In The News
A new study suggests a display of poor decision making during primary school increases the risk of interpersonal and behavioral difficulties during adolescence.
However, experts view decision-making as a skill and something that can be taught during youth.
Joshua Weller, Ph.D., an assistant professor in the School of Psychological Science at Oregon State University found that when a 10 or 11 year-old shows poor judgment, the potential for high-risk health behavior in their teen years escalates.
“These findings suggest that less-refined decision skills early in life could potentially be a harbinger for problem behavior in the future,” said Weller.
If poor decision-making patterns can be identified while children are still young, intervention to improve skills can be effective.
“Often a variety of mentors — parents, educators, and health professionals — can effectively help children enhance these skills,” said Weller.
“This research underscores that decision-making is a skill and it can be taught,” he said. “The earlier you teach these skills, the potential for improving outcomes increases.”
The study was recently published in the Journal of Behavioral Decision Making.
For the investigation, researchers wanted to better understand how pre-adolescent children’s decision-making skills predicted later behavior.
To do so, they conducted follow-up assessments with children who had participated in a previous decision-making study.
About 100 children, ages 10 and 11, participated in the original study, where they answered questions that helped assess their decision-making skills. They were evaluated based on how they perceived the risks of a decision, their ability to use appropriate decision-making rules, and whether their confidence about a decision matched their actual knowledge on a subject.
For the new study, researchers invited the original study participants, now 12 and 13 years old, and their parents back for a follow-up.
In all, 76 children ages participated in the second study, which included a behavior assessment that was completed by both the parent and the child.
The behavior assessment included questions about emotional difficulties, conduct issues such as fighting or lying, and problems with peers.
“Those kinds of behavioral issues are often linked to risky health behavior for teens, including substance abuse or high-risk sexual activity,” Weller said.
Researchers compared each child’s scores from the initial decision-making assessment to the child’s and their parent’s behavioral reports.
They found that children who scored worse on the initial decision-making assessment were more likely to have behavioral problems two years later.
“Previous studies of decision-making were retrospective,” Weller said. “To our knowledge, this is the first research to suggest how decision-making competence is associated with future outcomes.”
Researchers believe the study helps to clarify the association between decision-making and high-risk behavior. It also underscores the value of teaching decision-making and related skills such as goal-setting to youths.
“Some interventions have demonstrated promise in helping children learn to make better decisions,” said Weller.
In another recent study, Weller and colleagues studied the decision-making tendencies of at-risk adolescent girls.
The evaluation followed participation by the at-risk teen girls in an intervention program designed to reduce substance abuse and other risky behavior. The program emphasized self-regulation, goal-setting and anger management.
The study found that girls who received the intervention in fifth grade demonstrated better decision-making skills when they were in high school than their at-risk peers who did not participate in the intervention program.
“Most people can benefit from decision-making training. Will it always lead to the outcome you wanted? No,” Weller said.
“However, it boils down to the quality of your decision-making process.”
Researchers believe this is something that parents and other adults can help children learn. For instance, a parent can talk about difficult decisions with a child.
Then, by exploring multiple points of view or showing other people’s perspectives on the issue, the child learns to consider different perspectives.
“Following a good process when making decisions can lead to more favorable outcomes over time,” Weller said.
“Focus on the quality of the decision process, rather than the outcome.”
Source: Oregon State University
German neuroscientists have written a software program that they believe can calculate the risk for experiencing a major depression relapse.
For the project, Selver Demic, M.D., of the Ruhr University Bochum and his colleagues from the Mercator Research Group examined a variety of factors that influence depression.
“Approximately 20 percent of the population will suffer a depressive episode in the course of their lives,” said Demic. ”This cohort of 20 percent includes people who will never again experience any problems after that one-time episode is over.
“The others, however, will suffer repeatedly or chronically under the disorder, despite taking appropriate medication. We want to use our model to explain the occurrence and recurrence rates.”
The model includes factors such as rate of memory lapses, cognitive bias, and activity levels of the mood-related neurochemical serotonin.
Some of the variables such as serotonin are well-recognized as being associated with depression while other items include social factors such as family demographics and job situation. A unique aspect of the research is the inclusion of all factors into one model.
After using the model for analysis, Demic discovered the observed patterns of depression could only be explained by a division into two distinct patient groups: A high-risk group whose parameters are so unfortunately aligned that they will always suffer from recurring depressions; another group in which depression will only occur by chance.
The scientists also wanted to compile a systematic definition for the individual disease states based on objective facts, moving beyond the existing classification system that has some degree of subjectivity.
Currently, psychologists and doctors use a system based on:
- the depressive episode, diagnosed after characteristic symptoms such as lack of motivation and sadness have lasted for minimum of 14 days;
- the recovery phase, which applies when the patient has not presented any symptoms for a period of at least six months;
- and the remission phase, if the period between two depressive episodes is shorter than six months.
“When assessing which phase the patient is currently undergoing, psychologists and doctors will also always rely on their intuition and experience.
“Often, it is not clear if a patient is going through the remission or the recovery phase when he shows depressive symptoms for a few days during the six-month period,” said Demic.
Consequently, the neuroscientist developed a mathematical model, a so-called finite state machine (FSM).
This tool is fed data regarding a patient’s state every day. Based on those data and as result of the time course, the FSM calculates the disease state that the patient is currently undergoing.
“Our approach to understand depression is entirely novel,” said Demic. ”Therefore, we expect animated debates with doctors, psychologists, and other scientists.
“What’s important is that we have demonstrated the potential computer-based models offer with regard to research into depression.”
Source: Ruhr-University Bochum
Researchers found a 60 percent decrease in self-reported anxiety and loneliness symptoms among college students following animal-assisted therapy.
The study by investigators at Georgia State University, Idaho State University and Savannah College of Art and Design is published in the Journal of Creativity in Mental Health.
For the study, researchers provided animal-assisted therapy to 55 students in a group setting at a small arts college in the Southeast. The therapy included use of a registered therapy dog under the supervision of a licensed mental health practitioner.
Eighty-four percent of the participants reported their interaction with the therapy dog, Sophie, was the most significant part of the program.
The group sessions were held twice monthly during an academic quarter. Students were invited to stop by and interact with the therapy dog as long as they wished, up to two hours.
They were allowed to pet, hug, feed, brush, draw, photograph, sit near, and play fetch with the therapy dog.
Dr. Leslie Stewart of Idaho State University, who led the study, began the research as a Ph.D. student at Georgia State. She collaborated with Drs. Franco Dispenza, Lindy Parker, and Catherine Chang of Georgia State and Taffey Cunnien of Savannah College of Art and Design.
College can be an intense environment with social pressures mirroring the real world. The stress often takes a toll on students.
The additional prevalence of anxiety and loneliness on college campuses has placed extra demands on college counseling centers.
Researchers note that budget limitations have made it necessary for these centers to find creative ways to meet the needs of their students.
This study suggests animal-assisted therapy could be an effective way for college counseling centers to meet the growing demands of their students.
It is one of the first to apply animal-assisted therapy in a group, college setting, and use a systematic form of measurement.
“College counseling centers are also becoming more and more reflective of community mental health agencies,” Dispenza said.
“That’s something that’s been noted in the field in probably the last 10 to 15 years. College counseling centers aren’t seeing students struggling with academics, which major to pick or how to study.
“They’re coming in with post-traumatic stress disorder, anxiety disorders, pervasive mood disorders, and considerable contextual strains that are happening out in the world, such as poverty and experiences of homelessness, as well as a history of medical issues and family health issues.”
Dogs can be ideal therapy animals because they are thoroughly domesticated. They also seem to be able to read emotional cues. For instance, a dog can tell when a human is sad, Dispenza said.
“The presence of a therapy dog facilitates a therapeutic connection between the client and the mental health professional,” Parker said.
“When you’re trying to do mental health work with someone, establishing that therapeutic relationship and rapport is so important. Any way to do it faster or more effectively only helps facilitate the therapeutic process.”
Source: Georgia State University
Researchers believe a combination of marital hostility and a history of depression increase the risk for obesity in adults.
The provocative new research suggests social factors play a role in the way the body processes high-fat food.
Investigators discovered that men and women with a history of depression – whose arguments with spouses were especially heated – showed several potential metabolic problems after eating a high-fat meal.
They burned fewer calories and had higher levels of insulin and abnormal spikes of triglycerides, a form of fat in the blood, after eating a heavy meal as compared to others without the risk factors.
Research scientists believe the combination of depression and marital hostility resulted in a reduced calorie consumption of 118 calories, an amount that translates to weight gain of up to 12 pounds in a year.
Moreover, the multiple problems can increase the risk for heart disease and diabetes.
“These findings not only identify how chronic stressors can lead to obesity, but also point to how important it is to treat mood disorders. Interventions for mental health clearly could benefit physical health as well,” said Jan Kiecolt-Glaser, Ph.D., lead author of the study and Distinguished University Professor at the Ohio State University College of Medicine.
“Our results probably underestimate the health risks because the effects of only one meal were analyzed. Most people eat every four to five hours, and often dine with their spouses,” said Kiecolt-Glaser.
“Meals provide prime opportunities for ongoing disagreements in a troubled marriage, so there could be a longstanding pattern of metabolic damage stemming from hostility and depression.”
For the study, researchers recruited 43 healthy couples, ages 24 to 61, who had been married for at least three years.
As part of the study, participants completed a range of questionnaires that included assessments of marital satisfaction, past mood disorders, and depressive symptoms.
During the two daylong study visits, all participants ate eggs, turkey sausage, biscuits, and gravy that totaled 930 calories and 60 grams of fat.
The meal was designed to mimic common fast-food options, and matches the calories and fat in a Burger King double whopper with cheese or a Big Mac and medium fries at McDonald’s.
Two hours later, the couples were asked to discuss and try to resolve one or more issues that researchers had previously judged to be most likely to produce conflict. Common topics were money, communication, and in-laws.
Researchers left the room during these videotaped discussions, and later categorized the interactions as psychological abuse, distress-maintaining conversations, hostility, or withdrawal.
After the meals, participants’ energy expenditure — or calories burned by converting food to energy — was tested for 20 minutes of every hour for the next seven hours.
Researchers obtained this data by using equipment that measured inhaled and exhaled airflow of oxygen and carbon dioxide.
Blood samples were drawn several times after the meals to measure glucose, insulin, and triglycerides and compare them to baseline levels.
Participants with both a mood disorder history and a more hostile marriage burned an average of 31 fewer calories per hour and had an average of 12 percent more insulin in the blood than low-hostility participants in the first measurement after the meal.
The insulin level did not match other participants’ lower levels until two hours after eating. Insulin contributes to the storage of fat.
The peak in triglycerides in the high-hostility and depressed participants four hours after eating exceeded all others’ levels.
High levels of triglycerides are considered a risk factor for cardiovascular disease.
Source: Ohio State University
A review of studies of more than 6,000 patients suggests ordinary over-the-counter painkillers and anti-inflammatory drugs may aid in the treatment of depression, when taken in combination with antidepressants.
The meta-analysis, recently published in JAMA Psychiatry, is the work of researchers from Aarhus University in Denmark.
They discovered analgesics and anti-inflammatory drugs used against muscle pain and arthritis may have a beneficial effect on depression symptoms.
The Dutch study team said up to up to 15 percent of the Danish population can expect to suffer from depression at some point in their lives. Americans have between a 10 to 20 percent risk of depression during a lifetime.
The World Health Organization (WHO) estimates that depression is one of the top five reasons for loss of quality of life and also life years.
In recent years, research has demonstrated a correlation between depression and physical illnesses, such as painful conditions or infections.
In the Danish study, researchers evaluated 14 international studies with a total 6,262 patients who either suffered from depression or had individual symptoms of depression.
“The meta-analysis supports this correlation and also demonstrates that anti-inflammatory medication in combination with antidepressants can have an effect on the treatment of depression.
“When combined they give an important result which, in the long term, strengthens the possibility of being able to provide the individual patient with more personalized treatment options,” said medical student Ole Köhler. Köhler is the first author of the scientific article and a member of the research group from Aarhus University.
The meta-analysis shows strong support for the effect of treatment with anti-inflammatory drugs.
“However, these effects must always be weighed against the possible side effects of the anti-inflammatory drugs. We still need to clarify which patients will benefit from the medicine and the dose-sizes required,” Köhler said.
“The biggest problem with depression is that we do not know the causes that trigger the condition in the individual patient. Some studies suggest that the choice of antidepressant medication can be guided by a blood sample that measures whether there is an inflammatory condition in the body,” he said.
The researchers also report that other studies have shown that the same blood samples could be used as a guideline. Physicians and mental health providers would then know if inflammation is present.
If so, a combination treatment with anti-inflammatory drugs and antidepressants could be an appropriate method of treatment.
“These findings must, however, be verified before they can be implemented in clinical practice,” said Köhler.
He emphasizes that it is not possible to conclude on the basis of the meta-analysis that an inflammatory state can be the sole explanation for a depression.
“The analysis should be seen as a significant milestone in a research context and this could be a landmark for what future research projects and treatment need to focus on,” Köhler said.
Source: Aarhus University
A new study finds that even depressed people are optimistic about the future.
However, researchers also discovered the positive outlook may not lead to better outcomes.
Canadian researchers found that middle-aged adults with a history of depression typically evaluated their past and current lives in more negative terms than did adults without depression.
Yet, the negativity didn’t extend to their beliefs about the future.
“It turns out that even clinically depressed individuals are also characterized by the belief that one’s life in the future will be more satisfying than one’s past and current life,” said psychological scientist and lead researcher Michael Busseri, Ph.D., of Brock University in Canada.
“And this pattern of beliefs appears to be a risk factor for future depression, even over a 10-year period.”
Adults typically believe that life gets better — today is better than yesterday was and tomorrow will be even better than today.
The findings are published in the journal Clinical Psychological Science.
Busseri and co-author Emily Peck of Acadia University, also in Canada, analyzed data available from the Midlife Development in the United States (MIDUS) survey, a nationally representative sample of middle-aged Americans.
The researchers looked at data from both waves of the study, collected 10 years apart. They limited their sample to those participants who were 45 years old or younger at the first wave.
In addition to demographic data, the researchers looked at participants’ reports of life satisfaction for the past, present, and future.
Participants were asked to rate their life satisfaction on a scale from zero to 10, from worst life possible to best life possible. They also examined symptoms of depression measured via clinical interview.
Compared to non-depressed participants, MIDUS participants who showed signs of depression reported lower levels of life satisfaction at each time point: past, present, and future.
Like non-depressed participants, however, the depressed participants seemed to think that life would get better over time.
And yet, the discrepancy between optimistic beliefs about the future and a more sober reality might contribute to sub-optimal outcomes for these individuals.
“What we don’t know yet is whether this improved future life is actually something that depressed individuals feel they will achieve,” Busseri said.
“It’s possible, for example, that envisioning a brighter future is a form of wishful thinking — rather than a sign of encouragement and hope.”
Looking at the participants’ subjective trajectories across all three time points, the researchers found that non-depressed participants showed linear increases in life satisfaction from one point to the next, but depressed participants did not.
Instead, they tended to show a relatively flat trajectory between past and current life satisfaction and then a significant increase between current and future life satisfaction.
Busseri and Peck also found that relatively low ratings of past and current life satisfaction were each associated with a higher risk of depression 10 years later. This even after taking various demographic characteristics and baseline levels of depression into account.
Taken together, these findings suggest that subjective trajectories may be an important point of intervention for people suffering from or at risk of depression.
“The fact that even depressed individuals can envision their lives being more satisfying in the future may provide clinicians and mental health workers with a valuable new avenue for intervention, for example, through focusing on helping individuals develop concrete goals and realistic plans for achieving a more satisfying future life,” said Busseri.
“An important next step is determine whether modifying individuals’ subjective trajectories — making them more realistic, or ‘flatter’ — might attenuate symptoms of depression, or longer-term risk of depression.”
A new study suggests learning may be improved by the use of strategies that “prime” the brain to learn new content and allow time for the brain to rest and reflect.
University of Texas at Austin researchers used brain imaging technology to show that brain mechanisms engaged when people allow their minds to rest and reflect on things they’ve learned.
This mental engagement can boost later learning, say the researchers.
Scientists have already established that resting the mind, as in daydreaming, helps strengthen memories of events and retention of information.
Researchers expanded on this premise as by showing that the right kind of mental rest — believed to strengthen and consolidate memories from recent learning tasks – helps improve future learning.
The results appear online in the journal Proceedings of the National Academy of Sciences.
Margaret Schlichting, a graduate student researcher, and Dr. Alison Preston, an associate professor of psychology and neuroscience, gave participants in the study two learning tasks.
In both tasks, participants were asked to memorize different series of associated photo pairs.
Between the tasks, participants rested and could think about anything they chose, but brain scans found that the ones who used that time to reflect on what they had learned earlier in the day fared better on tests pertaining to what they learned later.
Comprehension was strongly improved in the cases where small threads of information between the two tasks overlapped.
Participants seemed to be making connections that helped them absorb information later on, even if it was only loosely related to something they learned before.
“We’ve shown for the first time that how the brain processes information during rest can improve future learning,” said Preston.
“We think replaying memories during rest makes those earlier memories stronger, not just impacting the original content, but impacting the memories to come.”
Until now, many scientists assumed that prior memories are more likely to interfere with new learning. This new study shows that at least in some situations, the opposite is true.
“Nothing happens in isolation,” Preston said.
“When you are learning something new, you bring to mind all of the things you know that are related to that new information. In doing so, you embed the new information into your existing knowledge.”
Preston described how this new understanding might help teachers design more effective ways of teaching.
Imagine a college professor is teaching students about how neurons communicate in the human brain, a process that shares some common features with an electric power grid.
The professor might first cue the students to remember things they learned in a high school physics class about how electricity is conducted by wires.
“A professor might first get them thinking about the properties of electricity,” Preston said. ”Not necessarily in lecture form, but by asking questions to get students to recall what they already know.
“Then, the professor might begin the lecture on neuronal communication. By prompting them beforehand, the professor might help them reactivate relevant knowledge and make the new material more digestible for them.”
This research was conducted with adult participants. The researchers will next study whether a similar dynamic is at work with children.
Source: University of Texas – Austin
New research suggests a robust vocabulary may reduce mild cognitive impairment and lead to a lower risk of developing dementia.
Mild cognitive impairment (MCI) or incipient dementia is a condition that some people develop as they age. Many experts believe it is an intermediate state between normal cognition and dementia.
MCI is defined as cognitive decline greater than expected for an individual’s age and education level but that does not interfere notably with activities of daily life. Symptoms often include forgetfulness and a decline in executive skills.
Researchers from the University of Santiago de Compostela in Spain studied the way in which the brain compensates for cognitive impairment and discovered the brain uses its cognitive reserve to make up for memory loss.
“Cognitive reserve” is the name given to the brain’s capacity to compensate for the loss of its functions. This reserve cannot be measured directly; rather, it is calculated through indicators believed to increase this capacity.
Scientists discovered use of a higher level of vocabulary appears to buttress cognitive reserve.
As Cristina Lojo Seoane, co-author of the study published in the journal Anales de Psicología (Annals of Psychology), said, “We focused on level of vocabulary as it is considered an indicator of crystallized intelligence (the use of previously acquired intellectual skills). We aimed to deepen our understanding of its relation to cognitive reserve.”
Investigators chose a sample of 326 subjects over the age of 50. Two hundred twenty two were healthy individuals and 104 presented mild cognitive impairment.
Researchers then measured subjects levels of vocabulary, along with other measures such as their years of schooling, the complexity of their jobs, and their reading habits.
They also analyzed the scores they obtained in various tests, such as the vocabulary subtest of the Wechsler Adult Intelligence Scale (WAIS) and the Peabody Picture Vocabulary Test.
“With a regression analysis we calculated the probability of impairment to the vocabulary levels of the participants,” Lojo Seoane said.
The results revealed a greater prevalence of mild cognitive impairment in participants who achieved a lower vocabulary level score.
“This led us to the conclusion that a higher level of vocabulary, as a measure of cognitive reserve, can protect against cognitive impairment,” Lojo Seoane said.
A new study discovers positive subliminal messages that flip negative stereotypes of aging can improve physical functioning among the elderly.
Yale School of Public Health researchers say the novel intervention method was designed to examine whether exposure to positive age stereotypes could weaken negative age stereotypes.
Researchers also used the study design to ascertain if the new benefits could lead to healthier outcomes.
Investigators discovered older individuals who were subliminally exposed to positive stereotypes about aging showed improved physical functioning that lasted for several weeks.
The study, to be published online in an upcoming issue of the journal Psychological Science, consisted of 100 older individuals (average age 81 years) who live in the greater New Haven, Connecticut area.
Some of the participants were subjected to positive age stereotypes on a computer screen that flashed words such as “spry” and “creative” at speeds that were too fast to allow for conscious awareness.
Individuals exposed to the positive messaging exhibited a range of psychological and physical improvements that were not found in control subjects.
They benefited from improved physical function, such as physical balance, which continued for three weeks after the intervention ended.
Also, during the same period, positive age stereotypes and positive self-perceptions of aging were strengthened, and negative age stereotypes and negative self-perceptions of aging were weakened.
“The challenge we had in this study was to enable the participants to overcome the negative age stereotypes which they acquire from society, as in everyday conversations and television comedies,” said lead researcher Becca Levy, Ph.D.
“The study’s successful outcome suggests the potential of directing subliminal processes toward the enhancement of physical function.”
While it has been previously shown by Levy that negative age stereotypes can weaken an older individual’s physical functioning, this is the first time that subliminal activation of positive age stereotypes was found to improve outcomes over time.
The study found that the intervention influenced physical function through a cascade of positive effects.
Researchers believe the intervention strengthened the subjects’ positive age stereotypes, which then strengthened their positive self-perceptions, which then improved their physical function.
Investigators found the subliminal messages lead to improvements in physical function that surpassed a previous study that involved a six-month-exercise intervention’s effect.
Source: Yale University
Emerging research suggests that some anti-inflammatory medicines can improve the efficacy of existing schizophrenia treatments.
A group of researchers at the University of Utrecht in the Netherlands discovered anti-inflammatory medicines such as aspirin, estrogen, and fluimucil can help improve schizophrenia symptoms.
This work was presented at the European College of Neuropsychopharmacology (ECNP) conference in Berlin.
Although physicians have believed that helping the immune system may aid the treatment of schizophrenia, until now there has been no conclusive evidence that this would be effective.
In the study, researchers carried out a comprehensive meta-analysis of all robust studies on the effects of adding anti-inflammatories to antipsychotic medication.
This has allowed them to conclude that anti-inflammatory medicines, such as aspirin, can add to the effective treatment of schizophrenia.
Experts have known that the immune system is linked to certain psychiatric disorders, such as schizophrenia and bipolar disorder. Schizophrenia in particular is linked to the HLA gene system, which is found on chromosome six in humans. The HLA system controls many of the characteristics of the immune system.
According to lead researcher Iris Sommer, Ph.D., of the Utrecht Psychiatry Department, ”The picture on anti-inflammatory agents in schizophrenia has been mixed, but this analysis pulls together the data from 26 double-blind randomized controlled trials, and provides significant evidence that some (but not all) anti-inflammatory agents can improve symptoms of patients with schizophrenia.
“In particular, aspirin, estrogens in women and the common antioxidant N-acetylcysteine (fluimicil) show promising results. Other anti-inflammatory agents, including celecoxib, minocycline, davunetide, and fatty acids showed no significant effect.”
Although schizophrenia affects around 24 million people worldwide, treatment of the condition has remained consistent over the past 50 years.
Current pharmacological therapy for schizophrenia consists of correcting the regulation of dopamine.
This strategy has been shown to help symptoms such as hallucinations and delusions, but has been unable to help many other symptoms such as decreased energy, lack of motivation, and poor concentration.
In addition, around 20 to 30 percent of all patients don’t respond to antipsychotic treatment.
Researchers and other experts believe co-treatment with anti-inflammatory agents holds the possibility of improving patient’s response to treatment.
“The study makes us realize that we need to be selective about which anti-inflammatory we use,” Somner said. “Now that we know that some effects are replicated, we need to refine our methods to see if we can turn it into a real treatment.
“We have just started a multicenter trial using simvastatine to reduce inflammation in the brain of patients with schizophrenia. Studies like these will provide the proof-of-concept for targeting the immune system in schizophrenia.”
An expert associated with the ECNP, psychiatrist Dr. Celso Arango of the Hospital General Universitario Gregorio Marañón in Madrid, said, ”Inflammation and oxidative stress seem to be important factors in different mental disorders.
“Patients with different mental conditions, including schizophrenia, have been shown to have reduced antioxidants in the brain as well as excess inflammatory markers.”
Arango said animal models and clinical trials have shown that antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders but also prevent the appearance of neurobiological abnormalities and transition to psychosis, if given early enough during brain development.
“This work is a step towards the possibility of better treatment, but we need more research in this area, especially with younger subjects where we might expect more brain plasticity,” he said.
Bereavement affects a person’s immune system, and the impact varies as we grow older, say researchers.
“During the difficult weeks and months after loss we can suffer from reduced neutrophil function,” said Dr. Anna Phillips of Birmingham University, U.K.
“Neutrophils are the most abundant type of white blood cell and as such are essential at combating infections and illness, so we become vulnerable when this happens.”
Her research is the first to investigate the links between stress hormones and immune function across different ages. It looked at participants who were grieving for the loss of either a spouse or close family member. Taking part were 41 young adults, with a mean age of 32 years, and 52 older adults, with a mean age of 72 years.
Results showed that as we age, the balance of so-called “stress hormones” during grief alters, putting the elderly at greater risk of reduced immune function and consequent infections. The young bereaved participants showed “robust neutrophil function,” whereas it was reduced among the older bereaved participants.
Specifically, the hormones cortisol and dehydroepiandrosterone sulphate (DHEAS) respond differently to loss as we age. This has a negative impact on neutrophil function.
In younger people, the ratio of cortisol and DHEAS was more balanced, whereas cortisol was significantly higher than DHEAS among older participants. This is a hormone with known immune-suppressive effects. DHEAS, while also secreted by the adrenal gland in response to stress, is thought to be immune-enhancing.
This study is published in the journal Immunity and Ageing.
“The effects of loss are poorly understood on the whole, we know that it affects the immune system amongst other things, but we don’t fully understand the role played by our stress hormones,” said Phillips.
“We hope that this is a step towards that understanding, and being able to provide the best possible support.”
The team suggests that younger people show no detrimental effect of bereavement on neutrophils due to “the absence of immunosenescence and adrenopause in this younger aged bereaved group.” Immunosenescence is the gradual deterioration of the immune system over the lifetime, and adrenopause is the gradual slowing of adrenal gland activity.
Co-author Janet Lord, Ph.D., pointed out, “Cortisol is known to suppress elements of the immune system during times of high stress, so having an unbalanced ratio of cortisol and DHEAS is going to affect how able we are to ward off illness and infection when grieving.
“But, of course, it is also incredibly useful, particularly in activating some anti-stress and anti-inflammation pathways, so it’s not as simple as trying to suppress the cortisol in vulnerable people.”
However, hormonal supplements or similar products may prove to be useful for people at an increased risk. Once we know more about the changing ratio of these hormones, researchers can test whether altering the balance artificially could be a short-term help, believes Phillips.
But she added, “However, there is quite simply no substitute for a strong support network of family and friends to help manage the risks during a period of grieving.”
Further studies have suggested that sources of stress besides bereavement may have a more detrimental impact on the immune system as we age. Studies of older spouse caregivers for partners with dementia have found clear evidence of compromised immune function. Findings on younger caregivers have come up with more variable results.
Studies of hip fracture have shown impaired immune function specifically in older adults, and not in young patients with similar injuries. It affected the cortisol:DHEAS ratio most negatively among older patients with depressive symptoms compared with those without depression.
“These data suggest that the effects of some types of stress on immunity may only be observed among older adults, or among those with poorer psychological status, e.g., high depressive symptoms,” write Phillips and colleagues.
In fact, there is accumulating evidence that stress and age are interactive, with chronic stress exacerbating the immune effects of aging. In one study, lower marital satisfaction in older adults was linked to less effective antibody responses to vaccination. The same study showed that bereavement was also associated with a worse antibody response to vaccination.
The death of a loved one is one of life’s greatest stresses, with reports of increased mortality and illness especially in the early months. Research to date suggests that bereavement is associated with a range of damaging physiological changes.
In summary, it seems that the stress of bereavement exaggerates the age-related decline in immune function, which may help to explain the increased risk of infection in bereaved older adults.
Vitlic, A. et al. Bereavement reduces neutrophil oxidative burst only in older adults: role of the HPA axis and immunesenescence. Immunity & Ageing, 10 September 2014 doi:10.1186/1742-4933-11-13
A new European study suggests that panic attacks may be associated with an aversion to bright light.
Although the finding does not imply a cause-and-effect relationship, the discovery of an association may lead to development of new therapies for panic disorder.
Panic attacks occur when a person’s fear response is out of proportion for an often non-threatening situation. Panic disorder is different from normal fear and anxiety reactions to stressful events in our lives.
Panic disorder is a serious condition that affects 2.4 million Americans. Previous studies have shown that tit has a strong seasonal component.
The new European study is the first to look specifically at panic disorder patients’ reactions to light.
A group of researchers from the University of Siena (Italy) compared 24 patients with panic disorder (PD) against 33 healthy controls.
Using a standard Photosensitivity Assessment Questionnaire (PAQ), they found that healthy controls showed a slight (not statistically significant) tendency to be photophilic — that is, to be attracted to bright light.
In contrast, the patients with panic disorder showed medium to high levels of aversion to bright light.
The Photosensitivity Assessment Questionnaire asks subjects to agree or disagree with a series of questions about their attitude towards light, for example “My ideal house has large windows” or “Sunlight is so annoying to me, that I have to wear sunglasses when I go out.”
The mean values in the Photosensitivity Assessment Questionnaire were as follows: patients with photophobia scored 0.34 (± 0.32 SD), healthy subjects scored 0,11 (± 0,13 SD).
According to lead researcher Dr. Giulia Campinoti, ”There have been several hints that photophobia is associated with panic disorder; for example in some people, fluorescent light can induce panic attacks. It had also been noted that people with panic disorder often protect themselves from light, for example by wearing sunglasses.”
Researchers admit the study was small and needs replication by a larger studies before the relationship between an abnormal fear of light (photophobia) and panic disorders can be confirmed.
However, if photosensitivity and panic attacks are related, then steps can be developed to avoid some of the triggers to panic attacks.
“It is important to note that our work shows an association, not necessarily a cause and effect. We don’t yet know exactly what the relationship might be, but there is probably some underlying biochemical basis,” said Campinoti.
People with severe mental health issues are willing to go online and share stories to provide support for others with similar conditions.
Researchers found people with schizophrenia, schizoaffective disorder, or bipolar disorder are comfortable using a social media website like YouTube to provide and receive naturally occurring peer support.
“What we found most surprising about our findings was that people with severe mental illness were so open about their illness experiences on a public social media website like YouTube,” said lead author John Naslund, a Ph.D. student at the Dartmouth Institute for Health Policy & Clinical Practice.
“We saw that people with severe mental illness did not appear to be concerned about the risks of openly sharing their personal illness experiences because they really wanted to help others with similar mental health problems.”
The study is published in the journal PLOS ONE.
Naslund and colleagues found that people with severe mental illness used YouTube to feel less alone and to find hope, to support and to defend each other, and to share personal stories and strategies for coping with day-to-day challenges.
They also sought to learn from the experiences of others about using medications and seeking mental health care.
“It helps them to overcome fears associated with living with mental illness, and it also creates a sense of community among these individuals,” the researchers said.
Severe mental illnesses such as schizophrenia, schizoaffective disorder and bipolar disorder are among the leading causes of disability worldwide and are associated with a great deal of stigma and discrimination.
For the study, researchers used a method called online ethnography to analyze over three thousand comments posted to 19 videos.
The comments were uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder.
Investigators then used qualitative methods to analyze the comments and find common themes in the data.
“What is also important is that our findings are consistent with how peer support is viewed in mental health research and practice, which suggests that YouTube or other social media websites might help to extend the reach of informal peer support activities between people with severe mental illness,” Naslund said.
Investigators concede limitations to the study, as the findings were observational and exploratory.
Source: The Dartmouth Institute
A new study discovered people who play action video games such as “Call of Duty” or “Assassin’s Creed” were able to learn a new sensorimotor skill quicker than non-gamers.
University of Toronto researchers believe the study shows that action video games strengthen sensorimotor skills.
Learning a new sensorimotor skill — such as learning to ride a bike or typing — often requires a new pattern of coordination between vision and motor movement.
With such skills, an individual generally moves from novice performance, characterized by a low degree of coordination, to expert performance, marked by a high degree of coordination.
As a result of successful sensorimotor learning, one comes to perform these tasks efficiently and perhaps even without consciously thinking about them.
“We wanted to understand if chronic video game playing has an effect on sensorimotor control, that is, the coordinated function of vision and hand movement,” said graduate student Davood Gozli.
Researchers set up two experiments.
In the first, 18 gamers (those who played a first-person shooter game at least three times per week for at least two hours each time in the previous six months) and 18 non-gamers (who had little or no video game use in the past two years) performed a manual tracking task.
Using a computer mouse, they were instructed to keep a small green square cursor at the center of a white square moving target which moved in a very complicated pattern that repeated itself.
The task probes sensorimotor control, because participants see the target movement and try to coordinate their hand movements with what they see.
In the early stages of doing the tasks, the gamers’ performance was not significantly better than non-gamers.
“This suggests that while chronically playing action video games requires constant motor control, playing these games does not give gamers a reliable initial advantage in new and unfamiliar sensorimotor tasks,” said Gozli.
By the end of the experiment, all participants performed better as they learned the complex pattern of the target.
The gamers, however, were significantly more accurate in following the repetitive motion than the non-gamers.
“This is likely due to the gamers’ superior ability in learning a novel sensorimotor pattern, that is, their gaming experience enabled them to learn better than the non-gamers,” said Gozli.
In the next experiment, the researchers wanted to test whether the superior performance of the gamers was indeed a result of learning rather than simply having better sensorimotor control.
To eliminate the learning component of the experiment, they required participants to again track a moving dot, but in this case the patterns of motion changed throughout the experiment.
This time, neither the gamers nor the non-gamers improved as time went by.
Researchers believe this confirms that learning was playing a key role and the gamers were learning better.
Experts believe one of the benefits of playing action games may be an enhanced ability to precisely learn the dynamics of new sensorimotor tasks.
These skills are paramount for highly technical work. An example is laparoscopic surgery which involves high precision manual control of remote surgery tools through a computer interface.
Their study is published in the journal Human Movement Science.
Source: University of Toronto
European psychiatrists and other health experts are calling for a change in the way mental health drugs are named.
The reason for the switch is that the name of the drug you are prescribed may significantly influence the way you respond to the medication.
The new terminology shifts away from a system-based nomenclature (e.g. antidepressant, antipsychotic etc.) to pharmacologically based (e.g. focusing on pharmacological target such as serotonin, dopamine and the like and the relevant mode of action).
Experts believe this will decrease the confusion that can happen when a patient is prescribed a drug for what appears to be an unrelated condition.
The new naming convention is also expected to make drug names more understandable to doctors.
The new language is being presented to international clinicians at the European College of Neuropsychopharmacology conference in Berlin.
This international launch marks the start of a process of discussion and negotiation between academics, clinicians, pharmaceutical companies, and regulatory bodies.
The rigorous nature of the new nomenclature means that this can be supported by an app, which will assist clinicians in making the correct treatment choices.
The initiative to improve prescription drug terminology stems from the realization that in psychiatry, drug names can cause more problems than they solve.
For example, a patient may be being treated for anxiety, and yet may be prescribed an “antidepressant” or an “antipsychotic”.
Unfortunately, an unintended consequence of this practice has been increased anxiety because of the stigma of being prescribed an antipsychotic. Often this means that patients stop taking the drug for fear of the association with the different disease.
The terminology of the drugs used by neuropsychopharmacologists (mostly psychiatrists looking at how drugs affect the mind) is based on a classification developed in the 1960′s. This often leads to confusion in both patients, and a lack of clarity in doctors.
As Professor Josef Zohar (Tel Aviv, Israel), leading the international nomenclature project, said, “As in many fields, what we know about drugs has evolved enormously since the 1960s, but the names we use to describe these drugs have not evolved in 50 years.
“As an analogy, I mostly use my smartphone to type SMS text messages, yet I would not call it a ‘typewriter,’ as I would have in the 1960′s; the names need to reflect our contemporary knowledge. If this is true of electronics, it is certainly true of medicines.”
Most drugs have more than one effect, and this can lead to confusion in patients. For example, some antipsychotics are used to treat depression (somewhat like aspirin is taken for headaches, but also to help prevent heart disease).
So the Joint Taskforce on Nomenclature has agreed that the nomenclature of drugs used in mental health need to reflect how the drugs work, rather than any one single use (This is what already happens in some fields such as hypertension).
Said Zohar, “This is more than just a name change. This will change the way we talk about medications, the way we use medications and the way we explain to our patients why we are selecting the specific medications for them.
“We can also use the new naming system to help a clinician make informed decisions. We are proposing that the naming system will have four components or four axes:”
- Axis one describes pharmacological target and mode of action;
- Axis two describes approved indications — what the drug is used for;
- Axis three describes efficacy and major side effects;
- Axis four gives the neurobiological description.
As an example, the drug fluoxetine (also known as Prozac, etc.) is currently classified as an antidepressant, but is also used for bulimia and other indications.
Obviously, suffering from bulimia and being given an antidepressant is potentially confusing.
Under the new classification fluoxetine would be described as follows:
- Class/ mechanism: Serotonin, reuptake inhibitor;
- Indications: Major depressive disorder, obsessive compulsive disorder, bulimia nervosa, panic disorder (and others);
- Efficacy: Improves symptoms of depression and anxiety and reduces compulsive behaviour and obsessional thoughts;
- Side effects: GI symptoms, anxiety, changes in sleep early in treatment, sexual dysfunction;
- Neurobiological description: Neurotransmitter actions / Physiological / Brain Circuits are all listed in the new classification.
Note: the above points one-four are not the complete listing for fluoxetine.
A new European study suggests that the season you are born has a significant impact on your risk of developing mood disorders.
Researchers from Budapest, Hungary, believe their findings show that people born at certain times of year may have a greater chance of developing certain types of affective temperaments.
The temperaments can then lead to mood disorders (affective disorders).
This work is being presented at the European College of Neuropsychopharmacology Congress in Berlin.
Historically, seasons of birth have traditionally been associated with certain personality traits, such as novelty seeking. Folklore justifications, such as astrology, have sought to explain these associations.
According to lead researcher Dr. Xenia Gonda of Semmelweis University in Budapest, “Biochemical studies have shown that the season in which you are born has an influence on certain monoamine neurotransmitters, such as dopamine and serotonin, which is detectable even in adult life.
“This led us to believe that birth season may have a longer-lasting effect. Our work looked at over 400 subjects and matched their birth season to personality types in later life.
“Basically, it seems that when you are born may increase or decrease your chance of developing certain mood disorders,” she said.
“We can’t yet say anything about the mechanisms involved. What we are now looking at is to see if there are genetic markers which are related to season of birth and mood disorder.”
The group found the following statistically significant trends:
- Cyclothymic temperament (characterized by rapid, frequent swings between sad and cheerful moods), is significantly higher in those born in the summer, in comparison with those born in the winter;
- Hyperthymic temperament — a tendency to be excessively positive — were significantly higher in those born in spring and summer;
- Those born in the winter were significantly less prone to irritable temperament than those born at other times of the year;
- Those born in autumn show a significantly lower tendency to depressive temperament than those born in winter.
Commenting for the ECNP, psychiatrist Eduard Vieta, M.D., of the University of Barcelona, said, “Seasons affect our mood and behavior. Even the season at our birth may influence our subsequent risk for developing certain medical conditions, including some mental disorders. What’s new from this group of researchers is the influence of season at birth and temperament.
“Temperaments are not disorders but biologically driven behavioral and emotional trends. Although both genetic and environmental factors are involved in one’s temperament, now we know that the season at birth plays a role too.
“And the finding of ‘high mood’ tendency (hyperthymic temperament) for those born in summer is quite intriguing.”
Women are more likely to develop anxiety and depression after a heart attack than men, according to new research.
“The World Health Organization predicts that by 2020 depression will be the second leading cause of disability and mortality in the world, surpassed only by ischaemic heart disease,” said Dr. Pranas Serpytis of Lithuania.
“Major depression follows myocardial infarction (MI) in approximately 18 percent of cases and is an important predictor of disability and poor quality of life in the year post-MI.”
He noted that patients with depression are nearly six times more likely to die within six months after an MI than those without depression.
“The increased risk of death in patients with depression persists up to 18 months after the MI,” he continued. “But despite the fact that post-MI depression is common and burdensome, the condition remains under-recognized and undertreated.”
The current study investigated the impact of gender and cardiovascular disease risk factors on the risk of developing depression and anxiety after an MI. It was presented at the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC) in Geneva, Switzerland.
The study included 160 patients admitted with a myocardial infarction to the Vilnius University Hospital Santariskiu Clinics in Vilnius, Lithuania.
Patients were interviewed at least one month after the MI to collect demographic information, including gender, age, education and marital status; clinical characteristics, such as incidence of diabetes mellitus, previous treatment for hypertension, and previous MI; other cardiovascular disease risk factors, such as smoking and extent of physical activity; and history of mental health issues.
Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS) — no depression and anxiety (0-7 score), possible depression and anxiety (8-10), mild to moderate levels of depression and anxiety symptoms (11+ score).
The researchers found that nearly one quarter of patients in the study were depressed (24.4 percent). Of those, 28.2 percent had received treatment with antidepressants. The average HADS score for depression was 6.87 in men and 8.66 in women. For anxiety, the mean score was 7.18 in men and 8.20 in women.
“We found that women were more likely to develop anxiety and depression after a heart attack than men,” Serpytis said. “More research is needed to discover the possible reasons for this.”
The researchers also found a link between anxiety and smoking. In the study, 15.6 percent of patients were current smokers. Their mean HADS score for anxiety was 10.16. An additional 77.5 percent of patients had never smoked and their mean HADS score for anxiety was 7.3. The 6.9 percent of patients who had quit smoking more than two years ago had a mean HADS score for anxiety of 4.55.
“Current smokers were more likely to have anxiety after an MI than never smokers or people who had quit smoking more than two years ago,” Serpytis said. “We did not find any association between smoking and depression after an MI.”
Physically inactive patients tended to be depressed, with a mean HADS score of 8.96, he noted. Overall, 64 percent of patients with depression said they were not physically active, he added.
“Women are misrepresented in many clinical studies on MI even though they often have worse outcomes,” Serpytis said.
“Our study shows that women are more likely to develop anxiety and depression after MI than men but until now this issue has been largely unnoticed. Clinicians should assess MI patients, particularly women, for anxiety and depression so that timely treatment can be started.”
The study also suggests that patients should be encourage to quit smoking and increase their activity levels, which should reduce their risks of anxiety and depression after MI, he concluded.
New research shows that the natural opioid system in the brains of pathological gamblers responds differently, which may help explain why gambling can become an addiction.
A group of UK researchers note that gambling is widespread, with about 70 percent of the British population gambling occasionally. However, for about 0.6 percent of British adults — or about 300,000 people — gambling has spiraled out of control, taking on the features of an addiction.
For their study, which was presented at the European College of Neuropsychopharmacology Congress in Berlin, researchers recruited 14 pathological gamblers and 15 healthy volunteers, and used Positron Emission Tomography (PET) scans to measure opioid receptor levels in their brains.
These receptors allow cell to cell communication — they are like a lock, with the neurotransmitter or a chemical, such as endogenous opioids called endorphins, acting like a key, the researchers explain.
The researchers found no differences between the receptor levels in pathological gamblers and non-gamblers. This is different than in people addicted to alcohol, heroin or cocaine, where increases are seen in opioid receptor levels, according to the researchers.
All the volunteers were then given an amphetamine tablet that releases endorphins, which are natural opiates, and the PET scan was repeated. The scan showed that the pathological gamblers released less endorphins than non-gambling volunteers, the researchers report. The gamblers also reported less euphoria from the endorphin rush than the healthy volunteers.
“From our work, we can say two things,” said lead researcher Dr. Inge Mick. “Firstly, the brains of pathological gamblers respond differently to this stimulation than the brains of healthy volunteers. And secondly, it seems that pathological gamblers just don’t get the same feeling of euphoria as do healthy volunteers. This may go some way to explaining why the gambling becomes an addiction.”
The researcher noted that this is the first PET imaging study to look at the involvement of the opioid system in pathological gambling, which is a behavioral addiction.
“Looking at previous work on other addictions, such as alcoholism, we anticipated that pathological gamblers would have increased opiate receptors, which we did not find, but we did find the expected blunted change in endogenous opioids from an amphetamine challenge,” she said.
“These findings suggest the involvement of the opioid system in pathological gambling and that it may differ from addiction to substances such as alcohol. We hope that in the long run this can help us to develop new approaches to treat pathological gambling.”
Student field trips to live theater productions can lead to greater tolerance and empathy as well as increased vocabulary and enhanced knowledge of the plot, according to new research by the University of Arkansas Department of Education Reform.
The study, published inEducation Next, observed the impact on students after attending high-quality theater productions of either “Hamlet” or “A Christmas Carol.”
“What we determined from this research is that seeing live theater produced positive effects that reading a play or watching a movie of the play does not produce,” said Jay Greene, Ph.D., professor of education reform.
“Plays are meant to be seen performed live. You can’t always take your kids to a play but if you can, you should. The story can be conveyed in a movie, but it doesn’t engage the viewer in the same way.”
The researchers have conducted several studies exploring the effects of culturally enriching activities on students.
Two years ago, they found significant benefits in the form of knowledge, future cultural consumption, tolerance, historical empathy and critical thinking for students who had been assigned to visit Crystal Bridges Museum of American Art in Bentonville, Arkansas.
For the live theater study, the researchers offered free tickets to school groups in grades seven through 12 to attend one of the performances. A total of 49 school groups with 670 students completed the application process.
Lotteries were held to determine which groups would receive the free tickets and which would serve as the control group. Some members of both the control group and the treatment group also read the play or watched movie versions of these works.
All students completed a survey approximately six weeks after the performances. Students were asked six questions about the plot and five questions about the vocabulary used, combining them into a single rating of content knowledge.
Students who saw the live productions improved their knowledge of the plays by a very large margin, compared to the control group.
For example, 83 percent of the students who attended the live performance could identify Rosencrantz and Guildenstern as Hamlet’s friends, compared to only 45 percent of the control group. More than 94 percent of the live performance group knew that Ophelia drowns in “Hamlet,” compared to 62 percent of the control group.
To determine whether live theater increases students’ ability to empathize, researchers administered the youth version of the Reading the Mind in the Eyes Test, which was initially developed for research on autism.
Students who watched the live performances scored higher on the study’s tolerance measure than the control group by a moderately large margin and were better able to recognize and appreciate what other people think and feel.
Source: University of Arkansas
Toddlers who don’t feel guilty after bad behavior or who are less affectionate or less responsive to affection may be at risk for greater behavior problems by the time they enter first grade, according to a new study by the University of Michigan (UM).
Furthermore, when these behavior problems still aren’t resolved in elementary school, children are more likely to become aggressive and violent as teens and adults.
“Little analysis had been done among preschoolers, who undergo rapid physical and psychological development, making this a difficult time for parents to manage behaviors and an important time to help children improve their behavior,” said lead author Rebecca Waller, Ph.D., a UM psychology research fellow.
“Adults who are aggressive or violent have often shown early-starting behavior problems as young children. Thus, a focus on understanding the emergence and development of behavior problems before they become severe is important for creating new treatments that could help prevent children following a lifetime of violence or crime.”
Researchers evaluated 240 children and their parents who were part of the Michigan Longitudinal Study, a continuing study of young children at risk for behavior problems.
Information was gathered from parents when the children were three years old and again by teachers at six years old.
Parents completed questionnaires about their children’s behavior, while the children completed six tasks that were videotaped and analyzed by researchers.
The researchers identified three types of early behavior problems at age three: oppositional behaviors, ADHD behaviors, and callous and unemotional behaviors.
For oppositional behavior, parents reported that their children were often angry, frustrated and had difficulty controlling their emotions. Children with a high rating on ADHD behaviors had difficulty paying attention and staying focused during tasks.
Finally, if children were reported as having “callous and unemotional behavior,” they were found to experience less empathy, guilt and moral regulation of their behavior. Children with the highest ratings of these kinds of behaviors were more likely to show this behavior during first grade and were also more likely to have continued behavior problems according to their teachers.
“A key thing for parents and educators to take from this work is that many children during the preschool years show normative levels of behavior problems and aggression, but there may be different types of behavior problems that may need different interventions if the behavior is not declining as children get towards school age,” said study co-author Luke Hyde, Ph.D., UM assistant professor of psychology.
“For example, children with callous and unemotional behavior may be the most at risk and need therapy that teaches empathy,” he said.
“The good news is that we know from other work that early interventions are very successful and helpful with early child behavior problems,” Hyde said.
“If parents or teachers are concerned about a child’s behavior, they should seek out a mental health provider such as a clinical psychologist, who is trained in a treatment called Parent Management Training. This treatment is very effective and can help a child learn better behavior, particularly early in childhood.”
Source: University of Michigan