Tri-County Services

In The News

Syndicate content
Psychology, psychiatry and mental health news and research findings, every weekday.
Updated: 3 hours 7 min ago

Helping Kids with Autism Without Behavioral Meds, Restraints in ER

Thu, 12/13/2018 - 6:22am

A new emergency department (ED) care model reduces the use of medication given to kids with autism spectrum disorders (ASD) who are prone to stress and sensory overload in this care setting.

The innovative care model was developed by Nemours Children’s Hospital in Orlando, Florida. Information about this model was recently presented at the 2018 Institute for Healthcare Improvement’s National Forum in Orlando.

“Our program was designed to help prevent escalation of anxiety and agitation in children with ASD, therefore leading to the reduced use of sedatives and restraints,” said Cara Harwell, A.R.N.P., C.P.N.P., P.M.H.S., lead researcher and a nurse practitioner at Nemours Children’s Hospital.

“Sedative medications do have side effects, and if we can manage kids’ stress in other ways, we create a better experience for them and their families.”

In their evaluation of the program, Harwell and her colleagues reviewed two years of electronic health records and found 860 pediatric ED visits in which this model, known as the REACH (Respecting Each Awesome Child Here) Program, was used for patients with ASD or similar conditions.

With the REACH approach, fewer than 6 percent of these patients needed an anxiolytic (anxiety medication). None needed an antipsychotic (for aggressive behavior) or an alpha-agonist (for hyperactivity and anxiety). Fewer than one percent needed physical restraints.

“The noise and pace of the ED environment can greatly increase stress for children with ASD, leading to the need for medications or restraints to help manage irritability, anxiety or harmful behavior. Avoiding these stimuli provides better, more positive care experiences for these kids,” said Harwell.

There is little comparative research, but one study, not using the REACH model, found that sedation or restraints were used in nearly one-fourth of ED visits by children and adults with ASD.

The REACH Program, now in its third year, accommodates children with ASD, sensory disorders, mental health disorders and similar conditions. Staff receive ongoing training regarding ASD, REACH concepts, procedure planning, and recognizing and managing anxiety and agitation. Distraction objects and rewards are placed throughout the ED, which includes a sensory-friendly exam room.

Harwell, along with Emily Bradley, M.A., developed and instituted the program at Nemours Children’s Hospital, which was one of the first in the nation to adapt care to the needs of children in the ED.

Patient satisfaction survey results reveal the program has led to improved patient experiences and a survey of providers found improved comfort and knowledge for treating children with ASD.

Source: Nemours

 

Sleep Loss Can Hike Anger When Frustrated

Wed, 12/12/2018 - 10:15pm

New research shows that losing just a couple hours of sleep at night can leave you with a short fuse. That anger in turn can make  it more difficult to deal with frustrating or annoying circumstances.

Other studies have shown a link between sleep and anger, but questions remained about whether sleep loss was to blame or if anger was responsible for disrupted sleep, said Dr. Zlatan Krizan, professor of psychology at Iowa State.

“Despite typical tendencies to get somewhat used to irritating conditions – an uncomfortable shirt or a barking dog – sleep-restricted individuals actually showed a trend toward increased anger and distress, essentially reversing their ability to adapt to frustrating conditions over time. No one has shown this before,” Krizan said.

Study participants were randomly split into two groups: one maintained their normal sleep routine and the second restricted their sleep by two to four hours each night for two nights. Those who maintained averaged almost seven hours of sleep a night, while the restricted group got about four and a half hours each night. The difference reflects sleep loss we regularly experience in everyday life, Krizan said.

To measure anger, Krizan and Garrett Hisler, an ISU doctoral student in psychology, had participants come to the lab – before and after the sleep manipulation – to rate different products while listening to brown noise (similar to the sound of spraying water) or more aversive white noise (similar to a static signal).

Krizan says the purpose was to create uncomfortable conditions, which tend to provoke anger.

“In general, anger was substantially higher for those who were sleep restricted,” Krizan said.

“We manipulated how annoying the noise was during the task and as expected, people reported more anger when the noise was more unpleasant. When sleep was restricted, people reported even more anger, regardless of the noise.”

It is well established that sleep loss increases negative emotions, such as anxiety and sadness, and decreases positive emotions, such as happiness and enthusiasm, Krizan said. He and Hisler measured these effects to more generally understand the relationship between sleep, anger and emotions.

Krizan says they found sleep loss to uniquely impact anger, and not just result from feeling more negative in that moment.

The researchers also tested whether subjective sleepiness explained more intense feelings of anger. Sleepiness accounted for 50 percent of the experimental effect of sleep restriction on anger, suggesting individuals’ sense of sleepiness may point to whether they are likely to become angered, Krizan said.

To demonstrate whether the experimental evidence in the lab extends to daily life, Krizan and Anthony Miller, an ISU doctoral student, are working on a separate study analyzing data from 200 college students who kept a sleep diary for a month. Krizan says each day students recorded their sleep and rated feelings of anger.

The initial results show students consistently reported more anger than what is typical for them on days when they got less sleep than usual.

Based on the results, Krizan and Miller are now collecting data to test if sleep loss causes actual aggressive behavior toward others.

The study appears in the Journal of Experimental Psychology: General.

Source: Iowa State University

Many Vets For Reduced Gun Access in Times of High Suicide Risk

Wed, 12/12/2018 - 6:30am

A new survey of veterans who receive mental health care through the Veterans Health Administration finds that 93 percent would approve of the VA offering at least one option to address firearm access.

Reduced access might involve having health care providers ask about veterans’ access to firearms, providing gun locks, or teaching veterans’ family and friends about suicide warning signs and firearm safety.

In general, veterans are 22 percent more likely to die from suicide than members of the general U.S. population of the same age and gender. Approximately 20 American veterans die by suicide each day — and most of them use a firearm.

The survey focused on the attitudes and views of the veterans most at risk of suicide: those already in treatment for mental health conditions, including drug and alcohol problems.

The findings show that more than 68 percent of those surveyed would be in favor of the VA offering gun locks to veterans who have firearms at home. A total of 82 percent thought that there were situations where VA clinicians needed to ask veterans about their firearm access, and only seven percent opposed all such screening.

Three-quarters of surveyed veterans also favored at least one more-intensive effort by the VA to work with patients to voluntarily reduce their firearm access, such as efforts to store or dispose of veterans’ guns, or to help families secure veterans’ guns or gun lock keys.

The survey of 660 veterans polled at five VA centers around the country was led by Marcia Valenstein, M.D., M.S., of the University of Michigan and the VA Ann Arbor Healthcare System.

“Veterans in mental health care are in favor of voluntary programs to reduce firearm access during high-risk periods. This suggests the VA and other health systems should consider working with veterans to develop and implement these programs,” says Valenstein, a professor emerita in the University of Michigan (U-M) Department of Psychiatry and member of the U-M Institute for Healthcare Policy and Innovation and the VA Center for Clinical Management Research.

What’s more, she adds, “Half of veterans in mental health care indicated if they were suicidal, they would participate in interventions that would substantially limit their own access to their firearms.”

The higher rate of gun ownership among veterans, compared with non-veteran Americans, is linked to the higher rate of suicide, say the authors. More than 45 percent of the veterans surveyed said they had a firearm in their own home, and they were somewhat less likely than non-firearm owners to support the measures discussed in the survey.

Even so, 82 percent said they would be willing to take part in some sort of program that addressed their access to firearms, and two out of three of them said they might or would be open to the VA offering storage and disposal options that might limit their access to those guns during times when they might be at greater suicide risk.

“Voluntarily reducing access to these firearms during high-risk periods for suicide, such as periods of increased mental health symptoms, after serious personal setbacks, or particularly at times when suicidal thoughts or plans emerge, may reduce veteran deaths,” says Valenstein.

Valenstein worked with colleagues from U-M, Northeastern University and West Virginia University on the study, including Matthew Miller, M.D., M.P.H., Sc.D. of Northeastern’s Bouvé College of Health Sciences, who has studied firearm-related attitudes and practices among veterans and other groups.

The survey findings are published in the journal General Hospital Psychiatry.

Source: Michigan Medicine- University of Michigan

Online CBT Shown To Be Effective Even for Severe Depression

Wed, 12/12/2018 - 6:00am

New research bolsters the claim that a series of self-guided, Internet-based cognitive-behavioral therapy (CBT) platforms can reduce depression.

The study, published in the Journal of Medical Internet Research, is the first to examine whether the effects of these treatments were inflated by excluding patients with more severe depression or additional conditions such as anxiety or alcohol abuse.

Indiana University psychologists reviewed 21 pre-existing studies with a total of 4,781 participants, focusing on applications that provide treatment with CBT, a form of psychotherapy that focuses on changing thought patterns and behavior to alleviate symptoms of depression and other mental disorders.

Study leader Dr. Lorenzo Lorenzo-Luaces, a clinical professor, said that in the past several years, many Internet-based apps and websites have made claims to treat depression. IU researchers specifically studied interventions that provided treatment with cognitive-behavioral therapy, a form of psychotherapy that focuses on changing thought patterns and behavior to alleviate symptoms of depression and other mental disorders.

Previous studies had examined the effectiveness of individual internet-based cognitive behavioral therapy apps, or iCBT, using a range of methods.

“Before this study, I thought past studies were probably focused on people with very mild depression, those who did not have other mental health problems, and were at low risk for suicide,” Lorenzo-Luaces said. “To my surprise, that was not the case. The science suggests that these apps and platforms can help a large number of people.”

For Lorenzo-Luaces, iCBT apps are an important new tool for addressing a major public health issue: Individuals with mental health disorders like depression far outnumber the mental health providers available to treat them.

“Close to one in four people meet the criteria for major depressive disorder,” he said. “If you include people with minor depression or who have been depressed for a week or a month with a few symptoms, the number grows, exceeding the number of psychologists who can serve them.”

People with depression are also expensive for the health care system, he added.

“They tend to visit primary-care physicians more often than others,” Lorenzo-Luaces said. “They have more medical problems, and their depression sometimes gets in the way of their taking their medication for other medical problems.”

By conducting a “meta-regression analysis” of 21 studies, Lorenzo-Luaces and collaborators decisively determined that Internet-based therapy platforms effectively alleviate depression.

A central question was determining whether previous studies distorted the strength of these systems’ effects by excluding people with severe depression.

The conclusion was that the apps worked in cases of mild, moderate and severe depression.

Many of the studies in the analysis compared use of iCBT apps to placement on a wait list for therapy or the use of a “fake app” that made weak recommendations to the user. In these cases, the iCBT apps worked significantly better.

“This is not to say that you should stop taking your medication and go to the nearest app store,” added Lorenzo-Luaces, who said both face-to-face therapy and antidepressants may still prove to be more effective than the iCBT apps alone.

“People tend to do better when they have a little bit of guidance,” he said. But he added that a 10- to 15-minute check-in may be sufficient for many people, freeing health care providers to see more patients.

App-based therapy also has an advantage in situations where access to face-to-face therapy is limited due to logistical barriers, such as long distances in rural areas or inflexible work schedules.

“iCBT apps take the methods we have learned and make them available to the many people who could benefit from them,” Lorenzo-Luaces said. “It’s an exciting development.”

Source: Indiana University

Younger Sibs of Kids with Autism or ADHD May Be At Higher Risk

Tue, 12/11/2018 - 6:30am

Emerging research suggests later-born siblings of children with autism spectrum disorder or attention-deficit/hyperactivity disorder are at elevated risk for both disorders. The University of California, Davis, study suggests that families who already have a child diagnosed with ASD or ADHD may wish to monitor younger siblings for symptoms of both conditions.

The study, led by Dr. Meghan Miller, assistant professor in the Department of Psychiatry and Behavioral Sciences and at the UC Davis MIND Institute, appears in JAMA Pediatrics.

Symptoms of ADHD include difficulty focusing, nonstop talking or blurting things out, increased activity, and trouble sitting still.

Symptoms of ASD include significant challenges with social interaction and communication, as well as the presence of unusual interests or repetitive behaviors like hand flapping or lining up objects.

“We’ve known for a long time that younger siblings of children with autism are at higher-than-average risk for autism, but the field didn’t have adequate data to tell whether they were at increased risk for ADHD,” said Miller.

“Despite the fact that autism and ADHD appear very different in their descriptions, this work highlights the overlapping risk; younger siblings of children with ASD are at elevated risk of both ADHD and autism, and younger siblings of children with ADHD are at elevated risk not only for ADHD, but also for autism.”

Miller’s research team looked at medical records of 730 later-born siblings of children with ADHD, 158 later-born siblings of children with ASD, and 14,287 later-born siblings of children with no known diagnosis. Only families who had at least one younger child after a diagnosed child were included in the study.

“Evaluating recurrence risk in samples that include only families who have had an additional child after a diagnosed child is important because recurrence may be underestimated if researchers include families who decided to stop having children after a child was diagnosed with ASD or ADHD,” explained Miller.

In the study, investigators discovered the odds of an ASD diagnosis were 30 times higher in later-born siblings of children with ASD. It was 3.7 times higher for a diagnosis of ADHD, as compared to later-born siblings of children not diagnosed with ASD.

Among later born siblings of children with ADHD, the odds an ADHD diagnosis were 13 times higher in later-born siblings of children. The odds of an ASD diagnosis were 4.4 times higher, as compared to later-born siblings not diagnosed with ADHD.

ADHD and ASD are believed to share some genetic risk factors and biological influences. This study supports the conclusion that ASD and ADHD are highly heritable and may share underlying causes and genetics.

Researchers believe the development of reliable recurrence risk estimates of diagnoses within the same disorder and across other disorders can aid screening and early-detection efforts. Moreover, the linkage can enhance understanding of potential shared causes of the disorders. The ability to diagnose ASD and ADHD early could improve both treatment and quality of life.

“There are reliable screening measures and practices for the diagnosis of autism in very young children,” Miller said.

“Unfortunately, we don’t have any clinical standards or adequate tools for screening for ADHD at such young ages. We are currently working on identifying early markers of autism and ADHD in infants and toddlers who have an older diagnosed sibling, since these younger siblings are at elevated risk for ASD and ADHD.”

Source: UC, Davis

Early Life Career Choices May Impact Personality Years Later

Tue, 12/11/2018 - 6:00am

New research published in the journal Psychological Science suggests that early life career choices may influence personality traits years later.

The study focused on 16-year-old students in the state of Baden-Wurttemberg, Germany, who are given the choice of either staying in school to pursue an academic career or enrolling in a vocational training program.

“We wanted to understand whether choosing different career paths would result in different patterns of personality development,” said University of Illinois psychology professor Dr. Brent Roberts, who led the study with researchers from the University of Tubingen in Germany.

“We know from our prior research that entering the labor market is associated with increases in personality traits like conscientiousness and emotional stability,” Roberts said. “But we seldom have the opportunity to compare groups of people at the same age who choose different paths.”

The researchers observed two groups of 16-year-olds in Baden-Wurttemberg. The first group chose to enter apprenticeships or other vocational training programs, and the second group stayed in school and entered the labor market after completing higher education.

At the beginning of the research, and again six years later, the study participants rated themselves on multiple measures that included personality traits and vocational interests. The team used a technique called propensity score matching to align the traits of the two groups of participants.

“In this approach, you do everything you can to equate the two groups at the start of the study,” said study co-author Dr. Ulrich Trautwein, of the University of Tubingen. “This approximates an experimental design that tries to equate groups through random assignment. Many social scientists believe this method allows you to make stronger causal inferences from correlational data.”

The findings reveal that, after six years, self-reported conscientiousness increased more among those who pursued vocational training and employment than their peers in academia. Those on the vocational track also expressed less interest in engaging in scientific, business or entrepreneurial activities.

“This means that those who didn’t continue their education were losing interest in jobs that normally are fostered by going to college,” Roberts said.

The new findings add to the growing evidence that personality is not immutable, but continues to change throughout life, Roberts said. The changes are often subtle, but meaningful. The study suggests many of those changes are the result of one’s life choices.

“This study provides the strongest evidence we have yet that the path you choose may change your personality,” Roberts said.

Source: University of Illinois at Urbana-Champaign

Mom’s Stress at Conception Tied to Child’s Later Stress Response

Mon, 12/10/2018 - 10:53am

A mother’s stress levels around the time of conception may be linked to the way her child responds to life challenges at age 11, according to a new Canadian study published in the Journal of Developmental Origins of Health and Disease.

Researchers from Simon Fraser University (SFU) in British Columbia measured cortisol levels in mothers-to-be, beginning before pregnancy and continuing through the first eight weeks of gestation, and then years later in their children. The aim of the study was to understand the link between a mother’s biological stress around the time of conception and the development of her child’s stress physiology.

Using urine samples to measure reproductive hormones, the researchers were able to pinpoint the day the children were conceived, as well as the moms’ cortisol levels — a biomarker of physiological stress — during the first eight weeks after conception.

Twelve years later, the researchers looked at how the children reacted to the start of a new school year (a well known “natural” stressor) and to a public-speaking challenge (a frequently used “experimental” stressor).

Maternal cortisol following conception was tied to different facets of the children’s cortisol responses to those challenges, and many of these associations differed between boys and girls.

Study lead author Cindy Barha, Ph.D., said that sons of mothers who had higher cortisol in gestational week two had higher cortisol reactions to the experimental public-speaking challenge, but this link was not found in daughters.

In contrast, mothers with higher cortisol in gestational week five had daughters with higher basal (baseline or bottom layer) cortisol before the start of a new school term, but not sons.

However, both sons and daughters had higher cortisol responses to the start of a new school year, as well as to the experimental public speaking challenge, if their mothers had higher cortisol during gestational week five.

The biological mechanisms behind these associations are not yet clear, but are likely to involve genetics and epigenetics as well as environmental and cultural factors shared by moms and their children.

“Stress plays a critical role not only in children’s ability to respond to social and academic challenges, but also in their development and health as adults,” said SFU health sciences professor Dr. Pablo Nepomnaschy, leader of the research team.

The team will continue researching the association between the stress levels of both mother and child from the moment of conception forward. The findings can help develop successful programs and interventions that prepare children to live healthy and fulfilling lives and realize their full potential.

Source: Simon Fraser University

 

 

Aging Research May Hold Key to New Alzheimer’s Treatments

Mon, 12/10/2018 - 7:00am

A full review of Alzheimer’s drug research, including current agents being studied for the prevention and treatment of the disease (and other dementias), emphasizes the need to develop and test drugs based on an understanding of the multiple effects of aging on the brain.

“Alzheimer’s is a complex disease with many different factors that contribute to its onset and progression,” said Dr. Howard Fillit, founding executive director and chief science officer of the Alzheimer’s Drug Discovery Foundation (ADDF), senior author of the review paper.

“Decades of research have revealed common processes that are relevant to understanding why the aging brain is vulnerable to Alzheimer’s disease. New therapeutics for Alzheimer’s disease will come from this understanding of the effects of aging on the brain.”

Old age is the leading risk factor for Alzheimer’s disease, a progressive neurodegenerative disease that affects 50 million people worldwide and around 5 million in the United States. With a growing aging population, the Centers for Disease Control and Prevention projects the burden of Alzheimer’s disease will nearly triple to 14 million Americans by 2060.

Currently, the approved drugs for Alzheimer’s disease are able to relieve some symptoms, but they do not stop disease progression. New treatments that can prevent, slow, or halt the disease are urgently needed to help the millions of people affected by dementia worldwide.

According to Fillit, the biology of aging itself provides numerous novel targets for new drug development for Alzheimer’s disease.

Along with old age, many biological processes go awry that have also been implicated in Alzheimer’s disease. For example, as people get older, they are more likely to have chronic systemic inflammation and neuroinflammation, which is linked to poor cognitive function.

Other aging problems include impaired clearance of toxic misfolded proteins, mitochondrial and metabolic dysfunctions (associated with diabetes), vascular problems, epigenetic changes (changes in gene regulation without alterations in the DNA sequence), and loss of synapses (points of communication between neurons).

“Our success in fighting Alzheimer’s disease will likely come from combination therapy — finding drugs that have positive effects on the malfunctions that happen as people age,” Fillit said.

“Combination therapies are the standard of care for other major diseases of aging, such as heart disease, cancer, and hypertension, and will likely be necessary in treating Alzheimer’s disease and other dementias.”

Later-phase (phase 3) Alzheimer’s trials tend to focus on drugs targeting beta-amyloid and tau, the classic pathological hallmarks of Alzheimer’s disease (of phase 3 trials, 52 percent are targeting amyloid or tau), but other strategies are gaining ground and are in phase 1 or 2 trials, according to the review paper.

Although therapeutic attempts to remove or decrease the production of beta-amyloid have been largely unsuccessful in altering the disease course of Alzheimer’s disease, said Fillit, researchers still learned important information from those clinical trials even if they didn’t immediately result in treatments. And recent clinical trials suggest that problems with clearance of beta-amyloid may yet prove fruitful.

“It is currently not known if these classic pathologies (amyloid and tau) represent valid drug targets and if these targets alone are sufficient to treat Alzheimer’s disease,” said Fillit.

“Targeting the common biological processes of aging may be an effective approach to developing therapies to prevent or delay age-related diseases, such as Alzheimer’s.”

Source: Alzheimer’s Drug Discovery Foundation

Brain Alterations May Help Explain Why Some Kids are More Resilient

Mon, 12/10/2018 - 6:00am

A new study sheds light on the mystery of why some children are more vulnerable to the effects of maltreatment — a major risk factor for psychiatric complications including anxiety, depression, addiction and suicide — and others seem more resilient.

Researchers at McLean Hospital of Harvard Medical School found that while many young adults with a history of child abuse exhibit brain network abnormalities, those who do not go on to develop psychiatric symptoms actually show more alterations.

The findings, published in the journal Biological Psychiatry, suggest these additional changes may help compensate for the effects of maltreatment.

“These are important findings as they provide a radically new perspective on resilience,” said lead author Kyoko Ohashi, PhD. “Maltreated individuals without psychiatric symptoms are not unaffected or immune. Rather, they have additional brain changes that enable them to effectively compensate.”

For the study, the research team created models of brain networks in 342 young adults — over half of whom had experienced maltreatment as a child — by tracing pathways of connections throughout the brain.

“We found that susceptible and resilient emerging adults with childhood maltreatment had the same abnormalities in brain network organization. Interestingly, resilient individuals had additional abnormalities in specific brain regions that reduced their susceptibility to different types of psychiatric symptoms, and this information was able to reliably predict whether individuals were not maltreated or were susceptible or resilient,” said Ohashi.

These additional abnormalities in resilient adults appeared to decrease the efficiency of information transfer in brain regions likely altered by maltreatment and that are involved in psychiatric symptoms, like pain, stress, depression and anxiety.

“This study highlights that resilience is an active process that is associated with its own alterations in brain function over and above the negative effects of stress,” said John Krystal, M.D., editor of Biological Psychiatry.

“The observation that the illness-related network changes are present in the resilient individuals may help to explain why some individuals have periods of both vulnerability and resilience after traumatic stress exposure.”

“We wonder whether these additional changes in connectivity are the causes, consequences, or both causes and consequences of resilience.”

Source: Elsevier

 

 

New Drug Shown to Ease Pot Withdrawal, Lessen Use

Sun, 12/09/2018 - 7:00am

A new drug can help people diagnosed with cannabis use disorder reduce withdrawal symptoms and marijuana use, according to a new study.

According to recent national data, approximately one-third of all current cannabis users meet the diagnostic criteria for cannabis use disorder.

The double-blind, placebo-controlled study shows marijuana use declined among subjects who were administered the new drug — a fatty acid inhibitor that acts upon endocannabinoid metabolic receptors in the brain — compared to those receiving a placebo, according to researchers at Yale University.

Subjects who took the drug also reported fewer withdrawal symptoms and exhibited better sleep patterns, which are disrupted in cannabis-dependent individuals attempting to quit, the researchers discovered.

“With an increase of marijuana legalization efforts, it is reasonable to expect an increase in demand for treatment, and right now we don’t have any medications to help individuals trying to quit,” said Dr. Deepak Cyril D’Souza, a professor of psychiatry at Yale and corresponding author of the study.

Cannabis use becomes a disorder when the person cannot stop using the drug even though it interferes with many aspects of his or her life. Cannabis use disorder (CUD) is marked by social and functional impairment, risky use, tolerance, and withdrawal symptoms, according to DSM-5, the statistical manual of mental health disorders developed by the American Psychiatric Association.

Withdrawal symptoms are marked by cravings for marijuana, irritability, anger, depression, insomnia and a decrease in appetite and weight.

In 2015, about 4 million people in the United States met the diagnostic criteria for a cannabis use disorder, and almost 150,000 voluntarily sought treatment for their cannabis use.

Today, it is estimated that 33 percent of all current cannabis users meet the diagnostic criteria for CUD.

For the new study, the Yale researchers recruited males who use cannabis daily. Seventy subjects completed the trial, with 46 receiving the drug and the remainder receiving placebo.

All subjects in the study underwent forced withdrawal on the inpatient research unit for the first week and continued receiving treatment for three weeks as outpatients after their release from the hospital, the researchers explained.

A reduction in cannabis use was confirmed by both self-report and urine drug testing, they add.

Researchers have tried many different drugs in an attempt to reduce cannabis withdrawal symptoms and increase abstinence in those trying to quit, but none have been consistently successful or well-tolerated, D’Souza said.

The new drug works by inhibiting fatty acid amide hydrolase (FAAH), the enzyme that degrades anandamide, a brain chemical that acts on brain cannabis receptors. Anandamide is an endocannabinoid present in the human body that is produced naturally by the brain.

“Anandamide is to cannabis as endorphins are to heroin,” D’Souza said.

A larger multicenter trial of the new drug funded by the U.S. National Institute of Drug Abuse is currently underway.

The study was published in the journal Lancet Psychiatry.

Source: Yale University

Narcissists May Be Less Likely to Support Democracy

Sun, 12/09/2018 - 6:00am

A new study suggests that narcissistic people are less likely to support democracy.

They are also more likely to feel that democracies are not good in maintaining order, or that it would be better if countries were run by strong leaders or the military, say researchers from the University of Kent in England and the Polish Academy of Sciences.

This is probably because narcissists tend to feel entitled and superior to others, which results in lower tolerance of diverse political opinions, the researchers note.

In contrast, people who take a positive, non-defensive self-view and trust others are more likely to show support for democracy, according to the study’s findings.

The study consisted of two parts that analyzed the relationship between different types of self-evaluation — narcissism and self-esteem — and support for democracy in the United States and Poland.

The researchers, led by Dr. Aleksandra Cichocka of Kent’s School of Psychology, and Dr. Marta Marchlewska of the Polish Academy of Sciences, set out to understand the psychological mechanisms driving support for democracy. They built on previous research that demonstrated that basic personality traits can predict broader opinions about the organization of the social world.

“The jury is out on whether the new generations are becoming more narcissistic than previous ones, but it is important to monitor how societal changes can affect the self,” said Cichocka.

“We need to make sure we are not fostering feelings of entitlement or expectations of special treatment. In the end, these processes may have important implications for our social and political attitudes.”

The study was published in the British Journal of Social Psychology.

Source: University of Kent

Infections In Childhood Linked to Increased Risk of Mental Disorders

Sat, 12/08/2018 - 6:39pm

A new study shows that fevers, sore throats and infections during childhood can increase the risk of also suffering from a mental disorder as a child or adolescent.

According to researchers, the study’s findings expand the understanding of the role of the immune system in the development of mental disorders.   

For the study, researchers followed all children born in Denmark between Jan. 1, 1995, and June 20, 2012, totaling more than 1 million children.

The researchers looked at all infections treated from birth and also at the subsequent risk of childhood and adolescent psychiatric disorders.

“Hospital admissions with infections are particularly associated with an increased risk of mental disorders, but so too are less severe infections that are treated with medicine from the patient’s own general practitioner,” said Dr. Ole Köhler-Forsberg from Aarhus University and Aarhus University Hospital’s Psychoses Research Unit.

The study showed that children who had been hospitalized with an infection had an 84 percent increased risk of suffering a mental disorder and a 42 percent increased risk of being prescribed medicine to treat mental disorders.

Furthermore, the risk for a range of specific mental disorders was also higher, including psychotic disorders, OCD, tics, personality disorders, autism and ADHD, according to the study’s findings.   

“This knowledge increases our understanding of the fact that there is a close connection between body and brain and that the immune system can play a role in the development of mental disorders,” he said. “Once again research indicates that physical and mental health are closely connected.”

“We also found that the risk of mental disorders is highest right after the infection, which supports the infection to some extent playing a role in the development of the mental disorder,” he added.

The study’s findings could have importance for further studies of the immune system and the importance of infections for the development of a wide range of childhood and adolescent mental disorders, according to the researchers.

“The temporal correlations between the infection and the mental diagnoses were particularly notable, as we observed that the risk of a newly occurring mental disorder was increased by 5.66 times in the first three months after contact with a hospital due to an infection and were also increased more than twofold within the first year,” said research director Dr. Michael Eriksen Benrós from the Psychiatric Centre Copenhagen at Copenhagen University Hospital.    

Benrós, the senior researcher on the study, added that it first and foremost corroborates the increasing understanding of how closely the body and brain are connected.

The study was published in JAMA Psychiatry.

Source: Aarhus University

Nursing Home Quality May Suffer When Economy is Good

Sat, 12/08/2018 - 6:30am

Quality of care in U.S. nursing homes is more likely to improve during periods of high unemployment and worsen when the economy is good, according to a new study by researchers at Georgetown University Medical Center (GUMC) in Washington, D.C.

The reason is likely tied to how the strength of the economy affects the ability of nursing homes to maintain adequate staffing levels and minimize turnover.

For example, most nursing home residents have cognitive dysfunction or physical impairment, requiring round-the-clock care, and providing this care can be physically and mentally draining. As a result, many nursing homes have a hard time hiring and retaining nurses and nurse aides.

“During economic downturns, many people are willing to take positions with work environments they may not prefer because there aren’t many options,” said the study’s principal investigator, Sean Shenghsiu Huang, Ph.D. “But when the economy is good, there are plenty of employment opportunities and taking a nursing home job may not be that attractive.”

Huang is assistant professor in the Department of Health Systems Administration at GUMC’s School of Nursing & Health Studies.

The study, published in The Gerontologist, is among the first to look at whether fluctuations in business cycles (economic expansions and recessions) affect quality of nursing home care, nursing staff levels and turnover/retention of staff.

The researchers analyzed more than a decade of records. Data from 2001 through 2015 were pulled from several sources, such as state annual recertification of all Medicare- and Medicaid-certified nursing homes (about 15,000 nursing homes), and county-level unemployment rates from the Bureau of Labor Statistics.

These records included two economic expansions and contractions. Statistical models were estimated to determine the effect the unemployment rate had on nursing home quality and staffing outcomes.

The findings show that higher unemployment rates were correlated with a statistically significant improvement in quality of care. Nursing homes were found to be more compliant with health regulations during period of higher unemployment. And nursing home residents, on average, were less likely to have pressure ulcers, be physically restrained, or have significant weight loss — all measures of care quality.

“It is clear from our data that as unemployment rates increased, nursing home quality was higher as fewer residents would develop pressure ulcers, be restrained, and experience weight loss,” Huang said.

“This is likely due to nursing home staff. Higher unemployment rates are linked to higher nursing staff levels. In these recessions, nursing homes were better able to retain their staff and reduce turnover.”

The research team also found that when unemployment rates were low, nursing homes have lower nursing staff levels, higher employee turnover, and lower staff retention rates. Because most care is provided by nurses and nurse aides, keeping an adequate and stable workforce is important for delivering high quality of care.

For example, high turnover of staff inhibits the ability of nursing homes to consistently assign staff to the same resident, a practice that is tied to quality care. Given today’s low unemployment rates, it will be challenging to maintain or even attempt to lower the turnover rates, say the researchers.

“The solution lies with changes to federal and state policy, such as measures to increase reimbursement for nursing home care with the goal of paying staff enough to make these positions attractive,” Huang said.

“In general, the work environment offered by nursing homes are not considered desirable, and this situation, especially in today’s economy, needs to be addressed through better compensation and benefits.”

However, any effort to improve the pay and benefits of nursing home workers would require efforts from federal and state policymakers as nearly three-quarters of nursing home residents are funded by Medicare and Medicaid, he says.

“Policymakers and researchers have long been concerned about nursing home quality, and this study suggests strong action is needed now,” Huang said.

Source: Georgetown University

Study: Masculine Faces Are Seen as More Competent

Sat, 12/08/2018 - 6:00am

People tend to view masculine faces as more competent, according to a new study published in the journal Psychological Science. This correlation is also true for female faces, but only to a certain point, after which more masculine female faces are perceived as less competent.

“Our research sheds light on the pernicious gender bias in how we perceive others — we judge masculine looking people as competent, a judgment that can affect our leadership choices,” said psychology researcher DongWon Oh of Princeton University, a doctoral student and first author of the research.

Oh and coauthors Elinor A. Buck and Dr. Alexander Todorov wanted to identify the “visual ingredients” that influence how we perceive competence based solely on an individual’s appearance.

To do this, they relied on a computational model of competence they had established through previous research. Using participant ratings of several different faces, the team established the parameters that were most reliably associated with impressions of competence. Then they built a model that allowed them to digitally alter face stimuli according to these specific parameters, producing faces that varied in perceived competence.

In one online experiment, the researchers used this model to present a variety of faces to 33 participants. Some participants rated how competent the faces were, while others rated their attractiveness.

The findings reveal that the faces designed to look more competent were rated as such, and they were also rated as more attractive, consistent with the “attractiveness halo” found in previous research.

Still, the researchers suspected there were probably other components of appearance that reflect competence.

“Using the computational methods we developed for visualizing appearance stereotypes, we can literally remove the attractiveness of the competent-looking faces,” says Oh. “We can then test whether ‘competent’ faces still appear competent and inspect what visual properties other than attractiveness drive the competence impressions.”

The results of this new model showed that participants perceived more competent faces as more confident and more masculine, impressions that are not explained by attractiveness.

In another online experiment, the researchers discovered a clear gender bias: When participants were asked to identify faces as either male or female, they tended to rate more competent faces as male and less competent faces as female.

Together, these findings suggest that competence and masculinity are correlated components of first impressions based on appearance.

To determine whether this link works similarly for male faces and female faces, the researchers manipulated photorealistic images of male and female faces so that they varied in masculinity. They randomly assigned 250 online participants to rate the competence of either male faces or female faces.

Again, they found a gender bias in first impressions: As male faces increased in masculinity, so did their perceived competence. For female faces, this correlation only held up to a point, after which more masculine female faces were actually perceived as less competent.

The findings have significant implications as impressions of competence can influence who we choose as our leaders: Research has shown that individuals with more competent-looking faces are more likely to be elected as high-ranking politicians such as U.S. senators and as the heads of large companies.

“Problematically, how competent someone appears does not guarantee their actual competence,” Oh said. “Needless to say, these gender biases pose a threat to social justice, creating unfair environments for everyone.”

The researchers hope to expand on these findings, investigating the origins of this gender bias and how it might be mitigated. In addition, they are looking into whether there are systematic differences in the impressions we have of male and female faces.

Source: Association for Psychological Science

Very Shy People More Likely to Have Anxiety During a Hangover

Fri, 12/07/2018 - 6:15am

Very shy people are more likely to experience “hangxiety” — anxiety during a hangover — compared to their more extroverted peers, according to a new U.K. study conducted by researchers from the University of Exeter and University College London (UCL).

“We know that many people drink to ease anxiety felt in social situations, but this research suggests that this might have rebound consequences the next day, with more shy individuals more likely to experience this, sometimes debilitating, aspect of hangover,” said researcher Dr. Celia Morgan, professor of psychopharmacology at the University of Exeter in England.

“It’s about accepting being shy or an introvert. This might help transition people away from heavy alcohol use. It’s a positive trait. It’s OK to be quiet.”

The study involved nearly 100 social drinkers with either high or low levels of shyness. After drinking around six units of alcohol, very shy people reported a slight decrease in their anxiety levels.  But by the next day, this slight relaxation was replaced by a significant increase in anxiety — a state the researchers refer to as “hangxiety.”

One alcohol unit is measured as 10 milliliters or 8 grams of pure alcohol.

The researchers also found a strong link between this hangxiety in very shy people and higher scores on the AUDIT (Alcohol Use Disorders Identification Test) assessment, which is used to help detect alcohol use disorder.

“These findings also suggest that hangxiety in turn might be linked to people’s chance of developing a problem with alcohol,” said Morgan.

For the study, participants were tested at home and were assigned at random either to drink or to remain sober. Baseline measures of shyness, social phobia and alcohol use disorder were taken at the beginning, and anxiety levels were tested again during the evening and the following morning.

“While alcohol use is actually going down, there are still 600,000 dependent drinkers in the UK,” said first author Beth Marsh, of UCL. “And while statistics show that, overall, people are drinking less, those with lower levels of health and wellbeing — perhaps including people experiencing anxiety — are still often doing so.”

The study is published in the journal Personality and Individual Differences.

Source: University of Exeter

Drawing Is Better Than Writing for Memorizing Information

Fri, 12/07/2018 - 5:30am

Older adults who take up drawing — even when they’re not very good at it — can help boost their memory, according to a new Canadian study published in the journal Experimental Aging and Research.

The findings show that drawing as a method to help retain new information is more effective than re-writing notes, visualization exercises or passively looking at images.

“We found that drawing enhanced memory in older adults more than other known study techniques,” said Melissa Meade, PhD candidate in cognitive neuroscience at the University of Waterloo (UW) in Ontario, Canada.

“We’re really encouraged by these results and are looking into ways that it can be used to help people with dementia, who experience rapid declines in memory and language function.”

In a series of experiments, the researchers asked both young adults and older adults to do a variety of memory-encoding techniques and then tested their recall. Meade conducted the study with Dr. Myra Fernandes, a psychology professor in cognitive neuroscience at Waterloo, and Dr. Jeffrey Wammes.

The researchers believe that drawing can help a person’s memory more than other study techniques because it incorporates several ways of representing the information: visual, spatial, verbal, semantic and motoric.

“Drawing improves memory across a variety of tasks and populations, and the simplicity of the strategy means that it can be used in many settings,” said Fernandes.

As part of the research, the team compared different types of memory techniques designed to help participants mentally retain a set of words.

The volunteers would either encode each word by writing it out, by drawing it, or by listing physical attributes associated with each item. Later on after completing each task, memory was assessed. Both groups showed better retention when they used drawing rather than writing to encode the new information, and this effect was particularly strong in older adults.

Retaining new information typically gets worse as people age, due to deterioration of critical brain structures involved in memory such as the hippocampus and frontal lobes. In contrast, research has shown that visuospatial processing regions of the brain, involved in representing images and pictures, are mostly intact in normal aging, and in dementia.

“We think that drawing is particularly relevant for people with dementia because it makes better use of brain regions that are still preserved, and could help people experiencing cognitive impairment with memory function,” said Meade.

“Our findings have exciting implications for therapeutic interventions to help dementia patients hold on to valuable episodic memories throughout the progression of their disease.”

Source: University of Waterloo

 

Fetal Malnutrition Linked to Early Menopause, Ovarian Failure

Thu, 12/06/2018 - 6:45am

Insufficient nutrition during fetal development may be linked to early menopause and premature ovarian failure, according to a new large-scale study of Chinese women born during the Great Chinese Famine, between 1956 and 1964.

Although several studies have looked at the association between famine exposure in early life and the risk of various metabolic diseases in adulthood, such as type 2 diabetes, the association with reproductive aging has not been thoroughly studied.

Infants are particularly sensitive to changes in their environment while still in the womb, during their earliest stages of development. Prior research has shown that the development of the hypothalamic-pituitary-gonadal axis during the fetal stage plays a critical role in adulthood reproductive health.

For the new study, researchers evaluated nearly 2,900 Chinese women specifically sought to address the effect of early life exposure to famine on age at menopause. All of the study participants had been born during China’s infamous famine occurring between 1956 and 1964.

The findings reveal that prenatal malnutrition is linked to a greater risk of early menopause (age younger than 45 years), as well as a higher risk of premature ovarian failure. Although the study participants were born in China several decades ago, the findings offer valuable insights into the benefits of proper nutrition during early life stages for women of any culture.

“The findings that natural menopause occurs earlier after prenatal famine exposure suggests that food deprivation during early fetal life affects how long the future ovaries function,” said Dr. JoAnn Pinkerton, executive director of The North American Menopause Society (NAMS).

“For those women, if they are not taking estrogen therapy until the average age of menopause, their early menopause could be associated with increased risk of heart disease, osteoporosis, depression, and memory changes and changes in vaginal and sexual health.”

Natural menopause is a milestone of ovarian aging that results in the end of a woman’s reproductive years; it is defined as the absence of periods for at least 12 months. Most women reach menopause between the ages of 45 and 55 (average age is 51).

The new findings are published online in Menopause, the journal of The North American Menopause Society.

Source: The North American Menopause Society

Vitamin D Deficiency May Up Risk of Depression for Older Adults

Thu, 12/06/2018 - 6:16am

A new study by researchers from The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin suggests that a deficiency in vitamin D is associated with a substantial increased risk of depression over a four-year follow-up period.

It is well-recognized that later life depression can significantly reduce quality of life and is a potent risk factor for functional decline, admission to residential care and early death. Moreover, the majority of older adults are undiagnosed given the complex nature of depression.

The findings form part of the largest representative study of its kind and appear in The Journal of Post-Acute and Long-Term Care Medicine (JAMDA).

Vitamin D is essential for bone health and has recently been linked with other non-bone health outcomes such as inflammation and diabetes. Small studies have found links between vitamin D and depression but few have followed up with the same affected people over time, while others have not taken into account other factors that can also affect depression.

These findings are important as researchers discovered that 1 in 8 older Irish adults are deficient in vitamin D.

The current study investigated the links between vitamin D and depression in older Irish adults and then re-examined the participants four years later to see if vitamin D status affected the risk of developing depression.

The authors found that:

• vitamin D deficiency was associated with a 75 percent increase in the risk of developing depression by 4 years;
• this finding remained robust after controlling for a wide range of relevant factors including depressive symptoms, chronic disease burden, physical activity and cardiovascular disease;
• furthermore, excluding participants taking antidepressant medication and vitamin D supplementation from the analyses did not alter the findings.

Researchers believe the findings could be due to the potential direct effect of vitamin D on the brain. That is, given the structural and functional brain changes seen in late life depression, vitamin D may have a protective effect in attenuating these changes.

Similarly, other studies have shown that vitamin D status has also been linked with neurodegenerative conditions such as dementia, Parkinson’s disease and multiple sclerosis.

Although the benefits of vitamin D remain debatable, vitamin D status is relatively easy and inexpensive to modify through supplementation or fortification. Interestingly, in Ireland, fortification of food products with vitamin D is voluntary and few manufacturers fortify their products.

Commenting on the significance of the research, first author of the study and Specialist Registrar in Geriatric Medicine, Dr. Robert Briggs, said, “This is the largest representative and most comprehensive study of depression risk and vitamin D status in older adults ever conducted in Ireland. Our findings will provide useful information to help inform public health policy, particularly regarding the proposition of the usefulness of vitamin D treatment/supplementation for depression.”

Senior author Dr. Eamon Laird added, “This study shows that vitamin D is associated with a health condition other than bone health. What is surprising is the large effect on depression even after accounting for other control variables.

“This is highly relevant for Ireland as our previous research has shown that one in eight older adults are deficient in the summer and one in four during the winter. Moreover, only around 8 percent of older Irish adults report taking a vitamin D supplement.”

“Given that vitamin D is safe in the recommended intakes and is relatively cheap, this study adds to the growing evidence on the benefits of vitamin D for health. It also helps to continue to impress the need on our public health bodies to develop Irish vitamin D recommendations for the general public. Up to this point, these are severely lacking.”

Principal Investigator of TILDA Professor Rose Anne Kenny said, “The new finding that the development of depression could potentially be attenuated by having a higher vitamin D status could have significant policy and practice implications for Government and health services.

“It is our responsibility to now ascertain whether supplementation will influence depression. There are many reasons for vitamin D supplementation in Ireland. Benefits to something as disabling and often ‘silent’ as depression are therefore important for well-being as we age.”

Source: Trinity College Dublin

Less Strife Seen in Longer Marriages as Partners Mellow

Wed, 12/05/2018 - 7:21am

In a new study, researchers discovered the squabbling and acrimony between couples in the early and middle years of a marriage decline with age as conflicts give way to humor and acceptance.

For the study, University of California, Berkeley, investigators analyzed videotaped conversations between 87 middle-aged and older husbands and wives who had been married for 15 to 35 years. They then tracked their emotional interactions over the course of 13 years.

Researchers found that as couples aged, they showed more humor and tenderness towards another.

Overall, the findings showed an increase in such positive behaviors as humor and affection and a decrease in negative behaviors such as defensiveness and criticism. The results challenge long-held theories that emotions flatten or deteriorate in old age and point instead to an emotionally positive trajectory for long-term married couples.

The study appears in the journal Emotion.

“Our findings shed light on one of the great paradoxes of late life,” said study senior author Dr. Robert Levenson, a UC Berkeley psychology professor.

“Despite experiencing the loss of friends and family, older people in stable marriages are relatively happy and experience low rates of depression and anxiety. Marriage has been good for their mental health.”

The findings from the new longitudinal study are consistent with previous research that revealed wives were more emotionally expressive than their husbands, and as they grew older they tended toward more domineering behavior and less affection. But generally, across all the study’s age and gender cohorts, negative behaviors decreased with age.

“Given the links between positive emotion and health, these findings underscore the importance of intimate relationships as people age, and the potential health benefits associated with marriage,” said co-lead author Dr. Alice Verstaen, who led the study as a Ph.D. student.

The results are the latest to emerge from a 25-year UC Berkeley study headed by Levenson of more than 150 long-term marriages. The participants, now mostly in their 70s, 80s and 90s, are heterosexual couples from the San Francisco Bay Area whose relationships Levenson and fellow researchers began tracking in 1989.

In their investigation of marital relationships, researchers viewed 15-minute interactions between spouses in a laboratory setting as they discussed shared experiences and areas of conflict. They tracked the emotional changes every few years.

The spouses’ listening and speaking behaviors were coded and rated according to their facial expressions, body language, verbal content and tone of voice. Emotions were coded into the categories of anger, contempt, disgust, domineering behavior, defensiveness, fear, tension, sadness, whining, interest, affection, humor, enthusiasm and validation.

Researchers found that both middle-aged and older couples, regardless of their satisfaction with their relationship, experienced increases in overall positive emotional behaviors with age, while experiencing a decrease in overall negative emotional behaviors.

“These results provide behavioral evidence that is consistent with research suggesting that, as we age, we become more focused on the positives in our lives,” Verstaen said.

Source: UC-Berkeley

How Real-World Learning Experiences Can Help Kids Retain Knowledge

Wed, 12/05/2018 - 7:00am

A new study finds that real-world learning experiences, such as an animal-focused summer camp, can significantly improve children’s knowledge in just a few days.

Significantly, this type of real-world learning offers more than just an increase in factual knowledge, say the researchers. It improves how children organize what they know, which is a key component of learning.

The new study, published in the Journal of Experimental Child Psychology, is one of the first to show how quickly knowledge organization changes can occur in children.

“This suggests organization of knowledge doesn’t require years to happen. It can occur with a short, naturalistic learning experience,” said Dr. Layla Unger, lead author of the study and a postdoctoral researcher in psychology at Ohio State University (OSU). “It highlights the enriching potential of real-world programs like summer camps. They aren’t just recreation.”

“We didn’t know if it would take months or years for children to accomplish this. Now we have evidence that it can happen in days,” Unger said.

Unger conducted the research with Dr. Anna Fisher, associate professor of psychology at Carnegie Mellon University. They observed 28 children, ages 4 to 9, who attended a four-day summer zoo camp in Pittsburgh.

The zoo camp attendees were compared to a control group of 32 children who participated in a different summer camp in a nearby neighborhood of Pittsburgh, which was not at the zoo and didn’t involve animals.

At the beginning and end of each camp, all children completed two different tests that measured how well they understood the differences between mammals, birds and reptiles.

The zoo camp involved lessons, interactions with preserved and live animals, tours of the zoo, games and craft sessions.

“Most of the themes at the zoo camp were not oriented toward explicitly teaching children biological taxonomic groups,” Unger said. “So the children were not spending every day talking about the differences between mammals, birds and reptiles.”

At the beginning of the camps, children in both groups had similar knowledge about the relationships between mammals, birds and reptiles. But the zoo camp attendees knew significantly more by the end of their four-day camp, while the others did not.

Children who had attended zoo camp showed a 64 percent increase in test scores on one assessment from the beginning to the end of camp, and a 35 percent increase in the other. Not surprisingly, there was no change in test scores among kids in the other camp.

Importantly, this study was not designed to test whether a four-day classroom lesson about animals could produce the same results as the four-day zoo experience, Unger said. But other studies show that a class may not have the same positive effect, partly because it might not engage students as much as the real-world experience.

Source: Ohio State University