In The News
New research suggests spirituality may offer benefits for people with mental health issues, but people may encounter barriers when reaching out for this help.
Investigators from the University of Southern California School of Social Work discovered that spirituality is often an underused resource in urban communities.
To resolve this shortcoming, and to cultivate spiritual resources that might have therapeutic value, associate professor Dr. Ann Marie Yamada worked with the Los Angeles County Department of Mental Health (LAC-DMH) to design and test a new spirituality-based treatment program.
“Stigma prevents many individuals experiencing schizophrenia or bipolar disorders from seeking spiritual or religious support from a faith-based community organization. It is difficult for some people to find a community where they feel comfortable and accepted,” said Yamada, co-author of the study with Dr. Andew Subica of the School of Medicine at the University of California, Riverside.
“These concerns may not be shared with mental health providers as they may perceive spiritual needs are not appropriate to discuss.”
This stigma creates a gap when patients are unable to find spiritual support from either a health care provider or religious community.
“Within the urban community served by LAC-DMH, spirituality has been an underutilized resource. It is a great tool for addressing the health and recovery needs of the largely African-American and Latino patients served by the participating LAC-DMH agency,” Yamada said.
It is essential, she noted, that investigators understand the significance of spirituality and religion in these cultures and respectfully acknowledge the philosophical differences in practices between both groups.
In the program, “The Spiritual Strategies for Psychosocial Recovery,“ spirituality is used as a therapeutic tool to teach practical coping skills.
“After learning that there are few well-documented interventions that incorporate spirituality, Dr. Subica and I wanted to take the best practices already being used and add greater emphasis on coping skills that have been shown to be effective,” said Yamada.
Participants attended group therapy sessions that included breathing exercises, goal setting training, and group discussion to build both social and coping skills.
When people find the strength to improve their coping skills, they are more likely to adhere to their treatment plans and see themselves as active participants in their health and recovery.
“When people find the strength to improve their coping skills, they are more likely to adhere to their treatment plans and see themselves as active participants in their health and recovery,” Yamada said.
Yamada hopes more innovative providers like LAC-DMH will explore the potential of spirituality-infused treatments. Many of the LAC-DMH-affiliated wellness and recovery centers already offer some type of spirituality-related activities that involve meditation, mindfulness or support groups.
It’s just a matter of time, given that 80 percent of the adults sampled across California community mental health centers support integration of spirituality into mental health services, she said.
The study included a small pool of participants, but early findings are promising and participants were consistently satisfied with the therapy sessions. Many patients described mood improvements and a feeling of empowerment and control over their conditions.
“I like having these tools because it helps me feel less tense,” said one woman in the program. “During the week when we don’t have group, I can use them.”
The success of the program suggests that health care providers and spiritual leaders could work together to address the needs of their communities.
“Involvement of both clinicians and religious leaders is one way to reduce the stereotypes held by both professions,” Yamada said.
“These stereotypes serve as barriers to developing mental health services that integrate spirituality effectively.”
Understanding that spirituality can be a resource for many individuals, mental health providers are better equipped to offer comprehensive treatment.
“Ultimately, this intervention is about strengthening coping skills,” she said. “Spirituality enhances personal hope through connection to a greater power that could be religious, but is fundamentally defined in whatever way has meaning to each participant.”
Amyotrophic lateral sclerosis (ALS) — also known as Lou Gehrig’s disease or motor neuron disease (MND) — appears to share a genetic origin with schizophrenia, according to a new study published in the journal Nature Communications.
ALS/MND is a rare group of progressive neurological diseases that cause the death of nerve cells (neurons) involved in controlling voluntary muscle movements, such as walking, breathing, chewing and talking. Currently there is no known cure or treatment that can reverse the damage.
“This study demonstrates the power of genetics in understanding the causes of diseases. While neurological and psychiatric conditions may have very different characteristics and clinical presentations, our work has shown that the biological pathways that lead to these diverse conditions have much in common,” said Dr. Russell McLaughlin, Ussher Assistant Professor in Genome Analysis at Trinity College Dublin, and lead author of the paper.
The study was prompted by earlier epidemiological findings by Trinity researchers, revealing that people with ALS/MND were more likely than expected to have family members with schizophrenia and to have had another family member who had committed suicide.
This earlier work investigated the rates of various neurological and psychiatric conditions among more than 12,000 relatives of ALS/MND participants and controls. The findings were subsequently published in 2013 in the journal Annals of Neurology.
For the new study, researchers from the University of Utrecht, Kings College London and members of the Project MinE and Psychiatric Genome Consortia analyzed the genetic profiles of almost 13,000 ALS/MND cases and over 30,000 schizophrenia cases. They found that many of the genes associated with these two distinct conditions are the same.
In fact, the research shows an overlap of 14 percent in genetic susceptibility to the adult onset neurodegenerative condition ALS/MND and schizophrenia.
While overlaps between schizophrenia and other neuropsychiatric conditions including bipolar affective disorder and autism have been shown in the past, this is the first time that an overlap in genetic susceptibility between ALS/MND and psychiatric conditions has been shown.
“Our work over the years has shown us that ALS/MND is a much more complex disease than we originally thought,” said senior author Dr. Orla Hardiman, professor of neurology at Trinity and consultant neurologist at the National Neuroscience Centre.
“So instead of thinking of ALS/MND as a degeneration of one cell at a time, and looking for a ‘magic bullet’ treatment that works, we should think about ALS/MND in the same way that we think about schizophrenia, which is a problem of disruptions in connectivity between different regions of the brain, and we should look for drugs that help to stabilize the failing brain networks.”
Hardiman added that the dividing line between psychiatry and neurology is a false one. “We need to recognize that brain disease has many different manifestations, and the best way to develop new treatments is to understand the biology of what is happening,” she said.
Hardiman said these findings will have major future implications regarding how we classify diseases, and in turn how doctors will be trained in both psychiatry and neurology.
Source: Trinity College Dublin
A group of psychologists and psychiatrists have put forth a new evidence-based alternative to the mental health field’s long-established diagnostic categories, which one of the researchers said has significant limitations.
The new approach, a Hierarchical Taxonomy of Psychopathology (HiTOP), addresses what the authors say are limitations to the reliability and validity of traditional models like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is the American Psychiatric Association’s (APA) authoritative handbook currently used by clinicians and researchers to diagnose and treat mental disorders.
“HiTOP is the first attempt by any group of individuals to put forth a classification and diagnostic system that has the features we’ve described,” said Dr. Leonard Simms, an associate professor in UB’s Department of Psychology and one of the 40 researchers who worked on the study with team leaders Drs. Roman Kotov of Stony Brook University, Robert Krueger of University of Minnesota, and David Watson of University of Notre Dame.
Simms, an expert in the description and classification of mental disorders, said the potentially paradigm-shifting model could advance research efforts and improve clinical outcomes related to the causes and treatments of mental disorders.
HiTOP’s guiding spirit is correcting the shortcomings of DSM-5 and other similar classification schemes, like the World Health Organization’s International Classification of Diseases (ICD), by changing the way mental disorders are classified and diagnosed.
HiTOP uses a diagnostic approach that is dimensional and hierarchical. Traditional systems, like DSM-5, are categorical.
Categorical systems associate each disorder with a set of symptoms. Clinicians make a diagnosis of a disorder only when patients present an established minimum number of those symptoms.
For instance, major depressive disorder is associated with nine symptoms. At least five of those symptoms must be present for a patient to receive a diagnosis of major depressive disorder.
“That’s an arbitrary classification,” says Simms. “Somebody with four symptoms of depression could be experiencing as much if not more impairment than someone who meets the five criteria. Yet five gets the diagnosis and four does not. You see this throughout DSM-5.”
“I use a word like ‘arbitrary’ because in many cases the threshold in the diagnostic manual is usually half the number of symptoms. There is no evidence brought to bear on that threshold.”
Forcing people into categories means losing critical information because of distinctions between symptoms and impairment.
“That distinction creates a false negative,” said Simms. “A patient can have one symptom of depression and still be impaired.”
By eliminating arbitrary boundaries that separate either having a disorder or not having a disorder, researchers and clinicians can make more meaningful decisions.
Simms says statistical analysis shows that shades of gray, or dimensions, are more meaningful than categories.
“There are a variety of statistical techniques that have been in use over the last 25 years that allow us to determine whether underlying symptoms are better described as a categorical or dimensional phenomenon, with the vast majority of that evidence favoring a dimensional approach to psychiatric classification,” he said.
HiTOP’s hierarchical component is based on analysis of symptom similarities. Any group of symptoms might be very close to others.
“There are various ways to talk about depression or anxiety,” Simms said. “Statistics provide researchers with evidence-based ways of combining those symptoms or not. DSM-5 has more disorders than we need. It’s not always clear how one disorder differs from another.”
The core issue for the authors is that traditional systems have been shaped by considerations other than empirical evidence.
“A lot of this is inertia,” said Simms. “We’ve had categories for mental disorders for decades, and that inertia has been an impediment to making changes in the way we think about the mental disorders.”
It comes down to a system characterized by past practice, he said.
“Imagine a physician saying, ‘the research says we should do an MRI on your knee, but my training was in the 1970s, so we’re going to take an X-ray and that’s going to have to be good enough.’ The same thing applies here. Many current clinicians are not being influenced by the evidence.”
Simms said a system like HiTOP that’s based on solid evidence is an advance all by itself.
“A diagnostic system that places people into these messy categories that aren’t necessarily distinct from one another creates a lot of noise in the research world,” he says. “We can make further advances in research into the causes and treatments of these disorders if we have an evidence-based system with known patterns of correlation among these symptoms.
“If we have a system that’s cleaned up this way, not only would the research be stronger in terms of the causes and treatments of these disorders, but it presumably would lean toward better connections with different treatment modules that would be useful clinically.”
The HiTOP classification system remains a work in progress, but several parts of the model are ready for clinical and research applications, according to Simms.
Source: University of Buffalo
Twenty-first century Americans appear to have a new philosophy on characteristics associated with status and prestige. And, our view is quite the opposite of our European counterparts.
Long gone are the days when a life of material excess and endless leisure time signified a well-to-do reputation.
According to a new study in the Journal of Consumer Research, Americans increasingly perceive busy and overworked people as having high status.
“We examined how signaling busyness at work impacts perceptions of status in the eyes of others,” write authors Silvia Bellezza (Columbia Business School), Neeru Paharia and Anat Keinan (both Harvard University).
“We found that the more we believe that people have the opportunity for social affirmation based on hard work, the more we tend to think that people who skip leisure and work all the time are of higher standing.”
High-status Americans a generation ago might have boasted about their lives of leisure, but today they’re more likely to engage in humblebrag, telling those around them how they “have no life” or desperately need a vacation.
To research this phenomenon, investigators performed a series of studies among participants mostly from Italy and the U.S.
While busyness at work is associated with high status among Americans, the effect is reversed for Italians, who still view a leisurely life as representative of high status.
Further, the authors found that the use of products and services showcasing one’s busyness can also convey status.
For instance, the online shopping and delivery grocery brand Peapod signals status just as much as expensive brands, such as Whole Foods, by virtue of its associations with time-saving and a busy lifestyle.
“We uncovered an alternative type of conspicuous consumption that operated by shifting the focus from the preciousness and scarcity of goods to the preciousness and scarcity of individuals,” the authors said.
“People’s social-mobility beliefs are psychologically driven by the perception that busy individuals possess desirable characteristics, leading them to be viewed as scarce and in demand.”
Source: Journal of Consumer Research
A new survey of college freshmen found that those who identified as transgender were at greater risk of experiencing negative consequences from drinking, including memory blackouts, academic problems, and conflicts such as arguments or physical fights.
The findings are published in the journal Alcoholism: Clinical and Experimental Research.
Of the more than 422,000 college freshmen who participated in the survey, 989 students identified as transgender. These students were more likely than their cisgender peers to cite stress reduction, relationship troubles, or the sedating effects of alcohol as motivation for drinking.
The survey suggests that transgender students may be particularly vulnerable to alcohol abuse, which can negatively affect their academic standing and their physical health, said Scott Swartzwelder, Ph.D., senior author of the analysis and professor in the Department of Psychiatry and Behavioral Sciences at the Duke University School of Medicine.
“For people who work with this age group, it’s important to understand that these students are drinking at levels that are quite dangerous,” Swartzwelder said. “A blackout is a serious neurological event that occurs when you drink enough to impair the parts of your brain that encode new memory. The last thing you want to do as a college student is disrupt your memory.”
Students took the survey in 2015 through the alcohol abuse prevention program called AlcoholEdu for College, which includes a web-based questionnaire before beginning the course. The data did not represent a random sample, but included data from 370 US colleges and universities that chose to offer the course to incoming students.
More than 64 percent of the respondents reported having at least one alcoholic drink within the previous year. Students who reported drinking in the previous two weeks were asked to complete a more detailed description of those activities.
The survey found that more than a third (36 percent) of transgender students said they had consumed so much they forgot where they were or what they did at least once in the previous two weeks as compared to 25 percent of cisgender students.
Additional details from the analysis include the following:
- 26 percent of transgender students said they had passed out from alcohol use during the previous two weeks, compared to 13 percent of cisgender students
- 21 percent of transgender students said they drove after consuming five or more drinks, compared to four percent of cisgender students
- 19 percent of transgender students said they got in trouble with authorities as a result of drinking, compared to four percent of cisgender students
- 21 percent of transgender students said they deliberately vomited in order to continue drinking, compared to five percent of cisgender students
- 19 percent of transgender students said they had been taken advantage of sexually due to drinking during the previous two weeks, compared to eight percent of cisgender students
Among transgender students, those transitioning from a male to female reported the highest incidence of negative consequences and high-risk behaviors from using alcohol.
Forty-six percent of male-to-female transgender students reported at least one memory blackout in the two weeks prior to the survey, compared to 36 percent of transgender students overall. This subgroup also reported the highest incidences of missing classes, becoming argumentative, drinking and driving or riding with someone who had been drinking, and getting into trouble with authorities.
“The results tell us we have a lot more to learn about transgender people and about the specific challenges they face,” Swartzwelder said.
“The outcomes of the study also tell us that college students who are transgender represent a vulnerable population with respect to alcohol abuse and its negative consequences. That suggests college administrators and clinicians who interact with these students should be prepared to provide them with better and more effective coping strategies.”
Next the researchers plan to investigate the motivations and consequences of above-average alcohol use of transgender students.
“Why do these students drink more, and what’s making them more vulnerable to these negative consequences of drinking?” Swartzwelder said. “These are very important social questions we hope to answer.”
Source: Duke University Medical Center
If all of your exes were placed in a single room, would others be able to detect similarities among them? Would your ex-partners have a similar look or similar interests?
Findings from a new study at the University of California, Davis suggest they probably would — your exes (as well as your current partner) most likely share quite a few similarities in both physical appearance and personality traits. This applies to both long-term and short-term relationships.
“Do people have a type? Yes,” said the study’s primary author, Dr. Paul Eastwick, associate professor of psychology. “But sometimes it reflects your personal desirability and sometimes it reflects where you live.”
For outward qualities, such as attractiveness, similarities emerge because good-looking people tend to attract other good-looking people, say the researchers. However, for qualities that vary widely depending on where you live, such as education or religion, similarities tend to emerge because educated or religious people happen to meet each other, not necessarily because they actively select each other.
The researchers, who conducted three slightly different studies, looked at the characteristics of people in more than 1,000 current and past heterosexual relationships. The information was provided voluntarily through social media sites and live interviews in recent years, culminating in 2014.
In one of the studies, researchers found that people’s past partners shared similar physical qualities. This was true even when the partners were short-term or casual relationships. The researchers wrote that “during the partner selection process, people may have difficulty differentiating between partners that prove to be casual and short-term versus committed and long-term.”
While intelligence or educational level did play a role, Eastwick said, it was often related to where the people went to school or the field in which they worked.
A second study examined the ex-partners of several hundred young adults sampled from schools across the United States. The exes of a particular person tended to be very similar on variables like education, religiosity, and intelligence, but this type of similarity was entirely due to the school that people attended.
Within their local school context, people were no more or less likely to select educated, intelligent, or religious partners.
The study differs from most other research on relationships because this study surveys people’s relationships over time, not just one committed relationship, Eastwick said.
The findings were published online in the Journal of Personality and Social Psychology of the American Psychological Association.
Source: University of California, Davis
A strong sense of smell is associated with a more active social life in older women, according to a new study led by researchers at Monell Chemical Senses Center in Philadelphia, Pa. The findings also showed that older women who did poorly on a smell identification task were more likely to have fewer social connections.
“Our findings confirm that the sense of smell is a key aspect of overall health in the aging population,” said Johan Lundström, Ph.D., a cognitive neuroscientist and senior Monell author on the study. “More than 20 percent of the U.S. population over the age of 50 has a reduced sense of smell. We need to better understand how olfaction is linked to social behavior in order to improve quality of life as we age.”
For the study, the researchers analyzed data from a nationally-representative sample of 3,005 American adults between the ages of 57 and 85 registered with the National Social Life, Health, and Aging Project (NSHAP), a US population-based study of health and social factors. The data included odor identification test scores as well as information about subjects’ social lives.
The researchers compared each participant’s odor identification score — an established measure of olfactory function — with an aggregated “overall social life” score, which included measures such as participants’ number of friends and close relatives, and how often they socialized. Researchers factored in potential confounding variables, including education level, tobacco use, and physical and mental health status.
The findings showed a clear link between an older woman’s olfactory ability and her overall social life score: women with strong olfactory abilities tended to have more active social lives while those with diminished olfactory function were more likely to receive a poor social life score.
“We know that social interactions are closely linked to health status, so older women who have a poor sense of smell may want to focus on maintaining a vital social life to help improve their overall mental and physical health,” said study lead author Sanne Boesveldt, Ph.D., a sensory neuroscientist.
No link was found between olfactory function and social life in older men.
“This intriguing sex difference could suggest that smell training, which has been shown to improve a reduced sense of smell in both men and women, may have an additional beneficial function in older women by helping to restore both the sense of smell and, by extension, social well-being,” said Lundström.
While the study establishes a connection between the sense of smell and social life, it is not yet clear exactly how the two are connected or if the same relationship also exists in younger women. In the future, longitudinal studies following the same participants over time could help clarify whether olfactory loss directly influences social life and potentially allow the researchers to identify the mechanisms involved.
Still, being aware that olfactory status is related to social activity could already be valuable to those affected by olfactory disorders.
“You hear anecdotal accounts from women who have lost their sense of smell about having fewer friends than they had previously,” said Lundström. “We hope our findings can help reassure them that they are not alone in feeling that way.”
The findings are published in the journal Scientific Reports.
Source: Monell Chemical Senses Center
A new study demonstrates how people use the word “you” rather than “I” to help them cope with negative experiences or share an insight.
For the study, researchers from the University of Michigan conducted nine experiments with 2,489 people to understand why people use “you” not only to refer to specific others, but also to reflect on their own experiences.
“It’s something we all do as a way to explain how things work and to find meaning in our lives,” said Ariana Orvell, a doctoral student in the Department of Psychology and the study’s lead author. “When people use ‘you’ to make meaning from negative experiences, it allows them to normalize the experience and reflect on it from a distance.”
For example, “you win some, you lose some” would indicate that a person has failed in a situation, but by using the word “you,” they are able to communicate that this could happen to anyone, the researcher explained.
“Or saying that ‘when you are angry, you say and do things that you will most likely regret’ might actually explain a personal situation, but the individual attempts to make it something many people relate to,” Orvell said.
In one experiment, researchers asked participants to write about a personal experience: 201 were asked to make meaning from a negative event, 198 were asked to relive a negative event, and 203 were simply asked to write about a neutral experience.
Those in the meaning-making group used generic you more in their essays (46 percent used the word at least once) than those in the relive group (10 percent used the word at least once) and the neutral group (three percent used the word at least once).
The researchers also found that using generic you led people to view the event as more distant.
The researchers acknowledge that it may seem contradictory that a means of generalizing people at large is used when reflecting on one’s most personal and idiosyncratic experiences.
“We suspect that it’s the ability to move beyond your own perspective to express shared, universal experiences that allows individuals to derive broader meanings from personal events,” Orvell said.
The study was published in Science.
Source: University of Michigan
Why do people pay for experiences deliberately marketed as painful?
According to a new study, people will pay big money for extraordinary — even painful — experiences to offset the physical malaise resulting from today’s sedentary lifestyles.
“How do we explain that on the one hand consumers spend billions of dollars every year on analgesics and opioids, while exhausting and painful experiences such as obstacle races and ultra-marathons are gaining in popularity?” asked Drs. Rebecca Scott of Cardiff University in the U.K., Julien Cayla of Singapore’s Nanyang Technological University, and Bernard Cova of KEDGE Business School in France.
The researchers interviewed people who participate in Tough Mudder, a grueling challenge involving about 25 military-style obstacles that “Mudders” must overcome in half a day. Events include running through torrents of mud, plunging into freezing water, and crawling through 10,000 volts of electric wires.
Injuries have included spinal damage, strokes, heart attacks, and even death, the researchers noted.
Through their interviews with Mudders, the researchers discovered that pain helps them deal with the reduced physicality of office life.
Through sensory intensification, pain brings the body into sharp focus, allowing Mudders, who spend much of their time sitting in front of computers, to rediscover their physical body.
The pain also helps these Weekend Warriors escape their daily life, while providing temporary relief from the burdens of self-awareness, the researchers found.
Electric shocks and exposure to icy waters might be painful, but they also allow the participants to escape the demands and anxieties of modern life, they added.
“By leaving marks and wounds, painful experiences help us create the story of a fulfilled life spent exploring the limits of the body,” the researchers concluded. “The proliferation of videos recording painful experiences such as Tough Mudder happens at least partly because a fulfilled life also means exploring the body in its various possibilities.”
The study is published in the Journal of Consumer Research.
Source: Journal of Consumer Research
While structure is important to organizing our activities and helping us understand the world, it can be a killer of creativity, according to new research.
A new study from the University of Toronto’s Rotman School of Management found that while most management research claims that giving structure to information makes it easier to cope with its complexity and boosts efficiency, that belief comes with a double-edged sword.
“A hierarchically organized information structure may also have a dark side,” said Yeun Joon Kim, a Ph.D. student who co-authored the paper with Dr. Chen-Bo Zhong, an associate professor of organizational behavior and human resource management at the Rotman School.
In a series of experiments, the researchers showed that participants displayed less creativity and cognitive flexibility when asked to complete tasks using categorized sets of information, compared to those asked to work with items that were not ordered in any special way.
Those in the organized information group also spent less time on their tasks, suggesting reduced persistence, a key ingredient for creativity, the researchers pointed out.
For the study, the researchers ran three experiments. In two, study participants were presented with a group of nouns that were either organized into neat categories or not, and then told to make as many sentences as they could with them.
The third experiment used LEGO bricks. Participants were asked to make an alien out of a box of bricks organized by color and shape or out of a box of unorganized bricks. Participants in the organized category also were prohibited from dumping the bricks out onto a table.
According to the researchers, the study’s findings may have applications for leaders of multi-disciplinary teams, which tend to show inconsistent rates of innovation, perhaps because team members may continue to organize their ideas according to functional similarity, area of their expertise, or discipline.
“We suggest people put their ideas randomly on a white board and then think about some of their connections,” Kim said.
The tendency to categorize information, rather than efficiency itself, is what those working in creative industries need to be most on guard about, the researchers conclude.
The study was published in Organizational Behavior and Human Decision Processes.
New research from Emory University in Atlanta has found that specific patterns of activity on brain scans may help clinicians identify whether psychotherapy or antidepressant medication is more likely to help individual patients recover from depression.
The study, called PReDICT, randomly assigned patients to 12 weeks of treatment with one of two antidepressant medications or with cognitive behavioral therapy (CBT).
At the start of the study, patients underwent a functional MRI brain scan, which was then analyzed to see whether the outcome from CBT or medication depended on the state of the brain prior to starting treatment.
The MRI scans identified that the degree of functional connectivity between an important emotion processing center — the subcallosal cingulate cortex — and three other areas of the brain was associated with the treatment outcomes, according to the researchers.
Specifically, patients with positive connectivity between the brain regions were significantly more likely to achieve remission with CBT, while patients with negative or absent connectivity were more likely to benefit from antidepressant medication.
“All depressions are not equal and like different types of cancer, different types of depression will require specific treatments. Using these scans, we may be able to match a patient to the treatment that is most likely to help them, while avoiding treatments unlikely to provide benefit,” said Helen Mayberg, M.D., a professor of psychiatry, neurology and radiology at Emory University School of Medicine.
Mayberg and her co-investigators, Boadie Dunlop, M.D., director of the Emory Mood and Anxiety Disorders Program, and W. Edward Craighead, Ph.D., a professor of psychiatry and behavioral sciences, sought to develop methods for a more personalized approach to treating depression.
Current treatment guidelines for major depression recommend that a patient’s preference for psychotherapy or medication be considered in selecting the initial treatment approach. However, in the PReDICT study, patients’ preferences were only weakly associated with outcomes — preferences predicted treatment drop-out, but not improvement, the study found.
These results are consistent with prior studies, suggesting that achieving personalized treatment for depressed patients will depend more on identifying specific biological characteristics in patients rather than relying on their symptoms or treatment preferences, the researchers noted.
The results from PReDICT suggest that brain scans may offer the best approach for personalizing treatment going forward, they add.
The researchers recruited 344 patients for the study from across the metro Atlanta area. Researchers note they were able to convene a more diverse group of patients than other previous studies, with roughly half of the participants self-identified as African-American or Hispanic.
“Our diverse sample demonstrated that the evidence-based psychotherapy and medication treatments recommended as first-line treatments for depression can be extended with confidence beyond a white, non-Hispanic population,” said Dunlop.
“Ultimately our studies show that clinical characteristics, such as age, gender, etc., and even patients’ preferences regarding treatment, are not as good at identifying likely treatment outcomes as the brain measurement,” concluded Mayberg.
The study results were published in the American Journal of Psychiatry.
Source: Emory University
Tobacco use is now concentrated among the least advantaged socioeconomic groups in society, according to a new study at the Colorado School of Public Health at University of Colorado (CU) Anschutz. The findings show that most remaining smokers in the United States have low income, no college education, a disability or no health insurance.
After decades of declining smoking rates overall, about 15 percent of U.S. adults — more than 36 million — continue to smoke cigarettes. About 50 to 75 percent of smokers have one or more low-socioeconomic disadvantages, and the lowest socioeconomic categories have the highest smoking rates.
The researchers say that quitting methods that have been working for smokers in higher economic brackets aren’t working for the disadvantaged and that new strategies are needed.
“It’s unusual to find part of the population experiencing high rates of a health problem and also representing the majority of affected people,” said study author Dr. Arnold Levinson, associate professor of community and behavioral health at the Colorado School of Public Health at CU Anschutz.
“But with smoking, we have this unusual situation: Americans with lower socioeconomic status today are suffering from epidemic smoking rates, and they make up nearly three-fourths of all our remaining smokers.”
The study, published in the Journal of Health Care for the Poor and Underserved, used data from a national survey which the University of Colorado conducted in 2012.
The continued epidemic can’t be blamed on lack of desire to quit or efforts to quit. In fact, several studies have found no socioeconomic differences in smokers’ desires to quit or attempts to quit. Instead, the disparities continue and have gotten worse because lower socioeconomic smokers who try to quit are less likely to succeed.
“In the last half-century, public health efforts helped cut the smoking rate by more than half, but we probably need to change our strategies for helping smokers quit,” Levinson said. “The methods that worked for the upper half of society don’t seem to be working well for the other half.”
“Now the nation’s public health system has a dual moral obligation toward smokers of low socioeconomic class. We must eliminate the disparity in smoking rates, and we must provide cessation-supporting services to the new majority of smokers,” said Levinson.
According to the Centers for Disease Control, cigarette smoking remains the leading cause of preventable disease and death in the US, causing more than 480,000 premature deaths every year, or one of every five deaths.
University of Sydney scholars have found that medications designed to boost the effect of natural brain opioids might be a better way to reduce anxiety.
Investigators believe the new approach has many advantages over the current method of using ‘receptor-binding’ opioid drugs like morphine, which have major side effects.
Fear and anxiety are natural responses that help defend us against harm. The feelings are largely controlled via circuits of interconnected nerve cells and activity in a specific brain region (the amygdala) that allow neurons to pass electrical or chemical signals to each other.
Specialized neural circuits control these emotions, but disturbances in the circuits can cause prolonged and disabling emotional responses that are out of proportion to threatening events.
These disturbances are thought to underlie many anxiety disorders such as phobias and post-traumatic stress disorder, which affect millions each year.
Anxiety disorders affect approx. 14 percent of the population but are poorly managed by commonly prescribed medications such as benzodiazepines and 5HT-reuptake inhibitors.
“These drugs weren’t developed to treat anxiety but they’re widely used because of chance findings suggesting their clinical usefulness,” says the University of Sydney’s Associate Professor Elena Bagley, who led the research.
“Many experts agree that better anxiety treatments will come when science uncovers how the neural circuits and endogenous or naturally occurring opioids regulate fear and anxiety.
“The precise action of these natural opioids in the brain is poorly understood, but better insights are critical because these opioids control how we acquire and store fear memories and regulate our emotional responses once a threat has passed.”
As published in Nature Communications, experiments in mice have shown that “deleting” the natural opioid encephalin — which is heavily expressed in the brain’s amygdala — increases their fear, anxiety, and aggressiveness.
By contrast, increasing enkephalin or reducing its breakdown reduces these behaviors.
While this effect of enkephalin suggests that it is anxiety-inhibiting, when it binds to different receptors in the amygdala, it exerts opposing effects, depending on which one it binds to.
For example, when it binds to the mu-opioid receptor, enkephalin promotes anxiety, but when it binds to the delta-opioid receptor, it inhibits it.
“Given this complexity, understanding the cellular actions of natural opioids at these two receptors is critical if we hope to use opioid-related medications for emotional issues,” says Dr Bagley.
“Our findings show that opioids produced and released by our own brain cells strongly regulate these critical neural circuits that are important for fear responses.
“We also show that we could boost the actions of these endogenous opioids using a novel pharmacological approach.”
Source: University of Sydney
It is very important that premature babies being cared for in Neonatal Intensive Care Units (NICU) receive plenty of caring and supportive touch experiences and as few painful procedures as possible, as these events can significantly impact brain development, according to new research published in the journal Current Biology.
Disruptions in the normal development of the somatosensory system — a baby’s first sensory system that perceives temperature, the body’s position in space, movement, and all degrees of touch, from the lightest to most painful — can affect the child’s socio-emotional development.
Healthy sensory processing allows young children to learn from their experiences, and provides the foundation for developing higher-level perceptual and cognitive abilities.
“Parents should know that every minute they hold their baby counts,” says first author Nathalie Maitre, M.D., Ph.D., associate professor of Pediatrics, medical director of the NICU Follow-up Program and a principal investigator in the Center for Perinatal Research at Nationwide Children’s Hospital.
“Touch is a critical building block of infant learning,” says Maitre, adjunct professor of Hearing and Speech Sciences and former assistant professor of Pediatrics at Vanderbilt. “It helps babies learn how to move their bodies, how to discover the world around them and how to communicate with their families.”
The findings show that exposure to painful procedures can impact brain development even when sedatives and analgesics are used.
“Until new research can prove which medications work at preventing these changes in brain function, we need to focus on effective non-pharmacological alternatives,” said Mark Wallace, Ph.D., dean of the Graduate School at Vanderbilt and the study’s co-senior author with Micah Murray, Ph.D., of the University of Lausanne.
Wallace says that “it is absolutely essential to minimize exposure to painful procedures that infants can often experience during hospitalizations.”
For the study, the researchers compared the cortical responses to light touch among 125 premature and full-term infants at Vanderbilt. They found that preterm infants exhibited decreased responses to light touch when they were discharged from the NICU compared to full-term infants and that the decreases were greatest among the most premature.
However, when these NICU babies were given more supportive touch experiences, including skin-to-skin care and breastfeeding, their brains responded more strongly to light touch.
Promoting optimal development and function may help keep these newborns’ brains on track to establish the sensory building blocks of cognition, behavior, and communication, the researchers concluded.
The study was conducted by an international research team from Nationwide Children’s Hospital in Columbus, Ohio, Monroe Carell’s Jr. Children’s Hospital at Vanderbilt in Nashville, Tennessee, and Lausanne University in Switzerland.
New research finds that exercise can delay declines in mobility and help to maintain quality of life for individuals with Parkinson’s disease.
Parkinson’s disease (PD) is a progressive condition that often results in mobility impairments and can lead to decreased health-related quality of life (HRQL) and death.
In the new study, researchers determined that people who exercised regularly had significantly slower declines in HRQL and mobility over a two-year period. Importantly, investigators determined that exercise can provide a significant benefit to those with advanced PD.
The research appears in the Journal of Parkinson’s Disease.
Lead investigator Miriam R. Rafferty, Ph.D., of Northwestern University and Rehabilitation Institute of Chicago, describes the main findings of the study.
“We found that people with Parkinson’s disease who maintained exercise 150 minutes per week had a smaller decline in quality of life and mobility over two years compared to people who did not exercise or exercised less.
The smaller decline was significant for people who started the study as regular exercisers, as well as for people who started to exercise 150 minutes per week after their first study-related visit.”
The data came from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII), an international, multicenter, prospective clinical study of care and outcomes. Over 3400 participants provided data over two years, with information collected during at least three clinic visits.
The NPF-QII study collects a variety of data on pharmacologic and non-pharmacologic management of PD symptoms. These observational study visits are scheduled on a yearly basis. At each visit, exercise is measured by the self-reported number of hours per week of exercise.
Although this study did not determine which type of exercise is best, it suggests that any type of exercise done with a “dose” of at least 150 minutes per week is better than not exercising.
“People with PD should feel empowered to find the type of exercise they enjoy, even those with more advanced symptoms,” remarked Dr. Rafferty.
An unanticipated finding from the study was that the HRQL benefit associated with 30-minute increases in exercise per week was greatest in people with advanced PD.
This finding suggests the value of making exercise and physical activity more accessible to people with more severe disability.
The distinction is important as people with more advanced PD may have poor access to regular exercise, as their mobility impairments would limit their independent participation in existing community and group exercise programs.
“The most important part of the study,” according to Dr. Rafferty, “is that it suggests that people who are not currently achieving recommended levels of exercise could start to exercise today to lessen the declines in quality of life and mobility that can occur with this progressive disease.”
Source: IOS Press/EurekAlert
New research finds that when you are tired it is more difficult to detect whether people around you are happy or sad. Saliently, this subtle disadvantage may influence interpersonal relationships, work productivity, and life satisfaction.
Specifically, University of Arizona researchers found that study participants had a harder time identifying facial expressions of happiness or sadness when they were sleep deprived versus well-rested.
The sleepy participants’ ability to interpret facial expressions of other emotions — anger, fear, surprise, and disgust — was not impaired, however.
That’s likely because we’re wired to recognize those more primitive emotions in order to survive acute dangers, said lead researcher William D.S. Killgore, a University of Arizona professor of psychiatry, psychology, and medical imaging.
Study findings appear in the journal Neurobiology of Sleep and Circadian Rhythms.
While emotions such as fear and anger could indicate a threat, social emotions such as happiness and sadness are less necessary for us to recognize for immediate survival.
When we’re tired, it seems we’re more likely to dedicate our resources to recognizing those emotions that could impact our short-term safety and well-being, Killgore said.
“If someone is going to hurt you, even when you’re sleep deprived you should still be able to pick up on that,” Killgore said.
“Reading whether somebody is sad or not is really not that important in that acute danger situation, so if anything is going to start to degrade with lack of sleep it might be the ability to recognize those social emotions.”
The data used in the study was part of a larger research effort on sleep deprivation’s effects on social, emotional, and moral judgment.
The current study is based on data from 54 participants, who were shown photographs of the same male face expressing varying degrees of fear, happiness, sadness, anger, surprise, and disgust.
Participants were asked to indicate which of those six emotions they thought was being expressed the most by each face.
Researchers used an innovative technique to assess participants’ ability to interpret subtler emotional expressions. The methodology included presenting images that were composite photos of commonly confused facial expressions morphed together by a computer program.
For example, a face might show 70 percent sadness and 30 percent disgust or vice versa. Participants saw a total of 180 blended facial expressions at each testing session.
Participants’ baseline responses to the images were compared to their responses after they were deprived of sleep for one night.
Researchers found that blatant facial expressions — such as an obvious grin or frown (90 percent happy or 90 percent sad) — were easily identifiable regardless of how much sleep a participant got.
Sleep deprived participants had a harder time, however, correctly identifying more subtle expressions of happiness and sadness, although their performance on the other emotions was unchanged.
When participants were tested again after one night of recovery sleep, their performance on happiness and sadness improved, returning to its baseline level.
While the difference in performance was not overwhelming, it’s enough that it could have a significant impact in critical social interactions, Killgore said.
“As a society, we don’t get the full seven to eight hours of sleep that people probably need to be getting. The average American is getting a little less than six hours of sleep on average, and it could affect how you’re reading people in everyday interactions,” Killgore said.
“You may be responding inappropriately to somebody that you just don’t read correctly, especially those social emotions that make us human. Or you may not be as empathic. Your spouse or significant other may need something from you and you are less able to read that.
It’s possible that this could lead to problems in your relationships or problems at work. To me, that is one of the biggest problems — how this affects our relationships.”
Killgore’s research builds on existing work on the effects of sleep deprivation on the brain’s ventromedial prefrontal cortex — an area that helps people make judgments and decisions using their emotions.
A prior study, showed that when people are sleep deprived, a disconnect occurs between the prefrontal cortex and the amygdala — one of the key emotionally responsive areas of the brain.
“So, in simplistic terms, the part of the brain that controls your emotions and the part that sees faces and responds to the emotional content basically start to lose their ability to communicate,” Killgore said.
“We wanted to test that out and see if it plays out in terms of how people read facial expressions — and, in fact, it looks like it does.”
Source: University of Arizona
Emerging research suggests that losing a partner to suicide may result in physical and mental issues for the remaining partner.
The new Johns Hopkins Bloomberg School of Public Health research study discovered people who lose a partner to suicide are at increased risk for a number of mental and physical disorders, including cancer, depression, herniated discs, and mood disorders.
The study, believed to be the first large-scale examination of the broader impact of losing a partner to suicide, underscores the need for support systems for bereaved partners and others who have lost loved ones to suicide.
Researchers believe interventions addressing complicated grief could help mitigate some of the effects. More than 800,000 people around the world die by suicide each year, and the suicide rate in many countries, including the United States, is on the rise.
The study, which appears in JAMA Psychiatry, followed 4,814 Danish men and 10,793 Danish women bereaved by partner suicide for up to 35 years, from 1980 to 2014, and compared them to the general population of Denmark.
“It is an exceedingly devastating experience when someone you love dearly dies suddenly by suicide,” said study leader Annette Erlangsen, Ph.D., an adjunct professor in the Bloomberg School’s Department of Mental Health.
“We were able to show that being exposed to such a stressful life event as the suicide of your partner holds higher risks for physical and mental disorders and is different from losing a partner from other causes of death, such as illness or sudden accident.”
Using Denmark’s Cause of Death Registry, the researchers identified everyone in the country age 18 or older who died by suicide since 1970. Using national records on the entire population, the team then identified surviving partners, including spouses, registered partners or those with whom the deceased cohabitated and studied these over the years after the loss.
The researchers compared this data to two groups: Denmark’s general population age 18 or older living in the country between 1980 and 2014 and people in the general population who were bereaved by partner death due to causes other than suicide.
Those who lost partners to suicide were at increased risk of cancer, cirrhosis of the liver, and spinal disc herniation than the general population. After long-term follow-up, there was an increased risk of sleep disorders and, for women only, chronic respiratory disease.
The new findings confirm earlier research that suggested the risk was particularly elevated during the first five years after the loss. The study found that suicide bereaved had an increased risk for mood disorders, post-traumatic stress disorder, anxiety disorders, alcohol use disorder as well as self-harm compared to the general population.
“The suicide rate in the United States is increasing which makes this research even more relevant,” said another study author, Holly C. Wilcox, Ph.D., associate professor in the Bloomberg School’s Department of Mental Health and the Johns Hopkins University School of Medicine’s Department of Psychiatry.
“Health care providers, friends, and neighbors often do not know how best to support those bereaved by suicide.”
While the researchers were not surprised by the thrust of the findings, there were some things that were unexpected, such as the finding of an increased risk for a herniated disc.
Also, they found that partners who had lost a loved one to suicide and who remarried had a lower chance of divorcing than the general population. At approximately 44 percent, the divorce rate in Denmark is comparable to other developed countries, including the United States.
“Maybe people who have experienced such a traumatic loss might be more selective when they choose a new partner and as such are less likely to experience a divorce,” Erlangsen said.
The research highlights the need for both personal and professional interventions for people whose lives have been impacted by the suicide of their spouse or partner.
“This is a population in need of support and outreach,” Wilcox said.
“Surviving a family member’s suicide is often a very isolating experience. Often friends and family of the bereaved are afraid of saying the wrong thing so they don’t say anything at all. The stigma associated with suicide can lead survivors to suffer in silence alone.”
The researchers say they chose Denmark because it has such a rich data set. Sweden has comparably rich databases for large-scale studies. The U.S. does not. The findings, the researchers say, are applicable to other countries.
From mood disorders to substance abuse, much of psychopathology is related to difficulty in regulating emotions. In a new study, researchers at the University of Buffalo (UB) sought to better understand and categorize the different strategies people tend to use to help manage their negative emotions.
They discovered that emotion regulation strategies tend to fall into three core groupings: evading emotions (distraction and avoidance); fixating on negative thoughts; and acceptance and problem solving.
By streamlining emotion regulation strategies, the new categories can help researchers and clinicians better treat a wide range of psychological disorders and also give people the necessary tools to help regulate their own emotions.
“The groupings can be useful for clinicians who are trying to better characterize the nature of the emotion regulation difficulties their clients are having,” said Dr. Kristin Naragon-Gainey, an assistant professor in UB’s Department of Psychology, and an expert on emotion and affect in mood and anxiety disorders.
“Because it’s not always feasible for researchers to assess every strategy, they may now be able to narrow down from the larger group into the core underlying groupings.”
Emotion regulation is a term that describes how people respond to an emotional experience and attempt to feel better. For example, a person who is nervous about public speaking may use distraction to take their mind off a presentation in order to feel calmer.
Emotion regulation becomes problematic when emotions can’t be downgraded, like a lingering sadness that can’t be managed, or if the strategy is unhealthy, such as substance abuse.
“There are different motivations for substance abuse, but one common motivation is that it’s a means of emotion regulation,” said Naragon-Gainey. “If a therapist has a client who is using drugs or alcohol to change their emotions in some way this research may help identify if that client is lacking in other skills.”
For her analysis, Naragon-Gainey and a research team comprised of UB graduate students Tierney McMahon and Thomas Chacko, looked at hundreds of studies that reported correlations between different emotion regulation strategies to understand how they relate to one another. They also wanted to know whether all these strategies could be synthesized into something much simpler and even be applied in a streamlined manner to psychopathology.
The researchers found that people tend to use multiple strategies simultaneously. If one doesn’t work then they’ll move on to another. But it has been unclear to what extent these strategies are distinct.
“What we found was that these strategies weren’t so highly related that they seemed redundant,” she said. “So people did fairly uniquely and specifically report on using certain strategies. Many of the strategies were related, but not everyone who used avoidance also uses rumination, for example.”
The first grouping, which includes distraction and avoidance strategies, involves trying to feel better by steering clear of one’s own negative thoughts and feelings.
“It’s associated with low mindfulness so that you’re not aware of the present moment,” said Naragon-Gainey. “Your thoughts and attention are elsewhere and you’re trying to feel better through that.”
The second grouping involves a tendency to stay fixed on negative thoughts, particularly those of failure and self-blame. In this case, people can’t stop focusing on their negative thoughts and feelings and often suffer through endless rumination.
Strategies found in the third grouping, such as acceptance and problem-solving, are more productive and likely to be useful across multiple situations.
Naragon-Gainey says she hopes to take the research further by asking individuals to assess their emotions on a daily basis. Traditionally, researchers in the emotion regulation field ask about emotions sometimes long after the fact. While this practice is convenient, perfect recall among subjects is nearly impossible.
“In the lab, we’re sending people questions as they go about their day,” she says. “This will provide a better sense of how well this applies to people’s lives and give researchers even more confidence that we’re getting at what’s happening to people.”
The findings are published in the journal Psychological Bulletin.
Source: University at Buffalo
It seems an emerging source of anxiety and mental health concern is the fear that robots, artificial intelligence, and new technology will replace people at work.
In a national randomized survey, Baylor University investigators found that more than a third of individuals are “technophobes,” fearful that automation could lead to job displacement.
Researchers found that the anxiety experienced by these individuals leads to more stress than circumstances such as romantic rejection, public speaking, and police brutality.
“If you’re afraid of losing your job to a robot, you’re not alone,” said researcher Dr. Paul McClure, a sociologist in Baylor’s College of Arts & Sciences.
“This is a real concern among a substantial portion of the American population. They are not simply a subgroup of generally fearful people.”
Previous research has found that employees with little job security suffer from poorer mental health and that unemployment and job insecurity are often linked to heart disease and mortality rates.
McClure’s study found that:
The study appears in the journal Social Science Computer Review.
For his study, McClure used data from Wave 2 of The Chapman Survey of American Fears, an annual national random survey. In it, 1,541 respondents were asked about their fears and worries about politics, crime, natural and man-made disasters, technology, mental health, and unemployment.
They also were asked about their anxieties, worries, sleep patterns, restlessness, inability to relax, susceptibility to irritation, and feelings of dread.
Anxiety about job loss to automation is nothing new, McClure said, noting that 19th-century textile workers in England destroyed new machines to protest against employers who used inventions that allowed for faster and cheaper labor by less-skilled workers.
But some researchers in economics caution that the impact of robotics and artificial intelligence in the next several years will be much more rapid than job displacement of the past, particularly for those with routine job responsibilities.
Potential job loss could span the blue- and white-collar divide, from truck drivers and warehouse workers to loan officers and paralegals, rather than manual laborers in non-routine jobs or workers in creative fields, McClure said.
While technology visionaries contend that new markets with new job opportunities have emerged and that developing countries will benefit economically, “many people in the United States suspect that technology will not deliver widespread financial security, nor will it be a panacea for the world’s underprivileged,” McClure said.
“People in certain occupations may legitimately fear losing their jobs to robots and software that can work for cheaper and for longer hours than any human.”
While a transformation would most likely be gradual, it could trigger a major social unrest among those who are displaced from their jobs, McClure said.
“Anticipating the individual and social outcomes is a matter worth pursuing,” he said. “If these fears are misplaced, more research needs to be done to dispel technophobia as a legitimate social concern.
“Regardless of whether technology might lead to certain people’s jobs becoming obsolete, the fear itself is real.”
Source: Baylor University/EurekAlert
New research suggests insulin resistance, both among diabetic and non-diabetic individuals, increases cognitive decline in executive function and memory.
Insulin resistance is caused in part by obesity and physical inactivity. Although the new finding is sobering, the results also offer hope and a solution to reduce some forms of cognitive decline.
“These are exciting findings because they may help to identify a group of individuals at increased risk of cognitive decline and dementia in older age,” said Tel Aviv University Professor David Tanne.
“We know that insulin resistance can be prevented and treated by lifestyle changes and certain insulin-sensitizing drugs. Exercising, maintaining a balanced and healthy diet, and watching your weight will help you prevent insulin resistance and, as a result, protect your brain as you get older.”
The study appears in the Journal of Alzheimer’s Disease.
The study was led jointly by Prof. Tanne and Prof. Uri Goldbourt and conducted by Dr. Miri Lutski, all of TAU’s Sackler School of Medicine.
“These are exciting findings because they may help to identify a group of individuals at increased risk of cognitive decline and dementia in older age,” Tanne said.
Insulin resistance is a condition in which cells fail to respond normally to the hormone insulin. The resistance prevents muscle, fat, and liver cells from easily absorbing glucose.
As a result, the body requires higher levels of insulin to usher glucose into its cells. Without sufficient insulin, excess glucose builds up in the bloodstream, leading to prediabetes, diabetes, and other serious health disorders.
The scientists followed a group of nearly 500 patients with existing cardiovascular disease for more than two decades.
They first assessed the patients’ baseline insulin resistance using the homeostasis model assessment (HOMA), calculated using fasting blood glucose and fasting insulin levels. Cognitive functions were assessed with a computerized battery of tests that examined memory, executive function, visual spatial processing, and attention.
The follow-up assessments were conducted 15 years after the start of the study, then again five years after that.
The study found that individuals who placed in the top quarter of the HOMA index were at an increased risk for poor cognitive performance and accelerated cognitive decline compared to those in the remaining three-quarters of the HOMA index.
Adjusting for established cardiovascular risk factors and potentially confounding factors did not diminish these associations.
“This study lends support for more research to test the cognitive benefits of interventions such as exercise, diet, and medications that improve insulin resistance in order to prevent dementia,” Tanne said.
The team is currently studying the vascular and non-vascular mechanisms by which insulin resistance may affect cognition.
Source: Tel Aviv University