In The News
The hallucinations and delusions in a subset of children with psychosis may be linked to overactive antibodies, according to a new study published in the journal Biological Psychiatry. The findings add to a growing body of research that supports an “immune hypothesis” for certain types of psychosis.
“The antibodies we have detected in children having a first episode of acute psychosis suggest there is a distinct subgroup for whom autoimmunity plays a role in their illness,” said Dr. Fabienne Brilot, senior author on the article and Head of the Neuroimmunology Group at The Children’s Hospital at Westmead in Sydney.
In a healthy person, antibodies protect the body against bacteria, viruses, and other invaders. But when the antibodies begin to attack healthy cells, an automimmune disorder can develop.
In the new study, researchers detected antibodies to the dopamine D2 receptor or the N-methyl-D-aspartate (NMDA) glutamate receptor in a subgroup of children experiencing their first episode of psychosis. Both are key neural signaling proteins that have previously been implicated in psychosis. These antibodies were not found in healthy children.
For decades, psychiatrists have administered drugs that stimulate dopamine D2 receptors or block NMDA receptors. Sometimes these drugs produce side effects that resemble psychosis, including changes in perception, delusions, and disorganization of thought processes. The current study suggests that people may develop antibodies that affect the brain in ways that are similar to these psychosis-producing drugs.
“This study adds fuel to the growing discussions about the importance of antibodies targeting neural proteins and it raises many important questions for the field. Do these antibodies simply function like drugs in the brain or do they ‘attack’ and damage nerve cells in some ways?” questioned Dr. John Krystal, Editor of Biological Psychiatry. “Also, are these antibodies producing symptoms in everyone or do they function as a probe of an underlying, perhaps genetic, vulnerability for psychosis?”
Importantly, work is advancing rapidly in this area. Not too long ago, scientists first identified anti-NMDA receptor encephalitis, a disease characterized by inflammation of the brain. It is known to trigger acute psychiatric symptoms including psychosis, and it is commonly misdiagnosed as schizophrenia or bipolar disorder. It is far more treatable, however, as it is essentially brain inflammation caused by antibodies that attack the brain’s NMDA receptors.
“The data from this study suggests that better interventions are possible, providing hope that major disability can be prevented for the subset of children experiencing acute psychosis with antibodies,” Brilot added. “These findings also contribute significantly to an emerging acceptance in the field of the involvement of autoimmune antibodies in neurological diseases. Combined, these investigations are providing a better understanding of the biology of psychiatric and neurological diseases, as well as pointing to novel treatment approaches for children with these debilitating illnesses.”
New research finds that a synthetic nasal formulation of the hormone oxytocin helps men reduce their caloric intake.
The study was presented at the annual meeting of the Endocrine Society with researchers explaining that the nasal spray specifically helped men reduce consumption of fatty foods. The effects occurred after a single treatment.
Investigators also note that the human study confirmed results found in animal studies showing that oxytocin reduces food intake.
In the study, oxytocin nasal spray lowered the number of calories men consumed at a subsequent breakfast whether they were normal weight or overweight.
In addition, the researchers found that oxytocin improved metabolic measures, such as insulin sensitivity, which is the body’s ability to successfully clear glucose (sugar) from the bloodstream.
“Our results are really exciting,” said lead investigator Elizabeth Lawson, MD, MMSc, assistant professor of medicine at Harvard Medical School, Boston.
“Further study is needed, but I think oxytocin is a promising treatment for obesity and its metabolic complications.”
The oxytocin nasal spray (made by Novartis) is approved in Europe but not in the U.S. other than in clinical trials. Oxytocin is available in the U.S. as an intravenous or injectable drug (Pitocin) to induce labor.
For the study, Lawson and her colleagues enrolled 25 healthy men with an average age of 27. Thirteen of the men had a healthy weight, and the other 12 were overweight or obese.
The men were randomly assigned to self-administer a single dose (24 International Units, or IU) of either oxytocin nasal spray or a placebo (dummy drug) after fasting. All were unaware which treatment they received.
One hour later, the men received breakfast, which they picked out from a menu. Each meal contained double portions. After the meal, the researchers measured how many calories each man ate.
In a separate visit, the men repeated the experiment but received the opposite treatment (placebo or oxytocin) from the first visit.
According to the investigators, there was no difference in how much food the men reported eating in the three days before each experiment.
On average, the men ate 122 fewer calories and 9 grams less fat at the meal after they received oxytocin nasal spray compared with placebo, the study data showed.
Oxytocin also reportedly increased the use of body fat as a fuel for energy. There were no serious side effects and no difference in side effects between oxytocin and placebo, according to Lawson.
Oxytocin had no effect on self-reported appetite or on appetite-regulating hormones measured in their blood, the researchers discovered.
Therefore, how oxytocin affected caloric intake is unclear, Lawson said. In preclinical studies, oxytocin was involved in appetite-reducing pathways in the brain.
Because oxytocin has sex-specific effects, it needs to be studied in women, as well as in both sexes for an extended treatment duration, she said.
Source: The Endocrine Society/EurekAlert
New research suggests that people with poor physical fitness in their 40s may undergo accelerated brain aging.
In a paper presented at the American Heart Association EPI/Lifestyle meeting, researchers say poor fitness may lead to lower brain volumes by the time a person reaches age 60.
“Many people don’t start worrying about their brain health until later in life, but this study provides more evidence that certain behaviors and risk factors in midlife may have consequences for brain aging later on,” said Nicole L. Spartano, Ph.D., lead author and a postdoctoral fellow at the Boston University School of Medicine.
In the longitudinal study, researchers reviewed and then updated data taken from a group of individuals who have been followed for over three decades.
The study group included a subset of 1,271 participants from the Framingham Offspring Study who had participated in exercise treadmill testing in the 1970s, when their average age was 41.
Starting in 1999, when their average age was 60, they underwent magnetic resonance imaging (MRI) of their brains as well as cognitive tests.
The participants did not have heart disease or cognitive problems at the beginning of the study, and none were taking medication that alters heart rate.
In individuals with low fitness levels, the blood pressure and heart rate responses to low levels of exercise are often much higher than in individuals with better fitness.
“Small blood vessels in the brain are vulnerable to changes in blood pressure and can be damaged by these fluctuations,” Spartano said.
“Vascular damage in the brain can contribute to structural changes in the brain and cognitive losses. In our investigation we wanted to determine whether exaggerated blood pressure fluctuations during exercise were related to later structural changes in the brain.”
The researchers found:
• People who had a lower fitness level or greater increase in diastolic blood pressure (bottom number) or heart rate a few minutes into the low-intensity treadmill test (2.5 miles an hour) had smaller brain tissue volume later in life.
• People who had a larger increase in diastolic blood pressure during low-intensity exercise also performed more poorly on a cognitive test for decision-making function later in life.
Investigators hypothesize that poor physical fitness could be associated with accelerated brain aging.
“For every 3.4 units lower exercise capacity, every 7.1 mm Hg higher exercise diastolic blood pressure, and for every 8.3 beats/minute higher exercise heart rate in midlife, these effects are approximately equivalent to an additional 0.5 years of brain aging,” Spartano said.
Apart from the exercise tests, a higher resting systolic blood pressure (top number) at age 40 was associated with a smaller frontal lobe volume and a greater volume of white matter hyperintensity (an indicator of loss of blood flow with aging) on the later brain MRIs.
Promotion of midlife physical fitness may be an important step towards ensuring healthy aging of the brain in the population, researchers said.
“It will be interesting to follow up with these participants in another 10 years to determine how many developed dementia, and if that may be related to their fitness or exercise blood pressure or exercise heart rate in midlife,” Spartano said.
Source: American Heart Association
New research suggests smartphones are making us cognitively lazy. And, the evidence is still out as to if this will be an issue as we age.
The ubiquitous cellular devices allow us to obtain information without having to retrieve information that is traditionally coded in our brain. Phone numbers, directions and even recommendations to restaurants are provided with a touch of a finger or upon a voice command.
The study, from researchers at the University of Waterloo and published in the journal Computers in Human Behavior, suggests that intuitive thinkers are especially disposed to use a smartphone’s convenient features.
Intuitive thinkers typically rely on gut feelings and instincts when making decisions and frequently use their device’s search engine rather than their own brainpower.
Smartphones allow them to be even lazier than they would otherwise be.
“They may look up information that they actually know or could easily learn, but are unwilling to make the effort to actually think about it,” said Gordon Pennycook, co-lead author of the study, and a PhD candidate in the Department of Psychology at Waterloo.
In contrast, analytical thinkers second-guess themselves and analyze a problem in a more logical sort of way. Highly intelligent people are more analytical and less intuitive when solving problems.
“Decades of research has revealed that humans are eager to avoid expending effort when problem-solving and it seems likely that people will increasingly use their smartphones as an extended mind,” said Nathaniel Barr, the other lead author of the paper.
In three studies involving 660 participants, the researchers examined a variety of measures including cognitive style. Investigators reviewed individuals preferred method of information retrieval ranging from intuitive to analytical, and verbal and numeracy skills. Then they looked at the participants’ smartphone habits.
Participants in the study who demonstrated stronger cognitive skills and a greater willingness to think in an analytical way spent less time using their smartphones’ search-engine function.
“Our research provides support for an association between heavy smartphone use and lowered intelligence,” said Pennycook.
“Whether smartphones actually decrease intelligence is still an open question that requires future research.”
The researchers say that avoiding using our own minds to problem-solve might have adverse consequences for aging.
“Our reliance on smartphones and other devices will likely only continue to rise,” said Barr.
“It’s important to understand how smartphones affect and relate to human psychology before these technologies are so fully ingrained that it’s hard to recall what life was like without them. We may already be at that point.”
The results also indicate that use of social media and entertainment applications generally did not correlate to higher or lower cognitive abilities.
Source: Waterloo University
According to a new study in the Journal of Consumer Research, children who receive more material rewards from their parents grow up to be more materialistic as adults.
“Using material possessions to express love or reward children for their achievements can backfire. Loving and supportive parents can unintentionally foster materialism in their children despite their best efforts to steer them away from relying on material possessions to find happiness or to judge others,” write the authors, Drs. Marsha L. Richins (University of Missouri) and Lan Nguyen Chaplin (University of Illinois at Chicago).
The authors surveyed 701 adults to measure the long-term impact of material parenting.
Study participants described their current life situation and values, and also reported on a variety of childhood circumstances, their relationship with their parents, and the rewards and punishments they received during three critical ages of childhood (at grades three, seven, and 10).
Adults who had received more material rewards and punishments as children were more likely than others to use possessions to define and express who they are.
Researchers believe parents should be cautious about using material goods to express their love and reward their children for good behavior.
An overemphasis on material possessions during childhood can have long-lasting effects. Adults who received many material rewards as children are likely to continue rewarding themselves with material goods and defining themselves through their possessions.
Parents don’t want their children to use possessions to define their self-worth or judge others, yet loving and supportive parents may use material goods to express their love, say the authors.
Unfortunately, this may encourage their children to be more likely than others to admire people with expensive possessions and judge success by the kinds of things people own.
For military personnel with blast-related mild traumatic brain injuries, early symptoms of post-traumatic stress such as anxiety, emotional numbness, flashbacks, and irritability are the strongest predictors of later disability, said researchers from Washington University School of Medicine in St. Louis.
Investigators were surprised that mental health issues more closely correlated with disability than cognitive and physical assessments typically made after concussions such as tests of memory, thinking, balance, coordination, and severity of headaches and dizziness.
“Symptoms of post-traumatic stress and depression have always been thought to develop months to years later,” said David L. Brody, M.D., Ph.D., associate professor of neurology.
“We don’t know what causes these symptoms, whether they result from the brain injury itself, from the stress of war or some combination of factors. But regardless of their origin, the severity of these psychological symptoms soon after injury was the strongest predictor of later disability.”
The study is found in the journal Brain.
Researchers say the study suggests that mild concussions have more severe long-term effects than previously thought, including difficulty returning to previous work, family and social activities. The results raise questions about how best to treat U.S. troops who suffer head injuries.
During the conflicts in Iraq and Afghanistan, about one-fifth of service members experienced a head injury, according to recent estimates from the U.S. Department of Defense, and more than 80 percent of those were considered mild.
“I was surprised by how severe the level of disability was six to 12 months after these seemingly mild injuries, especially given that virtually all of these patients returned to duty soon after their concussions,” said Brody, the study’s senior author.
According to the investigators, the study is the first to evaluate active-duty service members with blast-related mild concussions very early, in the first week after injury, and to combine that with follow-up evaluations of the same patients six to 12 months later. Most studies of traumatic brain injury in military personnel have focused on those injured severely enough to be evacuated from war zones.
For the study, investigators at Washington University and the Naval Medical Center Portsmouth in Virginia evaluated traumatic brain injury from blast exposure in active-duty military personnel stationed in Afghanistan in 2012.
The study included 38 patients diagnosed with mild blast-related brain injury and 34 service members without brain injury who volunteered to serve as controls. Those in the study ranged in age from 19-44, with a median age of 26 in the study group and 28 in the control group.
Early assessments of service members were made in Afghanistan within the first week after injury.
Mental health evaluations were accomplished with a standard military questionnaire for assessing symptoms of post-traumatic stress disorder.
The tool asked soldiers if they experienced repeated, disturbing memories, or dreams, feelings of emotional numbness, difficulty concentrating, and feelings of anger or hyper-alertness. Follow-up mental health assessments were conducted with standard interviews six to 12 months later.
At the later evaluations, 63 percent of patients in the brain injury group were classified as moderately disabled, compared with 20 percent of the control group.
Patients were classified as moderately disabled if they were unable to work as they did before injury; unable to continue previous social and leisure activities; or had mental health problems that disrupted relationships with family and friends.
The remaining 37 percent of the brain injury group were considered to have a good recovery.
“When we were able to connect the dots, we saw that injuries that might have been considered trivial seemed to have a big impact on how these patients did later on,” said first author Christine L. MacDonald, Ph.D.
This result was unexpected, according to the investigators, because the vast majority of past research on traumatic brain injury in military personnel and civilians has focused on cognitive function and physical symptoms such as headaches.
“Most previous studies have hypothesized that things such as duration of loss of consciousness, duration of post-traumatic amnesia and how well patients could perform tasks of thinking, memory, attention, balance and coordination would be the predictors of later disability,” Brody said.
“We looked at these factors. And they were not strongly correlated with how well patients did long term.”
MacDonald said the findings suggest that care for brain injuries among military personnel should be broadened to include psychological evaluations earlier in the process.
Currently the decision criteria used to determine whether a service member should return to active duty are focused on cognitive function and clinical symptoms and do not include assessments of mental health.
“We hope to contribute to the discussion about what should be done for these patients when they come in with seemingly mild concussions,” MacDonald said.
“We need to investigate whether there are new approaches to early care that will improve their quality of life over the long term.”
Brody and his colleagues are planning a similar study of civilian concussions, looking at mental health measures immediately following mild head injuries in patients who come to the emergency room. Those patients will be followed to determine long-term outcomes.
“The lessons that we learn from military trauma apply quite readily to civilian trauma,” Brody said.
“Still, there may be unique aspects of military brain injury that are not true in the civilian world. It could also be that this is a general phenomenon that has not been carefully addressed in civilian or military populations.”
Source: Washington University, St. Louis
Divorce is six percent more likely when the wife becomes seriously ill, compared to marriages in which the wife remains healthy, according to a new study by Iowa State University researchers.
When a husband becomes ill, however, there is no increase in divorce risk.
The study, published in the Journal of Health and Social Behavior, analyzed the divorce rate for couples when one of the spouses had been diagnosed with a serious illness.
The researchers focused on four illnesses — cancer, heart disease, lung disease, and stroke — to see whether the type of illness or its severity made a difference in divorce rates. While they found slight variations, the results between each were not statistically significant.
According to the findings, 32 percent of the 2,701 marriages ended in divorce, compared to 24 percent which ended in widowhood. The marriage data covered nearly 20 years, and one spouse had to be at least 51 years old at the beginning of that period.
Divorce was more common among the younger participants, whereas death was more common as respondents got older. Researchers found the odds of widowhood increased by five percent when husbands got sick and four percent when wives got sick.
There are a few reasons why illness can add stress to a marriage. First, the healthy spouse is often the primary caregiver and may have to take sole responsibility of managing the household.
“There is a difference between feeling too sick to make dinner and needing someone to actually feed you. That’s something that can really change the dynamics within a marriage,” said Dr. Amelia Karraker, lead author of the study and an assistant professor of human development and family studies at Iowa State.
“If your spouse is too sick to work, we know that financial strain is a major predictor of divorce in and of itself.”
Quality of care may be another factor. Overall, wives seem less satisfied with the care from their husbands, Karraker said. In general, men — especially older men — have not been socialized to be caregivers in the same way women have, and are less comfortable in that role.
Karraker and colleague Dr. Kenzie Latham, an assistant professor at Indiana University-Purdue University Indianapolis, used data from the Health and Retirement Study, an ongoing University of Michigan longitudinal study that surveys a sample of approximately 20,000 Americans over the age of 50 every two years.
Although the data does not indicate whether the husband or wife initiated the divorce, it is possible some women ended the marriage because of their care.
“Life or death experiences may cause people to re-evaluate what’s important in their lives,” Karraker said.
“It could be that women are saying, ‘You’re doing a bad job of caring for me. I’m not happy with this, or I wasn’t happy with the relationship to begin with, and I’d rather be alone than be in a bad marriage.'”
Prior studies have shown that married couples have better physical and mental health. Ironically, Karraker’s research shows that illness puts women at risk of losing those health benefits from marriage.
“I think the research shows the potential vulnerabilities for people in society who are sick. There is an elevated risk for depression with illness and now you’re also at risk for divorce,” Karraker said.
“People in poor health may have less access to beneficial social relationships, which in turn can compromise their health further.”
Source: Iowa State University
An analyses of over three decades of data on 475,000 individuals suggests that men, on average, believe they are entitled to preferential treatment.
University of Buffalo School of Management researchers examined 31 years of narcissism research and found that men consistently scored higher in narcissism across multiple generations, among all ages.
The study is forthcoming in the journal Psychological Bulletin.
“Narcissism is associated with various interpersonal dysfunctions, including an inability to maintain healthy long-term relationships, unethical behavior, and aggression,” said lead author Emily Grijalva, Ph.D., assistant professor of organization and human resources.
“At the same time, narcissism is shown to boost self-esteem, emotional stability, and the tendency to emerge as a leader,” she says. “By examining gender differences in narcissism, we may be able to explain gender disparities in these important outcomes.”
The researchers examined more than 355 journal articles, dissertations, manuscripts, and technical manuals, and studied gender differences in the three aspects of narcissism: leadership/authority, grandiose/exhibitionism, and entitlement.
They found that men were especially prone to feelings of entitlement, suggesting that men are more likely than women to exploit others and feel entitled to certain privileges.
The second largest difference was in leadership/authority.
“Compared with women, men exhibit more assertiveness and desire for power,” Grijalva said. “But there was no difference in the exhibitionism aspect, meaning both genders are equally likely to display vanity or self-absorption.”
In addition, the study looked at data from college students between 1990 and 2013, and found no evidence that either gender has become more narcissistic over time.
Research has shown that personality differences, like narcissism, can arise from gender stereotypes and expectations that have been ingrained over time. The authors speculate that the persistent lack of women in senior leadership roles may partially stem from the disparity between stereotypes of femininity and leadership.
“Individuals tend to observe and learn gender roles from a young age, and may face backlash for deviating from society’s expectations,” Grijalva said.
“In particular, women often receive harsh criticism for being aggressive or authoritative, which creates pressure for women, more so than for men, to suppress displays of narcissistic behavior.”
Future research could further investigate the social, cultural or biological factors that contribute to these gender differences.
Source: University of Buffalo
Use of Twitter to communicate with others appears to provide a level of social support and collegiality that helps smokers kick the habit.
University of California, Irvine (UCI), and Stanford University researchers discovered that when subjects in a smoking cessation program tweet each other regularly, they’re more successful at kicking the habit.
Furthermore, daily “automessages” that encourage and direct the social media exchanges may be more effective than traditional social media interventions for quitting smoking.
Cornelia Pechmann, Ph.D., professor of marketing at UCI’ , and Judith J. Prochaska, Ph.D., associate professor of medicine at Stanford, found that overall engagement in two consecutive “Tweet2Quit” groups was high, with 78 percent of members tweeting their fellow study subjects at least once during the 100-day study.
The average number of tweets per person was 72, and 60 percent tweeted past the 30-day mark.
Group one had a smoking cessation rate of 42 percent. Researchers then used lessons gleaned from that trial to improve the automessaging process and group two had a success rate of 75 percent.
The findings were published recently in the Journal of Medical Internet Research.
“Our results indicate that incorporating social media-delivered automessages from trained counselors was effective in promoting smoking cessation,” Pechmann said.
“The twice-daily messages encouraged people to tweet their group members, which made them more accountable for quitting.”
Each group had 20 member and they communicated online via Twitter for 100 days. Participants each received a free supply of nicotine patches, along with daily automated text messages.
They were encouraged to use a Web-based guide to develop a cessation plan and were asked to tweet their group at least once a day about their progress.
There were no expert facilitators in the groups; the smokers themselves supported one another. However, the daily automessages encouraged and directed peer-to-peer discussions, and distinct tweeting spikes occurred when the messages were sent, at 9:00 a.m. and 5:00 p.m.
“The Twitter environment created a sort of party dynamic,” Pechmann said. “That’s especially important for social smokers. In addition, group leaders naturally emerged, facilitating the online conversations. These leaders played a critical role in keeping people engaged.”
Several types of tweets related positively to smoking abstinence. The more people shared about setting a quit date, using nicotine patches, countering roadblocks, utilizing self-rewards, believing in themselves, and feeling pride, the more likely they were to remain smoke-free.
Support, accountability, advice and bragging rights are a few of the benefits that make social media a promising platform for self-help groups, Pechmann noted.
However, while health-related online forums, blogs and websites can be informative, they lack the instantaneous interaction of Twitter.
Tweet2Quit’s hybrid approach combines automated messages with the social media element. The prompts are based on clinical guidelines for smoking cessation and employ positive, open-ended questions that encourage online discussion, such as “What will you do when you feel the urge to smoke?”
On average, about 23 percent of tweets were in response to these automated texts, while 77 percent were spontaneous.
Source: University of California, Irvine
Although it appears counterintuitive, new research finds that people will often put in more effort to obtain uncertain rewards.
Investigators Luxi Shen, Ph.D., of the Chinese University of Hong Kong, and Drs. Ayelet Fishbach and Christopher K. Hsee of the University of Chicago, found that an uncertain reward is more motivating than a certain reward when comparing a person’s investment of time, money, and effort.
The researchers called this the “motivating-uncertainty effect” and discuss the implications in the Journal of Consumer Research.
In one study, consumers were asked to drink a large amount of water within two minutes. Some were told they would receive a guaranteed reward of two dollars, while others were told they would receive either one or two dollars (decided by a coin toss).
Even though the reward was potentially lower, more consumers completed the task when the reward was uncertain.
In another study, consumers were asked to bid against each other for a bag of Godiva chocolates. Some were told there were four chocolates in the box, while others were told there were either two or four. Consumers bid higher when they didn’t know how many chocolates were in the bag.
These findings can help companies and public policy makers when designing incentive systems. Introducing a bit of uncertainty can help to motivate people and make the effort required to achieve a reward seem more like a game and less like work.
Researchers agree that although the idea that uncertainty can increase motivation appears contradictory, its underlying mechanism is not.
“Consider the experience of slowly unwrapping a gift. Getting closer to finding out what is in the box is exciting and this excitement motivates action. Stated formally, the motivating-uncertainty effect is based on the positive experience that revealing the unknown induces,” the authors conclude.
Women married to men with alcohol abuse problems can face a host of barriers that prevent them from obtaining necessary support.
A new program, developed by researchers at the University at Buffalo Research Institute on Addictions (RIA), helps these women receive Internet-based, interactive support program.
Approximately 7.7 million U.S. adults are currently married to or living with a partner with an alcohol use disorder. The burden of living with an alcoholic partner can cause considerable psychological distress, said Robert G. Rychtarik, Ph.D., senior research scientist at RIA. But many spouses do not or cannot seek help.
“Specialized professional help for spouses of alcoholics is not widely available and insurance coverage can be limited,” Rychtarik says.
“Fear of retribution, family turmoil, stigmatization, and financial, time and geographical constraints also can be barriers.”
Researchers developed a self-paced, Internet-administered coping skills training program to determine if it could be an effective way to help reduce distress in this frequently underserved population.
In a new study, nearly 100 women living with an alcoholic partner tested the program, which included narrated instruction, animated presentations, and video dramatizations of the most effective ways to deal with problems arising from a partner’s drinking.
Certified counselors (“coaches”) were available to chat via computer or telephone.
“The program’s goals are to help women focus on their own needs, reduce stress and talk to their partners in a more effective way,” Rychtarik said.
“The majority of the participants showed significantly higher levels of coping skills and experienced decreased depression and anger compared to those who didn’t take part in the program.”
Although the program is not yet available to the public, RIA researchers are seeking additional funding to evaluate it on a larger scale.
One objective of future research is to determine the best method to deliver the program. Investigators hope to determine if the program is best provided through social service agencies, treatment programs or health care providers, or as a standalone for women to access themselves.
Source: University of Buffalo
New research suggests Family Based Interpersonal Psychotherapy (FB-IPT) is more effective for treating preadolescent children with depression than child-centered therapy (CCT).
Many are concerned that preadolescents with depressive disorders may be under-diagnosed and go untreated. This occurs because those presenting for outpatient treatment with clinically significant depressive symptoms often do not meet full diagnostic criteria for Major Depressive Disorder (MDD).
However, preadolescents with depressive symptoms are at increased risk of experiencing MDD in adolescence.
For the study, researchers at the University of Pittsburgh School of Medicine randomly assigned 42 preadolescents (ages seven to 12) with depression to one of two therapy conditions.
The research is important because a “best practice” method of care for preadolescences diagnosed with depression has not been determined.
Researchers compared FB-IPT, an intervention that included parents in the child’s treatment and focused on improving family and peer relationships, to child-centered therapy (CCT), a supportive therapy for children.
Depressive symptoms in children were measured by a clinician-rated children’s depression rating scale, and mood questionnaires that both the child and parent completed.
Preadolescents receiving FB-IPT had higher rates of remission (66 percent vs. 31 percent), a greater decrease in depressive symptoms from pre- to post-treatment, and lower depressive symptoms at post-treatment than did preadolescents with depression receiving CCT.
Children receiving FB-IPT also reported significant reductions in anxiety symptoms than did preadolescents in the CCT group.
In addition, the study demonstrated that FB-IPT helped to reduce social impairment in depressed preadolescents, and these changes were associated with decreases in their depressive symptoms.
“These findings provide strong support for Family Based Interpersonal Psychotherapy as an effective treatment for depression in children between the ages of seven to 12,” said Laura J. Dietz, Ph.D., assistant professor of psychology and psychiatry at the University of Pittsburgh School of Medicine and principal investigator of the study.
“It also highlights the importance of early intervention for depressed preadolescents who are at risk for depression as teenagers.”
The study is ublished in the Journal of the American Academy of Child and Adolescent Psychiatry.
For high-risk kids, whose parents have been diagnosed with bipolar disorder, a new study shows s a strong link between having subthreshold manic episodes (milder episodes that come close to but do not reach the criteria for bipolar disorder) and the eventual development of bipolar disorder.
The findings also show that children of parents with bipolar disorder have much greater rates of having subthreshold mania or hypomania compared to their peers (13.3 vs 1.2 percent); manic, mixed, or hypomanic episodes (9.2 vs 0.8 percent); and major depressive episodes (32 vs 14.9 percent). While these results, published in the American Journal of Psychiatry, may be unsurprising, they could lead to earlier identification, treatment, and preventive measures.
“Mental health practitioners should carefully assess for short episodes of manic symptoms, major depression, and disruptive behavior disorders in high-risk children, as these are risk factors for the future onset of bipolar disorder,” said senior author David Axelson, M.D., medical director of Behavioral Health at Nationwide Children’s Hospital.
“This may be particularly important if medication is going to be used for treating mood or behavioral symptoms in the child, because some medications might increase the risk of developing mania or psychotic symptoms in someone who is already at very high risk for developing bipolar disorder. Prescribers might choose different medication options, or use lower doses and monitor for problems more closely.”
For the study, researchers followed high-risk children as well as demographically matched children of community parents. Follow-up interviews were completed in 91 percent of the offspring with a mean follow-up duration of 6.8 years.
The findings showed that the cumulative rate of bipolar spectrum disorders at age 21 was 23 percent in the high-risk group, compared to 3.2 percent in the comparison group. The mean age of onset for a bipolar spectrum disorder was 12 years, with the earliest manic episode being documented at eight years.
“Most children who have a parent with bipolar disorder will have a diagnosable psychiatric disorder, such as attention-deficit disorder, oppositional defiant disorder, an anxiety disorder or depression, at some point during their youth,” said Axelson, a professor of clinical psychiatry at Ohio State University.
“However, most children who have a parent with bipolar disorder do not develop bipolar disorder.”
Among the high-risk children who did go on to develop bipolar disorder, nearly all had identifiable mood episodes and other psychiatric disorders before the onset of full-fledged bipolar illness.
“Short, distinct episodes of manic symptoms were the most specific predictor of developing bipolar disorder in high-risk offspring,” Axelson said. “But so far, many children with these short manic episodes have not progressed to full-fledged bipolar disorder.”
“I am continuing to collaborate with researchers on the Pittsburgh Bipolar Offspring Study,” Axelson said. “We expect to find more exciting results that will impact the diagnosis and treatment of high-risk children as we follow the participants into young adulthood.”
Source: Nationwide Children’s Hospital
Young women with attention deficit hyperactivity disorder (ADHD) and a history of a troubled childhood are at greater risk for a variety of negative psychosocial outcomes.
Specifically, researchers at the University of California, Berkeley (UC Berkeley), found that women with ADHD who have been exposed to abuse, neglect, or other traumas in childhood and adolescence, are at greater risk for a variety of problems than those with ADHD who were not mistreated in early youth. The abused women were found to be at increased risk for self-injury, eating disorders, and suicide.
The findings support a new model that suggests environmental factors, including maltreatment in childhood, can have a significant bearing on the negative psychosocial outcomes of attention-deficit hyperactivity disorder.
The research is published in the journal Development and Psychopathology.
“While ADHD is clearly a heritable and biologically based disorder, and can be treated with medications, it is very important for clinicians and treatment providers to pay close attention to the trauma experiences of individuals, particularly women, with ADHD,” said Maya Guendelman, a Ph.D. student in psychology at UC Berkeley, and lead author of the study.
The results also raise the question of whether children with ADHD are more vulnerable to maltreatment due to family stress. ADHD is a neurodevelopmental disorder that is estimated to afflict at least six million children and teenagers in the United States.
Characteristics of ADHD include poor concentration, distractibility, hyperactivity, impulsiveness, and other behaviors that are inappropriate for the child’s age.
“In the United States, we have a large contingent of kids being diagnosed with ADHD. At the same time, 10 to 20 percent of U.S. kids are abused or neglected. But we have very limited understanding of the overlap between these two groups,” Guendelman said.
“What if, in some portion of cases, we as clinicians, parents, and teachers are superficially seeing and diagnosing and treating symptoms of hyperactivity and inattention, but it is really trauma experiences that underlie some of those overt manifestations of ADHD?” she added.
To investigate the relationship between ADHD and childhood maltreatment, Guendelman and fellow researchers compared data from the Berkeley Girls with ADHD Longitudinal Study (BGALS), which has tracked more than 140 girls with ADHD from childhood to adulthood since 1997.
Led by UC Berkeley psychologist Dr. Stephen Hinshaw, BGALS has consistently found that — unlike boys, whose symptoms are more overt — girls with ADHD suffer in hidden ways, and are more likely to internalize struggles as they mature into adolescence and young adulthood.
This coping mechanism can make them more prone to depression, self-mutilation, eating disorders, and suicide attempts as they enter adulthood, the study’s data shows.
Researachers looked into how many of the women with ADHD in the BGALS sample had reported incidents of physical abuse, sexual abuse, or neglect during childhood or adolescence.
They found that nearly 25 percent of the ADHD group had reported some form of trauma by adolescence, compared to 11 percent in the non-ADHD control group. Moreover, members of the maltreated ADHD subgroup had a higher risk for depression, anxiety, and self-destruction than both the girls with ADHD who had not been maltreated and the girls in the non-ADHD control group.
“Our findings clearly support the contention that child or adolescent maltreatment specifically is an important risk factor for maladaptive functioning in young adulthood among women with childhood ADHD, particularly with respect to depression, anxiety, and suicidal behavior,” Guendelman said.
“This is not to say that all ADHD is due to social adversity rather than biological factors,” she added. “Rather, it suggests that we must consider the contribution of factors such as severe social stress and trauma in our understanding of how children with ADHD develop.”
The BGALS sample is made up of a racially and socioeconomically diverse group of girls in the San Francisco Bay Area who have been tracked through early childhood summer camp participation, adolescence and now into early adulthood.
It has compared the behavioral, emotional, and academic development of the 140 girls with ADHD to that of a demographically similar group of 88 girls without ADHD. Every five years, the research team publishes studies looking into how ADHD impacts girls, including this latest research.
ADHD is not the only psychopathology impacted by environmental factors, said Hinshaw, senior author of the study.
“Across a range of mental disorders, from schizophrenia to depression and bipolar disorder, scientists are realizing that, despite the undisputed biological underpinnings of these conditions, key life experiences, including trauma, are essential forces related to long-term outcomes,” Hinshaw said.
Source: UC Berkeley
Cognitive-behavioral therapy (CBT) is a therapeutic approach frequently used to treat childhood anxiety.
New research suggests that when CBT is successful in reducing the childhood anxiety, the technique also conveys considerable benefit years after the treatment.
In a new study, Penn Medicine researchers found that patients who did not respond to cognitive-behavioral therapy (CBT) for anxiety in childhood had more chronic and enduring patterns of suicidal ideation at seven to 19 years after treatment.
The study has been published in the Journal of the American Academy of Child & Adolescent Psychiatry.
“This study underscores the importance of the identification and evidence-based treatment of youth anxiety,” said lead author Courtney Benjamin Wolk, Ph.D., a postdoctoral researcher at the Perelman School of Medicine.
The relationship between anxiety disorders in children and adolescents and the emergence of later depressive disorders is well established. But that between anxiety and the range of suicidal behaviors — including suicidal ideation (thoughts), plans, attempts, and completed suicides — is is by no means settled.
Furthermore, the way in which CBT treatment for anxiety in childhood and adolescence influences later suicidality is an ongoing area of investigation.
Wolk and colleagues looked at 66 patients who were treated for anxiety, particularly separation, social, or generalized anxiety, as children, who agreed to be followed for years after treatment.
These individuals had previously participated in two of the randomized controlled trials of the Coping Cat program, a manualized CBT intervention for child anxiety, developed by coauthor Philip C. Kendall, Ph.D., of Temple University.
Forty patients were classified as responding “successfully” to CBT treatment in childhood and adolescent years while 26 were treatment non-responders.
“Successful” treatment was defined as those patients whose primary anxiety disorder was no longer clinically significant after 16 weeks of treatment.
At seven to 19 years after treatment, treatment response was found to significantly predict lifetime suicidal ideation, such that treatment nonresponders were more likely to have experienced suicidal ideation. In fact, every patient who reported thinking about suicide in the past 12 months or past two weeks was among those who had not responded to CBT.
Eighteen of these reported experiencing suicidal ideation, nine reported having made one or more suicide plans and six described making one or more suicide attempts in their lifetime.
In those patients who reported suicidal ideation, onset occurred at a mean age of about 16 years and was last reported by most patients at about 20 years of age.
Finally, among those who reported making suicide attempts, ideation began at a mean of 17 years and occurred most commonly/recently at the age of 21. All instances of suicidal plans and attempts reported occurred after the age of initial treatment.
Investigators say that this is the longest known study looking at suicidal ideation following CBT treatment in youth.
“This study suggests the importance of ongoing monitoring of anxious youth who are not successfully treated for later suicidal ideation,” says senior author, Rinad Beidas, Ph.D., assistant professor at the Center for Mental Health Policy and Services Research at the Perelman School of Medicine.
It is the first study to demonstrate the protective function of successful evidence-based treatment for childhood anxiety disorders on suicidal ideation in late adolescence and adulthood.
More children are being prescribed antipsychotic medications — drugs designed to treat such mental illnesses as schizophrenia and bipolar disorder — and pediatricians and psychiatrists at the University of Vermont conducted a study to find out why.
Specifically, the researchers wanted to find out “whether the right youth are being prescribed the right medications at the proper time in their treatment,” they state in the journal Pediatrics. Their findings, for the first time, delve into the clinical decision-making process of doctors who prescribe these drugs to children.
“There are risks associated with using these medicines,” said David Rettew, M.D., associate professor of psychiatry and pediatrics. “At the same time, I think they’ve saved lives.”
Research has shown increasing use of antipsychotic medications in pediatric patients. In fact, treatment with such drugs climbed 62 percent for children on Medicaid between 2002 and 2007, reaching 2.4 percent of those youth, according to The Agency for Healthcare Research.
Rettew and fellow members of a Vermont state task force that keeps watch on use of psychiatric medications for young people wanted to answer the question: “Is this a reasonable thing, or are these medications potentially being overused?”
From Medicaid claims data, the researchers sent a survey to the prescriber of every antipsychotic medication — most commonly risperidone, quetiapine, and aripiprazole — issued between July and October 2012. Relevant surveys were received by 147 physicians who wrote prescriptions for 647 patients.
The American Academy of Child and Adolescent Psychiatry (AACAP) advises that kids who haven’t been diagnosed with major mental illness such as schizophrenia but who have other types of behavioral problems, such as aggression, eating disorders, or oppositional defiant disorder, receive treatment with these drugs only after other medications or nonpharmacological therapies are tried.
“Part of our concern is that these medicines may be getting pulled out too early in the treatment planning for things like oppositional behavior, ahead of things like behavioral therapy that could be tried first,” says Rettew, director of the Pediatric Psychiatry Clinic at the University of Vermont Medical Center and the Vermont Center for Children, Youth and Families.
In half of the cases, the results show, doctors veered from the guidelines. The most common problem was not prescribing lab tests to monitor cholesterol and blood-glucose levels before and after the patient began taking the medicine. The AACAP recommends the lab work because of the risk for using these drugs in patients with high cholesterol and diabetes.
Nearly 92 percent of doctors prescribed the drugs under the proper circumstances. While they did try antipsychotics as secondary treatment for aggression and mood instability, they did not prescribe them for low-level problems — for example, to help a child sleep or control temper tantrums, Rettew says.
“I’m not anti-antipsychotics; I just want to make sure they’re used very carefully,” says Rettew. “These findings could help us design a game plan for measures to improve best-practice prescribing.”
Source: University of Vermont
Researchers from Cornell University have found that sad movies are associated with a large increase in popcorn consumption.
Specifically, scientists from the Cornell Food and Brand Lab showed moviegoers watching tearjerkers consumed more popcorn both in the lab and in a mall theater during the Thanksgiving holiday.
As reported in the JAMA Internal Medicine research letter, moviegoers ate 28 percent more popcorn (125 versus 98 grams) when watching the sentimental drama “Love Story” than when watching the comedy “Sweet Home Alabama.”
Analyses of discarded mall movie popcorn in seven cities across the U.S. showed similar results over a Thanksgiving weekend.
After weighing discarded popcorn and counting popcorn boxes, Cornell Food and Brand Lab researchers found that moviegoers who bought popcorn and watched a sad movie, “Solaris,” ate an average of 55 percent more popcorn (127 versus 82 grams) than those watching the more upbeat movie, “My Big Fat Greek Wedding.”
If you love tearjerkers, don’t despair: You can use the movie genre to your advantage.
“Sad movies also lead people to eat more of any healthy food that’s in front of them,” said lead author Dr. Brian Wansink. “It’s a quick and mindless way of getting more fruit or veggies into your diet.”
The study complements a recent finding, also by the Cornell Food and Brand Lab, which shows that action and adventure movies also lead television viewers to eat more calories, but only if the foods are within arm’s reach.
“With action movies, people seem to eat to the pace of the movie,” said Aner Tal, Ph.D., a Cornell researcher and co-author. “But movies can also generate emotional eating, and people may eat to compensate for sadness.”
Wansink provides a last piece of advice for dieting movie-lovers, “Keep snacks out of arms reach, ideally leave them in the kitchen and only bring to the couch what you intend to eat. It’s easier to become slim by design than slim by willpower.”
Source: Cornell University/EurekAlert
Children with dyslexia must be diagnosed early and given treatment as soon as possible, say experts. The current state of dyslexia research and treatment are discussed by Robin L. Peterson, Ph.D., and Bruce F. Pennington, Ph.D., of the University of Denver, in a seminar article in the Lancet.
They explain that dyslexia involves slow and inaccurate word recognition, although comprehension is normal. Those affected do not tend to have intellectual impairments or sensory problems.
It affects about seven percent of the population, with boys being about twice as likely to be diagnosed with the condition as girls. But this discrepancy is partly due to a higher rate of comorbid conditions such as attention-deficit/hyperactivity disorder (ADHD) in boys.
About a quarter of children with dyslexia will also have math disabilities, “thus, many students with dyslexia can be expected to struggle broadly in school and have more than a specific reading disability,” say the authors.
They report that much progress has been made on the behavioral, neuropsychological, and neurobiological aspects of dyslexia and its causes. This shows that dyslexia “is characterized by dysfunction of the normal left hemisphere language network.” Rather than essentially being a problem of visual word recognition, it is now mostly believed that dyslexia involves problems processing sounds when reading.
Since the previous Lancet review on dyslexia in 2004, “the main advance has been the identification of six candidate genes and studies of their role in brain development,” say the experts. Four of these genes appear to control brain development in the fetus, they add.
The evidence shows that all six genes may interact with the environment to determine whether dyslexia is triggered.
But “like all behaviorally defined disorders, the cause of dyslexia is multifactorial and is associated with multiple genes and environmental risk factors,” write the authors. Despite the efforts so far, “much work remains to be done to fully understand the causes of dyslexia and to improve the lives of children who struggle to learn to read,” they add.
Most children are still only diagnosed after having serious difficulties in school, when it is much harder for them to master new skills. However, common coexisting conditions such as ADHD, language impairment, and speech sound disorder are likely to be apparent much earlier, and could indicate a child’s risk of reading problems.
“Professionals should not wait until children are formally diagnosed with dyslexia or experience repeated failures before implementation of reading treatment, because remediation is less effective than early intervention,” said the authors.
In terms of treatment, “the best interventions provide intensive, explicit instruction in phonological awareness, the alphabetic principle and phonics, word analysis, reading fluency, and reading comprehension,” says the team.
It seems to be easier to treat accuracy problems than fluency problems, they report, “perhaps in part because fluency is so dependent on reading experience, which varies dramatically by reading level.”
And there is evidence that fluency problems can be prevented by intervention in kindergarten and first grade. “An important conclusion is that professionals should not wait until children are formally diagnosed with dyslexia or experience repeated failures before implementing reading treatment,” they write.
Furthermore, research indicates that intervention is most effective on a one-to-one basis or in a small group setting. “Many effective treatments are low-cost, which further draws attention to the importance of early identification, prevention, and treatment of dyslexia for public health.”
About half of children treated successfully will show a benefit for at least one to two years, and in the long term, children and adults with greater language skills will show the most benefit. Alternative therapies for dyslexia “either lack sufficient evidence or have been shown to be ineffective,” and should not be recommended to children and families.
The experts conclude, “Further research is needed to reveal further undiscovered genes that may contribute to dyslexia, to identify which gene locations are shared and not shared with comorbid disorders, including ADHD, and to examine the effects of environmental risk factors such as the language and pre-literacy environments that parents provide for their children.”
Nevertheless, they point out, “Of all the neurodevelopmental disorders, dyslexia has been the most studied and is the best understood, and there has been considerable progress over the last five years in understanding dyslexia’s cross-cultural manifestation, etiology, neuropsychology, and neurobiology.”
Developmental dyslexia. Peterson, R. L. and Pennington, B. F. The Lancet, 17 April 2012 doi:10.1016/S0140-6736(12)60198-6
New research suggests women who believe they have control over life circumstances and have strong social support experience better psychological recovery after an assault.
Investigators studied 159 women who had been exposed to at least one assault-related, potentially traumatic event. They found that 30 percent developed major depressive disorder and 21 percent developed post-traumatic stress disorder.
Researchers attribute the development of depression to self-blame — a common factor among survivors of assault.
Investigators also found that mastery, or the degree to which an individual perceives control and influence over life circumstances, and social support, mitigated psychological damage.
Specifically, women who displayed mastery did not develop a trauma-related psychiatric disorder after assault exposure, while mastery and post-traumatic growth were related to psychiatric recovery. These factors, however, were less established in women with a current psychiatric disorder.
The study, found in the journal Brain and Behavior, has significance for the health and well-being of women, and for identifying individuals who are most in need of resilience-promoting interventions.
“Women exposed to assault may present with post-trauma depression in lieu of post-traumatic stress disorder. Resilience factors like mastery and social support may attenuate the deleterious effects of an assault,” said lead author Heather L. Rusch.
“The next step is to determine the extent that these factors may be fostered through clinical intervention.”
New research finds that highly anxious people have more trouble deciding how best to handle life’s uncertainties.
Experts say the anxiety can lead to off-based or unfounded beliefs. For example, individuals may interpret a lovers’ tiff as a doomed relationship or a workplace change as a career threat.
The behavior is especially problematic when individuals are faced with uncertainty. Scientists at the University of California, Berkeley, and the University of Oxford found that people prone to high anxiety have a tougher time reading the environmental cues that could help them avoid a bad outcome.
Their findings, published in the journal Nature Neuroscience, hint at a glitch in the brain’s higher-order decision-making circuitry. Researchers believe that this “flaw” could eventually be targeted in the treatment of anxiety disorders, which affect some 40 million American adults.
“Our results show that anxiety may be linked to difficulty in using information about whether the situations we face daily, including relationship dynamics, are stable or not, and deciding how to react,” said study lead author Dr. Sonia Bishop, an assistant professor of psychology at University of California, Berkeley.
“It’s a bit like being Alice in Wonderland, trying to work out if the same rules apply or if everything is different and if so, what choices you should make,” she added.
For example, a friend may suddenly lash out for no discernible reason. That friend’s behavior could reflect a typical variation in their day-to-day mood or interactions or, more dramatically, an underlying change in their relationship with you.
The challenge for a person prone to anxiety is assessing the situation in context of what else has happened recently and responding appropriately.
Bishop and fellow researchers used decision-making tasks, behavioral and physiological measurements, and computational models to gauge the probabilistic decision-making skills of 31 young and middle-aged adults whose baseline anxiety levels ranged from low to extreme.
Probabilistic decision-making requires using logic and probability to handle uncertain situations, drawing conclusions from past events to determine the best choice.
“An important skill in everyday decision-making is the ability to judge whether an unexpected bad outcome is a chance event or something likely to reoccur if the action that led to the outcome is repeated,” Bishop said.
The researchers’ measures also included eye-tracking to detect pupil dilation, an indicator that the brain has released norepinephrine, which helps send signals to multiple brain regions to increase alertness and readiness to act.
Participants were asked to play a computerized “two-armed bandit-style” game in which they repeatedly chose between two shapes, one of which, if selected, would deliver a mild to moderate electrical shock.
To avoid getting shocked, participants needed to keep track of the shape that most frequently delivered electrical jolts.
During one part of the game, the shock-delivering shape did not change for a long stretch of time. However, during another part of the game, it changed more frequently.
Highly anxious people had more trouble than their less anxious counterparts adjusting to this and thus avoiding shocks.
“Their choices indicated they were worse at figuring out whether they were in a stable or erratic environment and using this to make the best choices possible,” Bishop said.
Also weaker in highly anxious participants was their pupil response to receiving a shock (or not) during the erratic phase of the game.
Typically, our pupils dilate when we take in new information, and this dilation increases in volatile environments. Smaller pupils suggested a failure to process the rapidly changing information that was more prevalent during the erratic phase of the game.
“Our findings help explain why anxious individuals may find decision-making under uncertainty hard as they struggle to pick up on clues as to whether they are in a stable or changing situation,” Bishop said.