removed entry
Checking out the history I found a removed entry, it was discussing a game/travel thing hosted in Warsaw, Poland. But, it looks like it might be put on by a company. And I'm not sure if linking it is just advertising? They have a website (which doesn't display for me), but some details can be found in this xml file: ~ender 2012-02-25 11:46:AM MST

— Preceding unsigned comment added by 98.165.52.42 (talk • contribs) 18:47, 25 February 2012 (UTC)

Notoriety
In 1996 Introduction to Deviancy at the University of Washington, the professor showed a photo of him, so I shouted out "ENIGMA!", and he let me regale my story of having joined the freaks onstage, how he and Jim Rose had been featured on The X-Files, inspecting the nail Jim Rose hammered into his nose, chaining him up real good, and steadying Plastic Ass and a gal from the gallery while Jim Rose lied on a bed of nails. He called me "Jaded Fuck" during the performance, and their autographed t-shirt I wore around Seattle got dirty looks from an old lady. Jim Rose is the Geico Caveman.

title: Talk:Enigma


text:
User talk:ThomasStrohmann~enwiki

Hello Tom, welcome to Wikipedia!

There are lots of resources around to help guide you. be sure to check out:

 * Naming conventions
 * Manual of Style

Also check out
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Don't be afraid of making the odd mistake, there are any number of others eagerly waiting for a chance to correct it!

If you need any help try
 * Help
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 * My talk page User_talk:Jimfbleak.

Untagged image
An image you uploaded, Image:Wehrheim Coat of Arms.png, was tagged with the coatofarms copyright tag. This tag was deleted because it does not actually specify the copyright status of the image. The image may need a more accurate copyright tag, or it may need to be deleted. If the image portrays a seal or emblem, it should be tagged as seal. If you have any questions, ask them at Media copyright questions. -- 09:21, 30 December 2006 (UTC)

Orphaned non-free image (Image:Wehrheim Coat of Arms.png)
Thanks for uploading Image:Wehrheim Coat of Arms.png. The image description page currently specifies that the image is non-free and may only be used on Wikipedia under a claim of fair use. However, the image is currently orphaned, meaning that it is not used in any articles on Wikipedia. If the image was previously in an article, please go to the article and see why it was removed. You may add it back if you think that that will be useful. However, please note that images for which a replacement could be created are not acceptable for use on Wikipedia (see our policy for non-free media).

If you have uploaded other unlicensed media, please check whether they're used in any articles or not. You can find a list of 'image' pages you have edited by clicking on the "my contributions" link (it is located at the very top of any Wikipedia page when you are logged in), and then selecting "Image" from the dropdown box. Note that any non-free images not used in any articles will be deleted after seven days, as described on criteria for speedy deletion. Thank you. BetacommandBot 00:28, 14 May 2007 (UTC)

RSF 2007 table
Hey, thanks for your help with Template:Reporters Without Borders/Worldwide press freedom index, I was fully expecting to have to do it myself!

Cheers Brianski 21:34, 21 October 2007 (UTC)

File:Karte_Wehrheim_in_Deutschland.png listed for deletion
A file that you uploaded or altered, File:Karte_Wehrheim_in_Deutschland.png, has been listed at Files for deletion. Please see the to see why this is (you may have to search for the title of the image to find its entry), if you are interested in it not being deleted. Common Good (talk) 19:20, 19 April 2011 (UTC)

Your account will be renamed
Hello,

The developer team at Wikimedia is making some changes to how accounts work, as part of our on-going efforts to provide new and better tools for our users like cross-wiki notifications. These changes will mean you have the same account name everywhere. This will let us give you new features that will help you edit and discuss better, and allow more flexible user permissions for tools. One of the side-effects of this is that user accounts will now have to be unique across all 900 Wikimedia wikis. See the announcement for more information.

Unfortunately, your account clashes with another account also called ThomasStrohmann. To make sure that both of you can use all Wikimedia projects in future, we have reserved the name ThomasStrohmann~enwiki that only you will have. If you like it, you don't have to do anything. If you do not like it, you can pick out a different name. If you think you might own all of the accounts with this name and this message is in error, please visit Special:MergeAccount to check and attach all of your accounts to prevent them from being renamed.

Your account will still work as before, and you will be credited for all your edits made so far, but you will have to use the new account name when you log in.

Sorry for the inconvenience.

Yours, Keegan Peterzell Community Liaison, Wikimedia Foundation 03:05, 20 March 2015 (UTC)

Renamed
 This account has been renamed as part of single-user login finalisation. If you own this account you can |log in using your previous username and password for more information. If you do not like this account's new name, you can choose your own using this form after logging in: . -- Keegan (WMF) (talk) 19:40, 22 April 2015 (UTC)

ArbCom elections are now open!
MediaWiki message delivery (talk) 08:53, 23 November 2015 (UTC)

title: User talk:ThomasStrohmann~enwiki