In The News
Drinking alcohol appears to foster a sort of “social bravery” among men, enabling them to be more responsive to the smiles of others.
Researchers discovered that for men, alcohol increases male’s sensitivity to rewarding social behaviors like smiling.
This finding may help to explain some of the factors associated with problem drinking among men.
“This experimental alcohol study, which included a social context, finds the clearest evidence yet of greater alcohol reinforcement for men than women,” said psychological scientist and lead researcher Catharine Fairbairn, a doctoral student at the University of Pittsburgh.
Study results are published in the journal Clinical Psychological Science.
Previous research has shown that men are about 50 percent more likely to drink excessively than women, and much problem drinking among men occurs in social settings.
“Many men report that the majority of their social support and social bonding time occurs within the context of alcohol consumption,” said Fairbairn.
“We wanted to explore the possibility that social alcohol consumption was more rewarding to men than to women — the idea that alcohol might actually ‘lubricate’ social interaction to a greater extent among men.”
Fairbairn, Dr. Michael Sayette and their colleagues decided to focus on an objective non-verbal indicator of social bonding, examining the infectiousness of genuine smiles in drinking groups.
Genuine smiles are associated with actual felt emotion as opposed to outward displays of emotion, which may or may not be genuine, say researchers. Importantly, these smiles can be identified and measured using a standardized procedure.
The researchers randomly assigned 720 healthy social drinkers, ages 21 to 28, to groups of three.
Each group was then randomly assigned to receive a particular drink: an alcoholic beverage (vodka cranberry), a non-alcoholic beverage, or a non-alcoholic “placebo” beverage that was described as alcoholic.
The researchers smeared the glass of the fake alcoholic drink with vodka and floated a few drops of vodka on top of the drink to make it more believable.
The participants in each group were casually introduced and positioned around a table. The beverages were doled out in equal parts over time, and participants were told to drink them at an even rate.
Otherwise, the participants weren’t given any specific instruction and were allowed to interact freely.
Based on the video recordings, Fairbairn and colleagues used sophisticated analyses to model smiling behavior in the groups, following the spread of smiles from one individual in a group to the next.
They found that alcohol significantly increased the contagiousness of smiles, but only for all-male groups — it did not have a significant effect on emotional contagion for groups that contained any women.
The findings suggest that alcohol is especially likely to induce a sort of “social bravery” among men, disrupting processes that would normally prevent them from responding to another person’s smile.
Among groups who received alcoholic beverages, a smile was also more likely to be “caught” if those on the receiving end of the smile were heavier drinkers, regardless of gender.
Smiles that were likely to catch on were associated with increased positive mood and social bonding, as well as decreased negative mood.
Thus, smile infection could represent an important indicator of alcohol-related reinforcement and a mechanism supporting drinking.
“These findings are significant,” said Fairbairn, “because they highlight the importance of social context in understanding drinking behavior.”
“Historically, neither the scientific community nor the general public has been terribly concerned about drinking that occurs in social settings,” she said.
“According to popular opinion, a ‘social drinker’ is necessarily a non-problem drinker, despite the fact that the majority of alcohol consumption for both light drinkers and problem drinkers occurs in a social context.”
“Not only that, the need to ‘belong’ and create social bonds with others is a fundamental human motive,” she said. “Therefore, social motives may be highly relevant to the understanding of how alcohol problems develop.”
An independent study by the RAND Corporation discovers the U.S. Department of Defense has made progress in reducing the stigma associated with seeking help for mental illness.
Nevertheless, although the culture surrounding conditions such as depression and post-traumatic stress disorder has improved, researchers report that additional work is necessary.
Overall, researchers found that defense officials have made a concerted effort to promote treatment as a way to reduce stigma.
The department also has worked to create a culture shift where mental health is discussed in the context of readiness and resilience, and where seeking help is defined as a sign of strength.
“We found numerous examples of how the military is encouraging service members with mental illness to get help and treatment, but we also found some gaps,” said Joie D. Acosta, Ph.D., lead author of the report and a behavioral scientist at RAND, a nonprofit research organization.
“For example, we found language in 12 percent of relevant military policies that characterizes mental health issues in a negative light.
“In addition, the perceived stigma around getting help isn’t the only barrier service members face.”
Acosta and her colleagues were asked to inventory and assess stigma-reduction strategies across the military services and the Defense Department as a whole, and to identify strengths and gaps that should be addressed.
RAND researchers reviewed relevant literature on the topic and did micro-simulation modeling of the potential costs associated with stigma, including costs from cycling in and out of treatment, lost productivity, suicide attempts, and deaths by suicide.
They also interviewed program staff and convened an expert panel.
“Many experts believe that the fear of stigma can prevent military members from seeking help for mental health problems,” Acosta said.
The RAND study did not find an evidence-based link between stigma and the long-term outcomes of not treating those with mental health issues, although stigma may have an influence on treatment success.
Other barriers, such as the perception that support from family and friends provides a more-helpful alternative to professional mental health treatment, influence whether an individual seeks care.
“Reducing that barrier by half would increase treatment costs by just under three million, but would result in more than nine million in savings in lost productivity and other costs,” Acosta said.
“The biggest issue for the Defense Department to address is the tension that exists between a command’s need to know a service member’s mental health status and treatment history, and the service member’s right to privacy,” Acosta said.
The study recommends that a task force assess what type of information mental health providers should share with commanders, and develop clear processes for these exceptions.
Researchers also recommend that the U.S. military explore interventions that directly increase the rate of service members seeking mental health treatment.
They warn that too narrow of a focus — such as focusing on stigma — may limit other potential interventions that could promote help.
Military officials also should consider evidence-based approaches to empowering service members with mental health concerns to support their peers who have mental health needs.
“Service members’ preferences for self-management may be a key barrier to their getting help for mental health issues,” Acosta said.
So she and her colleagues recommend that the military develop alternative mechanisms for treatment delivery, such as Internet-based tools.
The military also should better define when a specific mental health issue would prohibit a service member from certain jobs or actions; currently, a large number of policies are vague.
“Much of stigma research focuses on schizophrenia or general mental health concerns, rather than post-traumatic stress disorder, anxiety, or depression, which are the disorders that may be of most interest to the Defense Department,” Acosta said.
Understanding how stigma differs among these disorders and whether there are different beliefs about treatment success for these disorders would help the department better target stigma reduction efforts.
Source: RAND Corporation
Although the general belief is that many cases of depression go untreated, new research suggests short questionnaires used to identify patients at risk for depression may lead to overprescribing of antidepressant medications.
The new research from University of California, Davis Health System (UC Davis) is published in the Journal of the American Board of Family Medicine.
Known as “brief depression symptom measures,” the self-administered questionnaires are used in primary care settings to determine the frequency and severity of depression symptoms among patients.
Recently, several questionnaires have been developed to help reduce untreated depression. Researchers were concerned that the questionnaires might lead to prescriptions for antidepressant medication being given to those who aren’t depressed.
Antidepressants can be effective in treating moderate to severe depression but can have significant side effects, including sexual dysfunction, sedation, and anxiety. They also have to be taken over several months to be effective.
“It is important to treat depression, but equally important to make sure those who get treatment actually need it,” said Anthony Jerant, M.D., professor of family and community medicine at UC Davis and lead author of the study.
The exploratory study included 595 patients of primary care offices affiliated with Kaiser Permanente in Sacramento, San Francisco VA Medical Center, Sutter Medical Group in Sacramento, UC Davis, UC San Francisco, and VA Northern California Healthcare System.
Patients selected for the study were considered at low risk for depression and therefore poor candidates for antidepressants, based on results of a widely-employed brief screening tool known as the Patient Health Questionnaire — 9 (PHQ-9), which was administered by the research team.
The screener, which includes questions about changes in sleep, concentration, energy, and appetite, was completed the same day the patients had appointments to see their primary care physicians, who were unaware their patients had completed the PHQ-9.
Based on a review of medical records, the patients were divided into two groups: those who were asked during their doctors’ office visits to complete brief depression symptom questionnaires, besides the one administered by the researchers, and those who were not.
The groups were compared in terms of rates of depression diagnoses and prescriptions for antidepressants received from their physicians.
Of the 545 patients who did not complete brief depression questionnaires during their doctors’ office visits, 10.5 percent were diagnosed with depression and 3.8 percent were prescribed antidepressants.
Of the 50 patients who completed brief depression questionnaires during their doctors’ office visits, 20 percent were diagnosed with depression and 12 percent were prescribed antidepressants.
Jerant said the study highlights the need for research to determine the best ways to apply brief depression questionnaires in daily practice, as use of the screeners tripled the likelihood that patients in the study who were not apt to be depressed would receive depression treatment.
“Part of the problem could be in how questionnaire results are interpreted,” Jerant said. Depression symptoms such as insomnia, fatigue, and poor concentration are associated with many health conditions.
“The questionnaires aren’t diagnostic in the sense that there’s a certain score that means the patient definitely does or does not have depression,” Jerant said.
“Formal interviews are required to help doctors decide whether a patient’s fatigue, for instance, is caused by depression. That fatigue could also be due to chronic lung or heart disease.
It could also be due to an adjustment disorder that is usually transient and isn’t likely to respond to antidepressants.
We need to give providers good guidance on how to use brief symptom measures in evaluating patients and making treatment decisions.”
Source: UC Davis Health System
New research shows Americans now report more psychosomatic symptoms of depression, such as trouble sleeping and trouble concentrating, than their counterparts in the 1980s.
San Diego State University researchers analyzed data from 6.9 million adolescents and adults from all over the country.
“Previous studies found that more people have been treated for depression in recent years, but that could be due to more awareness and less stigma,” said psychologist Dr. Jean Twenge, the author of “Generation Me: Why Today’s Young Americans are More Confident, Assertive, Entitled — and More Miserable than Ever Before.”
“This study shows an increase in symptoms most people don’t even know are connected to depression, which suggests adolescents and adults really are suffering more.”
Study results are published in the journal Social Indicators Research.
Compared to their 1980s counterparts, teens in the 2010s are 38 percent more likely to have trouble remembering, 74 percent more likely to have trouble sleeping, and twice as likely to have seen a professional for mental health issues.
College students surveyed were 50 percent more likely to say they feel overwhelmed, and adults were more likely to say their sleep was restless, they had poor appetite and everything was an effort — all classic psychosomatic symptoms of depression.
“Despite all of these symptoms, people are not any more likely to say they are depressed when asked directly, again suggesting that the rise is not based on people being more willing to admit depression,” said Twenge.
The study also found that the suicide rate for teens decreased, though the decline was small compared to the increase in symptoms of depression.
With the use of antidepressant medications doubling over this time period, Twenge speculates that medication may have helped those with the most severe problems but has not reduced increases in other symptoms that, she says, can still cause significant issues.
Source: San Diego State University
Although stress can increase the risk of poor mental or physical health, not everyone is affected the same way.
Researchers now report they have developed a way to identify those most susceptible to stress, creating an opportunity for interventions before it gets out of control.
In a paper recently published in the journal Stress, Concordia University psychology professor Dr. Jean-Philippe Gouin followed 76 university students during periods of lower stress at the beginning of term and higher stress during the exam period.
He found that, although all students experience similar challenges during finals, only some of them develop significant distress.
With the help of colleagues, Gouin recorded participants’ heart rate variability while they were relaxing and while they were thinking about things they tend to worry about most.
Researchers also tracked participants’ moods at a time of low stress early in the semester and at a time of high stress right before exams.
They found that those who exhibited a less variable heartbeat when they started worrying were more likely to be highly stressed later on, when faced with finals.
Said Gouin, “At rest, a more variable heartbeat is a good thing. It shows that your parasympathetic nervous system is hard at work. That’s the system that’s responsible for the ‘rest-and-digest’ state of being — the opposite of ‘fight-or-flight.’ The rest-and-digest phase puts you in a calm state that allows you to conserve and replenish your energy.
“When you’re facing a real threat in your life, a regular heartbeat helps you deal with the situation. If you encounter a lion in the jungle, you want your heartbeat to stay at consistently high levels so that you can run away as fast as you can,” he said.
“But if your body shows the same reaction when you worry about something that may or may not happen — like failing an exam — then you might be more susceptible to stress.
“By pinpointing those in the general population who are most vulnerable to stress, we can intervene before they hit the breaking point — and hopefully prevent the negative consequences of stress by doing so. That’s why it’s important to have an objective diagnostic tool like this one.”
Source: Concordia University
New research suggests male anorexia is similar to female anorexia although the male disorder is associated with personality and gender identity issues.
Although anorexia is traditionally associated with females, the disorder also occurs among boys and men. University of Montreal researchers embarked on a study to improve the current state of knowledge about anorexia in men and boys.
“Most of the knowledge about anorexia pertains to females. However, about 10 percent of persons affected are males, and we believe this figure is underestimated,” said Laurence Corbeil-Serre, Psy.D., lead author of the study.
“Our results show that there appear to be similarities between the behavioral symptoms of males and females, but certain particularities can be identified in males, especially related to personality, gender identity, and sexual orientation.”
The researchers conducted a review of the literature comparing 24 studies conducted over 15 years and involving 279 participants aged between 11 and 36 years.
From this review, they identified seven relevant cited variables, either because of their recurrence in the literature or because of divergent results found in the research, and were able to identify major trends among these variables.
The variables are clinical presentation, pre-existing conditions to the disorder, personality characteristics, sexual orientation and activity, gender identity, and comorbid disorders.
It is clear from their study that males and females affected by anorexia share the same fear of gaining weight and “getting fat.”
Participants in the study presented clinically significant weight loss, with an average BMI of 16.1, placing them in a state of malnutrition.
However, dissatisfaction with body image for males was more related to muscle mass, a motivation that can be associated with social norms of male beauty.
“Moreover, excessive physical exercise is far ahead of rituals around food and vomiting in the list of strategies used to lose weight and the behaviors associated with anorexia nervosa,” said Corbeil-Serre.
Their review also suggests a common comorbidity in males with depression and substance abuse and the presence of antisocial, explosive, or psychotic personality traits.
The researchers also note that the rate of homosexuality among participants was much higher than in the general population.
“We postulate that the importance of physical appearance in the gay community exacerbates the disorder once it is present and results in an overrepresentation of homosexual patients in treatment units.
As well, anorexia nervosa may be a way to delay sexual issues for individuals with a conflictual or questioning homosexual orientation,” said Corbeil-Serre.
Restrictive behavior, finally, may be used to suppress male sexual characteristics in order to evade issues related to sexual maturity, which are a source of anxiety, or to approach models of female beauty.
The researchers suggest, however, that because their hypotheses are not supported empirically, they must be submitted to further investigation.
“We largely compared males with females because there are many studies and tools for studying anorexia in females, which explains the rather difficult task we had in discovering which symptoms were specific to males.
Our study deepens our understanding of the subject and enables a better understanding of the disorder in males, by highlighting their specific characteristics,” said Corbeil-Serre.
The researcher recommends adopting a clinical observation model rather than automatically comparing males with knowledge already established regarding females with anorexia.
Source: University of Montreal
New research suggests an after-school physical activity program of moderate to intense exercise can improve seven, eight, and nine year-olds’ attention span and cognitive abilities.
For the study, researchers performed a nine-month-long, randomized controlled trial involving 221 prepubescent children.
They found that those who engaged in moderate-to-vigorous physical activity for at least 60 minutes a day after school saw substantial improvements in their ability to pay attention, avoid distraction, and switch between cognitive tasks.
Study results are reported in the journal Pediatrics.
Investigators explain that half of the study subjects were randomly assigned to the after-school program and the rest were placed on a wait list.
All participants underwent cognitive testing and brain imaging before and after the intervention.
“Those in the exercise group received a structured intervention that was designed for the way kids like to move,” said University of Illinois kinesiology and community health professor Dr. Charles Hillman, who led the study.
“They performed short bouts of exercise interspersed with rest over a two-hour period.”
The intervention, called FITKids, was based on the CATCH exercise program, a research-based health promotion initiative that was initially funded by the National Institutes of Health and now is used by schools and health departments across the U.S.
The children in the FITKids exercise group wore heart-rate monitors and pedometers during the intervention.
“On average, kids’ heart rates corresponded with a moderate-to-vigorous level of exercise intensity, and they averaged about 4,500 steps during the two-hour intervention,” Hillman said. The children were active about 70 minutes per day.
As expected, fitness increased most in the intervention group over the course of the study.
“We saw about a six percent increase in fitness in children in the FITKids intervention group,” Hillman said. Fitness improved less than one percent in the wait-list control group, he said.
Significantly, children in the exercise group demonstrated substantial increases in “attentional inhibition,” a measure of their ability to block out distractions and focus on the task at hand.
Furthermore, they improved in “cognitive flexibility,” which involves switching between intellectual tasks while maintaining speed and accuracy.
“Children in the wait-list control group saw minimal improvements in these measures, in line with what would be expected as a result of normal maturation over the nine months,” Hillman said.
“Kids in the intervention group improved two-fold compared to the wait-list kids in terms of their accuracy on cognitive tasks,” he said.
“And we found widespread changes in brain function, which relate to the allocation of attention during cognitive tasks and cognitive processing speed.
These changes were significantly greater than those exhibited by the wait-list kids.
“Interestingly, the improvements observed in the FITKids intervention were correlated with their attendance rate, such that greater attendance was related to greater change in brain function and cognitive performance,” Hillman said.
“The study did not distinguish improvements that were the result of increased fitness from those that might stem from the social interactions, stimulation, and engagement the children in the intervention group experienced,” Hillman said.
“Other research at Georgia Regents University led by Catherine Davis has actually used social and game-playing as their control group, and showed that the cognitive effects of their physical activity intervention are above-and-beyond those that are gained just through social interactions,” he said.
“The FITKids program is designed to get children socially engaged in exercise, which is part of what makes it an effective intervention,” Hillman said.
“The fact is that kids are social beings; they perform physical activity in a social environment,” he said.
“A big reason why kids participate in a structured sports environment is because they find it fun and they make new friends. And this intervention was designed to meet those needs as well.”
Source: University of Illinois
Researchers have discovered that self-compassion can protect girls and young women from unhealthy weight-control practices and eating disorders.
University of Waterloo investigators discovered women who accept and tolerate their imperfections appear to have a more positive body image despite their body mass index (BMI). Moreover, self-compassion helps girls cope with daily stress including personal disappointments and setbacks.
Importantly, the positive body image appears to protect girls and young women against unhealthy weight-control practices and eating disorders.
“Women may experience a more positive body image and better eating habits if they approach disappointments and distress with kindness and the recognition that these struggles are a normal part of life,” said Allison Kelly, Ph.D., the study’s lead author.
“How we treat ourselves during difficult times that may seem unrelated to our bodies and eating seems to have a bearing on how we feel about our bodies and our relationship with food.”
This study adds to the growing body of literature suggesting that self-compassion might offer unique benefits that self-esteem does not.
Self-esteem comes from evaluating oneself as above-average, and so may be limited in helping individuals cope with perceived shortcomings.
“Regardless of their weight, women with higher self-compassion have better body image and fewer concerns about weight, body shape, or eating,” said Kelly.
“There is something about a high level of acceptance and understanding of oneself that helps people not necessarily view their bodies more positively, but rather acknowledge their bodies’ imperfections and be OK with them.”
The research results suggest that eating disorder prevention and health promotion that focus on increasing young women’s self-compassion may be an important way to foster healthier weight management across the BMI spectrum.
This study gathered data from 153 female undergraduate students and used BMI calculations based on each participant’s self-reported height and weight.
The research team administered a series of questionnaires assessing levels of self-compassion, self-esteem, body image, and eating behaviors.
The study appears in the journal Body Image.
Source: Waterloo University
For many, drowsiness or fatigue when behind the wheel is combated by drinking caffeinated beverages or by listening to music.
New research evaluates which method, if either, can successfully combat driver fatigue.
Human factors/ergonomics researchers ShiXu Liu, Shengji Yao, Ph.D., and Allan Spence, Ph.D., designed a simulated driving study that measured driver fatigue levels against the use of caffeine, music, or no stimulant. Their study is to be presented at the HFES 2014 Annual Meeting in Chicago in October.
Twenty participants completed three 120-minute driving sessions over a three-day span at the same time each day, then scored their fatigue levels on a questionnaire.
Results indicated that drivers who used either caffeine or music as a stimulant felt significantly less tired than those who did not.
The researchers noted, however, that those who drank a caffeinated beverage to stay awake performed their driving tasks much better than those who listened to music or those in the control group.
“Even though both caffeine and music keep drivers feeling more awake, caffeine also helps them maintain good driving performance,” said Liu.
“Music, on the other hand, can distract drivers, which may explain why driving performance is not significantly improved when it is used as a fatigue countermeasure.”
A new process borrowed from the business sector helps women evaluate alternatives for breast reconstruction, using a decision analysis technique.
The approach helps surgeons and patients evaluate alternatives for breast reconstruction, leading to a good decision that reflects the woman’s preferences and values.
The special topic article introduces plastic surgeons to the use of decision analysis to help women navigate decisions about breast reconstruction after mastectomy for breast cancer.
“Decision analysis provides structure for methodic, thoughtful decision-making through the use of reason, logic, and mathematics,” the authors write.
Decision analysis, routinely used in business, is increasingly applied to complex medical decisions as well. The model provides women options based on statistical outcomes.
Women facing breast reconstruction may need to sort through a bewildering array of options — such as immediate versus delayed reconstruction, using implants or their own tissues — while dealing with the emotions of their breast cancer diagnosis and the uncertainty characteristic of difficult decisions.
“When making decisions about breast reconstruction, it is the patient who must live with the consequences,” the authors write.
They outline a process that plastic surgeons can follow in guiding patients through decision analysis.
The surgeon provides information about the available alternatives for breast reconstruction; and the probability of different outcomes — for example, the need for repeated surgeries, possible complications, and aesthetic results.
Based on the patient’s preferences, her values are assigned to possible outcomes. This information is used to create a “decision tree,” incorporating the options, the likelihood of various outcomes, and the values assigned to each outcome.
Researchers walk readers through the decision analysis process for a hypothetical patient considering breast reconstruction.
Their article includes a link to an educational spreadsheet that shows surgeons an example of how the decision analysis process works.
A step called sensitivity analysis weighs the impact of changing different variables that might affect the decision—for example, different assumptions regarding the risk of complications or out-of-pocket costs.
“If the decision remains the same, it is robust and likely good,” the authors write.
A study earlier this month found that while double mastectomy rates have dramatically increased in recent years, survival rates for this surgery remain similar to that of a lumpectomy (where only a section of the breast is removed). That study of 200,000 women followed for over 10 years, published in JAMA, showed those who received a double mastectomy carried a survival rate of 81 percent. That compares with 83 percent for patients who underwent a lumpectomy.
Researchers emphasize that decision analysis doesn’t guarantee a good outcome of breast reconstruction. However, it can help the patient reach a “good decision” — defined as “one that takes into account her preferences and the uncertainties inherent in reconstructive surgery.”
The authors add, “By making good decisions, patient outcomes may be improved.”
Although it can be “computationally intensive,” the researchers believe decision analysis has important benefits for women facing decisions about breast reconstruction.
They write, “Ideally, its application will attenuate worry, safeguard against regret, transmute uncertainty into certainty, and grant some measure of peace in what may ultimately be a very difficult decision.”
The methodology is discussed in an article in Plastic and Reconstructive Surgery.
Source: Wolters Kluwer Health
New research discovers that children with autism are more sedentary and inactive than their developing peers.
Oregon State University investigators found that children with autism averaged 50 minutes less a day of moderate physical activity and 70 minutes more each day of sitting.
However, in the small study of 29 children, some with autism and some without, children with autism perform as well as their typical peers on fitness assessments such as body mass index, aerobic fitness levels and flexibility.
Megan MacDonald, an assistant professor in OSU’s College of Public Health and Human Sciences believes the study should now be performed on a larger group of subjects.
Overall, researchers were pleased to discover that children with autism have generally similar fitness levels to that of typically developing peers.
“These kids, compared to their peers, are similarly fit,” MacDonald said.
“That’s really exciting, because it means those underlying fitness abilities are there.”
The findings are published in the journal “Autism Research and Treatment.”
For the study, researchers tested the fitness and physical activity levels of 17 children with autism and 12 children without autism.
The fitness assessments, conducted in the Movement Studies in Disability Lab at OSU, included a 20-meter, multi-stage shuttle run to measure aerobic fitness; a sit-and-reach test to measure flexibility and a strength test to measure handgrip strength; as well as height, weight and body mass index measurements.
The fitness tests were selected in part because they are commonly used in schools, MacDonald said.
Children in the study also wore accelerometers for a week to measure their movement, and parents filled out supplemental forms to report other important information.
Even though they were more sedentary, the children with autism lagged behind their peers on only one fitness measure, the strength test.
The results were surprising but also encouraging because they show that children with autism are essentially on par with their peers when it comes to physical fitness activities, MacDonald said.
“That’s really important for parents and teachers to understand, because it opens the door for them to participate in so many activities,” she said.
More research is needed to determine why children with autism tend to be more sedentary, MacDonald said.
It may be that children with autism have fewer opportunities to participate in organized sports or physical education activities, but if that is the case, it needs to change, she said.
“They can do it. Those abilities are there,” she said. “We need to work with them to give them opportunities.”
MacDonald encourages parents to make physical activity such as a daily walk or trip to the park part of the family’s routine.
She also calls for adaptive physical education programs or school-based programs designed around a child’s abilities and needs.
Some communities also offer physical fitness programs such as soccer clubs that are inclusive for children with autism or other disabilities, she said.
“Physical fitness and physical activity are so important for living a healthy life, and we learn those behaviors as children,” MacDonald said.
“Anything we can do to help encourage children with autism to be more active is beneficial.”
Source: Oregon State University
A provocative new study suggest the practice of retaining children in primary grades may have unintended consequences.
Student retention is when a child is “held back” from graduating to the next grade at the end of the school year. It’s often done because the student’s grades aren’t equivalent to their peers, whether it be due to their development or academic level. It has been believed that hold a child back in their current grade will help them catch up in their development level.
However, it’s also been known that student retention can have negative effects too.
In the study, sociologist Dr. Megan Andrew of the University of Notre Dame found that, just as is the case for labor-market careers, events early in a child’s education can leave lasting scars.
For example, retaining a child in early primary school reduces his or her odds of high school completion by about 60 percent.
These results suggest that the scarring effects of primary-grade retention operate mainly at high school completion — despite previous findings to the contrary.
The best hopes for recovery come relatively early in the educational career, Andrew suggested.
She believes that given the high-stakes environment in US education, it is important to understand the implications of potential triggering events in the educational career are often tied to singular indicators of ability.
The article is published in the journal Social Forces.
Source: Oxford University Press USA
New research finds evidence of differences in brain function in kids with attention-deficit/hyperactivity disorder (ADHD) that may underlie problems recognizing emotion in facial expressions.
Children with ADHD frequently exhibit inattention, hyperactivity, and impulsivity. These behaviors may explain why they are often excluded from peer activities, according to researchers led by Ryusuke Kakigi, M.D., Ph.D., of Japan’s National Institutes of Natural Sciences.
The researchers measured changing blood flow in the brain — called hemodynamics — to uncover the neural basis for the recognition of facial expression; they found differences between children with ADHD and typically developing children.
In the study, researchers showed images of a happy expression or an angry expression to 13 children with ADHD and 13 typically developing children and identified the area of the brain the expressions activated.
Investigators used non-invasive near-infrared spectroscopy to measure brain activity. Near-infrared light, which normally passes through the body, was projected through the skull and the absorbed or scattered light was measured.
The strength of the light depends on the concentration of oxyhemoglobin — the oxygen-loaded form of hemoglobin, the predominant protein in red blood cells — which fuels the active neurons.
Typically developing children showed significant hemodynamic response to both the happy expression and angry expression in the right hemisphere of the brain.
But kids with ADHD had a significant hemodynamic response only to the happy expression; there was no specific brain activity seen for the angry expression.
The researchers suggested this difference might be responsible for ADHD children’s difficulties with social recognition and establishing peer relationships.
The findings are discussed in the online journal Neuropsychologia.
Teen girls from poor families are at greater risk than boys for becoming overweight or obese, and, in turn, adult obesity results in further socioeconomic difficulties, suggesting a lifelong cycle, according to a new study from the University of Texas at Austin.
The research, published in the Journal of Health and Social Behavior, investigated the relationship between childhood poverty and obesity in adulthood.
The findings emphasize the need for programs and policies that target the negative health effects of socioeconomic disadvantage in childhood and adolescence, said lead author Dr. Tetyana Pudrovska, assistant professor of sociology.
For the study, researchers pulled data from the Wisconsin Longitudinal Study and tracked patterns of weight gain in more than 10,000 individuals from high school graduation in 1957 to later career stages in 1993.
They found that economic disadvantage in early life is strongly linked to higher body mass at age 18 and a greater risk of obesity at age 54. This link is the strongest among women and non-existent or inconsistent among men.
“Girls born into socioeconomically disadvantaged families are exposed from early life to an unfolding chain of lower socioeconomic status and higher body mass,” said Pudrovska, a faculty associate in the Population Research Center. “Women are more strongly impacted than men both by adverse effects of low socioeconomic status on obesity and by adverse effects of obesity on status attainment.”
Obese and overweight women must then face even further social and economic disadvantages, Pudrovska added. The findings show that obese women are less likely than thinner women to secure important social resources including education, occupational prestige and earnings.
This socioeconomic disadvantage in adulthood further increased the risk of obesity, suggesting a vicious circle of obesity and poverty. According to the study, this effect was not evident among men.
Why does being overweight exert such a strong and persistent negative result on women’s social achievement? The simple answer is that big is not considered beautiful, Pudrovska said.
“In our perpetual quest for female beauty, slenderness has become paramount,” Pudrovska said. “Physical attractiveness is more closely tied to thinness and more strictly enforced for girls and women than boys and men.”
To end this cycle of poverty and obesity, said Pudrovska, there is a need for more public awareness of weight-based discrimination in the labor market.
“Because obesity is not a protected status under federal law, promoting legal protection of overweight and obese persons from unfair treatment in the workplace is important, especially among women,” Pudrovska said.
Source: University of Texas at Austin
A new study shows that family-based therapies are twice as effective as individual therapy at combating anorexia nervosa in teenagers.
The study, which compares two different family-based therapies, adds to a growing body of evidence supporting the value of parents’ involvement in anorexia treatment, according to researchers at Stanford University.
“The take-away message for parents is that, first, there is good treatment available for their child who is struggling with anorexia,” said Stewart Agras, M.D., professor emeritus of psychiatry and behavioral sciences at Stanford and the lead author of the new study. “Second, the preferred treatment is family-based therapy in which parents help their child regain weight.”
Anorexia nervosa patients suffer distorted body image, believing they are overweight. They overexercise and refuse to eat enough to maintain a healthy body weight. The disease, which affects about 0.5 to 0.7 percent of adolescent girls, has one of the highest suicide rates of any psychiatric disorder, according to the researchers.
“For a long time, people blamed families for causing anorexia and thought they should be left out of treatment,” said James Lock, M.D., Ph.D., professor of psychiatry and behavioral sciences at Stanford and a co-author of the study. “But this study suggests that, however you involve them, families can be useful, and that more focused family treatment works faster and more cost-effectively for most patients.”
The study, a randomized, controlled trial of 164 patients conducted at six sites in the United States and Canada, compared two forms of anorexia treatment that involved regular therapy sessions with adolescents and their families.
One approach focused on teaching parents to help their children eat normally and regain weight at home. The other attempted to resolve difficult family dynamics.
Both therapies produced similar rates of recovery from anorexia, but patients treated with the first approach gained weight faster and needed less hospitalization, the study found.
The patients were ages 12-18 and had been ill with anorexia for an average of 13.5 months. At the start of the study, all had body weights of at least 75 percent of what was considered ideal, meaning that physicians considered it safe for them to receive outpatient treatment.
Nearly 90 percent of the patients were female. All had at least one parent who agreed to participate in treatment, which consisted of 16 one-hour therapy sessions over a nine-month period.
The success of the treatments was evaluated at the end of the nine-month period and again a year later, according to the researchers.
The therapy that focused on teaching parents to help their children eat normally again was about half as expensive as the family-dynamics approach, mostly because patients spent less time in the hospital, researchers explained.
However, the therapy that focused on family dynamics was more effective for one specific sub-group of patients: those who also had severe symptoms of obsessive-compulsive disorder, the study found.
Lock, who has done several previous studies of the therapy that teaches parents to help their children eat normally again, said he thinks this approach works by interrupting the patient’s behaviors that support erroneous thinking patterns.
“We think that parents are able to disrupt the maintaining behaviors of anorexia long enough that the thoughts and cognitions that go with the disease diminish,” he said. “At that point, the cognitions themselves have very little staying power.”
Tackling anorexia during the teenage years offers the best hope for long-term remission, Agras said.
“The longer anorexia goes on, the more difficult it is to treat,” he said. “A great many people live chronically restricted lives because of this disease — they plan their days around undereating and overexercise — and quite a few die. The idea is to treat the disorder in adolescence to prevent more adults from becoming anorexic.”
The study was published in JAMA Psychiatry.
Coaching patients with chronic obstructive pulmonary disease (COPD) on how to manage stress, practice relaxation, and participate in light exercise can boost a patient’s quality of life, improving both mental and physical health, according to a new study.
About 15 million Americans have COPD, a progressive disease that limits airflow in the lungs. It is now the third leading cause of death in the U.S., according to the Centers for Disease Control and Prevention.
During the five-year study, which was based at Duke University and Ohio State University, 147 COPD patients participated in coping skills training. Psychologists provided regularly scheduled phone sessions, offering patients and their caregivers general information about COPD, step-by-step instructions in relaxation techniques such as deep breathing, tensing and releasing muscles, and ways to manage their reactions to stressful events.
Another group of 151 patients also received regular phone consultations, but only on topics such as medication and nutrition. They did not receive specific coping techniques.
Participants who received training in coping skills reported improvements in their overall mental health, and lessened depression, anxiety, fatigue and shortness of breath when compared to the other group, according to the study’s findings.
Although there were no improvements in COPD-related hospitalizations or deaths, the study suggests that the low-cost approach could enhance quality of life, reduce distress and somatic symptoms, and improve physical functioning for patients, according to the researchers.
“COPD is an increasingly important public health problem. It’s a debilitating and distressing illness,” said Scott Palmer, M.D., M.H.S., an associate professor of pulmonary medicine at Duke University and medical director of the project.
“Our work has established an innovative and important intervention that could improve patient quality of life. Although it has not translated into improved survival rates, this approach is worthy of further investigation.”
“Patients with COPD do not often seek mental health services,” added James Blumenthal, Ph.D., the J.P. Gibbons Professor of Behavioral Medicine in the Department of Psychiatry and Behavioral Sciences at Duke. “Given the other issues patients face with this illness, they may not feel as though mental health treatment is a priority.”
Telephone coaching offers privacy and minimal inconvenience, he continued.
“This could be a valuable treatment for patients with other chronic conditions in which traditional mental health services are not easily accessible, or when patients are reluctant to seek such services,” he concluded.
The National Institutes of Health provided grant support for the study, which was published in the journal Psychosomatic Medicine.
Source: Duke University
Mothers of children with autism are far less likely to have taken iron supplements before and during their pregnancies than mothers of typically developing children, according to researcers..
The research is the first to examine the relationship between maternal iron intake and having a child with autism spectrum disorder, the authors said.
“The association between lower maternal iron intake and increased ASD risk was strongest during breastfeeding, after adjustment for folic acid intake,” said Dr.Rebecca J. Schmidt, assistant professor in the Department of Public Health Sciences and a researcher affiliated with the MIND Institute.
“Further, the risk associated with low maternal iron intake was much greater when the mother was also older and had metabolic conditions during her pregnancy.”
Among the study participants, mothers with low iron intake were five times more likely to have a child with autism if they were 35 or older at the time of the child’s birth or if they suffered from metabolic conditions such as obesity hypertension or diabetes.
The research involved mother-child pairs enrolled in the Northern California-based Childhood Autism Risks from Genetics and the Environment (CHARGE) Study. The participants included mothers of children with autism and 346 mothers of typically developing children.
The researchers examined the mothers’ iron intake, including vitamins, other nutritional supplements, and breakfast cereals during the three months prior to pregnancy through the end of the pregnancy and breastfeeding. In order to study the iron intake through supplementation, the researchers examined the frequency, dosages and the brands of supplements that the women consumed.
“Iron deficiency, and its resultant anemia, is the most common nutrient deficiency, especially during pregnancy, affecting 40 to 50 percent of women and their infants,” Schmidt said.
“Iron is crucial to early brain development, contributing to neurotransmitter production, myelination and immune function. All three of these pathways have been associated with autism.”
“Iron deficiency is pretty common, and even more common among women with metabolic conditions,” Schmidt said. “However we want to be cautious and wait until this study has been replicated.
“In the meantime the takeaway message for women is do what your doctor recommends. Take vitamins throughout pregnancy, and take the recommended daily dosage. If there are side effects, talk to your doctor about how to address them.”
The study is published in the American Journal of Epidemiology.
Women with post-traumatic stress disorder (PTSD) are at greater risk for developing a food addiction, according to a new study by researchers at the University of Minnesota.
In fact, women who show severe symptoms of PTSD are twice as likely to meet food addiction criteria.
“I’d really like the message to come across that people bring a whole lot of history to their eating behaviors,” said lead author Susan Mason, Ph.D., M.P.H., from the University of Minnesota in Minneapolis.
The study, published in the journal JAMA Psychiatry, involved more than 49,000 female participants who were asked to complete a questionnaire.
The findings showed that women who reported more PTSD symptoms were more likely to have food addiction when measured with the Yale Food Addiction Scale, a measure of food dependency.
More than 50 percent of the participants were exposed to some type of trauma, and about 66 percent of these women reported experiencing at least one lifetime PTSD symptom. Around 8 percent of these women also reported between 6 and 7 PTSD symptoms, which was the maximum on the questionnaire they had completed. About 8 percent of the total participants were believed to have food addiction.
“This prevalence ranged from 6 percent among women with no trauma and no PTSD symptoms to nearly 18 percent among women with trauma and 6-7 PTSD symptoms,” said the researchers.
Mason suggests that food addiction can also lead to obesity, which is also a major public health issue in the U.S. More research is needed, however, to establish a connection between PTSD and obesity.
“I just want this to add to a lot of research that people’s weight status is not just a symptom of willpower and education,” Mason said. “There may be psychological factors in play too.”
Mason added that they don’t know which occurred first in these women — PTSD or food addiction — or even if one causes the other.
“These two things appeared to happen a lot in the same women,” Mason said. “We don’t know it’s causal. It’s an interesting relationship and probably worth following up.”
The findings could help physicians treat women with eating disorders. “Clinicians may be able to look for that information to deliver better care,” Mason said.
Approximately 7 to 8 percent of Americans will suffer from PTSD at some point in their life and around 5.2 million adults experience PTSD each year in the U.S.
The study is published in the journal JAMA Psychiatry.
Source: University of Minnesota
While most severely obese people are much happier once they lose weight after bariatric surgery, this isn’t true for all patients, according to new research.
In fact, based on the findings of their new study, researchers at the Yale University School of Medicine advise that levels of depression be measured six to 12 months after bariatric surgery. This, they say, will ensure that the necessary help can be provided.
Researchers Valentina Ivezaj, Ph.D., and Carlos Grilo, Ph.D., set out to investigate how prone bariatric patients are to still experiencing symptoms of depressions after surgery.
Self-reported questionnaires were completed by 107 patients with extreme obesity before they underwent gastric bypass surgery, and then again six and 12 months after the procedure. They were asked to reflect on their levels of depression, possible eating disorders, their self-esteem and general social functioning, according to the researchers.
Of the 107 participants, 94 were women, 73 were white, and 24 had completed college.
Consistent with previous research, the researchers found that most people were in much better spirits after the surgery. In fact, most reported experiencing a normal and improved mood at six and 12 months after surgery, the researchers reported.
However, in some cases negative mood changes started to creep in between six and 12 months after the operation, the researchers discovered. They found that 3.7 percent of patients reported they felt discernibly more depressed 12 months post-surgery.
Between six and 12 months after the operation, however, even more patients — 13.1 percent — reported increases in symptoms of depression. These changes went hand-in-hand with significantly lower levels of self-esteem and social functioning, the researchers found.
“The majority of patients whose mood had worsened discernibly experienced these mood changes between six and 12 months post-surgery, suggesting this may be a critical period for early detection and intervention, as needed,” said Ivezaj.
“The increases in symptoms of depression are also notable given that they were associated with other difficulties, including lower self-esteem and social functioning,” added Grilo.
The researchers noted that the increases in symptoms were indicative of only subthreshold or mild mood disturbances. They also said that future research is needed to determine whether these mood changes continue to worsen over time.
The study was published in the journal Obesity Surgery.
“Active-shooting” incidents, such as deadly mass shootings, are on the rise in the United States. So public awareness of best practices is necessary, according to a new FBI study.
An “active shooter” is defined as one or more individuals with a gun actively trying to kill people in a populated area. The FBI is providing local law enforcement with advanced equipment and training for confronting these attackers.
Between 2000 and 2013, there were 160 active shooting incidents in the U.S.. During the first seven years of the study, an average of 6.4 incidents occurred each year. That average increased to 16.4 attacks in the last seven years.
“We know that the FBI, we’re not going to be the first responders.” said FBI Assistant Director James F. Yacone. “It’s going to be our state, local, college-campus and tribal partners that are going to be those first responders. And these incidents, the large majority of them are over in minutes.”
In fact, in 64 incidents in which the duration of the shooting was determined, 44 shootings (69 percent) were over in five minutes or less.
The report notes that “even when law enforcement was present or able to respond within minutes, civilians often had to make life and death decisions… ”
“We’re trying to push out lessons learned and best practices,” Yacone said. “Not just to law enforcement, who are going to be the first responders to this. But to the citizens, run, hide, fight, being a simple message that resonates with this.”
Although the research did not focus on the motivation of the shooters, the report determined that the shooter acted alone in all but two incidents. In school shootings, the attacker was usually a student or former student. In the 160 total shootings, only six female shooters were identified.
“Many [shooters] have real or perceived personal grievances, and believe that only catastrophic violence can provide them with relief,” said Andre Simons of the FBI’s Behavioral unit.
Researchers report that the 160 active-shooting incidents between 2000 and 2013 have killed 486 people and wounded 557. About 40 percent of the incidents also met the agency’s definition of a “mass killing,” in which three or more people are killed.
In most cases (56 percent) the shooting incident ends when the gunman fled the scene, or killed himself.
According to Simons, the real mission is to stop active-shooting incidents before they begin, and law enforcement needs the public’s help to do that. He said that public awareness of the issue is on the rise. In fact, the FBI has received three to four tips per week regarding potential shooters who have been identified as deeply troubled, and openly talking about violence.