In The News
The decades-long controversy of whether stimulant medications for childhood attention-deficit/hyperactivity disorder (ADHD) impact a child’s sleep may be finally over.
A new study from the University of Nebraska-Lincoln (UNL) concludes that stimulant medications for attention-deficit/hyperactivity disorder (ADHD) can cause sleep problems among the children who take them.
The study addresses decades of conflicting opinions and evidence about the medications’ effect on sleep.
In a meta-analysis, researchers from the UNL Department of Psychology combined and analyzed the results from past studies of how ADHD medications affect sleep.
In a study published online by the journal Pediatrics, the Nebraska researchers found children given the medicines take significantly longer to fall asleep, have poorer quality sleep, and sleep for shorter periods.
“We would recommend that pediatricians frequently monitor children with ADHD who are prescribed stimulants for potential adverse effects on sleep,” said Katie Kidwell, a psychology doctoral student who served as the study’s lead author.
About one in 14 children and adolescents in the U.S. are diagnosed with ADHD, a chronic condition that includes attention difficulty, hyperactivity, and impulsiveness. In the most common form of ADHD treatment, about 3.5 million are prescribed stimulant medications such as Ritalin and Adderall.
Many research articles have been written in the past 30 years on whether ADHD medications harm the ability to sleep. Some researchers have found that the drugs do interfere with sleep, particularly if taken later in the day.
Others maintain the medications improve patients with ADHD’s ability to sleep, by relieving symptoms and reducing resistance to bedtime. Indeed, some suggest that sleep problems are caused by the medication wearing off near bedtime, creating withdrawal symptoms.
“One reason we did the study is that researchers have hypothesized different effects, and there are some conflicting findings in the literature,” said Dr. Timothy Nelson, an associate professor of psychology involved in the study.
“This is when a meta-analysis is most useful. By aggregating and previous research in a rigorous and statistical way, we can identify the main findings that we see across all these studies. It’s essentially a study of studies.”
After screening nearly 10,000 articles, Kidwell and her colleagues reviewed 167 full texts before selecting nine studies of sufficient rigor for their analysis. Tori Van Dyk and Alyssa Lundahl, also psychology doctoral students, assisted in the effort.
Studies chosen for the analysis were peer-reviewed, randomized experiments. The studies did not rely on parental reports of their children’s sleeping patterns, instead requiring objective measures obtained through clinical sleep studies or wristband monitors used at home.
The researchers found that both methylphenidate medications like Ritalin and amphetamines like Adderall cause sleep problems, without identifying differences between the two. Although they were unable to determine whether varying dosage amounts changed the effect on sleep, they found that more frequent dosages made it harder for children to fall asleep.
Investigators also found that drugs tend to cause more sleep problems for boys. The problems dissipate, but never completely go away, the longer children continue to take the medication.
“Sleep impairment is related to many cognitive, emotional, and behavioral consequences, such as inattention, irritability, and defiance,” Kidwell said.
“Sleep adverse effects could undermine the benefits of stimulant medications in some cases. Pediatricians should carefully consider dosage amounts, standard versus extended release, and dosage frequencies to minimize sleep problems while effectively treating ADHD symptoms.”
She also recommended considering behavioral treatments, such as parental training and changes to classroom procedures and homework assignments, to reduce ADHD’s negative consequences.
The findings obviously represent a dilemma for parents and physicians.
“We’re not saying don’t use stimulant medications to treat ADHD,” Nelson said. “They are well tolerated in general and there is evidence for their effectiveness. But physicians need to weigh the pros and cons in any medication decision, and considering the potential for disrupted sleep should be part of that cost-benefit analysis with stimulants.”
Those promoting a “whole-child” approach to education contend that we need a holistic perspective that aims to nurture the full range of skills and capacities that will help children of today become healthy and competent future adults.
However, others believe that the increased scrutiny of academic achievement gaps among children in the United States, as well as between children in our country and other developed countries, has led to school curriculums that do not address non-academic skills.
In fact, this may be a false dilemma. New research suggests social-emotional learning may enhance academic proficiency.
School Psychology Quarterly recently reported on a randomized, controlled trial of an evidence-based social and emotional learning (SEL) curriculum (PATHS: Promoting Alternative THinking Strategies) performed for grades three to six.
Researchers found that students in schools randomized to receive an enhanced SEL program were more likely than those in the control group to achieve basic proficiency in reading, writing, and math on independently administered state mastery tests in later grades.
The project involved all students enrolled in regular or bilingual education in an inner-city school system where two out of three students qualify for a free or reduced price lunch and nine out of 10 students are African-American or Hispanic/Latino American.
The project focused on the impact of advancing academic proficiency at the lowest level (i.e., below basic proficiency) given that the curriculum has demonstrated positive impact on behavior and emotion for students most at-risk.
This concept follows the belief that these students might be most vulnerable to the negative impacts of suboptimal social and emotional skills, classroom and school climate, and school engagement. Furthermore, this group of students contributes most to the achievement gap that has challenged our country’s educational system.
Investigators were pleased to find that children randomized to schools where the enhanced SEL curriculum was taught were more likely to achieve basic proficiency in the three academic areas evaluated by the mastery test.
Furthermore, within the schools where the enhanced SEL curriculum was implemented, researchers saw a “dosage effect;” students whose teachers reported teaching more of the lessons were more likely to achieve basic proficiency. Positive intervention effects of the curriculum were found in at least some grade levels for all three academic content areas.
Learning social-emotional skills improved basic proficiency in fourth grade reading and math, as well as fifth and sixth grade writing, compared to the control group. Moreover, the dosage effects provide additional support for the intervention effects for reading and math.
Although the effect sizes were relatively small, considering that the curriculum aims to teach social-emotional skills and was implemented to reduce the onset of high-risk behaviors (a prior paper by the team showed that the program helped reduce early sexual behavior), the fact that there was also impact on academic test scores is noteworthy.
Investigators noted that this is one of the first studies to examine the impact of a multiyear SEL program on academic achievement among young students. Researchers believe the findings are important because many schools are actively restricting classroom time devoted to any subjects or activities that do not appear to directly prepare children for high-stakes testing in reading, writing, and math.
Teachers and school administrators are increasingly finding their job performance linked to the degree to which their students demonstrate achievement in these subject areas. As a result, many important components of children’s education, including SEL, are being seriously compromised or eliminated entirely.
This research provides support that SEL may be a promising approach to promote basic academic proficiency, especially for those students most at risk.
Toddlers as young as two years old are able to pick up on their mothers’ anti-fat prejudices, according to a new study led by the University of Otago in New Zealand.
Prior research has shown that anti-fat prejudice is evident in preschool children aged slightly more than three and a half years old and is well-established in five to 10-year-olds. But the new research suggests that these attitudes may have an even earlier onset.
For the current study, the researchers showed 70 infants and toddlers photos of two people; one person in the photo was obese and the other person was of normal weight. The persons’ faces were covered to keep the focus on the body type. The researchers also used questionnaires to gauge the mother’s attitude toward obesity.
“What we found is that younger infants, around 11 months of age, preferred to look at obese figures, whereas the older toddler group, around 32 months old, preferred to look at average-sized figures,” said Professor Ted Ruffman from Otago’s Department of Psychology.
“Furthermore we found that preference was strongly related to maternal anti-fat prejudice. It was a high correlation: The more the mother had expressed anti-fat attitudes in the questionnaire, the more the older toddlers would look away from the obese figure towards the normal weight one.”
The researchers considered other potential factors that could play a role in this prejudice, such as parental BMI, education, and children’s TV viewing but these were found to be unrelated to the sort of figure the child preferred to look at. Ruffman said the study is not meant to be a mother-blaming exercise, but it does indicate how early children begin to absorb and display the attitudes of those around them.
“It’s just that mothers tend to be the primary caregivers and they are just reflecting wider societal attitudes,” he says.
Ruffman said that “some argue this anti-fat prejudice is innate but our results indicate it is socially learned, which is consistent with findings about other forms of prejudice. What is surprising, is that children are picking up on these things so early.”
Study co-author Dr. Kerry O’Brien from Monash University noted that “weight-based prejudice is causing significant social, psychological, and physical harms to those stigmatized. It’s driving body dissatisfaction and eating disorders in underweight populations; and social isolation, avoidance of exercise settings, and depression in very overweight populations. We need to find ways to address this prejudice.”
Source: University of Otago
New research confirms that mental stress is associated with a variety of skin issues in college students.
In the study, scientists at the Lewis Katz School of Medicine (LKSOM) at Temple University (LKSOM) and Temple University sought to confirm that heightened levels of psychological stress are associated with skin complaints.
To do this they studied a large, randomly selected sample of undergraduate students. Study results appear in the international, peer-reviewed journal Acta Dermato-Venereologica.
“Previous studies have demonstrated an association between stress and skin symptoms, but those studies relied on small patient samples, did not use standardized tools, are anecdotal in nature, or focused their analyses on a single skin disease,” said Gil Yosipovitch, M.D., chair of the Department of Dermatology at LKSOM and corresponding author of the study.
Researchers performed a questionnaire-based, cross-sectional study at Temple University during the 2014 fall semester. Five thousand undergraduate students were invited to participate in a web-based survey in which they reported their perceived psychological stress and any skin complaints. Four hundred twenty-two students were included in the final sample size.
Respondents were divided into groupings labeled as low stress, moderate stress, and high stress.
Compared to low stress subjects, the high stress group suffered significantly more often from pruritus (itchy skin); alopecia (hair loss); oily, waxy, or flaky patches on the scalp; hyperhidrosis (troublesome sweating); scaly skin; onychophagia (nail biting); itchy rash on hands; and trichotillomania (hair pulling).
Surprisingly, there was no association between perceived psychological stress levels and the presence of pimples, dry/sore rash, warts, and other rashes on the face.
Despite study limitations (e.g., low response rate, absence of physical assessment of respondents), Yosipovitch says the results are important for dermatologists who treat undergraduate-aged patients.
“Our findings highlight the need for health care/dermatology providers to ask these patients about their perceived levels of psychological stress. Disease flare or exacerbation while on treatment in the setting of increased stress may not necessarily reflect treatment failure.”
Yosipovitch adds, “These findings further suggest that non-pharmacologic therapeutic interventions should be considered for patients presenting with both skin conditions and heightened levels of psychological stress.”
Source: Temple University/EurekAlert
An interdisciplinary team has developed a computer algorithm that can predict, with high levels of accuracy, if your relationship with your spouse will improve or deteriorate.
University of Southern California researchers say the software is 79 percent accurate. In fact, the algorithm did a better job of predicting marital success of couples with serious marital issues than descriptions of the therapy sessions provided by relationship experts.
Study results are reported in the journal Proceedings of Interspeech.
Researchers recorded hundreds of conversations from more than 100 couples taken during marriage therapy sessions over two years, and then tracked their marital status for five years. Drs. Shrikanth Narayanan and Panayiotis Georgiou of the University of Southern California Viterbi School of Engineering with doctoral student M.D. Nasir and collaborator Dr. Brian Baucom of University of Utah lead the research effort.
From the data gathered, investigators then developed an algorithm that broke the recordings into acoustic features using speech-processing techniques. These included pitch, intensity, “jitter” and “shimmer” among many; things like tracking warbles in the voice that can indicate moments of high emotion.
“What you say is not the only thing that matters, it’s very important how you say it. Our study confirms that it holds for a couple’s relationship as well,” Nasir said.
Taken together, the vocal acoustic features offered the team’s program a proxy for the subject’s communicative state, and the changes to that state over the course of a single therapy and across therapy sessions.
The innovative research looked at vocal patterns and inflections over time.
That is, the vocal signatures were not analyzed in isolation; rather, the impact of one partner upon the other and the vocal tone was studied over multiple therapy sessions.
“It’s not just about studying your emotions,” Narayanan said. “It’s about studying the impact of what your partner says on your emotions.”
“Looking at one instance of a couple’s behavior limits our observational power,” Georgiou said.
“However, looking at multiple points in time and looking at both the individuals and the dynamics of the dyad can help identify trajectories of the their relationship. Sometimes those are for the best or sometimes they are towards relationship deterioration.”
The power of such methods is to help identify how domain experts can better advise couples towards improved relationships, Georgiou said.
“Psychological practitioners and researchers have long known that the way that partners talk about and discuss problems has important implications for the health of their relationships. However, the lack of efficient and reliable tools for measuring the important elements in those conversations has been a major impediment in their widespread clinical use.
“These findings represent a major step forward in making objective measurement of behavior practical and feasible for couple therapists,” Baucom said.
Once it was fine-tuned, the program was then tested against behavioral analyses made by human experts who studied the couples. Those behavioral codes (positive qualities like “acceptance” or negative qualities like “blame”).
The team found that studying voice directly — rather than the expert-created behavioral codes — offered a more accurate glimpse at a couple’s future.
Researchers now plan to use behavioral signal processing — a framework for computationally understanding human behavior — to improve the prediction of how effective treatments will be.
This will entail the analysis of how language (e.g., spoken words) and nonverbal information (e.g., body language) influence the effectiveness of therapy.
New research suggests the role of serotonin is more complex than typically assumed, a finding that may allow for the development of better drugs for depression and anxiety.
Serotonin in the brain is known to play a role in depression and anxiety, and it is customary to treat these disorders with medications that increase the amount of this neurotransmitter.
However, a new study suggests that this approach may be too simple.
Researchers at Columbia University Medical Center (CUMC) have discovered that neighboring serotonin-producing brainstem regions exert different and sometimes opposing effects on behavior.
The findings, published in the online edition of Cell Reports, provide new insights into the development of mood disorders and may aid in designing improved therapies.
“Our study breaks with the simplistic view that ‘more is good and less is bad,’ when it comes to serotonin for mood regulation,” said study leader Mark S. Ansorge, Ph.D., assistant professor of psychiatry at CUMC and research scientist at New York State Psychiatric Institute.
“Rather, it tells us that a more nuanced view is necessary.”
From anatomical studies, researchers knew that the brainstem contains two distinct clusters of neurons that produce serotonin: one in dorsal raphe nucleus (DRN) and another in the median raphe nucleus (MRN). Together both regions harbor the vast majority of neurons that supply serotonin to the rest of the brain, but it was unclear how neuronal activity within these clusters controls behavior.
To learn more, researchers used a technique called pharmacogenetics to control the activity of serotonergic neurons in the DRN and MRN in both normal mice and in a mouse model of depression- and anxiety-like behavior.
The model was created by giving mice the drug fluoxetine (Prozac) shortly after birth, which produces long-lasting behavioral changes. Investigators discovered alterations in serotonergic neuronal activity in the DRN and MRN produce markedly different behavioral consequences.
“Going into the study, our hypothesis was that reduced activity of serotonergic neurons is what drives these mood behaviors,” said Ansorge.
“But what we found was more complicated. First, it appears that hyperactivity of the MRN drives anxiety-like behavior. We also observed that decreased DRN activity increases depression-like behavior, while decreased MRN activity reduces it.
“This led us to conclude that an imbalance between DRN and MRN activity is what leads to depression-like behavior.”
“This new understanding of the raphe nuclei should help us better understand why certain medications are effective in treating depression and anxiety, and aid in designing new drugs,” Ansorge added.
“In the future, it may be possible to find treatments that selectively target the DRN or the MRN, or that correct any imbalance between the two.”
Jeffrey Lieberman, M.D., chair of the department of psychiatry at CUMC, observed that studies such as this are essential to understand the molecular mechanisms and impact of antidepressant treatments as this will lead to the development of more effective therapies.
The study also demonstrated, in experiments using the fluoxetine-treated mice, that inhibition of serotonin reuptake early in life leads to long-lasting imbalances between the DRN and MRN.
“This raises possible concerns about exposure to serotonin-specific reuptake inhibitors during gestation,” said Ansorge.
“SSRIs cross the blood-brain barrier as well as the placenta, and bind maternal and fetal serotonin transporters alike. It’s too early to say whether this has any effect on behavior in humans, but it’s certainly something worth looking into.”
Source: Columbia University/EurekAlert
A new study finds that people diagnosed with a sexually transmitted disease (STI) are judged harshly and unfairly.
University of Michigan researchers found the public often overestimates the risk for STIs when compared to other health risks. And this perception can exacerbate negative outcomes.
Individuals who feel stigmatized often make riskier decisions, which can affect potential sexual partners, said Dr. Terri Conley, University of Michigan associate professor of psychology and women’s studies.
“Stigmatizing behaviors does not prevent unhealthy activities from occurring,” she said. “When STIs are stigmatized, it prevents people who suspect they have STIs from getting tested or informing their partners about the possibility of disease exposure.”
The twisted logic is illuminated by the finding that a person who unknowingly transmits chlamydia and causes a partner to have to take antibiotics is perceived more negatively than someone who transmits the H1N1 flu that results in a person’s death.
Understanding the stigma is critical in health contexts, Conley said.
Conley and colleagues performed several studies to examine the extent to which sexually transmitted infections and sexual behavior were perceived as risky compared to other deadlier behaviors.
Study participants were asked to make judgments about one of two risky behaviors, one associated with STIs (unprotected sex) and the other associated with driving.
The researchers also assessed the negative perceptions of people who transmit STIs compared to those who transmit another nonsexual disease.
Participants were asked to estimate how many of 1,000 people would be expected to die driving from Detroit to Chicago (about 300 miles) compared with the same number expected to die from an HIV/AIDs-related cause.
Most believed 17 times as many people would die from contracting HIV in one encounter.
Data from the Center for Disease Control and Prevention and the National Highway Traffic Safety report, on average, that a person is 20 times more likely to die from a car accident on a trip of 300 miles.
“In other words, participants’ impressions of the riskiness of unprotected sex compared with driving were highly inaccurate,” Conley said.
Participants viewed unprotected sex as being more risky than the more mundane, but more dangerous activity of driving, she said.
The findings appear in the International Journal of Sexual Health.
Source: University of Michigan
A simple impulsivity test may be able to predict how well a toddler will perform academically at age eight, according to a new study at the University of Warwick.
The findings show that toddlers who were born very prematurely tend to be more impulsive and subsequently have lower academic achievement in elementary school.
The impulsivity test involved a single raisin and a transparent cup. The idea was to see if a 20-month old child could patiently wait a full minute before picking up the piece of dried fruit. After three practice runs, the toddlers were asked to wait until they were told (60 seconds) that it was OK to touch and eat the raisin.
Children who were born very prematurely were more likely to take the raisin before the time was up. In a follow-up study seven years later, the researchers found that the more impulsive toddlers weren’t performing as well in school as their full-term peers.
“An easy, five-minute raisin game task represents a promising new tool for follow-up assessments to predict attention regulation and learning in preterm and term born children. The results also point to potential innovative avenues to early intervention after preterm birth,” said senior author Professor Dieter Wolke at the University of Warwick’s Department of Psychology and Warwick Medical School.
The research was part of the ongoing Bavarian Longitudinal Study which began in Germany in 1985. During the study, 558 children born at 25 to 41 weeks gestation were assessed for self-control once they were 20 months old. The results of those born preterm at 25 to 38 weeks were compared to children born full term at 39 to 41 weeks.
Around age eight, the same children were evaluated by a team of psychologists and pediatricians using three different behavior ratings of attention from mothers, psychologists, and the whole research team. Academic achievement — including mathematics, reading, and spelling/writing — was assessed using standardized tests.
The findings showed that the lower the gestational age, the lower a toddler’s inhibitory control — and the more likely those children would have poor attention skills and low academic achievement at eight years of age.
“This new finding is a key piece in the puzzle of long-term underachievement after preterm birth,” said Dr. Julia Jaekel, lead author of the study and honorary research fellow at the University of Warwick and assistant professor of child and family studies at the University of Tennessee.
The researchers believe that being able to identify cognitive problems early on could result in the development of a specialized, tailored education to help prevent these children from underachievement at school and later on as adults.
The study is published in The Journal of Pediatrics.
Source: University of Warwick
States cut five billion dollars in mental health services from 2009 to 2012, according to USA Today. A new article online in Annals of Emergency Medicine starkly illustrates the impact on one California county.
Sacramento County emergency departments saw more than triple the number of emergency psychiatric consults and 55 percent increases in lengths of stay for psychiatric patients in the first year after funding was slashed.
“As is often the case, the emergency department catches everyone who falls through the cracks in the health care system,” said lead study author Arica Nesper, M.D., M.A.S., of the University of California Davis School of Medicine in Sacramento.
“People with mental illness did not stop needing care simply because the resources dried up. Potentially serious complaints increased after reductions in mental health services, likely representing not only worse care of patients’ psychiatric issues but also the medical issues of patients with psychiatric problems.”
After Sacramento County in California decreased its inpatient psychiatric beds from 100 to 50 and closed its outpatient unit, the average number of daily psychiatry consults in the emergency department increased from 1.3 to 4.4. The average length of stay for patients requiring psychiatric consults in the emergency department increased by 55 percent, from 14.1 hours to 21.9 hours.
Three hundred and fifty patients (out of a total of 1,392 patients undergoing psychiatric evaluation) were held in the emergency department longer than 24 hours. The study period was 16 months: eight months before the cuts and eight months after.
“Between 2009 and 2011, $587 million was cut from mental health services in California,” said Nesper. “These cuts affect individual patients as well as communities and facilities like emergency departments that step in to care for patients who have nowhere else to turn.
“Ultimately, these cuts led to a five-fold increase in daily emergency department bed hours for psychiatric patients. That additional burden on emergency departments has ripple effects for all other patients and the community.”
A new academic review of the ethical considerations of establishing a social media relationship with a medical professional raises a bevy of issues that should be considered by patients and providers.
Although social media has become engrained into almost every area of our life, becoming Facebook friends with your doctor may alter the traditional patient-physician relationship in ways that may be positive or negative.
In a recent AMA Journal of Ethics article, two Loyola University Chicago Medicine professors analyzed the issue.
In the article, Kayhan Parsi, J.D., Ph.D., and Nanette Elster, J.D., M.P.H., who are part of Loyola’s Neiswanger Institute for Bioethics, discuss the good, the bad, and the ugly of social media and health care.
“Maintaining privacy and confidentiality are integral to the patient-health care professional relationship, since preserving patient trust is essential for competent clinical care,” Parsi and Elster said.
“The use of social media in health care raises a number of issues about professional and personal boundaries, and the integrity, accountability, and trustworthiness of health care professionals.”
The article uses five case studies to highlight possible ethical and legal issues that arise with the use of social media in health care.
The cases address topics such as posting work-related photos on Facebook, tweeting personal or political opinions, and Googling patients and prospective candidates for jobs. The article analyzes questions like: is it appropriate for health care professionals to friend a patient on Facebook, or even connect through LinkedIn?
“When it comes to social media it’s important for health care professionals to be aware of personal and professional boundaries. When someone reads a post, do they see it is as a statement from a physician, or an individual? These lines are easily blurred on social media,” said Parsi.
Despite the potential pitfalls of social media, Parsi and Elster also highlight benefits of social media in health care. Examples include more rapid response to public health emergencies and better communication about pharmaceutical and other recalls.
“We also see that social media makes health care institutions more personal and more human. Patients feel they can engage with the hospital or their doctor’s office and they want to tell their stories,” said Elster.
The researchers believe the review will aid health organizations in creating guidelines and finding ways to use these social media to promote good outcomes.
Source: Loyola University/EurekAlert
New research has found that older adults who improved their fitness through a moderate intensity exercise program increased the thickness of their brain’s cortex, the outer layer of the brain that typically atrophies with Alzheimer’s disease.
According to a new study from the University of Maryland School of Public Health, the improvements were found in both healthy older adults and those diagnosed with mild cognitive impairment (MCI), an early stage of Alzheimer’s disease.
“Exercise may help to reverse neurodegeneration and the trend of brain shrinkage that we see in those with MCI and Alzheimer’s,” said Dr. J. Carson Smith, an associate professor of kinesiology and senior author of the study, published in the Journal of the International Neuropsychological Society.
“Many people think it is too late to intervene with exercise once a person shows symptoms of memory loss, but our data suggest that exercise may have a benefit in this early stage of cognitive decline.”
For the study, previously inactive people between the ages of 61 and 88 were put on an exercise regimen that included moderate intensity walking on a treadmill four times a week over a 12-week period.
On average, cardiorespiratory fitness improved by about eight percent as a result of the training in all participants, the researchers reported.
The researchers also found that the people who showed the greatest improvements in fitness had the most growth in the cortical layer, including both the group diagnosed with MCI and the healthy participants.
Both groups showed strong associations between increased fitness and increased cortical thickness after the intervention. But the MCI participants showed greater improvements compared to the healthy group in the left insula and superior temporal gyrus, two brain regions that have been shown to exhibit accelerated neurodegeneration in Alzheimer’s disease, the study found.
Smith previously reported that the participants in this exercise intervention showed improvements in neural efficiency during memory recall, and this new data adds to the evidence for the positive impact of exercise on cognitive function.
Other research he has published has shown that moderate intensity physical activity, such as walking for 30 minutes three to four days a week, may protect brain health by staving off shrinkage of the hippocampus in older adults.
Smith noted that he plans future studies that include more participants engaging in a longer-term exercise intervention to see if greater improvements can be seen over time, and if the effects persist over the long term.
The key unanswered question is if regular moderate intensity physical activity could reverse or delay cognitive decline and help keep people out of nursing homes and enable them to maintain their independence as they age, he noted.
Source: University of Maryland
A new study has found that caffeine in moderation during pregnancy does not lead to reduced IQ or increased behavioral problems in children.
“We did not find evidence of an adverse association of maternal pregnancy caffeine consumption with child cognition or behavior at four or seven years of age,” said Mark A. Klebanoff, M.D., principal investigator in the Center for Perinatal Research at the Research Institute at Nationwide Children’s Hospital and faculty member at the Ohio State University College of Medicine.
For the study, published in the American Journal of Epidemiology, researchers analyzed a marker of caffeine in the blood of 2,197 expectant mothers who took part in the Collaborative Perinatal Project, conducted at multiple sites in the United States from 1959 to 1974.
According to the researchers, this was an era when coffee consumption during pregnancy was more prevalent than today, as there was little concern regarding the safety of caffeine. Therefore, the study was able to investigate a broader range of caffeine intake than if a similar study was done today, the researchers noted.
The researchers looked at the association between a chemical called paraxanthine, caffeine’s primary metabolite, at two points in pregnancy. They compared those levels to the child’s IQ and behavior at four and seven years of age.
Researchers found there were no consistent patterns between maternal caffeine ingestion and the development and behavior of those children at those points in their lives.
This new study follows previous research regarding caffeine consumption during pregnancy conducted at the Research Institute at Nationwide Children’s Hospital. Klebanoff and Sarah Keim, Ph.D., published a study in Epidemiology in March 2015 involving the same group of women and found that increased ingestion of caffeine during pregnancy did not increase the risk of childhood obesity.
Of the children in that study, about 11 percent were considered obese at four years and about seven percent at seven years. However, the researchers found no associations between their mother’s caffeine intake and these occurrences of obesity.
“Taken as a whole, we consider our results to be reassuring for pregnant women who consume moderate amounts of caffeine or the equivalent to one or two cups of coffee per day,” said Keim, who is also a faculty member at the Ohio State University College of Medicine.
Source: Nationwide Children’s Hospital
Ongoing studies of college-age women with tattoos paint a complex, even contradictory picture of mental health and illness, self-esteem and suicide.
In the latest research, Texas Tech University sociology professor Dr. Jerome Koch, found such women with multiple tattoos tend to have increased levels of self-esteem. Further, there was no connection found between increasing acquisition of body art and increased depression or suicidal ideation among men or women.
But at the same time, women with several tattoos report a much higher frequency of past suicide attempts.
The findings, according to Koch, may show that tattoos may be an act of empowerment — an expression of moving from depression to a stronger sense of self. Koch has been studying body art, both tattoos and piercings, for years.
“I think women, especially, are more aware of their bodies through, among other things, fat shaming, the cosmetics and plastic surgery industry, and hyper-sexualized imagery in media,” Koch said.
“What we may be seeing is women translating that awareness into empowerment. We know women sometimes replace a surgically removed breast, for example, with elegant body art. We wonder if more tattoos might be a way of reclaiming a sense of self in the wake of an emotional loss, evidenced by a suicide attempt.”
The study will be published in the Social Science Journal in 2016. It is the companion piece to Koch’s 2010 study, “Body art, deviance and American college students.” That study found participants with four or more tattoos, seven or more body piercings, or piercings in the nipples or genitals were significantly more likely to report regular marijuana use, occasional use of other illegal drugs, and a history of being arrested for a crime.
“This latest piece takes the same question inside out,” Koch said. “Instead of talking about deviance, it’s about wellness. We wanted to find out, to what extent does the acquisition of body art correlate to a sense of well-being or a greater sense of self? It’s pretty paradoxical.”
In a 2008 study, “Motivation for Contemporary Tattoo Removal,” Koch’s team found women were more than twice as likely as men to want to have a tattoo removed, most often as a way of disconnecting from the past. But these new findings appear to show the addition of a tattoo can serve the same purpose as a removal.
“That’s what we think is going on,” Koch said. “Women with four or more tattoos were the group that showed us the only two interesting connections: they had a much higher suicide attempt history, and paradoxically, it was this same group — and the only group — that showed an increased level of self-esteem.”
“Our interpretation is maybe it’s a parallel, emotionally, of what we see with breast cancer survivors. We can only speculate what these findings might mean, and more research needs to be done. But I think the logic holds when linking suicide survivors and breast cancer survivors who might use tattoos when reclaiming an emotional or physical loss.”
A meditation technique intended to create feelings of kindness can also reduce prejudice, according to new research.
The study, published online in the journal Motivation and Emotion, found that just seven minutes of Loving-Kindness Meditation (LKM), a Buddhist practice that promotes unconditional kindness, is effective at reducing racial bias, according to a researcher at the University of Sussex in England.
LKM is known to engender happiness and kindness to yourself and others through repeating phrases such as “may you be happy and healthy” while visualizing a particular person.
“This indicates that some meditation techniques are about much more than feeling good, and might be an important tool for enhancing inter-group harmony,” said Alexander Stell, a doctoral student in psychology and lead researcher on the study.
He noted that previous studies have shown that inducing happiness in people, for example by exposing them to upbeat music, can actually make them more likely to have prejudiced thoughts compared to those hearing sad music.
“We wanted to see whether doing LKM towards a member of another ethnic group would reduce the automatic preference people tend to show for their own ethnic group,” he explained.
For the study, a sample of 71 white, non-meditating adults were each given a photo of a gender-matched black person and either received taped LKM instructions, or instructions to look at the photos and notice certain features of the face. Both conditions lasted just seven minutes.
Using the Implicit Association Test, the researchers then scored the reaction times of the participants who were asked to match up positive and negative words — for example “happiness” or “wrong” — with faces that belonged to either their own or another ethnic group.
On average, people are quicker to match positive stimuli with their own group and quicker to match negative stimuli to the other group, the researchers noted. This produces a bias score that is considered a more accurate measure of prejudice than traditional questionnaire data, which are known to be strongly influenced by social desirability.
The researchers found that just seven minutes of LKM directed to a member of a specific racial group — in this case, a black person — was sufficient to reduce racial bias towards that group.
However, there was no marked reduction in racial bias towards other groups, the researchers noted.
The researchers also measured levels of positive emotions that were either “other-regarding” — such as love, gratitude, awe, or elevation — and those that were more self-directed, such as contentment, joy, or pride.
What they found is that people doing LKM showed large increases, specifically, in other-regarding emotions. These other-regarding emotions were found to be what drives the reduction of bias, they said.
Source: University of Sussex
A new study has found that sighted infants born to blind parents make less eye contact with adults in general, but otherwise tend to develop normally, and even excel, in memory and visual attention skills.
The findings show that babies born to blind parents are actively learning and adapting to their situation, seeking the best route to communication.
Eye gaze is an important channel for communication, and human infants show an amazing ability to recognize and react to adults’ gaze. The researchers wanted to investigate how infants develop their attention to the eyes when their primary caregiver is unable to make eye contact or react to an infant’s gaze because they can’t see.
“Infants of blind parents allocated less attention to adults’ eye gaze,” said researcher Atsushi Senju, Ph.D., of Birkbeck, University of London. “It suggests that infants are actively learning from communicating with their parents and adjusting how best to interact with them.”
Senju said it’s important to note that these babies developed typical overall social communication skills, suggesting that the patterns of difference the researchers observed were limited specifically to the babies’ attention to adults’ eye gaze.
For the study, the researchers used eye-tracking technology to follow the gaze of 14 sighted infants of blind parents at six to 10 months and then again at 12 to 16 months of age. They also observed the babies interacting with their blind parent and with an unfamiliar sighted adult.
In comparison to a group of infants with sighted parents, those whose parents were blind paid less attention to adults’ eyes, the researchers report. The babies with blind parents were otherwise typical in their development, and in some areas, they even excelled.
“Infants of blind parents showed advanced visual attention and memory skills when they are eight months old, which we did not expect when we started this project,” Senju said.
He said that perhaps the need to switch communication modes between blind parents and other sighted adults might boost infants’ early development of visual attention and memory.
The researchers are still unsure just how long these differences will last in infants born to blind parents. It’s possible the communication differences might diminish as children interact more with peers and other sighted adults. They are now following up on these children at the age of three to study their longer-term development.
In upcoming studies, they would like to investigate development in another interesting group of babies: the hearing infants of deaf parents.
The findings are published in the Cell Press journal Current Biology.
Children who live in chaotic, disorganized home environments benefit significantly when they attend daycare on a regular basis, according to a new study.
The findings show that children from dysfunctional homes who spend more time in daycare during infancy and early childhood have better cognitive, emotional, and social development than peers from similar homes who attend fewer hours of weekly child care.
Several studies have linked households that are overcrowded, noisy, unclean, and lacking predictable routines with low academic achievement as well as attention, social, and behavioral problems among children in poverty.
The current study, led by developmental psychologist Dr. Daniel Berry of the University of Illinois, involved more than 1,200 children from predominantly low-income families in rural Appalachia and North Carolina.
The researchers followed the children’s development from the age of seven months to five years, observing the children’s interactions with their primary caregiver at home and with their caregivers in child-care centers or other settings.
Children in the study spent an average of 21 hours weekly in nonparental care prior to age three, according to their families’ reports. About one third of the children spent 30 or more hours weekly in nonparental care, either in child-care centers or informal settings, such as relatives’ homes.
When the children turned four years old, they were given a battery of executive functioning tests, which measured their abilities to regulate their thoughts and attention, skills that impact learning and social development.
Later, the children were tested on their vocabulary and academic achievement at age five, and their pre-kindergarten teachers assessed them on their social behavior — how well they could control their emotions and get along with their peers.
Higher levels of household chaos and disorganization during early childhood were tied to poorer executive functioning, weaker vocabularies, and worse social behavior. However, these detrimental associations were significantly moderated by the amount of time the children attended daycare.
For those who attended daycare 35 hours or more per week, the connections between household chaos and adverse developmental outcomes were eliminated. The findings suggest that the mitigating effects of child care on the social and cognitive outcomes were explained largely by the buffering role that daycare played in protecting children’s executive functioning.
“The exposure to greater hours and higher quality care may provide a mitigating effect on the impact of chaos in the home,” Berry said. “We don’t understand the mechanisms fully, but we hypothesize that minimizing young children’s exposure to highly chaotic environments may provide some relief.”
Household chaos such as constant noise from a television, or frequent comings and goings by household members and visitors, may negatively impact a child’s executive functioning by frequently diverting the child’s attention, impairing their ability to regulate their attention and modulate their arousal, the researchers hypothesized.
Previous research on the effects of daycare on children has shown mixed results, with some studies suggesting that children who spend greater time in child care are prone to more behavioral problems.
However, families in poverty were underrepresented in many of these samples, and the developmental implications of child care may differ substantially for children from high-risk home environments, Berry said.
“One of the biggest take-home messages for me is that this emerging body of research highlights the critical importance of considering the interplay of children’s experiences across the multiple ecologies of early childhood,” Berry said.
A new study indicates that persistent inflammation is linked to anhedonia, a stubborn symptom of depression defined as the inability to experience pleasure.
The condition significantly weakens the brain’s reward system, the driving force that motivates us to accomplish things.
The findings add to the growing body of research showing that certain forms of depression are tied closely to inflammation. In fact, it has been found that about one-third of people with depression have markers of high levels of inflammation in their blood.
Anhedonia is a core symptom of depression that is particularly difficult to treat, says lead author Jennifer Felger, Ph.D., assistant professor of psychiatry and behavioral sciences at Emory University School of Medicine and Winship Cancer Institute.
“Some patients taking antidepressants continue to suffer from anhedonia,” Felger said. “Our data suggest that by blocking inflammation or its effects on the brain, we may be able to reverse anhedonia and help depressed individuals who fail to respond to antidepressants.”
In a brain imaging study of 48 patients with depression, high levels of the inflammatory marker CRP (C-reactive protein) were linked with a “failure to communicate” between regions of the brain important for motivation and reward.
While observing a brain with magnetic resonance imaging, neuroscientists can infer that two regions of the brain are talking to each other by whether they light up at the same time or in the same patterns, even when someone is not doing anything in particular. They describe this as “functional connectivity.”
In patients with high CRP, the researchers observed a lack of connectivity between the ventromedial prefrontal cortex and the ventral striatum. In contrast, patients with low CRP had robust connectivity.
“We were interested in these regions of the brain because of their known importance for response to reward,” she said. “In addition, we had seen reduced activation of these areas in people receiving immuno-stimulatory treatments for hepatitis C virus or cancer, which suggested that they may be sensitive to inflammation.”
High CRP levels were also linked to patients’ reports of anhedonia: an inability to derive enjoyment from everyday activities, such as food or time with family and friends. Low connectivity between another region of the striatum and the ventromedial prefrontal cortex was linked to a different symptom: slow motor function, as measured by finger tapping speed.
During the brain imaging portion of the study, participants were not taking antidepressants, anti-inflammatory drugs, or other medications for at least four weeks, and CRP was measured on repeat visits to make sure its levels were stable.
An earlier study of people with difficult-to-treat depression found that those with high inflammation (as measured with CRP), improved in response to the anti-inflammatory antibody infliximab.
In future research, Felger would like to test whether L-DOPA, a medicine that targets the brain chemical dopamine, can increase connectivity in reward-related brain regions in patients with high-inflammation depression. This upcoming study is being supported by the Dana Foundation.
Felger’s previous research in non-human primates suggests that inflammation leads to reduced dopamine release. L-DOPA is a precursor for dopamine and often given to people with Parkinson’s disease.
“We hope our investigations may lead to new therapies to treat anhedonia in high-inflammation depression,” she said.
The results are published online in the journal Molecular Psychiatry.
A team of researchers at Kyoto University have pinpointed where happiness happens in our brains.
According to Wataru Sato, Ph.D., and his research team at the Japanese university, overall happiness is a combination of happy emotions and satisfaction of life coming together in the precuneus, a region in the medial parietal lobe that becomes active when experiencing consciousness.
The researchers noted that people feel emotions in different ways. For instance, some feel happiness more intensely than others when they receive compliments. Psychologists have found that emotional factors like these combined with satisfaction of life constitutes the subjective experience of being happy.
The neural mechanism behind how happiness emerges, however, remained unclear. Understanding that mechanism will be a huge asset for quantifying levels of happiness objectively, according to Sato.
For the study, the researchers scanned the brains of study participants using MRI. The participants then took a survey that asked how happy they are generally, how intensely they feel emotions, and how satisfied they are with their lives.
The analysis revealed that those who scored higher on the happiness surveys had more grey matter mass in the precuneus. In other words, people who feel happiness more intensely, feel sadness less intensely, and are more able to find meaning in life have a larger precuneus.
“Over history, many eminent scholars like Aristotle have contemplated what happiness is,” Sato said. “I’m very happy that we now know more about what it means to be happy.”
But how does this help us achieve happiness? Sato noted he is hopeful about the implications this has for happiness training.
“Several studies have shown that meditation increases grey matter mass in the precuneus,” he said. “This new insight on where happiness happens in the brain will be useful for developing happiness programs based on scientific research.”
Source: Kyoto University
Children who take medications like Ritalin to treat attention-deficit hyperactivity disorder are twice as likely to be physically or emotionally bullied by peers than those who don’t have ADHD, according to a new study.
At even greater risk are middle and high school students who sold or shared their medications, according to researchers from the University of Michigan. They report that those kids were four-and-a-half times likelier to be victimized by peers than kids without ADHD.
“Many youth with ADHD are prescribed stimulant medications to treat their ADHD and we know that these medications are the most frequently shared or sold among adolescents,” said Quyen Epstein-Ngo, a licensed clinical psychologist, a research assistant professor at the University of Michigan Institute for Research on Women and Gender, and a fellow at the University of Michigan Injury Center.
For the study, researchers surveyed nearly 5,000 middle and high school students over four years. About 15 percent were diagnosed with ADHD and roughly four percent were prescribed stimulants within the past 12 months.
Of those who took ADHD meds, 20 percent reported being approached to sell or share them, and about half of them did.
When looking at the overall figures, relatively few students were asked to share or sell their medications or did. However, Epstein-Ngo said the numbers don’t tell the entire story.
“Having a diagnosis of ADHD has lifelong consequences,” she said. “These youth aren’t living in isolation. As they transition into adulthood, the social effects of their ADHD diagnosis will impact a broad range of people with whom they come into contact.”
From 2003 to 2011, there was a 42 percent increase in ADHD cases diagnosed in the U.S. Between 2007 and 2011, there was a 27 percent increase in stimulant-treated ADHD.
Epstein-Ngo said the findings shouldn’t scare parents away from considering a stimulant medication. Rather, she said, the study reinforces why parents must talk to their kids about never sharing their medications.
“For some children stimulant medications are immensely helpful in getting through school,” Epstein-Ngo said. “This study doesn’t say ‘don’t give your child medication.’ It suggests that it’s really important to talk to your children about who they tell.”
It’s unclear why kids with prescriptions for stimulant medications are more at risk for bullying and victimization, but Epstein-Ngo said it’s probably several factors.
“Is it a function of the fact that they are in riskier situations, or are they being coerced and forced to give up their medications? Probably a little bit of both,” she said.
Epstein-Ngo added she believes the biggest takeaway is to have compassion for kids with ADHD.
“I think the biggest misconception about ADHD is that these kids aren’t trying hard enough, and that’s just not the case,” she said. “If these kids could do better they would. With the proper support and treatment they can overcome this.”
Funded by the National Institute on Drug Abuse, the study was published in the Journal of Pediatric Psychology.
While the habit of smoking has declined significantly among the general public within the last decade, the rates are still relatively high among three groups of people: Native Americans, the LGBT community (lesbian, gay, bisexual, and transgender) and people with mental illness.
“We’re making great strides, but it’s evident that there are large groups of people who continue to struggle with tobacco and the chronic diseases associated with it,” said Amy Lukowski, Psy.D., clinical director of Health Initiatives at National Jewish Health in Denver. “We need to find ways to better reach and serve those vulnerable demographic groups that are disproportionately impacted by tobacco.”
About 17.8 percent of adults now smoke in the United States, according to a recent study by the Centers for Disease Control and Prevention. That’s the lowest percentage since 1965 (the first year of smoking statistics), when more than 42 percent of adults smoked.
“As an academic medical center devoted for decades to eliminating tobacco use and its associated disease states, we feel the imperative to better identify and understand the unique factors related to tobacco use in these groups and develop protocols that are specifically tailored to their needs,” said Lukowski. “This is a high priority for us.”
More than 26 percent of Native Americans are smokers, the highest rate of any ethnic group and significantly higher than the national average. What makes the issue particularly sensitive is that tobacco has been an integral part of Native American culture. It holds a sacred place in their history and is still used in spiritual ceremonies and traditional practice.
Until now, effective smoking cessation programs designed specifically for Native Americans across multiple tribes in different geographic locations did not exist. QuitLogix at National Jewish Health became the first quitline in the United States to hire Native coaches.
Prior to launching their American Indian Commercial Tobacco Program (AICTP), Lukowski said that researchers had met with dozens of previous and potential participants of quitline services in various regions.
“We needed to better understand the best ways to address commercial tobacco from community members themselves, while still honoring traditional tobacco practices,” she said.
Quitline experts are also working to better help counsel those with mental illness, who smoke at a rate of 36 percent, more than twice the national average. They are also working closely with people in the LGBT community, a population that is up to 200 percent more likely than others to be addicted to cigarettes.
“Those high rates of tobacco use in these populations are no accident,” said Lukowski. “Tobacco companies have identified and targeted these groups as being populations more vulnerable to nicotine addiction and are shrewdly advertising directly to them.”
One particular ad aimed at the LGBT community reads, Whenever someone yells ‘Dude, that’s so gay,’ we’ll be there. “That’s an ad for a tobacco company,” said Lukowski. “As absurd as it may sound, it works. Tobacco companies are reaching young members of the LGBT community, in particular, to convince them that they actually empathize with them and support them, all while selling them deadly products,” said Lukowski.
Other ads are aimed at appealing to Native Americans with their use of traditional colors and imagery. Some cigarette companies claim to use pure tobacco, insinuating that it’s much like the tobacco grown, dried, cut, and used in ceremonies. Tobacco companies also offer commercial products directly to tribes and, in some cases, it’s been suggested that they may give tribal leaders commission for products that are sold.
“Unfortunately, their efforts are often effective, and once members of these particular groups become consumers, it does not take long to develop a physical addiction to the nicotine found in these tobacco products,” said Lukowski. “If we’re going to help members of these populations quit smoking, we need to show the same level of interest in these groups as tobacco companies do.”
Source: National Jewish Health