Social Work Today E-Zine

New research from Cornell University indicates evidence of an environmental trigger for autism among genetically vulnerable children. The study, published in Archives of Pediatrics & Adolescent Medicine, is the first peer-reviewed study to positively associate the prevalence of autism to a factor related to the levels of precipitation in the areas in which children live.

“This analysis is an important first step towards identifying a specific environmental trigger, or triggers, for autism,” says lead author Michael Waldman, PhD, an economics and management professor at the Johnson Graduate School of Management at Cornell University.

While many autism experts believe that the disorder is triggered by the combination of an environmental element and a genetic predisposition, previous literature provided few clues concerning what the important environmental triggers might be.

The researchers discuss several possible environmental triggers related to higher levels of precipitation, including increased rates of early childhood television and video viewing, increased rates of vitamin D deficiency, and an increased exposure to chemicals used in household cleaners that children who spend more time indoors would likely experience. The research team plans to conduct further statistical studies aimed at identifying which of these possibilities are actual triggers for autism.

The study involved analyzing data from counties in the California, Oregon, and Washington, and it found that county-level, school-age autism prevalence rates and autism prevalence counts are positively associated with a county’s average annual precipitation. Additionally, analysis showed that within a county, autism prevalence rates and autism prevalence counts were higher for age groups that were exposed to more precipitation prior to the age of 3. The findings suggest that as many as 30% or more of autism diagnoses may be due to an environmental trigger or triggers related to levels of precipitation where the children live.

— Source: Cornell University

The end the year is a time when many of us will make resolutions to lose weight or quit smoking. But instead of making resolutions that are often quickly forgotten, New Year’s is a good time to take personal inventory of our lives, says Temple University psychologist professor Frank Farley.

“In so many fields we take stock, we take inventory, we take a pulse at the end of the year,” says Farley. “But we are not so good at doing that about ourselves, reflecting and assessing how we’ve done this past year,” he says.

“I don’t think it is trivial this time of year to take psychological stock or personal stock of ourselves, and try to decide, ‘Ok, I’m going to work on this, I’m going to do that,’” he says. “The taking stock, whether you make resolutions or not, is very helpful at the end of the year.

Farley suggests making a list of things that are absolutely essential that you have to deal with in the coming year. “We do that in a sense everyday; lots of people keep ‘to do’ lists in one way or another, but this one should be more reflective and it often isn’t.” Making a list will give you more focus and direction in how you can concentrate on those items that you wish to deal with, he says.

“To me, New Year’s can be turned into something profound,” adds Farley. “It represents a benchmark in the history of the world and it should be a benchmark in an individual’s personal history. It is a time to reflect on where we’ve been and where we’re going next,” Farley says. “Our journey is not random. You can influence that journey and this is a good time to do it.”

— Source: Temple University

The best chance of “reeling-in” an unmarried father and building the foundations for a stable family life are the critical months of pregnancy, says new research from the University of Maryland.

“Unmarried dads are less likely to drift away if they are involved with their partner during this vital period when a family can begin to bond,” says University of Maryland human development professor Natasha J. Cabrera, PhD, the principal investigator and a researcher at the school’s Maryland Population Research Center.

The study, published in the Journal of Marriage and Family, is the first to explain the importance of the prenatal period in the formation of nontraditional family patterns. The researchers analyzed data, drawn from the Fragile Families Child Well Being Study, that mostly involved unmarried couples, totaling 1,686 couples in all. In their analysis, Cabrera and her colleague found that fathers involved during pregnancy were significantly more likely to remain involved in raising their child at age three.

“The unmarried father is much more likely either to maintain or move into a more committed relationship if he’s involved before the birth, and that’s the critical difference,” Cabrera says. The study found that marital status is not a critical predictor of a father’s involvement. “It is the decision that couples make to strengthen commitment and move in together that is important, rather than marital status per se,” Cabrera says. “You don’t need much imagination to see that a live-in dad is likely to be more involved in child care and family life. It’s the personal investment in the child’s and the mother’s future that counts the most, not the paperwork.”

— Source: University of Maryland, College Park

Children whose eyes are misaligned and point outward are at significantly increased risk of developing mental illness by early adulthood, according to findings of a Mayo Clinic study published this month in Pediatrics.

The retrospective study examined the medical records of 407 patients with strabismus (misaligned eyes) and compared them with records of children matched for age and sex but with normal eye alignment. Children with eyes that diverged (exotropia) were three times more likely to develop a psychiatric disorder than were the control subjects, while those with inward deviating eyes (esotropia) showed no increase in the incidence of mental illnesses.

Brian Mohney, MD, the Mayo Clinic pediatric ophthalmologist who led the study, says the results can help alert physicians to potential problems in their pediatric patients. “Pediatricians and family practice physicians who see children with strabismus should be aware of the increased risk of mental illness,” says Mohney. “They can hopefully be alert to the earliest signs of psychiatric problems in patients with exotropia, so they can consider having them seen by a psychologist or psychiatrist.”

— Source: Mayo Clinic

Employees with high levels of job autonomy and control over their schedules are more likely to bring their work home with them, according to surprising new research from the University of Toronto.

Using data from a 2002 nationally representative survey of more than 2,600 American workers, sociology professor Scott Schieman, PhD, and doctoral student Paul Glavin examined the impacts of schedule control and job autonomy on work-family role blurring. Role blurring is measured by how often employees bring work home and how often they receive work-related contact outside of normal working hours.

The study found the following:

• having great schedule control is associated with more frequent work-family role blurring and this pattern is stronger among men;


• having greater job autonomy is associated with more frequent work-family role blurring among both women and men;


• men in autonomous jobs are more likely than women in similarly autonomous jobs to receive work-related contact outside of normal work hours;
and

• among both genders, receiving work-related contact outside of normal work hours increases work-to-family conflict, but only among individuals who have less autonomy at work.

“These patterns are somewhat unexpected because they identify a potential downside of work-related resources like schedule control and job autonomy,” says Schieman, lead author of the study.

— Source: University of Toronto

A multi-institution team of investigators led by researchers at the Keck School of Medicine of the University of Southern California (USC) has received $19 million in funding from the National Institutes of Mental Health (NIMH) for a groundbreaking effort to collect genetic information on tens of thousands of patients in order to study the genetic risks for schizophrenia and bipolar disorder.

The USC Center for Genomic Psychiatry and Massachusetts General Hospital (MGH) together received more than $25 million in grant funding to lead an international network of academic medical centers in creating the Genomic Psychiatry Cohort. Blood and DNA from 40,000 subjects will be deposited in the NIMH repository, along with clinical and phenotypic data.

Research will attempt to collect data on 10,000 patients with schizophrenia, as well as 10,000 individuals without the disorder. They will study 5,000 patients with bipolar disorder as part of a coordinated effort led by MGH investigators to collect an additional 19,000 patients with bipolar disorder.

The cohort will be the largest coordinated effort ever undertaken to understand the underlying genetic risks for these illnesses, says Carlos Pato, MD, PhD, chair of the department of psychiatry and behavioral sciences at USC, and who directs the Center for Genomic Psychiatry at the Keck School of Medicine.

“Our focus is on both determining genetic risks for serious mental illnesses and in developing a new model of care for these diseases,” he says. “This will be the major national effort in this area for the next five years. We expect a number of important studies to result from this effort.”

USC researchers will not only conduct large-scale genomic investigations in this population, but will also have a unique ability to follow patients for long-term studies.

— Source: University of Southern California Health Sciences

Psychiatric disorders appear to be common among 18 to 24 year olds, with overall rates similar among those attending or not attending college, according to a report in the Archives of General Psychiatry. Almost one half of college-aged individuals meet criteria for substance abuse, personality disorders, or another mental health condition during a one-year period, but only one fourth of those seek treatment. Overall, the authors noted, the rate of psychiatric disorders is high among young adults, who are at a vulnerable stage of development.

To compare the mental health status of college-enrolled 18 to 24 year olds to that of individuals the same age not enrolled in college, researchers analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions. In this national survey, individuals aged 19 to 25 who were attending (2,188) or not attending (2,904) college during the previous year were interviewed and assessed for psychiatric disorders between 2001 and 2002.

A total of 45.8% of college students and 47.7% of young adults not in college met the criteria for at least one psychiatric disorder. The most common disorders in college students were alcohol use disorders (20.4%) and personality disorders (17.7%), whereas those not in college most frequently met criteria for personality disorders (21.6%) and nicotine dependence (20.7%). College students were less likely to have a diagnosis of drug use disorder, nicotine dependence, or bipolar disorder and were less likely to have used tobacco. However, their risk of alcohol use disorders was significantly greater.

Treatment rates were low for all psychiatric disorders. College students were significantly less likely to receive treatment for alcohol or drug use disorders than those not in college. “In view of the high prevalence and low rate of treatment of alcohol use disorders in college students, greater efforts to implement screening and intervention programs on college and university campuses are warranted,” the authors wrote. “The centralized delivery of campus student health services might offer an advantageous structure for carrying out such screening and interventions.”

— Source: American Medical Association

People who have a sibling with a mental illness are more likely to suffer episodes of depression at some point in their lives, say researchers who analyzed four decades of data. The data for this study were obtained from the 46-year Wisconsin Longitudinal Study. Additionally, they found people with a sibling with low IQ are more likely to live near that brother or sister—but be somewhat emotionally detached from that sibling, according to the findings in the Journal of Family Psychology.

“So little is known about the impact that a person with low IQ or mental illness has on the psychological and social development of his or her siblings, especially beyond childhood,” says the study’s lead author, Julie Lounds Taylor, PhD. “Our findings highlight the need for families of the mentally ill, specifically siblings, to be more aware of their own mental health needs throughout their lifetimes.”

The researchers identified 351 people who had at least one sibling with a mental disability, which were later broken into two groups: those whose siblings had a mental illness and those whose siblings had a low IQ. The researchers also looked at results from a comparison group of 791 people who did not have a sibling who was mentally disabled.

The researchers found people who had siblings with mental illnesses were 63% more likely to report having a depressive episode during their lifetime. They also found the brothers and sisters of the people with low IQs were 18% more likely to live in the same state as the disabled brother or sister than those in the comparison group. However, they were significantly less likely to have contact with the disabled sibling, reporting an average of 13 fewer contacts a year with their disabled sibling than the comparison group. In addition, they reported feeling less emotionally close to their siblings.

The researchers also found those who had a brother with a mental illness had lower levels of psychological well being than those in the comparison group. They did not see this effect when looking at those who had a sister with a mental illness. This suggests genetics may not be the only link to poor mental health among siblings of the mentally ill, but the social relationship is also important.

— Source: American Psychological Association

A new study led by researchers at Albert Einstein College of Medicine of Yeshiva University has clarified how two major variants of HIV differ in their ability to cause neurologic complications. The finding, published in the Journal of Neuroscience, highlights a new target for drugs that could prevent HIV-associated dementia, an incurable and increasingly common complication in people with AIDS. Even with antiretroviral drug therapies, up to one half of people infected with HIV will develop mild to moderate neurological complications, according to some estimates.

Earlier this decade, scientists observed that people with AIDS in India developed dementia at a far lower rate than comparable populations in the United States and western Europe. Most cases of AIDS in India are due to infection with a subtype (clade) of HIV known as clade C, while most cases in the United States and western Europe are due to clade B.

Based on these observations, in 2004, a team of researchers led by Vinayaka R. Prasad, PhD, professor of microbiology and immunology at Einstein, searched for genetic variations between the two clades that could explain the differing rates of HIV-related dementia.

To determine whether this variation makes a practical difference in HIV’s neurotoxicity, the researchers injected either clade B or clade C HIV into the brain of a special strain of immunodeficient mice. After six days—enough time for the viruses to cause neurologic damage—the mice were tested in a complex water maze that challenged their long-term memory as well as their short-term working.

Mice infected with clade B performed significantly worse in the maze than those infected with clade C. Moreover, when the researchers examined the mouse brains, they found more damage to neurons in the brains of mice injected with clade B than with clade C. These results were in line with the
fact that people infected with clade B HIV are at greater risk for dementia than people infected with clade C.

— Source: Albert Einstein College of Medicine of Yeshiva University

As the Iowa Supreme Court hears a case that could clear the way for gay marriage in Iowa, a poll shows nearly 60% of voters in the state favor some type of legal recognition of same-sex relationships in Iowa.

In the random, statewide poll of 586 voters, University of Iowa political scientists found that 28% of Iowans support same-sex marriage. Another 30% support civil unions, not gay marriage. About one in three oppose both.

"Iowans are not yet ready to support gay marriage completely, but they are clearly ready to legally acknowledge same-sex relationships," says David Redlawsk, PhD, associate professor of political science in the University of Iowa College of Liberal Arts and Sciences.

Results, drawn from the Big Ten Battleground Poll, indicate that support for gay marriage will get a notable boost if the state's high court rules in favor of it. And, a majority of Iowa voters under the age of 30 are already in favor of gay marriage, suggesting that support for it could grow as time goes on.

Because of the pending Iowa Supreme Court case, the poll asked Iowans to consider what the state should do if the Supreme Court upholds a constitutional right to marriage for same-sex couples.

Thirty-five percent of respondents favored accepting a Supreme Court ruling to allow gay marriage. That means if the court rules in favor of gay marriage, support for it increases by 7 percentage points. Another 27% support the creation of civil unions as an acceptable alternative.
Even larger shifts in support are observed among independents, ideological moderates, and moderate church attendees. If the court sanctions gay marriage, support from those groups grows by 13 to 15 percentage points.

"Clearly opinion on the issue of gay marriage will change if the Iowa Supreme Court rules that the state's constitution requires it," Redlawsk says. "Overall support remains below 50% even then, but those in the political middle become much more likely to support gay marriage if the court rules in favor."

— Source: University of Iowa Health Sciences

A study in the Journals of Gerontology: Psychological Science found that older people tend to feel about 13 years younger than their chronological age. The researchers analyzed the responses of 516 men and women aged 70 and older who participated in the Berlin Aging Study, tracking how their perceptions about age and their satisfaction with aging changed over a six-year period.

"People generally felt quite a bit younger than they actually were, and they also showed relatively high levels of satisfaction with aging over the time period studied," says Jacqui Smith, PhD, a psychologist at the University of Michigan Institute for Social Research.

"We examined individual changes over time, and expected the gap to increase. But we were surprised to find that it was maintained, on average. Perhaps feeling about 13 years younger is an optimal illusion in old age," Smith says.

Smith and colleagues found that some of the oldest participants did feel even younger over time. But poor health reduced the gap between felt age and actual age.

In general, women perceived their appearance as being closer to their actual age, Smith says. "Women saw themselves as about four years older than their male peers," she says. "There are several likely reasons for this gender gap in subjective physical age. One is that women may be more aware of their appearance than men, especially given the negative stereotypes of older bodies."

Initially, men were more satisfied than women with their own aging. But over the six-year period studied, men's satisfaction decreased more than women's. Poor health magnified these patterns, Smith says.

"Feeling positive about getting older may well be associated with remaining active and experiencing better health in old age," she says. "Thus, studies on self-perceptions of aging can contribute to our understanding of potential indicators of resilience in older adults and the aging self."

— Source: University of Michigan Institute for Social Research

Single mothers come surprisingly close in the number of hours they spend caring for their children compared with married mothers, and the difference is explained almost entirely by socioeconomic factors and the kind of jobs they hold, say University of Maryland sociologists in a new study published in the Journal of Marriage and Family. The researchers conclude public policy focuses too heavily on the mother’s marital status.

The study finds that single mothers who may lack a large support network still manage to provide 83% to 90% of child-rearing time as their married counterparts. While the difference is statistically significant, the researchers expected a greater gap.

The researchers analyzed American Time Use Survey data collected between 2003 and 2004. The study is based on responses from 1,821 single mothers and 4,309 married mothers with children less than 13 years of age.

• Single mothers, on average, spend between three and five hours less time per week on child care than married mothers. These differences were statistically significant.


• Unmarried mothers who live with the father spend about the same time on child care as married mothers.


• The reduced amount of time single mothers spend on child care are accounted for by differences in available resources—type and hours of employment, education, maternal age, age of children. When these factors are statistically controlled, the differences disappear.


• Some mothers are more “single” than others—they differ in the support network available to them, such as help from the father or relatives.


— Source: University of Maryland, College Park

A new study found that adolescents were at the greatest risk of smoking when their parents began smoking at an early age and the parents' smoking quickly reached high levels and persisted over time. 
The study, published in Health Psychology, draws from the long-running Indiana University (IU) Smoking Survey and builds on previous research that suggests smoking behavior is influenced by both genetics and the environment.

"This particular study focuses more on the genetic influence in the specific case of a parent's smoking behavior impacting a teenage son or daughter's smoking," says Jon Macy, project director of the IU Smoking Survey in the department of psychological and brain sciences.

"The study findings suggest that the characteristics of early onset and high levels of long-term smoking are great candidates for behavioral and molecular genetic studies of the causes of smoking and how smoking behavior is passed from one generation to the next.

"Of course, environmental influences on adolescents such as parenting practices, availability of cigarettes in the home, and parents' attitudes about smoking are equally as important and can be addressed with effective public health interventions including family-based smoking prevention programs," he says.

"This study used a more informative description of parental smoking behaviors," Macy adds. "We've found that these descriptions might do a better job than current parental smoking status of predicting risk of their adolescent children starting to smoke."

— Source: Indiana University

During the holiday season and these difficult economic times, finding the perfect gift for any child can be a challenge. For family and friends looking for the right toy for a child with special needs, this process can cause even more anxiety and frustration.

According to Elisa Delia, a trained play therapist at the Kennedy Krieger Institute who coordinates toy testing, “People can spend an unnecessary amount of money on expensive toys marketed specifically to children with special needs, not knowing that there are many inexpensive toys available in average toy and superstores that will not only be loved by children with special needs, but act as learning and skill-building tools.”

Delia says family and friends should consider the following when buying games and toys for children with special needs:

1. Buy toys that are developmentally appropriate, or match the child’s motor and cognitive skill level.

2. Balance the child’s developmental age with their calendar age. Avoid hurt feelings and embarrassment by finding toys that are developmentally appropriate but not age-specific.

3. Choose toys that are engaging and help build skills. Simple, inexpensive toys such as balls, finger paints, blocks, and play dough can build motor skills and coordination. Board games or toys that involve the whole family help build social skills.

4. Make sure the toy is durable and doesn’t have a lot of small pieces. Small pieces or easily broken toys can be a safety hazard, and some disabilities can make working with small pieces difficult.

5. Avoid toys that put kids in a “win or lose” situation. Pick toys and games that can build the child’s self-esteem, and that you know they can succeed in.

— Source: Kennedy Krieger Institute

A new study shows that women who take the epilepsy drug valproate while pregnant may significantly increase their child’s risk of developing autism. The preliminary research is published in Neurology.

The ongoing study involves 632 children, nearly half of whom were exposed to epilepsy drugs during gestation. Of the children whose mothers took epilepsy drugs while pregnant, 64 were exposed to valproate, 44 to lamotrigine, 76 to carbamazepine, and 65 to other epilepsy drugs. Of the 632 children in the study, nine have been diagnosed with autism and one has shown symptoms of the disorder. The children were tested at one, three, and six years old. Two thirds of the children were six years old by the end of the study.

The study found seven of the children with autism had mothers who took an epilepsy drug while pregnant, four of those children were exposed to valproate while a fifth child’s mother took a combination of valproate and lamotrigine. The children whose mothers were given valproate during pregnancy were seven times more likely to develop autism compared with children whose mothers did not take an epilepsy drug while pregnant. This risk was not seen with the other epilepsy drugs. None of the children in the study had any known family history of autism.

“The potential risk for autism in this study was substantial for children whose mothers took valproate while pregnant, but more research needs to be done since these are early findings,” says study author Gus Baker, PhD, FBPsS, of the University of Liverpool in the United Kingdom.

— Source: American Academy of Neurology

Fifteen years after they completed an intervention program designed to help their social development in elementary school, young adults reported better mental health, sexual health, and higher educational and economic achievement than a control group of young adults who didn’t receive the intervention, according to a new study. The results are being published in the Archives of Pediatrics & Adolescent Medicine.

“We are seeing that the intervention appears to affect developmentally important outcomes that change as people age,” says J. David Hawkins, PhD, lead author of the study and founding director of the University of Washington’s Social Development Research Group.

“The effects of working with children in elementary school show up in their teen years as their rates of violence, heavy alcohol use, and dropping out of school are reduced. By age 21 more of them have completed high school and have better jobs. And by ages 24 and 27 they are above the median in socioeconomic status and education and they are having less mental health and sexual health problems.”

The study involved 598 students from 15 Seattle public schools serving high-crime neighborhoods. One group of 146 students received the intervention in grades one through six. A second group of 251 students received a partial intervention only in the fifth and sixth grades, and the third group of 201 children was not exposed to the program. The young adults surveyed in this study were evenly split between males and females. Forty-six percent were white, 26% black, 22% Asian American, and 6% Native American.

Those people who received the full intervention in grades one through six showed the strongest effects and the most positive functioning in young adulthood. Those who received the partial intervention showed lesser effects, though they fared somewhat better than people who did not receive either intervention.

— Source: University of Washington

People who have attempted suicide at some point in their lives are more likely to actually succeed in committing suicide at a later date. The risk is particularly high for people with serious psychiatric disorder, according to a new study from the Swedish medical university Karolinska Institutet.

One in ten suicide attempters actually commit suicide later on in life. However, knowledge of the factors affecting the risk of suicide is limited, which makes it hard to identify, and help, the people who are at the greatest risk.

A group of researchers at Karolinska Institutet performed a longitudinal follow-up of almost 40,000 people who have been admitted to the hospital after an attempted suicide. Their results show that the risk of later actually committing suicide differs significantly for each of the diagnostic groups. The risk was especially high for people diagnosed with schizophrenia, bipolar disorder or clinical depression on their first attempt.

The study, which followed people over a period of 21 years or more, also shows that many of the completed suicides were committed in the first years after the first suicide attempt. The short-term prognosis was particularly poor for people with schizophrenia, bipolar disorder, or clinical depression.

"These results can be of use in acute risk assessments following attempted suicide," says Bo Runeson, MD, PhD, a professor in the department of clinical neuroscience, who led the study. "Psychiatric disorder is a key factor in the planning of patient aftercare and evaluation. The medical treatment given and the psychological support provided must both take account of the diagnosis and be personalised."

— Source: Karolinska Institutet

Purse strings are tightening for individuals and corporations alike this holiday season, and donations may be the first to be cut from holiday budgets. Nonprofit organizations should take steps to ensure they stay afloat during the current economic recession, says Ray Sarnacki, visiting assistant professor of management at Saint Joseph’s University in Philadelphia.

According to the Giving USA Foundation, nonprofits historically receive most of their donations from individuals. In 2007, nearly 82% of all charitable giving came from individuals. Corporations accounted for only 5.1% of all donations, with foundational contributions slightly higher at 12.6%.

In times of recession, charitable giving decreases. In 2001, the last time the economy condensed, donations fell by 2.3%, according to the Giving USA Foundation.

Sarnacki says that for nonprofits to weather the recessional storm, they must receive funding from many different sources.

“Nonprofits need to develop multiple and diverse funding streams to sustain them if one source drops off,” explains Sarnacki. “They must invest in strengthening and expanding relationships with influential people, especially board members, who can help them generate additional revenue during tough economic times.”

In order to prevent marginal nonprofit organizations from going by the wayside, Sarnacki suggests they merge together with similar nonprofits to strengthen their support systems.

“Strong nonprofits have a network of people—both individuals and corporations—to sustain them,” Sarnacki explains.

— Source: Saint Joseph's University

A study published by researchers at Yeshiva University and Albert Einstein College of Medicine, strongly suggests that regular attendance at religious services reduces the risk of death by approximately 20%. The findings, published in Psychology and Health, were based on data drawn from participants who spanned numerous religious denominations.

The researchers evaluated the religious practices of 92,395 postmenopausal women aged 50 to 79 participating nationwide in the Women's Health Initiative (WHI). The women answered questions about baseline health conditions and religiosity and were followed by WHI researchers for an average of 7.7 years, with potential study outcomes of cardiovascular events and mortality adjudicated by trained physicians.

To evaluate the impact of religiosity on mortality and morbidity, the investigators looked at variables including self-reports of religious behavior in relation to coronary heart disease and death. It is important to note that the study did not attempt to measure spirituality; rather, it examined self-report religiosity measures (irrespective of the participant’s religion). Participants answered three key questions at registration, regarding religious affiliation; 
how often services were attended;
and if religion provided strength and comfort.

Although the study showed as much as a 20% decrease in the overall risk of mortality for those attending religious services, it did not show any consistent change in rates of morbidity and death specifically related to cardiovascular disease, with no explanation readily evident.

The study adjusted for participation of individuals within communal organizations and group activities that promote a strong social life and enjoyable routines, behaviors known to lead to overall wellness. However, even after controlling for such behavior and other health-related factors, the improvements in morbidity and mortality rates exceeded expectations.

The study investigators concluded that although religious behavior (as defined by the study’s criteria) is associated with a reduction in death rates among the study population, the physical relationships leading to that effect are not yet understood and require further investigation. “The next step is to figure out how the effect of religiosity is translated into biological mechanisms that affect rates of survival,” says coauthor Sylvia Wassertheil-Smoller, PhD, a professor of epidemiology and population health at Einstein.

— Source: Albert Einstein College of Medicine of Yeshiva University

A new study by sociologists at the University of Maryland concludes that unhappy people watch more TV, while people who describe themselves as very happy spend more time reading and socializing. The study appears in Social Indicators Research.

Analyzing 30-years worth of national data from time-use studies and a continuing series of social attitude surveys, the researchers report that spending time watching television may contribute to viewers’ happiness in the moment, with less positive effects in the long run. They analyzed two sets of data spanning nearly 30 years (1975-2006) gathered from nearly 30,000 adults.

“TV doesn’t really seem to satisfy people over the long haul the way that social involvement or reading a newspaper does,” says University of Maryland sociologist John P. Robinson, PhD, the study coauthor and a pioneer in time-use studies. In their study, Robinson and his coauthor, University of Maryland sociologist Steven Martin, PhD, set out to learn more about the activities that contributed to happiness in people’s lives.

From the General Social Survey, the researchers found that self-described happy people were more socially active, attended more religious services, voted more, and read more newspapers. By contrast, unhappy people watched significantly more television in their spare time—an estimated 20% more television even after taking into account their education, income, age, and marital status, as well as other demographic predictors of both viewing and happiness.

Data from time-diaries told a somewhat different story. Responding in “real time,” much closer to daily events, survey respondents tended to rate television viewing more highly. “What viewers seem to be saying is that ‘While TV in general is a waste of time and not particularly enjoyable, the shows I saw tonight were pretty good,’” Robinson says.

— Source: University of Maryland, College Park

According to an article published in Psychological Science, proper spacing of lessons, the researchers report, can dramatically enhance learning. And larger gaps between study sessions result in better recall of facts.

In light of the study, coauthors Hal Pashler, PhD, and John T. Wixted, PhD, professors of psychology at the University of California San Diego, wrote, “it appears no longer premature for psychologists to offer some rough practical guidelines to those who wish to use study time in the most efficient way possible to promote long-term retention.”

More than 1,000 subjects participated in three sessions. In the first session, they were taught a set of obscure but true facts. The second session was a review of the same facts. The time between the sessions ranged from several minutes to several months. Study time was held constant in all the conditions. After some further delay, up to about one year, subjects were then tested.

Not surprisingly, when the interval between the second session and the test was increased, memory got worse, reflecting the familiar curve of forgetting. However, increasing the time between the study sessions reduced the rate of forgetting. This reduction in forgetting was very large, sometimes increasing the likelihood that information would be recalled in the final session by 50%.

The results suggest, Pashler says, that the optimal amount of time over which learning should take place depends upon how long the information needs to be retained: “If you want to remember information for just a week, it is probably best if study sessions are spaced out over a day or two. On the other hand, if you want to remember information for a year, it is best for learning to be spaced out over about a month.”

— Source: University of California, San Diego

As Americans are struggling to make ends meet with rising costs, they are grappling more than ever with what's appropriate when it comes to rewarding service providers with tips, gifts, and other token gratuities, suggests Leonard Green, PhD, a psychology professor in arts and sciences at Washington University in St. Louis.

In recent research, Green and colleagues compiled data from nearly 1,000 tips left in restaurants, hair salons, and with cab drivers. Their analysis determined that the larger the bill, the smaller the tip percentage that food servers, hair stylists, and cab drivers receive. Their findings indicate that the percent of the tip actually decreases with the amount of the bill across all three tipping situations.

The researchers also found that with bills more than $100, the percent of the tip levels off—if the bill is $200, the server is likely to receive about the same percentage of tip as if the bill was $100.

Green, who comes from New York, says he has lots of friends back home who spent hours anguishing over how to distribute their holiday tipping budget—how much to give and to whom?

"I think the decision often comes down to how much control the person really has over your life," Green says. "When it comes down to it, getting your newspaper every day is not that important. But, if there's no heat in your apartment, who do you contact for help. If someone, like a building superintendent, provides essential services, then a person might think that a nice tip helps ensure that the service will be there the next time you need it. Some people tip because they don't want to take the risk that not tipping may cause someone to hold back on an essential service. A holiday tip might not get you better service, but it may reduce the chances of getting worse service."

— Source: Washington University in St. Louis

Despite common assumptions, new research suggests that women are not more likely to be sexually harassed when they are the minority or majority in a work group. Instead, researchers found that in most cases, women were sexually harassed at work when their work group had a similar proportion of males and females.

A study looking at 110 work groups from around the world found that women who work in relatively equally matched gender groups were more likely to be harassed than women who worked in predominantly male or female groups. Women in these situations were more likely to experience taunting, patronizing, and predatory behaviors. Workplaces ranging from less than 50 employees to more than 5,000 employees were included to more accurately represent the general workforce. The results were published recently in Work and Occupations.

“Some people argue that women are more likely to be harassed when there are just a few women, and other people argue that women are harassed when they are the dominant group in an occupation. But we found that actually was not the case. Most sexual harassment occurs in situations in equally mixed gender groups,” says Randy Hodson, coauthor of the study and professor of sociology at The Ohio State University.

Hodson says the logic behind the finding is simple: sexual harassment occurs where there is more opportunity. “There is a lot more opportunity in these groups because you have a lot of men who have contact on a regular basis with a lot of women, and that’s going to create more opportunities for sexual harassment,” he says.

More than one third of the work groups studied did not have any incidents of sexual harassment. But when sexual harassment was observed, it was found more often in groups with a nearly equal mixture of men and women than in groups with a lone female in a predominately male environment.

Compounding the issue, formal grievance procedures were also less effective in combating the less severe forms of sexual harassment. Hodson says most organizational policies are clearly defined to protect workers from the most extreme behaviors but many of the other, less severe forms of sexual harassment may be left out or less clearly defined, creating uncertainty among some workers on what can be considered sexual harassment.

— Source: The Ohio State University

When Temple University political science professor Gary Mucciaroni looked across the spectrum of gay rights issues, he saw a puzzle: Why have gays and lesbians been so successful in achieving some of their goals and not others?

In trying to put the puzzle pieces together, Mucciaroni initially looked at the role of public opinion and explored whether or not gays simply are more successful when the general public is not feeling threatened by gay rights issues. “That helped to explain the outcome in three cases: marriage, hate crimes, and civil rights,” Mucciaroni says.

But, it does not account for the outcome on the question of military service, where there had been high public support in favor of ending the ban. Conversely, in the area of adoption and the legalization of homosexual conduct, gays and lesbians have gained those rights, despite the lack of public support.

Closer examination of gay rights in the area of adoption led Mucciaroni to understand the critical role third-party stakeholders play. Mucciaroni found that social workers and judges were important allies in the fight for adoption rights for gays and lesbians. According to Mucciaroni, the vagueness of adoption laws—along with studies that say same sex parents are as successful as heterosexual couples and the societal need to give children stable, permanent homes—has allowed stakeholders, such as social workers, adoption agencies, family court judges, and lawyers to have a real impact in this arena.

Given his findings, Mucciaroni speculates that LGBT rights advocates may want to rethink some of their strategies. He argues that they have fared much better when issues are resolved at state and local levels rather than in Washington.

— Source: Temple University

A new study in the journal Appetite finds that obese women display significantly weaker impulse control than normal-weight women, but between obese and normal-weight men, the impulsivity levels are nearly the same. The study was conducted by researchers in the University of Alabama at Birmingham (UAB) psychology department.

UAB researchers conducted the study to see how obese and normal-weight men and women differed in their decision-making skills, specifically in delay discounting, the measure of how much an individual is driven by immediate gratification vs. the willingness to wait for delayed but greater rewards.

In the study of 95 men and women, UAB researchers gave the participants the choice of receiving varying hypothetical amounts of money immediately or fixed hypothetical amounts of money to be received after delays of two weeks; one month; six months; or one, three, five, or 10 years.

The researchers found that obese women discounted the value of future rewards at a rate three-to-four times greater than that of normal-weight women, suggesting greater impulsivity. However, obese men and the male and female control subjects all showed similar levels of delay discounting.

“Our study found that obese men have more impulse control than obese women. So, obese men may be protected from more impulsive behavior on the delay-discounting task by having lower disinhibition in general. Obese women may have the double whammy of being female and having higher body mass index,” Weller says.

— Source: University of Alabama at Birmingham

In contrast to recent findings, two of the most common medications used to treat attention-deficit/hyperactivity disorder (ADHD) do not appear to cause genetic damage in children who take them as prescribed, according to a new study by researchers at the National Institutes of Health and Duke University Medical Center.

The study, published online in the Journal of the American Academy of Child and Adolescent Psychiatry, provides new evidence that therapeutic doses of stimulant medications, such as methylphenidate and amphetamine, do not cause cytogenetic (chromosomal) damage in humans. The researchers looked at three measures of cytogenetic damage in white blood cells of each child participating in the study and found no evidence of any changes after three months of continuous treatment.

The researchers involved emphasize that the findings should not be interpreted as final proof of the long-term safety of stimulant drugs for the treatment of ADHD. "More research and close monitoring of children taking these medications for extended periods of time is needed to fully evaluate the physical and behavioral effects of prolonged treatment with stimulants," notes Scott H. Kollins, PhD, director of the Duke ADHD Program and a coauthor of the paper.

The current study included 63 children, aged 6 to12, who met full criteria for ADHD but who had not previously been treated with stimulant medications. Children in the study were divided into two groups and treated by a board-certified child psychiatrist with either methylphenidate or with mixed amphetamine salts. Blood samples were taken before the medication was started to establish baseline values for the cytogenetic measures that were analyzed in the study, and a second sample was collected after three months of continuous treatment. Forty-seven children completed the full three-month treatment schedule.

The researchers looked at three standard indicators of chromosomal damage: structural chromosomal aberrations (breaks in chromosomes), micronuclei (small nuclei consisting of chromosome fragments produced by breakage or whole chromosomes lost from the main nucleus after the cell divides), and sister chromatid exchanges (exchanges of genetic material between a pair of identical chromosomes). "We did not see any significant treatment-related increases in any of these three endpoints," says Donald R. Mattison, MD, senior advisor to the director at the National Institute of Child Health and Human Development. "These results add to a growing body of evidence that therapeutic levels of these medications do not damage chromosomes," he says.

— Source: The National Institutes of Health

Nearly 10% of adolescent girls in the United States meet the criteria for conduct disorder, a diagnosis describing youths who persistently exhibit behaviors that violate rules and rights of others. Conduct disorder is less prevalent in girls than in boys, although it is the second most common psychiatric diagnosis among adolescent females. Many of these teenage girls with conduct disorder may grow up to have poor adjustment in adulthood, with mental and physical health problems and difficulties parenting.

A recent study, conducted by researchers at Nationwide Children’s Hospital and published in Child and Adolescent Psychiatry and Mental Health, sought to determine if three domains of social context—neighborhood, family characteristics and parenting behaviors—were associated with conduct disorder in adolescent girls.

“Our findings indicate that conduct disorder in adolescent girls is not significantly associated with neighborhood quality, but is, in fact, correlated with family characteristics and types of parenting behaviors,” says Kathleen Pajer, MD, MPH, the study’s lead author and principal investigator in The Research Institute at Nationwide Children’s Hospital. “Minority race, neighborhood quality, and family poverty had some effect on conduct disorder in adolescent girls, but not once family interactions with the girl and her parents’ own history of delinquency, conduct disorder or criminality were taken into account.”

Data for the study were obtained from nearly 100 participants (15-to 17-year-old girls) in a large mid-Western city. Half of the girls were diagnosed with conduct disorder, while the other half, a demographically matched group, had no psychiatric disorder.

— Source: Nationwide Children's Hospital

Researchers at the University of California, Davis Medical Investigation of Neurodevelopmental Disorders (MIND) Institute have found that infants later diagnosed with autism exhibited unusual exploration of objects long before being diagnosed.

These findings could help pediatricians diagnose and treat autism earlier, reducing some of the social and educational challenges associated with the disorder. "There is an urgent need to develop measures that can pick up early signs of autism, signs present before 24 months," says MIND researcher Sally Ozonoff, PhD, first author of the current study, which was published in Autism.

The study involved 66 one-year-old infants. Nine of the children were later diagnosed with autism. Seven of the nine children displayed significantly more spinning, rotating and unusual visual exploration of objects than typically developing children. "We found that these behaviors were relatively rare in the contrast group, but very high in the group who later developed autism," Ozonoff says.

The children in the study were presented with four objects—a metal lid, a round plastic ring, a rattle, and a plastic baby bottle—one at a time for 30 seconds each while being videotaped. Researchers blind to the outcomes coded the behaviors in the tapes. The children were screened for autism at 36 months. Ozonoff and her colleagues found that children later diagnosed with autism were more likely to repeatedly spin and rotate objects. They were also more likely to explore objects in unusual ways, like glancing sideways at them or starting intently at them for prolonged periods.

"Our results suggest that these particular behaviors might be useful to include in screening tests," Ozonoff says. "The earlier you treat a child for autism, the more of an impact you can have on that child's future."

— Source: Medical Investigation of Neurodevelopmental Disorders Institute

A new study suggests that genetic factors influence size variations in a certain region of the brain, which could in turn be partly responsible for increased susceptibility to alcohol dependence. It appears that the size of the right orbitofrontal cortex, an area of the brain that is involved in regulating emotional processing and impulsive behavior, is smaller in teenagers and young adults who have several relatives that are alcohol dependent, according to a study led by Shirley Hill, PhD, professor of psychiatry at the University of Pittsburgh School of Medicine.

In the research, which was published online in Biological Psychiatry, researchers imaged the brains of 107 teens and young adults using magnetic resonance imaging. They also examined variation in certain genes of the participants and administered a well-validated questionnaire to measure the youngsters' tendency to be impulsive.

The participants included 63 individuals who were selected for the study because they had multiple alcohol-dependent family members, suggesting a genetic predisposition, and 44 who had no close relatives dependent on drugs or alcohol. Those with several alcohol-dependent relatives were more likely to have reduced volume of the orbitofrontal cortex.

When the investigators looked at two genes, they found certain variants that led to a reduction in white matter volume in the orbitofrontal cortex, and that in turn was associated with greater impulsivity.

These differences can be observed even before the high-risk offspring start drinking excessively, she adds, "leading us to conclude that they are predisposing factors in the cause of this disease, rather than a consequence of it."

— Source: University of Pittsburgh Medical Center

How well young people learn and develop during their college years may be due more to the normal process of maturing rather than the college experience itself, according to a new student assessment tool developed by researchers at Indiana State University.

The University Learning Outcomes Assessment is an indicator of student growth, learning, and development, says Mark Frederick, assistant to the vice president of student affairs for research and assessment. The survey examines seven areas of a student’s life—critical thinking, self-awareness, communication, diversity, citizenship, membership and leadership, and relationships.

“We looked for areas of study that could be shared across campus—areas that both student affairs and the academic community could get behind,” says Will Barratt, an associate professor of educational administration.

Findings include the following:

• Students belonging to two or three formally organized organizations or activities score higher on citizenship, membership and leadership, and relationships than those belonging to more or fewer organizations. Further, students holding two leadership positions score higher in citizenship, membership and leadership than those holding fewer or more positions.

• Student ethnicity produces different score profiles for critical thinking, self awareness, communication, and membership and leadership. This result, according to researchers, could reflect subtle cultural differences in how students' behaviors indicate holistic growth, learning, and development or the degree to which learning experiences are available and accessible to different ethnic groups.

• Scores in all areas correlate more with the educational level of the mother than the father. However, socioeconomic status, as measured by receiving a Pell Grant, does not appear to be a factor impacting scores in any of the areas surveyed.

• There are substantial differences between majors in critical thinking, communication, and citizenship with students in humanities, pre-medicine/dentistry, and social sciences scoring higher than students majoring in general studies, pre-law, and recreation/sports/leisure. Undeclared majors score the lowest.

The ultimate goal of the survey is to encourage colleges and universities to embrace a holistic approach to the student experience—shared learning outcomes of the classroom and student activities.

— Source: Indiana State University

About 1.4 million hospitalizations in 2006 involved patients who were admitted for a mental illness, while another 7.1 million patients had a mental disorder in addition to the physical condition for which they were admitted, according to the latest information from the Agency for Healthcare Research and Quality (AHRQ).

The 8.5 million hospitalizations involving patients with mental illness represented about 22% of the overall 39.5 million hospitalizations in 2006. AHRQ's analysis of the nearly 1.4 million hospitalizations specifically for treatment of a mental disorder found the following:

• Nearly 730,000 involved depression or other mood disorders, such as bipolar disease.

• Schizophrenia and other psychotic disorders caused another 381,000.

• Delirium, which can cause agitation or inability to focus attention; dementia; amnesia; and other cognitive problems accounted for 131,000.

• Anxiety disorders and adjustment disorders—stress-related illnesses that can affect feeling, thoughts, and behaviors—accounted for another 76,000.

• The remaining roughly 34,000 hospitalizations involved attention-deficit disorder, disruptive behavior, impulse control, personality disorders, or mental disorders usually diagnosed in infancy or later childhood.

This AHRQ information is based on data from Hospital Stays Related to Mental Health, 2006. The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.

— Source: Agency for Healthcare Research and Quality

Counseling and social support are key to alleviating depression for family caregivers, even when their relatives with Alzheimer’s disease receive pharmacologic treatment. These findings are reported in a recent issue of the American Journal of Geriatric Psychiatry. 
According to lead author Mary Sherman Mittelman, DrPH, of The William and Sylvia Silberstein Institute for Aging and Dementia at New York University (NYU) Langone Medical Center, the study looked at change in symptoms of depression in a total of 158 pairs of spouse-caregivers and patients with Alzheimer’s disease. 


All the Alzheimer’s patients were prescribed donepezil at no cost while they participated in the study. One half of the caregivers were given a comprehensive psychosocial intervention that included two individual and three family counseling sessions within three months of enrolling in the study, and counseling on demand for two years after enrolling, generally on the telephone; caregivers in the control group only received resource information upon request. Symptoms of depression in the caregivers were measured at intake and at follow-up assessments conducted at regular intervals for 24 months.

Over the two years they were in the study, symptoms of depression decreased among caregivers who received the five sessions of individual and family counseling, while depression increased among those who did not receive counseling. The results provide evidence that a multicomponent counseling and support program for caregivers can have significant benefits in reducing symptoms of depression in caregivers whose spouses are taking donepezil.

— Source: New York University Langone Medical Center

Individuals who receive implantable cardiac defibrillators after a sudden heart event appear more likely to die within five years if they experience symptoms of posttraumatic stress disorder (PTSD), regardless of the severity of their disease, according to a report in a recent issue of Archives of General Psychiatry.

Surviving a life-threatening heart condition, such as heart attack or cardiac arrest, causes significant distress, according to the article. Resulting symptoms may qualify an individual for a diagnosis of PTSD. Between 8% and 20% of patients with acute coronary syndromes and 27% to 38% of those who survive a cardiac arrest develop PTSD.

Karl-Heinz Ladwig, PhD, MD, of Technische Universitaet Muenchen, Munich, and Helmholtz Zentrum National Research Center for Environmental Health, Neuherberg, Germany, and colleagues studied 211 patients who had received implantable cardiac defibrillators following a heart event in 1998. Participants were surveyed an average of 27 months after implantation and 38 reported severe PTSD symptoms. All patients were then tracked through medical records, telephone interviews, reports from family members and death certificates through March 2005.

During the average follow-up period of five years, 45 of the patients (30.6%) died. This included 32 of the 109 patients with low or moderate PTSD symptoms and 13 of 38 patients with high levels of such symptoms. “Our findings provide direct evidence for an independent influence of PTSD symptoms on fatal outcome in these patients,” the authors wrote.

Patients with PTSD in the study reported more cardiac symptoms, such as chest pain, than those without PTSD. However, clinical characteristics that typically account for survival differences in such patients did not differ between the two groups. “Therefore, the perceived severity rather than the objective severity of a cardiac condition as determined by cardiac criteria may be associated with PTSD,” the authors wrote.

— Source: American Medical Association

The first of a fleet of 50 new mobile counseling centers for the VA Vet Center program was recently put into service with the remainder activated over the next three months.

"Our widespread distribution of this fleet from coast to coast marks a new chapter in VA's innovation to reach rural and underserved veterans with high-quality readjustment counseling," says VA secretary James B. Peake, MD.

Each vehicle will be assigned to one of VA's existing Vet Centers, enabling the center to improve access to counseling by bringing services closer to veterans. The 38-foot motor coaches, which have spaces for confidential counseling, will carry Vet Center counselors and outreach workers to events and activities to reach veterans in broad geographic areas, supplementing VA's 232 current Vet Centers, which are scheduled to increase to 271 facilities by the end of 2009.

Vet Centers, operated by VA's Readjustment Counseling Service, provide nonmedical readjustment counseling in easily accessible, consumer-oriented facilities, addressing the social and economic dimensions of post-war needs. This includes psychological counseling for traumatic military-related experiences and family counseling when needed for the veteran's readjustment.

The team leader at each Vet Center will develop an outreach plan for use of the vehicle within that region, not being limited to the traditional area of a particular Vet Center. These vehicles will be used to provide outreach and direct readjustment counseling at active-duty, reserve and National Guard activities, including post-deployment health reassessments for returning combat service members.

— Source: Department of Veterans Affairs

Precautionary health measures such as mammograms and cholesterol tests that identify the risk of heart disease are critical for the well-being of women over 50. Add the responsibility of providing sustained care for a grandchild, and these preventive examinations become even more important.

“Given that this group is already at risk for poor health outcomes because of their advanced age and vulnerability to chronic conditions, poor preventive behavior might precipitate a decline in health over time, a situation which could render the grandmother unable to care for her grandchild,” explains lead author, Lindsey Baker, a postdoctoral fellow at the University of Southern California Davis School.

In a recent paper in the Journal of Gerontology, researchers looked at five types of protective health behaviors. Their findings indicate that grandmothers in the early stages of caring for a grandchild were significantly less likely than grandmothers not raising grandchildren to undergo flu vaccination or cholesterol screening. They were also less likely to get Pap tests, the researchers found.

However, after two years of caring for a grandchild, what was once a health burden becomes a potential health benefit. Researchers found that caregiving grandmothers were increasingly health conscious once they made the transition into full-time care, becoming more likely than those not raising grandchildren to adopt preventative health measures such as flu vaccinations and monthly breast self-exams.

“Long-term caregivers are particularly motivated to maintain a healthy lifestyle, in order to be prepared to care for the child in the future. As grandmothers adapt to their new role, this motivation begins to outweigh constraints on service use,” Baker says.

The lower incidence of preventive healthcare in the first two years of raising a grandchild was true even among grandmothers for whom raising a grandchild was not a financial or emotional strain, according to the study.

“This implies that even grandparents and grandchildren in households traditionally seen as stable and therefore not generally targeted by state and federal programs, may be at adverse risk if lower use of health screening results in greater prevalence of disease and disability among caregiving grandparents,” Baker says.

— Source: University of Southern California

As this holiday season approaches, would-be Santa’s should look to be more creative about the toys they buy their young children.

“Old-fashioned inexpensive retro toys, such as red rubber balls, simple building blocks, clay and crayons, that don’t cost so much and are usually hidden in the back shelves are generally healthier for children than the electronic educational toys that have fancier boxes and cost $89.99,” says Temple University developmental psychologist Kathy Hirsh-Pasek, PhD.

The overarching principle is that children are creative problem-solvers, they’re discoverers, they’re active, says Hirsh-Pasek, codirector of the Temple University Infant Lab. “Your child gets to build his or her imagination around these simpler, more inexpensive toys; the toys don’t command what your child does, but your child commands what the toys do.”

As Roberta Golinkoff, PhD, head of the Infant Language Project at the University of Delaware says, “Electronic educational toys boast brain development and that they are going to give your child a head start. But developmental psychologists know that it doesn’t really work this way. The toy manufacturers are playing on parents’ fears that our children will be left behind in this global marketplace.”

Ironically, says Hirsh-Pasek and Golinkoff, the real educational toys are those that nurture the skills sets important in the 21st Century world: collaboration, communication, creative thinking, and a sense of confidence.

Golinkoff adds that “kids are not like empty vessels to be filled. If they play with toys that allow them to be explorers, they are more likely to learn important lessons about how to master their world.”

— Source: Temple University

Adolescents addicted to opioids who received continuing treatment with the combination medication buprenorphine-naloxone had lower rates of testing positive or reporting use of opioids compared with youths who went through a short-term detoxification program using the same medication, according to a study in The Journal of the American Medical Association.

“The usual treatment for opioid-addicted youth is short-term detoxification and individual or group therapy in residential or outpatient settings over weeks or months. Clinicians report that relapse is high, yet many programs remain strongly committed to this approach and, except for treating withdrawal, do not use agonist [a drug that mimics the action of a naturally occurring substance] medication,” the authors wrote.

George Woody, MD, of the University of Pennsylvania in Philadelphia, and colleagues conducted a study comparing outcomes of treating opioid addiction among adolescents with extended treatment using buprenorphine-naloxone vs. short-term detoxification. The study included 152 patients, aged 15 to 21. Patients in the 12-week buprenorphine-naloxone group were prescribed up to 24 milligrams per day for 9 weeks and then tapered to week 12; patients in the detox group were prescribed up to 14 milligrams per day and then tapered to day 14. All were offered weekly individual and group counseling.

The researchers found that overall, patients in the detox group had higher proportions of opioid-positive urine test results at weeks 4 and 8 but not at week 12. At week 4, 61% of detox patients had positive results vs. 26% of the 12-week buprenorphine-naloxone patients. At week 8, 54% of detox patients had positive results vs. 23% of 12-week buprenorphine-naloxone patients. At week 12, 51% of detox patients had positive results vs. 43% of buprenorphine-naloxone patients, who by that time had been tapered off their medication.

By week 12, 20.5% of detox patients remained in treatment vs. 70% of 12-week buprenorphine-naloxone patients. During weeks 1 through 12, patients in the 12-week buprenorphine-naloxone group reported less use of opioids, cocaine, and marijuana; less injecting; and less need for additional addiction treatment. High levels of opioid use occurred in both groups at follow-up.

“Taken together, these data show that stopping buprenorphine-naloxone had comparably negative effects in both groups, with effects occurring earlier and with somewhat greater severity in patients in the detox group,” the authors wrote.

— Source: American Medical Association

People from racial minorities in the United States are less likely to have access to care for depression and less likely to receive adequate care when treatment is available, according to a new study in Psychiatric Services.

"Despite recent advances in the treatment of mental illness and considerable efforts to improve quality of and access to treatment, there appears to be a significant mismatch between need and treatment in the United States," the authors conclude.

Researchers pooled data on 9,000 adults from three national surveys that included significant numbers of non-English-speaking participants belonging to racial and ethnic minority groups.

"The findings paint a stark, recent picture of care for depression among racial and ethnic minority populations in the United States and clearly point to areas in need of further sustained attention," the authors say.

The study shows that while 33% of non-Latino whites received adequate treatment if they experienced depression in the previous year, only 22% of Latinos, 13% of Asians, and 12% of African Americans who had experienced depression in the same period received adequate treatment.

For those with depression who had access to any care, African Americans in particular were significantly less likely than whites to receive adequate depression care. Adequate care was defined as four or more provider visits plus 30 days of antidepressant use or eight or more specialty mental health provider visits of at least 30 minutes each.

— Source: American Psychiatric Association

Federal and state laws make discrimination in the workplace illegal and to comply most organizations have developed their own diversity policies, which they list as part of their core values, recognizing and respecting the different perspectives of employees and customers.

However, having a policy does not always mean a favorable diversity climate. “Being a prodiversity organization is more than legal compliance and hiring the ‘right’ number of minorities in the workforce,” says Patrick F. McKay, PhD, of the school of management and labor relations at Rutgers University.

McKay and colleagues undertook a study of racial and ethnic differences in employee sales performances. They chose a large American retail company that is ranked in the “Top 50 Companies for Diversity” by Diversity, Inc. magazine and surveyed 6,130 workers at nearly 750 stores around the country. Their findings were published in the summer issue of Personnel Psychology.

The research showed some variableness among the different store units. “We found that diversity climates varied across the stores, although the company’s diversity policies and goals were the same for all stores,” says McKay. Their study showed that African American employees in stores with high prodiversity climates increased their sales by about $20 per hour, an annual sales gain of nearly $21,000. Hispanic employees increased hourly sales by $26, resulting in annual gain of $27,000.

Also, white sales personnel showed improvement in their sales figures, although not as strongly, primarily because there is less discrimination directed at whites.
The bottom line? Organizations that foster hospitable diversity climates by providing equitable opportunities for their minority workers can experience greater profits and a more harmonious workforce.

— Source: Society for Industrial and Organizational Psychology

Unusually aggressive youths may actually enjoy inflicting pain on others, research using brain scans at the University of Chicago shows. Scans of the aggressive youths’ brains showed that an area that is associated with rewards was highlighted when the youths watched a video clip of someone inflicting pain on another person. Youths without the unusually aggressive behavior did not have that response, the study showed. The results are reported in Biological Psychology.

“This is the first time that fMRI scans have been used to study situations that could otherwise provoke empathy,” says Jean Decety, a professor in psychology and psychiatry at the University of Chicago. “This work will help us better understand ways to work with juveniles inclined to aggression and violence.”

In the study, researchers compared eight 16- to 18-year-old boys with aggressive conduct disorder to a control group of adolescent boys with no unusual signs of aggression. The boys with the conduct disorder had exhibited disruptive behavior such as starting a fight, using a weapon, and stealing after confronting a victim.

The youths were tested with fMRI while looking at video clips in which people endured pain accidentally, such as when a heavy bowl was dropped on their hands, and intentionally, such as when a person stepped on another’s foot.

“Aggressive adolescents showed a specific and very strong activation of the amygdala and ventral striatum (an area that responds to feeling rewarded) when watching pain inflicted on others, which suggested that they enjoyed watching pain,” Decety says.

— Source: University of Chicago

For working parents, having grandparents as caregivers can cut the risk of childhood injury roughly in one half, according to a new study by researchers from the Johns Hopkins Bloomberg School of Public Health. Compared with organized daycare or care by the mother or other relatives, having a grandmother watch a child was associated with a decreased risk of injury for the child. The results are published in Pediatrics.

“Recent growth in the number of grandparents providing childcare has some observers concerned they don’t adhere to modern safety practices,” says lead study author David Bishai, MD, PhD, MPH, a professor with the Bloomberg School’s department of population, family, and reproductive health. “To the contrary, this research tells us not only is there no evidence to support this assumption, but families that choose grandparents to care for their children experience fewer child injuries.”

Bishai and colleagues analyzed data from the National Evaluation of the Healthy Steps for Young Children Program, which includes information on over 5,500 newborns enrolled in 15 U.S. cities in 1996 to 1997 with follow-up for 30 to 33 months. Data on childcare arrangements reported by the mother were linked to claims reporting children’s office visits, allowing researchers to identify medically attended injuries.

“As injuries are the number one cause of death for children in the United States, it’s critical we continue to determine risk and protective factors,” says study coauthor Andrea C. Gielen, ScD, ScM, a coauthor of the study and director of the Center for Injury Research and Policy in the department of health policy and management at the Bloomberg School of Public Health. “Additional studies of how households choose relatives to watch their children and the actual caregiving style of grandparents are warranted because the protective effect of grandparents may depend on choosing the right grandparent.”

— Source: Johns Hopkins Bloomberg School of Public Health

An individual’s level of commitment to religious rituals like praying and attending service is directly linked to their sense of personal control in life, according to new University of Toronto research.

University of Toronto sociology professor Scott Schieman interviewed 1,800 Americans in a groundbreaking survey that examined the link between levels of religious beliefs and sense of personal control over events and outcomes in everyday life.

The study’s results include that people who believe in a powerful and influential God but aren’t as strongly devoted to religious rituals like praying or attending service report a lower sense of personal control in their lives. By contrast, individuals who believe that God’s will influences outcomes in everyday life do not report a deflated sense of personal control if they actively participate in religious rituals.

“One might think the most devout religious practitioners would feel a lack of personal control in their lives because they have such faith in divine control,” says Schieman. “Surprisingly, we found the opposite. It’s those who believe in God but don’t dedicate much time to practicing religion who feel the least in control of their lives.”

“Some people feel unable to change the important events and outcomes in their daily lives. Some people turn to a divine power or authority for support. In some cases, this also implies a sense that one’s own fate is influenced or determined by powerful external forces, especially God,” Schieman says. “This notion of divine control is reflected in common phrases like ‘It is all in God’s hands.’”

— Source: University of Toronto

A study of 113 children and teens physically victimized by peers concludes that one-on-one mentoring about how to safely avoid conflict and diffuse threats makes them far less likely to become victims again if guidance is initiated in the immediate aftermath of the attack.

The research, by investigators at Johns Hopkins Children’s Center and Children’s National Medical Center in Washington, DC, was conducted on 10 to 15 year olds treated for assault injuries, including gunshot, knife, and fist-fight wounds, in their emergency department between 2001 and 2004.

Writing in Pediatrics, the researchers says one half of the victims were treated then referred by an emergency department (ED) doctor for at least six sessions with a mentor for one-on-one counseling and three parent home visits, while the other half were referred to community resources and received two follow-up phone calls.

Those who got the personalized counseling and forged a mentoring relationship with their counselors reported 25% fewer fights and 42% fewer fight injuries six months later, compared with those who received referrals only.

Comparing their attitudes and behaviors after six months, researchers found that teens who received mentoring reported less aggression and fewer misdemeanors and were more likely to “think about the consequences,” take steps to avoid fighting and “take a time out” when faced with a conflict.

“There can be a cycle of violence fueled by fear and retaliatory feelings,” says the study lead investigator Tina Cheng, MD, MPH, head of general pediatrics and adolescent medicine at Hopkins Children’s. “When we see youth with assault injuries in the ED, we have a golden window of opportunity to step in and interrupt this cycle, and our findings suggest that pairing teens with mentors who teach them problem-solving skills can help decrease the risk of future violence.”

— Source: Johns Hopkins Medicine

A new research study has found that youths with minimal exposure to violence in movies, television, music, games, and Web sites are significantly less likely to report violent and aggressive behaviors than those exposed to more violent media.

The study, presented at the American Public Health Association’s 136th annual meeting, examined data from the Growing up with Media survey, a national survey of almost 1,600 youths aged 10 to 15.

Researchers found that youths reporting that “none or almost none” of the media they consume depicts violence were 85% less likely to report seriously violent behavior than youths exposed to more violent media; youths reporting “some” violent media were 50% less likely. The results were similar for bullying behavior and fighting.

“Our findings suggest that a reduction of violent media consumption for children and adolescents to ‘almost none or none’ may decrease bullying and fighting behavior among youth,” said Michele Ybarra, MPH, PhD, lead researcher on the study.

— Source: American Public Health Association

Children who are breast-fed are less likely to suffer from behavioral or mental health issues than those who are not breast-fed, according to new research.

The study, which was presented at the American Public Health Association’s 136th Annual Meeting & Exposition in San Diego, looked at whether breast-feeding is associated with decreased behavioral problems and psychiatric illness during childhood.

Using 2003 National Survey of Children's Health data from 102,353 interviews of parents and guardians on the health of their children, researchers found that parents of breast-fed children were less likely to report concern for the child's behavior, and breast-fed children were less likely to have been diagnosed by a health professional as having behavioral or conduct problems and were less likely to have received mental health care. Additionally, parents of breast-fed children were less likely to report concern about the child's ability to learn.

“These findings support current evidence that breast-feeding enhances childhood intellectual ability while providing new evidence that breast-feeding may contribute to childhood emotional development and protect against psychiatric illness and behavioral problems,” said Katherine Hobbs Knutson, MD, lead researcher on the study.

— Source: American Public Health Association

Boys who experienced childhood physical or sexual abuse are more likely to use sexually coercive behavior against an unwilling female partner when they are adolescents and young adults.

Researchers trying to identify factors that put men at risk for committing sexual coercion have found that being victims of both childhood physical and sexual abuse made them 4½ times more likely to engage in sexually coercive behavior than men who were not abused, says Erin Casey, PhD, a University of Washington Tacoma assistant professor of social work.

Men who experienced some form of childhood abuse accounted for less than 30% of the 5,649 males (aged 22) surveyed, but they accounted for 45% of the group reporting sexually coercive behavior, adds Casey, the lead author of the study appearing online in the Journal of Interpersonal Violence.

“The higher the frequency of childhood abuse the more likely an adolescent or young adult was to engage in sexually coercive behavior,” she says. However, Casey stresses that this study and previous research have found that the majority of child abuse survivors do not use abusive behavior in adulthood.

The study also found that 55% of the men who reported coercive behavior did not experience any childhood sexual or physical abuse. “There is a lot of evidence indicating sexual coercion and aggression is a complex behavior with an array of risk factors. There is this whole group of men for whom we have yet to fully understand what their risk factors are. They are relatively ‘average’ men without terrible childhood histories, but who engage in this hurtful behavior,” Casey says.

— Source: University of Washington

Despite the lack of credible scientific evidence establishing a connection between vaccines and autism, debate rages on. The controversy seems to be everywhere, fuelled by celebrities, bloggers, Web sites, and the mainstream media. With autism rates continuing to rise (estimated at one child in 150 in the United States), now more than ever parents are finding themselves confused and doubtful about whether to vaccinate their children.

“We don’t want to close our minds to further research and inquiry, but we really need to treat the vaccine-autism connection as highly speculative,” says Susan Bryson, PhD, (pictured right) the Joan and Jack Craig Chair in Autism Research at Dalhousie University in Halifax, and a foremost autism experts.

A quick Internet search uncovers dozens of articles, Web sites, and discussion groups insisting the link between autism and vaccines exists. But scientific evidence establishing that link is much harder to come by. Bryson notes the complexity of autism as a relatively new disorder (only on
the books since the 1940s) may be a factor in the rise of some of the controversy. “There is so much we still don’t know about autism. … All we can say is that there is nothing in the science that has been discovered so far that suggests the answer will be that easy.”

In the meantime, she and her team continue to focus their efforts on early detection and intervention. As for the continuing debate over vaccines and autism, she says the focus needs to shift from speculation to proven fact. “There has been so much emphasis on the potential link between vaccines and autism, and not enough attention to the fact that diseases like measles can be fatal for children who are not immunized. That is a proven fact,” she says.

—Source: Dalhousie University

Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone are also effective, according to a new study funded by the National Institute's of Health's National Institute of Mental Health and published online in The New England Journal of Medicine.

The Child/Adolescent Anxiety Multimodal Study (CAMS) randomly assigned 488 children aged 7 to 17 to one of four treatment options for a 12-week period: cognitive behavioral therapy (CBT); the antidepressant sertraline (Zoloft); CBT combined with sertraline; or pill placebo.

The children all had moderate to severe separation anxiety disorder, generalized anxiety disorder or social phobia. Many also had coexisting disorders, including other anxiety disorders, attention-deficit/hyperactivity disorder, and behavior problems.

John Walkup, MD, of Johns Hopkins Medical Institutions, and colleagues found that among those in combination treatment, 81% improved. Sixty percent in the CBT-only group improved, and 55% in the sertraline-only group improved. Among those on placebo, 24% improved. A second phase of the study will monitor the children for an additional six months.

"CAMS clearly showed that combination treatment is the most effective for these children. But sertraline alone or CBT alone showed a good response rate as well. This suggests that clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs," says Walkup.

Results also showed that the treatments were safe. Children taking sertraline alone showed no more side effects than the children taking the placebo and few children discontinued the trial due to side effects. In addition, no child attempted suicide, a rare side effect sometimes associated with antidepressant medications in children.

— Source: The National Institute of Mental Health

According to preliminary research results from the VA, approximately 15% of recently returned female veterans utilizing the VA healthcare system report experiencing sexual trauma during military service.

The cross-sectional study, presented at the American Public Health Association’s 136th Annual Meeting & Exposition in San Diego, examined healthcare screening data of over 100,000 veterans of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom who utilized medical care at any Veterans Health Administration facility during a six-year period.

Along with the more than one in seven women, 0.7% of males also reported having experienced military sexual trauma. Both males and females reporting military sexual trauma were more likely to be diagnosed with a mental health condition than patients who did not report military sexual trauma.

“These data highlight the importance of the VA’s universal screening policy,” said Joanne Pavao, MPH, a VA researcher on the study, “as well as early intervention among veterans who have experienced sexual trauma, to prevent long-term consequences.” Veterans Health Administration policy requires that all male and female veterans are screened for experiences of military sexual trauma and that free treatment for military sexual trauma-related conditions is provided at all VA healthcare facilities.

— Source: American Public Health Association

A study conducted 13 months after same-sex marriage in Massachusetts became legal found that obtaining legal protections and making a public statement of commitment were the most often mentioned motivations for same-sex marriage. It also found that lack of family approval and difficulties planning and paying for the wedding were the most noted obstacles to marriage. The study was conducted by Pamela J. Lannutti, PhD, an associate professor of communication at Boston College, and was published in the Journal of GLBT Family Studies.

“The arrival of same-sex marriage brings up many issues that often lurk in the background in families. It forces same-sex couples and their parents to confront their deepest feelings about same-sex love,” says Robert-Jay Green, PhD, executive director of Rockway Institute, a national center for psychology research, education, and public policy on sexual orientation and gender issues.

For this study, Lannutti’s sample of 263 partners in same-sex couples had an average relationship duration of 7.5 years. Seventy-two percent had gotten legally married in the 13 months after same-sex marriage became legal in Massachusetts, and 28% planned to marry within 16 months. Attractions to marriage listed by the respondents included legal protections (24%), making a public statement of commitment (20%), feelings for partner (15%), means to acknowledgement from family (14%), legal protection for help in having children (13%), means to acknowledgement from friends (8%), political reasons (4%), and religious reasons (2%).

Obstacles to marriage included lack of family approval (41%), difficulties in funding and planning the ceremony and reception (27%), philosophical or political objections to marriage (14%), the legal limitations of same-sex marriage in Massachusetts such as no federal recognition or benefits of marriage (10%), lack of approval from friends (4%), or unresolved previous relationships (4%). “Lack of family approval” usually meant parents’ approval, Lannutti reports.

In commenting on the study, Green comments: “With the arrival of same-sex marriage in Massachusetts and now in California, we are just beginning to understand the psychological deprivation that has been imposed on lesbian and gay people, who have been excluded from marriage for centuries. Dr. Lannutti’s study supports what social scientists have long suspected—nothing short of marriage conveys the same multifaceted symbolic meanings nor evokes the same sense of hopefulness about finding life-long psychological intimacy in a relationship.”

— Source: Alliant International University

Millions of patients with treatment-resistant clinical depression who have struggled for years with disability and how to cope with their condition now have an option that could help them lead more productive and successful lives. The NeuroStar TMS (Transcranial Magnetic Stimulation) Therapy system, developed by Neuronetics, Inc and initiated by research at the Medical University of South Carolina (MUSC), is the first and only approved TMS therapy device cleared by the FDA for treating severe depression.

Patients must be adults with major depressive disorder, commonly known as treatment-resistant depression, who have failed to improve their condition with other treatments or medication. Patients will have access to the therapy at MUSC by mid-December.

In the randomized controlled trial conducted for the FDA, the therapy showed significant treatment effects without systemic side effects such as weight gain or sexual dysfunction.

Throughout the TMS therapy studies, more than 10,000 treatments were safely performed with: no systemic side effects, such as sedation, nausea, or dry mouth; no adverse effects on concentration or memory; no seizures; no device-drug interactions; mild to moderate scalp pain or discomfort at the treatment area during treatment, which declined after the first week of treatment; a less than 5% discontinuation rate due to adverse events; and there were no new safety observations compared with those seen during acute treatment during a 6-month follow-up period.

— Source: Medical University of South Carolina

When a group is without a leader, you can often count on a narcissist to take charge, a new study suggests. Researchers found that people who score high in narcissism tend to take control of leaderless groups. However, while narcissists are more likely to become leaders, results of one study suggests that, once in power, narcissists don’t perform any better than others in a leadership role. The research appeared online and in print issues of Personality and Social Psychology Bulletin.

“Not only did narcissists rate themselves as leaders, which you would expect, but other group members also saw them as the people who really run the group,” says Amy Brunell, PhD, the lead author of the study and an assistant professor of psychology at The Ohio State University at Newark.

The first study involved 432 undergraduate students who completed assessments that measured various personality traits, including narcissism. They were then put in groups of four, and told their task was to elect the director of the student union. Each person in a group was given a profile of a different candidate and was to argue for their candidate. Following the discussion, they voted on the director, and then completed a questionnaire evaluating the leadership of themselves and the other group members.

Results showed that students who scored higher on one dimension of narcissism—the desire for power—were more likely to say they wanted to lead the group, were more likely to say they did lead the group discussion, and were more likely to be viewed as leaders by the other group members.

In a second study, 408 students were placed in groups of four and given a scenario in which they were shipwrecked on an uninhabited island and had to choose which 15 salvageable items that the group should take ashore that would best help them survive. After a group discussion, those who scored highest on the power dimension of narcissism again showed the most desire to lead the group discussion, rated themselves as leaders, and were viewed by other group members as the leaders.

This study then evaluated how well the narcissists performed as leaders. Researchers compared the lists, prepared by each individual and group, with one prepared by an expert who taught survival skills to the military. Results showed that narcissists did no better than others on selecting the items that would best help them survive. In addition, groups that overall scored highest on narcissism did no better than other groups on the task.

Brunell says she believes the results apply to many parts of life, from the politics of the presidential race to Wall Street.

— Source: The Ohio State University

A new study reveals that the general appearance of a neighborhood is the single most important factor affecting how satisfied residents are about the area where they live. But beyond general appearance, people living in different neighborhoods may be looking at distinct factors when making their overall evaluations. The study, which was published recently in Environment and Behavior, was based on a survey of 2,060 homeowners in Franklin County, Ohio.

Some areas considered to be some of the worst neighborhoods were rated the lowest and people in these neighborhoods reported that safety from crime was 3.7 times more important to their overall satisfaction than people living in satisfactory areas. Proximity to known problem areas and the amount of traffic were also major concerns for these residents, aspects that were not statistically important to those in more highly rated neighborhoods.

On the other hand, while general appearance of the neighborhood was important to people living in both types of neighborhoods, only residents in satisfactory neighborhoods were significantly interested in access to recreational opportunities and to governmental services such as police and fire.

The other major difference between the two types of neighborhoods involves how people value social interaction. Only people living in higher rated neighborhoods reported that interaction was an important factor in how satisfied they were overall in their neighborhood. People in these areas valued spending time with neighbors and participating in neighborhood activities.

Overall, this new research provides clear evidence that focusing on different factors in different neighborhoods may be the key to making residents in all neighborhoods happier, says Misun Hur, PhD, coauthor of the study and doctoral student in city and regional planning at Ohio State University.

— Source: Ohio State University

White people may avoid talking about race so as not to appear prejudiced, according to new research. But that approach often backfires as blacks tend to view this “colorblind” approach as evidence of prejudice, especially when race is clearly relevant. These results are from two separate sets of experiments led by researchers from Tufts University and Harvard Business School. Their findings are reported in the Journal of Personality and Social Psychology and Developmental Psychology.

In one study, 101 white undergraduate students were paired with either a white or black female partner who pretended to be another participant. The pairs were presented with 30 photographs of faces that varied in race, gender, and background color. Each white participant’s objective was to guess which of the photographs the partner was holding by asking as few yes-or-no questions as possible.

Even though asking about the race of the person in the photograph was a sound strategy for completing the task, white participants were far less likely to do so with a black versus a white partner. Moreover, when the black partner was the first one to have a turn asking questions, whether she mentioned race had a dramatic effect. White participants whose black partner asked about race mentioned race on their own turn 95% of the time. When the black partner never asked about race, white participants only did so 10% of the time.

The researchers also wanted to see how outsiders interpreted such interactions. In another experiment, 74 black and white college students evaluated videos of whites engaging in the photo task. Black observers rated whites’ avoidance of asking about race as being evidence of prejudice. What’s more, when the researchers showed silent video clips of whites from the study to another group of individuals, those whites who avoided asking about race were judged as less friendly, just on the basis of their nonverbal behavior.

“The findings suggest that when race is clearly relevant, whites who think that it is a wise social strategy to avoid talking about race should think again,” says Evan Apfelbaum, a PhD candidate at Tufts University.

— Source: American Psychological Association

The University of North Carolina (UNC) at Chapel Hill is leading a novel clinical trial to compare the effectiveness of online cognitive behavioral therapy (CBT), delivered through a Web site and augmented with therapist-moderated, weekly online chat sessions, to face-to-face group therapy for the treatment of bulimia nervosa.

“For individuals with bulimia nervosa … face-to-face cognitive behavioral therapy or CBT has long been considered the gold standard of treatment,” says Cynthia M. Bulik, PhD, the study’s principal investigator and director of the UNC Eating Disorders Program.
The Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center will also take part in the study. Marsha D. Marcus, PhD, professor of psychiatry and psychology and service chief of the Center for Overcoming Problem Eating, is the principal investigator at the Pittsburgh site. 


Unfortunately, for several different reasons CBT does not reach everyone who needs treatment. “As a way to overcome these challenges,” Bulik says, “we’ve developed a Web site that will deliver the same content as traditional, manual-based cognitive behavioral therapy, but it will take advantage of all the bells and whistles—such as sound, animation, and video—that make the best Web sites so compelling.”



Bulik and colleagues plan to recruit 180 people with bulimia nervosa to take part in the study: 90 at UNC and 90 at Pittsburgh. One half will be randomized to receive CBT with weekly face-to-face group therapy sessions over a 20-week period. The other half will receive Web-based CBT with weekly online group therapy chat sessions. To measure the effectiveness of the intervention, follow-up assessments on each participant will be conducted at 3, 6, and 12 months after the end of treatment.

Marcus says, “If [online treatment] is as effective as CBT delivered in an in-person format, we will be able to provide CBT to individuals who currently are unable to obtain specialty care for the disorder.”

— Source: University of North Carolina at Chapel Hill School of Medicine

Stimulant medications like those often prescribed for children with attention-deficit/hyperactivity disorder (ADHD) raise blood pressure and heart rate, and some drugs carry warning labels for patients with heart problems. Two professional organizations are at odds over whether routine electrocardiogram (ECG) testing is necessary before a child starts taking a medication for ADHD, reports the Harvard Mental Health Letter.

The controversy is about whether routine ECG testing is necessary before a child starts taking ADHD medication. ECG measures the electrical activity of the heart. In April 2008, the American Heart Association released a statement recommending that it was reasonable—although not mandatory—for clinicians to consider ordering an ECG in children diagnosed with ADHD before beginning treatments with stimulants or other medications.

In August, however, the American Academy of Pediatrics published a statement recommending against routine ECGs—supporting earlier recommendations made by the American Academy of Child and Adolescent Psychiatry—citing data that sudden cardiac deaths, while tragic, are rare. Such deaths occur in about two children for every million taking ADHD medications—fewer than the eight to 62 sudden deaths per million that occur in the general pediatric population.

The discussion about the relationship between heart risk and ADHD medication is likely to continue. For now, Michael Miller, MD, editor in chief of the Harvard Mental Health Letter, says the best advice is for doctors to assess heart disease risk by doing a physical exam and taking a careful medical history and to rely on a mental health professional to evaluate for ADHD.

— Source: Harvard Health Publications

The Department of Health and Human Services (HHS) recently announced $36 million in new grant programs to 28 states to help older Americans and veterans remain independent and to support people with Alzheimer's disease to remain in their homes and communities. Just over $19 million of this funding involves a new collaboration with the VA.

HHS secretary Mike Leavitt and VA secretary James Peake, MD, announced the joint effort to provide essential consumer-directed, home- and community-based services to older Americans and veterans of all ages, as part of a Nursing Home Diversion (NHD) grants program. The new initiative builds on the similar missions of HHS and the VA with regard to caring for the populations they serve. In addition, Secretary Leavitt announced a $17 million investment to improve the delivery of home and community-based services to people with Alzheimer's disease and their family caregivers.

"Our mission is to honor and support America's veterans, and this collaboration provides an additional opportunity to do that by offering more services, choices and control over decisions to veterans in the least restrictive environment consistent with their needs and preferences," Peake said.

"The HHS funding is specifically designed to reach people who are not eligible for Medicaid, but who are at high risk of nursing home placement and spend-down to Medicaid -which often occurs when private pay individuals enter a nursing home," said assistant secretary for aging Josefina G. Carbonell. "The program will also offer consumers more control over their long-term care, including the ability to determine the types of services they receive and the manner in which they receive them, including the option of hiring their own care workers."

— Source: Health and Human Services

Compared to their younger counterparts, older problem gamblers who ask casinos to bar them from returning are three to four times more likely to do so because they fear they will kill themselves if they don’t stop betting, according to a new study.

Researchers Lia Nower, JD, PhD, of the Rutgers University Center for Gambling Studies, and Alex Blaszczynski, PhD, of the University of Sydney, Australia, looked at 1,601 self-described problem gamblers who asked between 2001 and 2003 to be banned from Missouri casinos. The results of their study were published in Psychology and Aging.

Older adults, aged 55 and older in this study, reported gambling an average of 17 years before “self-exclusion”—more than twice the length of time reported by younger adults. All participants were asked to cite the main reason or reasons why they sought to be barred from casinos. Younger, middle-aged, and older adults all gave as the primary reasons gaining control, needing help, and hitting rock bottom. However, nearly 14% of older adults surveyed, a higher proportion than any other group, indicated they sought help because they wanted to prevent themselves from committing suicide.

“This is particularly troubling because, irrespective of age, problem gamblers have reported rates of suicidal ideation and/or attempts as high as six times those found in the general population,” Nower says.

— Source: American Psychological Association

Researchers have found that infants who had an opportunity to use a plastic cane to get an out-of-reach toy were better able to understand the goal of another person’s use of a similar tool than were infants who had previously only watched an adult use a cane to retrieve a toy.

“Acting on the world is one way infants learn about the world, and only recently have there been studies showing that active, hands-on experience is a more effective way of learning than watching. This study indicates that there is a benefit to actual hands-on experience early in human development,” says Jessica Sommerville, PhD, a University of Washington assistant professor of psychology and lead author of a study published in Developmental Psychology.

The researchers divided 51 infants—26 boys and 25 girls—into three groups for the new study. Those in the training group were trained in how to use the crook of a cane to retrieve a toy. Finally, they were given two trials to see if they could pull the toy to them by themselves. A second group of infants, the observational group, watched an adult mimic the babies in the first group learning how to use the cane to get a toy. Finally the infants in those two groups, as well as those in the third, or baseline, group individually watched training trials in which a researcher seated behind a table used one cane to retrieve a toy and then picked up the toy.

Sommerville says the experiment was designed to see if the infants would play attention to a change in the experimenter’s goal of getting a new toy rather than using a different tool. Infants in the observational and baseline groups spent equal amounts of time looking at the new cane and toys trials. But the trained group spent more time looking at the new toy trials, suggesting they understood that the adult was using the cane as a tool.

“We speculate that for infants to really understand the tool use event, and, in particular, for them to anticipate upcoming actions and action outcomes while watching the event, they need to be able to perform the tool use sequence themselves,” says Sommerville. “Merely watching another person perform the sequence does not appear to be enough for them to understand it.

— Source: University of Washington

While many congregations of different faiths preach against drug abuse, it has been unclear whether a youth’s religious involvement has any effect on his or her risk of drug abuse. Now a new national study finds that religious involvement makes teens one half as likely to use marijuana. The study, published this week in the Journal of Drug Issues, settles a question scholars have disagreed on in the past.

"Some may think this is an obvious finding, but research and expert opinion on this issue have not been consistent," says Brigham Young University (BYU) sociology professor Stephen Bahr, PhD, an author on the study. "After we accounted for family and peer characteristics, and regardless of denomination, there was an independent effect that those who were religious were less likely to do drugs, even when their friends were users."

Two data sets were used in the study, 13,534 students who participated in the National Longitudinal Survey of Adolescent Health and 4,983 adolescents in a state-wide survey of Utah schools.

The study, coauthored by BYU sociologist John Hoffmann, PhD, also found individual religiosity buffered peer pressure for cigarette smoking and heavy drinking. The term religiosity as used in the study has to do with people's participation in a religion and not the particular denomination. Hoffmann says the protective effect of church and spirituality supplements the influence of parents.

"The power of peers is less among youths who are religious," Bahr says. "Meaning if you are religious, the pressure from peers to use drugs will not have as much effect."

— Source: Brigham Young University

Heavy advertising by both Democratic and Republican presidential candidates may actually make voters in battleground states more confused about which candidate to vote for, a new study suggests. The results appeared in a recent issue of Political Psychology.

A nationwide study found that voters in heavily contested states like Florida and Ohio become more ambivalent when they are exposed to a lot of opposing messages from the two candidates.

“In battleground states especially, both candidates will invest a lot of money in television commercials. So people in these states are getting a lot of competing messages from both candidates and that translates into voters in these states wrestling with conflicting ideas,” says Luke Keele, PhD, coauthor of the study and assistant professor of political science at Ohio State University.

“But if you live in a state that is not competitive, you’re probably seeing one-sided messages from a single candidate or few messages at all, so you’re less likely to be ambivalent. So the state in which you live can influence your decisions.”

The study was based on survey responses from the 2000 edition of the American National Election Study, a nationally representative survey of voters that examined the race between George Bush and Al Gore, as well as House of Representatives’ races. The survey, which is performed every two years by the University of Michigan, included face-to-face interviews with more than 1,800 people.

— Source: Ohio State University

Uninsured children in families earning between approximately $38,000 and $76,000 a year are about as likely to go without any healthcare as uninsured children in poorer families.

Nearly one half of uninsured children in the United States went without any medical care or prescriptions during the year they had no insurance, according to a University of Rochester Medical Center study published in The Journal of the American Medical Association. An even larger percentage of uninsured children went without preventive care, meaning they didn’t get a yearly physical and may not have received necessary vaccinations.

The study, by Laura Shone, DrPH, MSW, an assistant professor of pediatrics at the University of Rochester Medical Center, dispels the myth that the uninsured middle class are simply paying for their children to receive healthcare.

“There’s a great need for healthcare coverage for children and it’s not isolated to the poor. It’s moving up the income scale,” Shone says. “This study shows that a large percentage of both lower-income and middle class children who are uninsured don’t receive any care at all. We need to be aware that these children need help, too, as we make more coverage options available, especially in this difficult economy.”

Overall, almost 3 million uninsured U.S. children had no medical care of any kind and no prescription use for a full year, according to an analysis of nationally representative data from the 2004 Medical Expenditure Panel Survey. Of those, about 1.6 million children already qualify for public coverage but are not enrolled, and about 1 million more could gain coverage through expansion of the state children’s health insurance program.

— Source: University of Rochester Medical Center

As soon as children are old enough to interact socially, some become entrenched in chronic and increasing patterns of victimization by their peers, according to a report in the Archives of General Psychiatry. Children who are aggressive in infancy and are from families with harsh parenting styles and insufficient income appear more likely to be consistently victimized.

Edward D. Barker, PhD, of the University of Alabama, Tuscaloosa, and colleagues studied 1,970 children (51% boys) born in Québec, Montreal, Canada, between October 1997 and July 1998. Participating children were assessed at the ages of 4.5 months, 16.6 months, and 2.4, 3.4, 4.1, 5.1, 6.2, and 7.2 years. At each point, mothers provided information on factors such as victimization, family adversity, parenting styles, physical aggression, hyperactivity, and internalizing symptoms. At the age of 7.2, teachers and children reported on victimization by classmates.

“Three trajectory groups were identified with respect to victimization by peers between 3.4 and 6.2 years of age,” the authors wrote. “As expected, most of the children (71 percent) fell on a low/increasing trajectory, whereas 25 percent and 4 percent of the children followed moderate/increasing and high/chronic trajectories, respectively. The overall age-related increase in preschool peer victimization is consistent with the view that, as preschool children progressively spend more time interacting with peers, they are more likely to experience negative peer experiences.”

Children who were on the high/chronic and moderate/increasing trajectory according to their mothers’ reports at young ages also had the highest levels of victimization at the age of 7.2, as reported by themselves and their teachers. Children who were aggressive at a young age (17 months) were more likely to become victims in preschool than children who were less aggressive, but neither early internalizing symptoms (for example, sadness, fear, and anxiety) or hyperactivity were associated with later victimization. Children exposed to harsh parenting were more likely to be chronic victims, and insufficient family income also predicted high/chronic and moderate/increasing victimization trajectories.

— Source: American Medical Association

The American Psychological Association (APA) sent a letter to President Bush, informing him of a significant change in the association’s policy that limits the roles of psychologists in certain unlawful detention settings where the human rights of detainees are violated, such as has occurred at the U.S. naval base at Guantanamo Bay, Cuba.

“The effect of this new policy is to prohibit psychologists from any involvement in interrogations or any other operational procedures at detention sites that are in violation of the U.S. Constitution or international law (e.g., the Geneva Conventions and the U.N. Convention Against Torture),” says the letter, from APA President Alan E. Kazdin, PhD. “In such unlawful detention settings, persons are deprived of basic human rights and legal protections, including the right to independent judicial review of their detention.”

The roles of psychologists at such sites would now be limited to working directly for the people being detained or for an independent third party working to protect human rights, or to providing treatment to military personnel. The new policy was voted on by APA members and is in the process of being implemented.

— Source: American Psychological Association

About 44% of individuals who had bipolar disorder as children continue to have manic episodes as young adults, according to a report in Archives of General Psychiatry. This rate, along with the severity of the disease at young ages, strongly suggest that bipolar disorder can be continuous from childhood to adulthood, the authors noted.

Researchers studied 115 children (an average age of 11.1) diagnosed with bipolar disorder beginning in 1995 to 1998. At the beginning of the study and again during nine follow-up visits conducted over eight years, the children and their parents were interviewed separately about their symptoms, diagnoses, daily cycles of mania and depression, and interactions with others.

At the end of the follow-up period, 54 patients were aged 18 or older. Of those, 44.4% continued to have manic episodes and 35.2% had substance use disorders, a rate similar to those diagnosed with bipolar disorder as adults.

“In grown-up subjects with child bipolar disorder I, the 44.4 percent frequency of manic episodes was 13 to 44 times higher than population prevalences, strongly supporting continuity between child and adult bipolar disorder I,” the authors wrote. “Subjects with child bipolar disorder I who were grown up at the eight-year follow-up constituted approximately half the sample. However, even if all subjects younger than 18 years at the eight-year follow-up never had episodes of bipolar disorder I as adults, the overall significance of the findings would be similar, because the rate would still be six to 22 times higher than population prevalences.”

“In conclusion, mounting data support the existence of child bipolar disorder I, and the severity and chronicity of this disorder argue strongly for large efforts toward understanding the neurobiology and for developing prevention and intervention strategies,” they wrote.

— Source: American Medical Association

Magnetic resonance brain imaging reveals that patients with generalized social phobia respond differently than others to negative comments about themselves, according to a report in Archives of General Psychiatry.

“Generalized social phobia is characterized by fear/avoidance of social situations and fear of being judged negatively by others,” the authors wrote. “It is the most common anxiety disorder in the general population, with the lifetime prevalence estimated at 13.3 percent, and it is associated with a high risk for depression, alcohol and drug abuse and suicide.”

Karina Blair, PhD, and colleagues at the National Institute of Mental Health, Bethesda, MD, compared functional MRI (fMRI) scans of 17 unmedicated individuals with generalized social phobia to those of 17 controls who were the same age, sex, and IQ but did not have the disorder. During the fMRI scans, individuals read positive, negative, and neutral comments that could be either about the self or about somebody else.

The patients with generalized social phobia showed increased blood flow in their medial prefrontal cortex and amygdala—areas of the brain linked to concepts of self as well as fear, emotion and stress response—when reading negative statements about themselves. However, there were no differences between the two groups in response to negative comments referring to others or neutral or positive comments referring to either self or others.

“Given that medial prefrontal cortex regions are involved in representations of the self, it might be suggested that these regions, together with the amygdala, play a primary role in the development and maintenance of generalized social phobia and that the pathology in the disorder at least partly reflects a negative attitude toward the self, particularly in response to social stimuli,” the authors conclude.

— Source: American Medical Association

Living with posttraumatic stress disorder (PTSD) can strain any relationship—sometimes to the point of violence against a loved one. University of Arkansas psychologist Matthew T. Feldner, PhD, is part of two national research projects aimed at preventing relationship aggression in couples coping with PTSD and treating this type of aggression when it has already developed.

“The main aims of these projects are to reduce the number of new cases of interpersonal violence and reduce the number of cases already existing,” Feldner says. “We teach couples skills for better relationship behaviors, such as how to communicate better and how to manage anger.”

All people receiving these interventions will be closely monitored and referred for more intensive individual therapy should the need arise. Rather than going back to focus on the roots of the PTSD, Feldner says the couples in these interventions “will focus on the here and now of how the PTSD is affecting their relationship.” While teaching couples about the features of PTSD and improving their relationships, the group treatment can also serve as a gateway to further treatment for PTSD and other services.

If these interventions succeed in preventing or treating relationship aggression, Feldner says that these would be groundbreaking, landmark projects. “Ultimately, we are hoping we can conduct these interventions in such a way that they could be useful for the VA and could be extended to community populations as well, for situations that are not specifically military,” Feldner says.

— Source: University of Arkansas, Fayetteville

Opponents of affirmative action point to stigma as a reason for dismantling the policy, but a new University of Iowa (UI) study counters that argument. Challengers of the policy argue that minorities who benefit from it could doubt their own credentials or feel the burden of being treated as if they're employed or enrolled only because of race—not because they earned it.

But researchers surveyed 610 students at seven public law schools, and results indicate that minorities at affirmative action schools feel just as good about their qualifications and about how others treat them as minorities at nonaffirmative-action schools do.

Evidence that calls the powerful stigma argument into question is important at a time when California, Michigan, and Washington recently passed legislation to end affirmative action in public institutions, and similar measures are on the ballot this November in Colorado and Nebraska, says UI law professor Angela Onwuachi-Willig, JD. She conducted the study with UI sociologist Mary Campbell, PhD, and Emily Ming-Sue Houh, JD, a University of Cincinnati law professor.

On average, minority students at both types of schools disagreed or strongly disagreed with statements such as "I do not deserve to be a student at my school," "Classmates/teachers act as if I was admitted based only on affirmative action," and "I feel stigmatized by affirmative action."

"Generally, when good things happen to people, they think they deserve it. It's human nature," Campbell says. "So we had good reason to be skeptical of the idea that affirmative action makes whole groups of people say, 'I don't belong here, and therefore I'm not going to perform as well.'"

— Source: University of Iowa Health Sciences

A new study shows that 5-month-old babies can distinguish an upbeat tune, such as “Ode to Joy” from Beethoven’s Ninth Symphony, from a lineup of gloomier compositions. By the age of 9 months, babies can do the opposite and pick out the sorrowful sound of Beethoven’s Seventh Symphony from a pack of happy pieces.

The musical experiments offer another example of how babies make sense of the world long before they can talk, says Brigham Young University psychology professor and study author Ross Flom, PhD. “One of the first things babies understand communicatively is emotion, so for them the melody is the message,” he says. “Our study showed that by nine months, babies are categorizing songs as happy or sad the same way that preschoolers and adults do.”

The results of the musical study are published in Infant Behavior and Development.

First they displayed an emotionally neutral face for the baby while music played. When the baby looked away from the face, the music stopped and the researchers queued up a new song from a playlist of five happy and five sad songs. For each song, observers recorded how long the baby paid attention to the face. The babies that noticed a switch from happy to sad, or vice versa, stared at the face three to four seconds longer than usual because of their heightened interest.

Flom says this period of learning about emotion in sounds is a natural step before learning to talk. “Infants master so many things in such a short time frame,” he adds. “I can’t think of a better line of inquiry than how infants learn so much so quickly.”

— Source: Brigham Young University

Desperate to protect her children from skull fractures, black eyes, and repeated beatings, Holly Ann Collins fled to the Netherlands. There, the Dutch Court granted her human rights asylum, ruling it would be too dangerous for them to return to their father. Now, 14 years later, Collins and her children are finally coming home. In a Hennepin County, MN, courthouse, Collins pled guilty to contempt of court and accepted 40 hours of community service. The more serious charges of kidnapping and custody interference that could have resulted in a long prison sentence were dismissed.

Eli H. Newberger, MD, a member of the Leadership Council on Child Abuse and Interpersonal Violence’s Board and an assistant professor of pediatrics at Harvard University, evaluated Jennifer and Zachary before they were placed in the custody of their father. “Despite the children’s clear disclosures of abuse, their documented history of serious injuries, and our team’s strong conclusion that the children needed to be protected, the court still chose to place them with the person they feared most in the world,” states Newberger. The court acknowledged abuse had taken place but was swayed by the bogus legal argument that the children’s fears were a result of parental alienation syndrome, which claimed their mother brainwashed the children into false abuse disclosures. Collins was allowed only limited, supervised visitations. When they were 9 and 11, Jennifer and Zachary passed her secret notes during supervised visits begging to be rescued from their father’s home.

Joyanna Silberg, PhD, executive vice president of the Leadership Council, spoke about the case, stating that the problems in family court have gotten worse in the last 14 years. The Leadership Council estimates that over 58,000 children a year in the United States are abuse victims that are ordered by family court to have unsupervised contact with abusers when their parents divorce.
The Leadership Council, a coalition of professionals committed to education about child abuse, does not condone breaking the law, but hopes the story of Collins and her children sparks needed reforms that protect children from abusive parents involved in custody disputes.

— Source: Leadership Council on Child Abuse & Interpersonal Violence

Scientists with the National Space Biomedical Research Institute (NSBRI) are developing an interactive, multimedia program that will assist astronauts in recognizing and effectively managing depression and other psychosocial problems, which can pose a substantial threat to crew safety and mission operations during long-duration spaceflights.

Even though the depression treatment is under development for NASA, project leader James Cartreine, PhD, says it could be spun off for use on Earth.

“This project has great potential as a self-guided treatment for many people,” says Cartreine, a member of NSBRI’s Neurobehavioral and Psychosocial Factors Team and a Harvard Medical School research psychologist based in the Division of Clinical Informatics at Beth Israel Deaconess Medical Center in Boston. The depression treatment is part of the Virtual Space Station, a multimedia program that addresses multiple types of potential psychosocial problems and can be used for training before, and for assistance during, missions. Other problems being addressed via the Virtual Space Station include interpersonal conflict and stress and anxiety.

Cartreine says the Virtual Space Station will make effective therapeutic depression treatment more easily accessible to astronauts aboard the International Space Station and proposed missions to the moon and Mars. Currently, astronauts have audio and video access to psychologists only when communication links are available.

Eventually, the researchers want to adapt the system for use in many different settings, giving people access to treatment they may not have now. For instance, people with depression often seek treatment by going to their primary care physician, so the researchers hope to adapt it for use at the doctor’s office or in a person’s home.

The system could also be beneficial in rural areas where clinical help is in short supply or nonexistent. Other possible locations for use include schools, social service offices, places of worship, military bases, prisons, commercial ships, oil rigs, and underwater research stations.

— Source: National Space Biomedical Research Institute

New research suggests a solution coping with negative emotions, and to the related psychological paradox: Processing emotions is supposed to facilitate coping, but attempts to understand painful feelings often backfire and perpetuate or strengthen negative moods and emotions. The solution is not denial or distraction. According to Ethan Kross, a faculty associate at the University of Michigan Institute for Social Research and an assistant professor of psychology, the best way to move ahead emotionally is to analyze one's feelings from a psychologically distanced perspective.

The researchers conducted a series of studies that provide evidence of the benefits of analyzing depressive feelings from a psychologically distanced perspective. This approach is widely associated with eastern philosophies such as Buddhism and Taoism, but according to Kross, anyone can do it with a little practice.

In the study, appearing in an issue of Personality and Social Psychology Bulletin, the researchers randomly assigned 141 participants to one of three groups that required them to focus (or not focus) on their feelings using different strategies in a guided imagery exercise that led them to recall an experience that made them feel overwhelmed by sadness and depression. After the experience, participants completed a questionnaire asking how they felt at the moment, and wrote a stream-of-thought essay about their thoughts during the memory recall phase of the experiment.

Immediately after the session those who used the distanced-analysis approach reported lower levels of depression than those who used immersed-analysis, but not distraction. Thus distraction and distanced-analysis were found to be equally effective in the short-term. Participants then returned to the lab either one day or one week later. At that time, they were asked to think about the same sad or depressing experience, and their mood was reassessed.

Those who had used the distanced-analysis approach continued to show lower levels of depression than those who had used self-immersed analysis and distraction, providing evidence to support the hypothesis that distanced-analysis not only helps people cope with intense feelings adaptively in the short-term, but critically also helps people work-through negative experiences over time.

— Source: University of Michigan

According to a new study from the University of North Carolina at Chapel Hill, it appears how infants respond to stress is linked to if they have a particular form of a certain gene. Just as significantly, researchers say they have also found that good parenting—as early as within the first year of a child’s life—can counter the effect the gene has in babies who initially do not respond well to stressful situations. These findings appeared in a recent issue of Child Development.

Researchers looked at 142 infants over the first year of their lives, when the children were 3, 6, and 12 months old. On each occasion, they were placed in a stressful situation and researchers measured the infants’ heart rates, looking specifically at vagal tone, which normally limits heart rate, but during challenging situations, the level of vagal tone goes down, allowing heart rate to increase so the body can actively deal with the challenge. Researchers also collected DNA from the infants to see which form of a dopamine receptor gene they carried.

When the babies were 6 months old, researchers also videotaped the mothers and their infants playing together for 10 minutes, and assessed whether the mothers’ behavior was high or low in sensitivity.

At 3 and 6 months old, infants with the form of the dopamine gene associated with risky behaviors did not display a decrease in vagal tone when stressed, while those with the nonrisk version of the gene did. At these early ages, it did not appear to matter whether mothers were sensitive or not, according to Cathi Propper, PhD, the study’s lead author and a research scientist at the University of North Carolina’s Center for Developmental Science.

However, by the time the infants were 12 months old, the pattern changed. Infants with the risk form of the gene whose mothers were highly sensitive now showed the expected cardiac response when under stress—while those with the at-risk gene form who had insensitive mothers did not.

“Our findings provide further support for the notion that the development of complex behavioral and physiological responses is not the result of nature or nurture, but rather a combination of the two,” Propper says. “They also illustrate the importance of parenting not just for the development of children’s behavior, but for the underlying physiological mechanisms that support this behavior.

— Source: University of North Carolina at Chapel Hill

When it comes to gender roles in society, what you think may affect what you earn. A new study has found that men who believe in traditional roles for women earn more money than men who don’t, and women with more egalitarian views don’t make much more than women with a more traditional outlook.

Timothy Judge, PhD, and Beth Livingston from the University of Florida, analyzed data from a nationally representative study of men and women who were interviewed four times between 1979 and 2005. A total of 12,686 people, aged 14 to 22 at the beginning of the study, participated; there was a 60% retention rate over the course of the study. Results were published in a recent issue of the Journal of Applied Psychology.

At each of the four interviews, participants were asked about their views on gender roles in the workforce and at home. The researchers looked specifically at gender role views as a predictor of a person’s earnings. They controlled for job complexity, number of hours worked, and education. Their analyses showed that men in the study who said they had more traditional gender role attitudes made an average of about $8,500 more annually than those who had less traditional attitudes. For women, however, the situation was reversed. Women who held more traditional views about gender roles made an average of $1,500 less annually than the women with more egalitarian views.

Notably, the results also did not fundamentally change when other factors were controlled, such as industry, occupation, hours worked, and number of children. “These results cannot be explained by the fact that, in traditional couples, women are less likely to work outside the home,” Judge says.

— Source: American Psychological Association

Teen smokers who volunteer for programs to help them quit are more hooked on tobacco than other teens who smoke, new West Virginia University research has found. The teens believe quitting is a good idea, but they aren’t fully confident they’ll be able to kick the tobacco habit. What’s more, teens who volunteer for help are 60% more likely to use smokeless tobacco and more than 200% more likely to smoke cigars when compared with teen smokers nationally.

The conclusions, published in Tobacco Induced Diseases, come from analysis of data involving almost 6,000 teen smokers who enrolled in Not On Tobacco (N-O-T) between 1998 and 2006. Developed at WVU, N-O-T is the most widely used smoking-cessation program for teens in the nation. “This is the first time anyone has looked at the characteristics of teens who’ve joined the school-based N-O-T programs,” says Kimberly Horn, EdD, lead author of the study. “Knowing more about these students will help us to tailor and market the program. N-O-T has reached thousands of teens, but we can do better.”

The study, in highlighting which teen smokers join the program, also will help researchers understand who is not joining. It is important to come up with ways to better entice those missing teens to show up, Horn says. “The tobacco industry is notorious for effective marketing—it knows the audience. We need to be more effective than the industry in helping teens achieve the goal of quitting.”

— Source: West Virginia University Health Sciences Center

A six-year study published in a recent edition of the Journal of American College Health and conducted at the University of Virginia has found exposing college students to information that corrected misperceptions about campus drinking patterns resulted in dramatic reductions in alcohol-related negative consequences.

According to the study authors, the results are in direct contrast to national trends on negative consequences of drinking on campuses and offer what the authors call “cautious optimism and encouragement for those engaged in campus alcohol and drug prevention nationally.”

Starting in 1999, the University of Virginia embarked on a social norms marketing campaign to better inform first-year students about drinking behaviors as reported in student surveys. In general, according to these surveys, students actually drink less than their peers perceive.

Social norms research has shown that students are influenced by perceptions, whether right or wrong, and tend to behave according to what they perceive to be normal. Social norms marketing is an approach that communicates accurate information about the prevalence of healthy behaviors and attitudes among peers.

Once the marketing campaign had been launched, the researchers began surveying students who had been exposed to the campaign about 10 alcohol-related consequences, from missing class to having unprotected sex to getting in trouble with police.

During the study, students’ odds of experiencing none of 10 alcohol-related consequences nearly doubled, and multiple consequences decreased by more than one half for all undergraduate students.

First-year students exposed to the campaign reported a 22% reduction in the odds of experiencing multiple negative consequences and a 24% reduction in the odds of having an estimated blood alcohol content of greater than 0.08 the last time they partied.

— Source: University of Virginia

The Centers for Medicare & Medicaid Services (CMS) recently launched Ask Medicare, a new initiative to help family caregivers—those who are family members or friends who help people with Medicare—access and use valuable healthcare information, services, and resources.

More than 44 million Americans provide care to a loved one, friend, or neighbor, valued in economic terms at $350 billion annually, according to a recent report by AARP. The new initiative will provide a one-stop Web page (www.medicare.gov/caregivers) for caregivers that provides easy access to useful information about Medicare and other essential resources to help with caregiving.

The Web site will provide links to key partner organizations that assist caregivers and beneficiaries, and present personal stories from caregivers in the community. Support information and tools to help caregivers address common problems will also be available. As part of the initiative, CMS will launch an e-newsletter for caregivers that will deliver information into subscribers’ e-mail boxes.

“Through Ask Medicare and the new e-newsletter, CMS will help provide more information to caregivers, helping to streamline caring for Medicare beneficiaries and ultimately improve their quality of life and that of their loved ones,” said Kerry Weems, CMS acting administrator.

— Source: Centers for Medicare & Medicaid Services

Feeling connected to others is vital to a person’s mental well-being, as well as physical health, research at the University of Chicago shows. The studies, reported in a new book, Loneliness: Human Nature and the Need for Social Connection, show that a sense of rejection or isolation disrupts not only abilities, will power, and perseverance, but also key cellular processes deep within the human body.

The findings suggest that chronic loneliness belongs among health risk factors such as smoking, obesity, or lack of exercise, according to lead author John Cacioppo, PhD, the Tiffany & Margaret Blake Distinguished Service Professor in psychology at the university.

“Loneliness not only alters behavior, but loneliness is related to greater resistance to blood flow through your cardiovascular system,” Cacioppo says. “Loneliness leads to higher rises in morning levels of the stress hormone cortisol, altered gene expression in immune cells, poorer immune function, higher blood pressure, and an increased level of depression. Loneliness also is related to difficulty getting a deep sleep and a faster progression of Alzheimer’s disease, says Cacioppo. He drew on recent research in preparing the book, written with William Patrick, the former science editor at Harvard University Press.

It is not solitude or physical isolation itself, but rather the subjective sense of isolation that Cacioppo’s work shows to be so profoundly disruptive. Yet, outward circumstances such as moving to a new community or losing an intimate partner can trigger loneliness. The problem of social isolation will likely grow as conventional societal structures fade. The average household size is decreasing, and by 2010, 31 million Americans—roughly 10% of the population—will live alone. Sociologists also have found that people report significantly fewer close friends and confidants than those a generation ago.

— Source: University of Chicago

The first study to include a significant number of aggressive girls with conduct problems indicates that psychological conditions including conduct disorder may have separate causes in the two sexes. “Previous studies have focused on boys because boys with conduct disorder outnumber girls by a 10-to-1 ratio,” says Theodore Beauchaine, a University of Washington (UW) associate professor of psychology and lead author of the study.

In the study, UW researchers took physiological measurements of 110 boys and 65 girls aged 8 to 12 while they played a computerized game. About one half of the boys and girls met the criteria for conduct and/or oppositional defiant order. The other boys and girls had no psychological problems.

The game had the children, who were seated at a monitor, look at a number that appeared on the screen, and then press the same number on a keyboard. A correct response enabled them to win money. The faster and more accurately they played the more money could earn. “It was not unusual for some children to make $50 playing this game, which is a considerable amount of money for kids of these ages,” says Beauchaine. “Normal boys get pretty excited while they play, but boys with conduct problems don’t. However, we found no differences in the way the groups of girls responded.”

Biological markers that seem to make boys more vulnerable to conduct problems appear to be largely inherited, according Beauchaine. He adds that the failure to find a biological marker among girls with conduct problems suggests that this behavior is driven by different causes. They may be strong social or environmental influences such as ineffective parenting or simply hanging around the wrong kids.

— Source: University of Washington

Intelligence offers some protection against succumbing to immediate gratification, but psychologists have been unsure why. Yale University researchers report that they may have found the first clue to the mystery in an area of the brain that governs abstract problem solving and goal management. The findings were recently reported online in the journal Psychological Science.

"How do you juggle what you desperately want to do right now versus what you know to be best for yourself long term? Its not easy for anyone," says Jeremy Gray, an assistant professor of psychology and a coauthor of the study.

Gray and colleagues wanted to understand why people with better self-control also tended to score higher on intelligence tests. So they conducted functional magnetic resonance imaging tests on 103 participants undergoing working memory tests. They also measured "delay discounting,'' or the strength of the desire to take a smaller award immediately when a greater award could be obtained by waiting.

Participants who showed greater resistance during the reward tests also had better performance and greater activation of working memory, especially in an area of the brain called the anterior prefrontal cortex, which helps integrate a many types of information and manage complex problems. These subjects also tended to score higher on intelligence tests. However, there was no difference in activity in other areas of the brain between those who waited for the higher award and those who preferred to take lesser rewards immediately.

The work suggests that exercises aimed at improving one's ability to process complex information might also help people increase their self-control. "Understanding the factors that support better self-control, including the subjective value of immediate gratification, is relevant to a host of important behaviors, ranging from saving for retirement to maintaining physical and mental health,'' the authors concluded.

— Source: Yale University

Older adults may be better able to comply with medication regimens by working with providers to fill out simple paper tables that track what they take and when they take it, according to a report in a recent Journal of Experimental Psychology: Applied. Psychologists at the University of Illinois at Urbana-Champaign found that when pairs of older adults filled out a written matrix listing medications and instructions by days and times to take them, they solved medication-related problems more efficiently and accurately, especially for the complex medication schedules increasingly common among older adults.

In one experiment, 96 participants (average age of 69) were randomly assigned to the role of patient or provider. These pairs were randomly assigned to use a predesigned medtable, a blank piece of paper, or no aid. To simulate real life, the researchers varied information about both medication and patient. There were both complex and simple patient conditions as well as complex and simple medication conditions. The “patient-provider” pairs completed problems created by combining medication and patient complexity. Then, the pairs collaborated on schedules that reflected medication and patient constraints. The researchers assessed problem-solving accuracy, completion time, and efficiency.

Compared with the no-aid condition, the use of both blank paper and the medtable increased collaborative problem-solving accuracy and efficiency while reducing subjective workload, primarily for the complex medication problems. Researchers noticed that participants found it hard to use that particular design of the medtable, probably because it was too rigid about meal times.

A second experiment included 64 older adults (average age of 69), but used a redesigned medtable and increased complex problem-solving time. With these changes, the authors found that the medtable compared with blank paper supported significantly more accurate and efficient collaborative problem solving. These benefits occurred primarily for the complex-schedule problems.

The authors see the medtable as a tool most suitable for pharmacists or nurses who help chronically ill older adults manage complex medication regimens. They wrote that the medtable may also be suitable when time is less of a barrier, such as when nurses or caregivers work with older patients at home. In the future, electronic medtables could possibly expedite the updating of comprehensive medication lists. The authors wrote, “It would be important for patients to take home a copy of their medtable schedule to guide adherence.”

— Source: American Psychological Association

Two newer atypical antipsychotic medications were no more effective than an older conventional antipsychotic in treating child and adolescent schizophrenia and may lead to more metabolic side effects, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH) and published online in the American Journal of Psychiatry.

The six-year, multisite Treatment of Early Onset Schizophrenia Study (TEOSS) included 116 youths between the ages of 8 and 19 diagnosed with early onset schizophrenia spectrum disorder. The TEOSS team randomly assigned the children to eight weeks of either olanzapine (Zyprexa) or risperidone (Risperdal)—both new generation atypical antipsychotics—or to the older conventional antipsychotic molindone (Moban) plus benztropine, a medication often used to reduce side effects like uncontrolled shaking or tremor that can be associated with molindone.

Response rates after eight weeks of treatment were comparable among the three medications—50% of the children taking molindone improved, 46% taking risperidone improved, and 34% taking olanzapine improved. Children taking olanzapine or risperidone improved within the first two weeks, while the children on molindone improved within three weeks.

The treatment groups did differ in side effects. The children taking olanzapine gained about 13 pounds during the trial on average, while children taking risperidone gained about 8 pounds, and those taking molindone did not gain weight. The olanzapine group also showed increases in cholesterol levels and other metabolic disruptions that may have become dangerous. The outcome prompted the safety review board to end the olanzapine arm of the study in 2006.

"Atypical antipsychotics are commonly used to treat kids with [early onset schizophrenia spectrum], but these results question the wisdom of that approach," says lead author Linmarie Sikich, MD, of the University of North Carolina at Chapel Hill. "They also remind us that we need to develop safer, more effective medications to treat these children, given the limited effectiveness of both the atypical and the conventional medications."

— Source: National Institute of Mental Health

In a room dubbed the E-WoMP (exploratory world-music playground) that serves as the centerpiece of the Music-Play Project housed at Florida State University’s (FSU) College of Music, children with autism spectrum disorders are making impressive gains in creativity, emotional regulation, and social participation.

FSU ethnomusicologist and associate professor Michael B. Bakan likes to call such gains “response-ability.” He’s the director of the innovative medical ethnomusicology program, which uses an array of unusual musical instruments from around the world for improvisational music-play activities that help create a unique therapeutic environment.

“Our program emphasizes ability and personhood over disability and ‘treatment’ and accepts that there are different ways of interacting, just as there are different ways of making music in different cultures,” says Bakan. “The Music-Play Project fosters the growth of response-ability, and in turn, happiness, because it gives children the chance to contribute to the cocreation of culture who too often are characterized as being incapable of doing so.”

The Music-Play Project welcomes children three at a time to the E-WoMP, where they can choose from among safety-modified world-music options such as Balinese gamelan instruments, a West Javanese angklung (tuned bamboo-tubes rattle), and a West African gyil (xylophone), along with less exotic instruments. Bakan describes all the instruments as “high yield for low input” because they yield satisfying sounds with minimal effort and require little or no technical competence.

“The medium of free music-play can help children with [autism spectrum disorders] to gain confidence and self-esteem, and we are seeing this bear fruit not just in the E-WoMP but also at home, at school, and in peer relationships,” Bakan says.

— Source: Florida State University

Low-birth weight children appear to be at higher risk for psychiatric disturbances from childhood through high school than normal-birth weight children, according to a report in Archives of General Psychiatry. In addition, low-birth weight children from urban communities may be more likely to have attention problems than suburban low-birth weight children.

Kipling M. Bohnert, BA, and Naomi Breslau, PhD, of Michigan State University, examined the long-term association between low-birth weight and psychiatric problems among 413 children from a socially disadvantaged community in Detroit and 410 children from a middle-class Detroit suburb. Children’s psychiatric disturbances were rated by mothers and teachers at the ages of 6, 11, and 17. Psychiatric disturbances were separated into three categories: externalizing, including delinquent and aggressive behavior; internalizing, including withdrawn behavior and anxiety/depression; and attention, including characteristic symptoms of ADHD such as not being able to pay attention for long or difficulty following directions.

Low-birth weight children were more likely to exhibit externalizing and internalizing problems than normal-birth weight children in their community. “An increased risk of attention problems was associated with low birth weight only in the urban community and was greater among very low-birth weight children (weighing 1,500 grams or less) than heavier low-birth weight children (weighing 1,501 grams to 2,500 grams),” the authors wrote. “In the suburban community, there was no increased risk for attention problems associated with low birth weight. Psychiatric outcomes of low birth weight did not vary across ages of assessments.”

— Source: American Medical Association

Older age among fathers may be associated with an increased risk for bipolar disorder in their offspring, according to a report in a recent issue of Archives of General Psychiatry.

Emma M. Frans, MMedSc, of the Karolinska Institutet, Stockholm, and colleagues identified 13,428 patients in Swedish registers with a diagnosis of bipolar disorder. For each one, they randomly selected from the registers five controls who were the same sex and born the same year but did not have bipolar disorder.

When comparing the two groups, the older an individual’s father, the more likely he or she was to have bipolar disorder. After adjusting for the age of the mother, participants with fathers older than 29 years had an increased risk. “After controlling for parity [number of children], maternal age, socioeconomic status, and family history of psychotic disorders, the offspring of men 55 years and older were 1.37 times more likely to be diagnosed as having bipolar disorder than the offspring of men aged 20 to 24 years,” the authors wrote.

The offspring of older mothers also had an increased risk, but it was less pronounced than the paternal effect, the authors noted. For early-onset bipolar disorder (diagnosed before the age of 20), the effect of the father’s age was much stronger and there was no association with the mother’s age.

“Personality of older fathers has been suggested to explain the association between mental disorders and advancing paternal age,” the authors wrote. “However, the mental disorders associated with increasing paternal age are under considerable genetic influence.”

— Source: American Medical Association

Women with depression may be much more likely than men to get relief from citalopram, a commonly used, inexpensive antidepressant drug, according to a new national study published online in the Journal of Psychiatric Research. But members of both sexes may find that it helps ease their depression symptoms.

Researchers from the University of Michigan Depression Center and their colleagues from around the country tested the drug’s ability to help patients with depression achieve remission, or total relief from their symptoms, in a multiyear study.

The gender differences emerged from a detailed analysis of data from 2,876 men and women who had a clear diagnosis of major depression, and took citalopram over a number of weeks, with the doses increasing over time.

In the end, women were 33% more likely to achieve a full remission of their depression, despite the fact that women in the study were more severely depressed than the men when the study began. The study showed no differences between men and women in side effects, the amount of time that patients stuck to taking the drug, or the amount of time it took for them to achieve remission of their symptoms.

But the study’s authors are quick to caution that their findings don’t mean that citalopram should only be used in women. Raw data from the study show that 24% of men achieved remission with the drug, compared with 29% of women. Rather, they note that many people with depression need to try several treatments to find the one that’s right for them and will produce lasting results.

— Source: University of Michigan Health System

Elderly patients who are prescribed a conventional, or first-generation, antipsychotic medication are at an increased risk of death from cardiovascular or respiratory diseases as compared with those who take an atypical, or second-generation, antipsychotic medication, according to a study funded by the Agency for Healthcare Research and Quality.

The new study, posted online in the Journal of the American Geriatrics Society, adds to growing evidence that conventional antipsychotics may not be safer than atypical anitpsychotics for the elderly. Researchers had previously identified that such second-generation medications may pose increased mortality; the new study compares specific causes of death among elderly patients newly started on conventional vs. atypical antipsychotics.

In 2005, after studies suggested second-generation antipsychotics increased the risk of death by 60% in elderly patients with dementia, the FDA issued a public health advisory, which did not extend to first-generation antipsychotics. However, the new study provides additional evidence of the risks associated with first-generation versions for elderly patients. While this study does show an association with cardiovascular deaths, further studies will be needed to confirm this association.

Authors examined records of all seniors in British Columbia who took either first-generation or second-generation antipsychotics between 1996 and 2004, including 12,882 patients who commenced use of conventional and 24,359 patients who began a regimen of atypical antipsychotic medications. Of 3,821 total deaths within the first 180 days of use, cardiovascular deaths accounted for 49% of the excess deaths.

— Source: Agency for Healthcare Research and Quality

The National Alliance on Mental Illness (NAMI) is preparing to grade each of the 50 states on mental health services and invites the public to help by taking an online survey.

In 2006, NAMI's "Grading the States: A Report on America's Mental Healthcare System for Serious Mental Illnesses" provided the first comprehensive assessment in 15 years of publicly funded mental health services, establishing a benchmark against which future progress could be measured.

The national average was a D.

The next report card will come out in 2009 and will look at which states improved and if any states are sliding backwards, while also identifying strengths and weaknesses from the perspective of the people they serve.

NAMI is asking individuals and families affected by serious mental illnesses to take the survey to measure real world experiences. Anyone age 18 or older who has been diagnosed with a serious mental illness or who has an adult family member with a diagnosed mental illness can take the survey.

Specific survey questions include whether mental health services in a state are easy to find, convenient, affordable and without waiting lists-as well as whether they are sensitive to cultural backgrounds. Open-ended questions ask for the "best thing" and "worst thing" about each state system, whether their mental health services emphasize recovery and what recovery means for each individual.

— Source: The National Alliance on Mental Illness

New data indicate that more than 13 million children are living in poverty, 22% of rural children and 25% of children living in central cities, according to a new report released by the Carsey Institute at the University of New Hampshire. The report, based on U.S. Census Bureau data, finds that on average, rates of child poverty are persistently higher in rural parts of the country relative to suburban areas and share similar rates with many central cities.

“Because poverty is closely linked to undesirable outcomes in areas such as health, education, emotional welfare, and delinquency, we take child poverty seriously as a measure of children’s well-being,” says report author Sarah Savage, a research assistant at the Carsey Institute and PhD candidate in sociology at the University of New Hampshire. The data are based on the official U.S. Office of Management and Budget poverty measure of $21,027 for a family of two adults and two children.

The Carsey report finds that in 17 states, particularly those in the South and Southwest, rural child poverty is higher than rates in both suburban and urban areas. In 2007, the rural child poverty rate in ranges from a low of just 7% in Connecticut to a high of 35% in Mississippi.

— Source: University of New Hampshire

Five years after Vermont allowed civil unions, the first study to examine the experience has found that legalized same-sex couple relationships appear to be longer-lasting than those without a legal status. The study was published in Developmental Psychology.

Sixty-five male and 138 female couples who entered into civil unions during the first year they were available were asked to provide information. They were compared with 23 male and 61 female couples not in civil unions and 55 heterosexual married couples who were related to the same-sex couples in civil unions.

In the study sample, same-sex couples not in civil unions ended 9.3% of their relationships whereas only 3.8% of same-sex couples in a civil union ended their relationships. Heterosexual married couples ended 2.7% of their relationships. The difference between the percentages of break-ups for same-sex civil union couples and heterosexual married couples were not statistically significant, thus demonstrating that legalized same-sex and heterosexual couples lasted longer than nonlegalized same-sex couples.

The study questioned all of the couples about relationship conflict, relationship satisfaction, commitment, intimacy and equality. Interestingly, researchers found that same-sex couples reported more positive relationship quality and less conflict than heterosexual married couples on several dimensions.

“In contrast to old myths about same-sex couples being deficient or less viable than male-female couples, this research project shows that same-sex partners who seek to legalize their relationships actually may be among the best functioning couples in this society,” says Robert-Jay Green, PhD, executive director of the Rockway Institute, a national center for lesbian, gay, bisexual and transgender research.

— Source: Alliant International University

A study led by researchers at Beth Israel Deaconess Medical Center and Boston College offers new insights into the specific components of emotional memories, suggesting that sleep plays a key role in determining what we remember and what we forget.

Reported in Psychological Science, the findings show that a period of slumber helps the brain selectively preserve and enhance those aspects of a memory that are of greatest emotional resonance, while at the same time diminishing the memory’s neutral background details.

The authors tested 88 study participants who were shown scenes that depicted either neutral subjects on a neutral background (a car parked on a street in front of shops) or negatively arousing subjects on a neutral background (a badly crashed car parked on a similar street). The participants were then tested on their memories of both the central objects in the pictures and the backgrounds in the scenes. In this way, memory could be compared for the emotional aspects of a scene (the crashed car) versus the nonemotional aspects of the scene (the street on which the car had crashed.)

Subjects were divided into three groups. The first group underwent memory testing after 12 hours spent awake during the daytime; the second group was tested after 12 nighttime hours, including their normal period of nighttime sleep; and the third baseline group was tested 30 minutes after viewing the images, in either the morning or evening.

The results revealed that study subjects who stayed awake all day largely forgot the entire negative scene they had seen with their memories of both the central objects and the backgrounds decaying at similar rates. However, among the individuals who were tested after a period of sleep, memory recall for the central negative objects (i.e., the smashed car) was preserved in detail.

“After an evening of sleep, the subjects remembered the emotional items [smashed car] as accurately as the subjects whose memories had been tested only 30 minutes after looking at the scenes,” explains study author Elizabeth Kensinger, PhD, an assistant professor in the College of Arts and Sciences at Boston College. “By contrast, sleep did little to preserve memory for the backgrounds [i.e., street scenes] and so memory for those elements reached a comparably low level after a night of sleep as it did after a day spent awake.”

— Source: Beth Israel Deaconess Medical Center

A sudden and dramatic increase in pediatric suicides may reflect an emerging trend rather than a single-year anomaly. That’s the conclusion of new suicide research, conducted at The Research Institute at Nationwide Children’s Hospital and published in a recent issue of The Journal of the American Medical Association.

Following a decade of steady decline, the suicide rate among U.S. youths younger than the age of 20 increased by 18% from 2003 to 2004—the largest single-year change in the pediatric suicide rate over the past 15 years. Although worrisome, the one-year spike observed in 2003 to 2004 does not necessarily reflect a changing trend. Therefore, researchers examined national data on youth suicide from 1996 to 2005 in order to determine whether the increase persisted from 2004 to 2005, the latest year for which data are available.

Researchers estimated the trend in suicide rates from 1996 to 2003 using log-linear regression. Using that trend line, they estimated the expected suicide rates in 2004 and 2005 and compared the expected number of deaths with the actual observed number of deaths. Researchers found that although the overall observed rate of suicide among 10 to 19 year olds decreased by about 5% between 2004 and 2005 (the year following the spike) both the 2004 and 2005 rates were still significantly greater than the expected rates, based on the 1996 to 2003 trend.

“The fact that this significant increase in pediatric suicides continued into 2005 implies that the alarming spike witnessed from 2003 to 2004 was more than just a single-year anomaly,” says Jeff Bridge, PhD, lead author and a principal investigator in The Research Institute at Nationwide Children’s Hospital. “We now need to consider the possibility that the increase is an indicator of an emerging public health crisis.”

— Source: Nationwide Children's Hospital

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced the award of 12 grants totaling more than $16 million over three years to support suicide prevention efforts undertaken by tribes/tribal organizations. This grant program is authorized under the Garrett Lee Smith Memorial Act, which provides funding for programs to combat suicide.

SAMHSA Deputy Administrator Eric Broderick, DDS, MPH, made the announcement at the Interdepartmental Tribal Justice, Safety and Wellness Government-to-Government Consultation, Training and Technical Assistance Session. "As a result of the Garrett Lee Smith Memorial Act, SAMHSA works with state and local governments, communities and tribes/tribal organizations to stem the number of youth suicides in our country," said Broderick. "These new grantees will help fill a significant need in their communities."

Nationally, an estimated 900,000 youth had made a plan to commit suicide during their worst or most recent episode of major depression, and 712,000 attempted suicide during such an episode. The data are from SAMHSA's National Survey on Drug Use and Health, which asked youths aged 12 to 17 about symptoms of depression, including thoughts about death or suicide.

The total approximate amount for the grant award period, which ranges from one to three years, is $16 million. First-year funding totals nearly $6 million. Continuation of these awards is subject to both availability of funds and progress achieved by awardees. Additional grants will be awarded this year for suicide prevention efforts under the Garrett Lee Smith program.

— Source: Substance Abuse and Mental Health Services Administration

Much can be learned from China’s culture according to says Deb Sellers, Kansas State University Research and Extension specialist on adult development and aging. “Exploring aging in China can offer ideas for America’s population,” she says. As a gerontologist curious about how Chinese families care for—and interact with—older adults, she traveled to China to attend the American Society on Aging’s seminar.

During the trip, Sellers observed cultural contrasts that could be applied in the United States:

In China, women are required to retire at age 55; men must retire at age 60. In jobs that require physical labor, women retire at 50 and men at 55. “Retiring older workers helps to create job opportunities for the growing population of about 1 million younger workers,” says Sellers, who also noted an apparent lack of discussion pertaining to the gender difference in the mandatory retirement ages.

Displaced workers are encouraged to enroll in low-cost educational opportunities ($8 tuition per semester) available at more than 26,000 senior universities, so they can explore and develop new interests to fill the remaining decades of their lives, she says. More than 47,000 recreation and activity centers also are available to serve older adults.

Long-term care is gaining attention in China, at least in part due to familial changes. There now are about 40,000 such institutions in China. An obvious difference from American facilities, however, is that retirement center staff may live at the retirement facility and are on-call.

Traditional Chinese medicine (TCM) offers a holistic approach to wellness by addressing nutrition, lifestyle, emotion, physical activity, and mental fitness. “Prevention and wellness are emphasized,” says Sellers, who notes that the physical activity vital to a healthy lifestyle is part of everyday life there.

— Source: Kansas State University Research and Extension

Whether a family attends religious services has similar impact on a teen's grade point average as whether the student's parents earned a college degree, a University of Iowa study indicates.

Researchers found that on average, students whose parents received a four-year college degree average a GPA 0.12 higher than those whose parents only completed a high school education. Students who attend religious services weekly average a GPA 0.144 higher than those who never attend services, says Jennifer Glanville, a sociologist in the University of Iowa College of Liberal Arts and Sciences who led the study.

Glanville and colleagues from the University of Notre Dame analyzed data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of 7th through 12th graders that began in 1994. Students from 132 schools in 80 communities participated.

The study confirmed four reasons church-going teens tend to have more success in school: they have regular contact with adults from various generations who serve as role models; their parents are more likely to communicate with their friends' parents; they develop friendships with peers who have similar norms and values; and they're more likely to participate in extracurricular activities.

"There are two directions you can go with this research," she says. "Some might say this suggests that parents should have their kids attend places of worship. Or, if we use it to help explain why religious participation has a positive effect on academics, parents who aren't interested in attending church can consider how to structure their kids' time to allow access to the same beneficial social networks and opportunities religious institutions provide."

— Source: University of Iowa Health Sciences

Younger service members and Reserve and National Guard combat personnel returning from the wars in Iraq and Afghanistan are at increased risk of new-onset heavy drinking, binge drinking, and other alcohol-related problems, according to a recent study in The Journal of the American Medical Association.

Isabel G. Jacobson, MPH, of the Naval Health Research Center in San Diego, and colleagues examined whether military deployment to the wars in Iraq and Afghanistan is associated with new-onset or changes in alcohol consumption, binge drinking behavior, and other alcohol-related problems. Data were derived from questionnaires completed by participants at the beginning of the and follow-up. After the researchers applied exclusion criteria, the analyses included 48,481 participants (active duty, n = 26,613; Reserve or National Guard, n = 21,868). Of these, 5,510 deployed with combat exposures, 5,661 deployed without combat exposures, and 37,310 did not deploy.

The researchers found that among Reserve or National Guard personnel who deployed with combat exposures the rate of new-onset heavy weekly drinking was 8.8%; the rate for new-onset binge drinking was 25.6%; and for new-onset alcohol-related problems, 7.1%. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Among Reserve/Guard personnel, deployment with combat exposures was associated with increased odds of new onset of all three drinking outcomes compared with nondeployed personnel, with heavy weekly drinking (63%) and alcohol-related problems (63%) showing the strongest association.

Among active-duty personnel, those deployed with combat exposures were at increased odds (31%) of new-onset binge drinking at follow-up. Those born after 1980 were at 6.7 times increased odds of new-onset binge drinking and 4.7 times increased odds of new-onset alcohol-related problems. Those with PTSD and depression were at increased odds of new-onset and continued alcohol-related problems at follow-up.

“These results are the first to prospectively quantify changes in alcohol use in relation to recent combat deployments. Interventions should focus on at-risk groups, including Reserve/Guard personnel, younger individuals, and those with previous or existing mental health disorders,” the authors concluded.

— Source: American Medical Association

As students across the country return to school, school districts face an often complicated and confusing legal landscape on how to deal with cyber bullies in their schools, according to Todd DeMitchell, EdD, a professor of education, who studies school liability, adequate supervision, and responses to preventing bullying and cyber bullying from school administrators and state legislatures. In addition to his research in this area, DeMitchell has two decades of experience in K-12 as a teacher, principal, and superintendent.

According to DeMitchell, if a student is bullied at school or on the bus, the school can take action because the student is under the control of the school. “However, if the bullying occurs outside of school, the situation is more complicated since the evolution of face-to-face bullying to cyber-bullying tests the limits of whether a public school can institute discipline for acts—primarily speech—that occur away from school via the Internet,” DeMitchell says.

Cyber bullying conducted at school allows school authorities to more easily impose discipline. The use of school equipment to cyber bully also makes a stronger legal argument for action by the school. And if the student e-mails offensive speech to school or downloads it at school and then distributes it, the school is in an advantageous position regarding disciplining the student. However, speech created at home—such as the creation of a Web site—affords greater legal protection for cyber bullies.

“Unfortunately, the courts have not spoken with one voice on the issue of cyber speech or cyber-bullying,” DeMitchell says. “The problem with the approach that web speech created at home can—if accessed at school—become school speech that can be regulated is the very nature of the Internet. Once something is created and placed on the Internet, the author loses control over who can access the speech and where it can be accessed.”

Because of the unique problems presented by cyber-bullying, DeMitchell suggests that the approach to cyber-bullying be part of the overall approach to providing a safe school environment.

— Source: University of New Hampshire

A group at the University of Washington (UW) has developed software that for the first time enables deaf and hard-of-hearing Americans to use sign language over a mobile phone. This is the first time two-way real-time video communication has been demonstrated over cell phones in the United States. "A lot of people are excited about this," says principal investigator Eve Riskin, a UW professor of electrical engineering.

For mobile communication, deaf people now communicate by cell phone using text messages. "But the point is you want to be able to communicate in your native language," Riskin says. "For deaf people that's American Sign Language."

Low data transmission rates on U.S. cellular networks, combined with limited processing power on mobile devices, have so far prevented real-time video transmission with enough frames per second that it could be used to transmit sign language. The team tried different ways to get comprehensible sign language on low-resolution video. The current version of MobileASL uses a standard video compression tool to stay within the data transmission limit. The team developed a scheme to transmit the person's face and hands in high resolution, and the background in lower resolution.

Mobile video sign language won't be widely available until the service is provided through a commercial cell-phone manufacturer, Riskin says. The team has already been in discussion with a major cellular network provider that has expressed interest in the project.

— Source: University of Washington

Families of children with disabilities are struggling to keep food on the table, a roof over their heads, and to pay for needed health and dental care. But according to a new study from the University of North Carolina (UNC) at Chapel Hill, these challenges are now falling on middle-income households and not just on poor families as previous research found.

“The bottom line is that U.S. families raising children with disabilities are reporting severe hardships at rates that are chilling, including families that are solidly middle-class,” says Susan L. Parish, PhD, the study’s lead investigator and an assistant professor in the UNC School of Social Work.

The study, which is based on 2002 data from the National Survey of American Families and analyzed 28,141 households, was recently published in Exceptional Children.

Data indicated that a significant percentage of struggling families of children with disabilities are higher-income households. Yet based on federal poverty guidelines, those same households would not be classified as “poor,” she says. They also would not qualify for assistance, despite the higher costs of raising children with disabilities, Parish notes. In 2002, the federal poverty level for a family of four was $18,100.

According to the study, 40% of the surveyed families of children with disabilities who earned between two to three times the federal poverty level (between $36,200 and $54,300 for a family of four, for example) experienced at least one food hardship, including worrying that food would run out or skipping meals because of a lack of money. Fifteen percent of families with incomes at three or more times the federal poverty level ($54,300 and up for a family of four) experienced housing instability, meaning they were unable to pay their rent or had to move in with others.

“These families struggle to provide adequate care for their disabled children,” Parish says, “and stronger supports are vital.”

— Source: University of North Carolina at Chapel Hill

Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD) and the American Academy of Child and Adolescent Psychiatry (AACAP) applaud Olympic gold-medalist Michael Phelps and his mother, Deborah Phelps for educating the public about succeeding with attention-deficit/hyperactivity disorder (ADHD).

"Congratulations to Michael Phelps for winning eight Olympic gold medals. I applaud him and his mother for speaking about ADHD. Mr. Phelps shows that it's possible to go beyond coping with ADHD and truly achieve. His candor addresses stigma and, hopefully, will inspire others to seek help," says AACAP president Robert Hendren, DO.

"It's important for people living with ADHD to pursue interests they enjoy and at which they excel," explains Marie Paxson, CHADD's board president. "Phelps's success demonstrates that being a part of a supportive family, setting goals, engaging in enjoyable activities, and receiving positive feedback are all important in building self-esteem. Phelps is clearly an exceptionally talented athlete and a source of pride for the millions of people affected by ADHD."

On men's mental health Hendren says, "Among men, there is a deep stigma associated with seeking treatment for ADHD. I hope that Michael Phelps's openness conveys to young men that it's okay to seek treatment, that it is part of a wise game plan."

On the role of family support, Hendren says, "It's obvious to everyone who watched the Olympic games that Mr. Phelps has an engaged, supportive, and enthusiastic family who helped him find his right fit with swimming."

— Source: Children and Adults with Attention-Deficit/Hyperactivity Disorder

An estimated 15 million American children are diagnosed with a mental disorder, but only about one quarter of them are getting appropriate treatment based on scientific evidence. Many more children are at risk of developing behavioral disorders. And the problem is only going to get worse unless the healthcare system changes how it delivers services, according to a task force of the American Psychological Association (APA).

A report released by the APA’s Presidential Task Force on Evidence-Based Practice with Children and Adolescents at the annual conference recommends dissemination of evidence-based practice approaches—treatments that are based on scientific evidence along with clinical expertise while taking into account patient characteristics, culture and preferences—as a way to ensure that children and adolescents with mental health problems receive the best available care.

“The care should include prevention, early intervention, targeted treatments for particular disorders, an understanding of developmental processes, and continuity of care,” said task force chair Anne E. Kazak, PhD, ABPP. “Furthermore, treatments should be accessible regardless of age, gender, sexual orientation, disability, race, ethnicity, and culture. Lastly, evidence-based practice should be cross-disciplinary and include collaborations with families, schools, practitioners, and researchers from various health fields.”

These treatments and services need to reach youth from all different cultures, geographic regions and socioeconomic groups to prevent further escalation of the problem, said Kazak. “This is especially true for low-income youth, for youth in the juvenile justice and child welfare systems, ethnic minority youth, and those with drug/alcohol problems.”

— Source: American Psychological Association

Certain types of video games can have beneficial effects, improving gamers’ dexterity as well as their ability to problem-solve—attributes that have proven useful not only to students but to surgeons, according to research discussed at the annual convention of the American Psychological Association.

In one paper, Fordham University psychologist Fran C. Blumberg, PhD, and Sabrina S. Ismailer, MSED, examined 122 fifth-, sixth-, and seventh-graders’ problem-solving behavior while playing a video game that they had never seen before. As the children played the game, they were asked to think aloud for 20 minutes. Researchers assessed their problem-solving ability by examining the types of cognitive, goal-oriented, game-oriented, emotional, and contextual statements they made.

“Younger children seem more interested in setting short-term goals for their learning in the game compared to older children who are more interested in simply playing and the actions of playing,” said Blumberg. “Thus, younger children may show a greater need for focusing on small aspects of a given problem than older children, even in a leisure-based situation such as playing video games.”

In a second paper, Iowa State University psychologist Douglas Gentile, PhD, and William Stone, BS, described several studies involving high school and college students and laparoscopic surgeons that looked at their video game usage and its effects.

A study of 33 laparoscopic surgeons found that those who played video games were 27% faster at advanced surgical procedures and made 37% fewer errors compared with those who did not play video games, said Gentile.

A second study of 303 laparoscopic surgeons (82% men; 18% women) also showed that surgeons who played video games requiring spatial skills and hand dexterity and then performed a drill testing these skills were significantly faster at their first attempt and across all 10 trials than the surgeons who did not the play video games first.

“The big picture is that there are several dimensions on which games have effects, including the amount they are played, the content of each game, what you have to pay attention to on the screen, and how you control the motions,” said Gentile. “This means that games are not ‘good’ or ‘bad,’ but are powerful educational tools and have many effects we might not have expected they could.”

— Source: American Psychological Association

Argun Saatcioglu, PhD, assistant professor of educational leadership and policy studies and an adjunct assistant professor of sociology at the University of Kansas, presented “The Hidden Value Of School Desegregation: Evidence On Integration’s High School Promoting Power From The Cleveland Municipal School District, 1977-1998” at the American Sociological Association’s annual meeting.

In his research, Saatcioglu examined the changing contribution of high schools to students’ drop out tendencies in districts that experienced both desegregation and resegregation over the last few decades. He showed that although desegregation could not sufficiently improve student performance, it was able to considerably increase the schools’ contribution to success.

Saatcioglu addressed desegregation’s “hidden value” in making urban schools a positive force in the lives of disadvantaged students, although student-level outcomes such as test scores may continue to remain low due to social and economic impediments to student performance originating from outside the schools.

By separating the schools’ contribution to student performance (or the schools’ “promoting power”) from other factors that play a role in performance, Saatcioglu examines changes in schools’ influence over dropout behavior under conditions of segregation, desegregation, and resegregation. His analysis, based on data from the Cleveland Municipal School District (CMSD), suggests that, during the 1980s when CMSD desegregated, its high schools effectively counteracted dropout tendencies, particularly when students began high school having attended desegregated elementary and middle schools.

By contrast, both before desegregation (in the 1970s) and in the resegregation era (1990s), the district’s high schools functioned as a major obstacle to success, severely hurting the average student’s chances of graduation. Essentially, not only did students suffer from nonschool disadvantages, the schools aggravated the problem.

Sociologists and policy researchers have known for a long time that success is affected by various nonschool factors. “Though we know this,” Saatcioglu argued, “we have not properly integrated this insight in our ways of evaluating educational reform.”

— Source: American Sociological Association

As NASA prepares to send humans back to the moon and then on to Mars, psychologists are exploring the challenges astronauts will face on missions that will be much longer and more demanding than previous space flights. Psychologists outlined these mental health challenges at the American Psychological Association’s (APA) 116th Annual Convention, and introduced a new interactive computer program that will help address psychosocial challenges in space.

Psychologists said longer missions mean astronauts will be faced with immense psychological pressures as they adjust to being so far away from Earth, which could lead to depression and interpersonal conflicts. The presenters spoke at the APA’s first symposium to address the psychological challenges of returning to the moon and going to Mars.

Historically, astronauts have been reluctant to admit to mental or behavioral health problems for fear of being grounded. Psychologist James Carter, PhD, and his colleagues are in the process of developing a suite of interactive computer programs, dubbed the Virtual Space Station, using input from 13 veteran long-duration NASA astronauts who have flown on the International Space Station, Mir and Skylab. This interactive program will help astronauts prevent, detect, assess and manage their own psychosocial problems. They will learn how to cope with depression and how to resolve conflicts with other astronauts.

“Behavioral health problems can interfere with the success of the mission, especially on long-duration space flights like missions to the International Space Station, the moon, and Mars. These self-guided software tools will provide private and immediate access to treatments even though the patient may be many miles from Earth,” Carter said.

— Source: American Psychological Association

It’s a catch-22 of the highest order. People with alcohol problems often use alcohol to get to sleep—but it actually keeps them from getting good-quality sleep all night long. At the same time, they’re highly likely to suffer from full-blown chronic insomnia, a condition has been shown to cut their chances of getting sober again. Meanwhile, their doctors aren’t likely to prescribe them insomnia medications, because most sleeping pills can be habit-forming or have adverse effects due to an alcohol-damaged liver.

Now, a small new pilot study from a team of University of Michigan (UM) alcoholism and sleep researchers offers some sign of a possible way out of this conundrum. The study, published in Alcoholism: Clinical and Experimental Research, suggests that the drug gabapentin might be able to reduce insomnia in recovering alcoholics, and help them stay away from alcohol more successfully. The drug, often used to treat epilepsy and chronic pain, is not habit-forming and is not processed by the liver.

Although the study involved only 21 insomniacs in recovery from alcohol dependence, and did not provide long-term gabapentin treatment or long-term follow-up on their sleep or their alcohol recovery, it was randomized, placebo-controlled, and double-blinded. In all, 30% of the patients who received gabapentin during alcohol recovery relapsed to drinking, compared with 80% of those who received a placebo.

“We showed that the patients who got the real drug, rather than placebo, were less likely to relapse to drinking—or if they relapsed it was later,” says lead author Kirk Brower, MD, FASAM, executive director of UM Addiction Treatment Services and a professor of psychiatry at the UM Medical School.

— Source: University of Michigan Health System

More than one half of 26,000 students across 70 colleges and universities who completed a survey on suicidal experiences reported having at least one episode of suicidal thinking at some point in their lives. The survey was administered in the spring of 2006 and gathered information about a range of suicidal thoughts and behaviors among college students. The survey was reviewed by the participating campus counseling directors as well as two experts in suicidology.

Six percent of undergraduates and 4% of graduate students reported seriously considering suicide within the 12 months prior to answering the survey. Approximately two thirds of those who contemplate suicide do so more than once in a 12-month period. More than one half of students who experienced a recent suicidal crisis did not seek professional help or tell anyone about their suicidal thoughts.

Fourteen percent of undergraduates and 8% of graduate students who seriously considered attempting suicide in the previous 12 months made a suicide attempt. Nineteen percent of undergraduate attempters and 28% of graduate student attempters required medical attention. One half of attempters reported overdosing on drugs as their method, according to the study.

From the survey, the authors found that relying solely upon the current treatment model, which identifies and helps students who are in crisis, is insufficient for reducing all forms of suicide behavior on college campuses. The authors suggested a new model for dealing with the problem of student suicidal tendencies in order to address the entire continuum of suicidal thoughts and behaviors. By focusing on suicidal thoughts and behaviors as the problem, rather than looking only at students in crisis, interventions can be delivered at multiple points, they said.

— Source: American Psychological Association

At the American Psychological Association (APA) annual convention, the APA urged psychologists to take a leading role in ending discrimination based on gender identity, calling upon the profession to provide “appropriate, nondiscriminatory treatment to all transgender and gender-variant individuals” and encouraging more research into all aspects of gender identity and expression.

The association’s governing Council of Representatives adopted a resolution supporting full equality for transgender and gender-variant people. The resolution also calls on the APA to: support legal and social recognition of transgender individuals consistent with their gender identity and expression; 
support the provision of adequate and medically necessary treatment for transgender and gender-variant people; 
recognize the benefit and necessity of gender transition treatments for appropriately evaluated individuals;
and call on public and private insurers to cover these treatments.

In addition to adopting the wide-ranging resolution, the Council of Representatives received a report by the APA’s Task Force on Gender Identity and Gender Variance. The report, noting that transgender people, their families, friends, and employers are increasingly turning to psychologists for help, stated that “this trend underscores the need for psychologists to acquire greater knowledge and competence in addressing transgender issues.”

— Source: American Psychological Association

Researchers at the Johns Hopkins University have discovered that children as young as 14 months old can—and do—use the same technique that adults use to remember numbers to increase their working memories, indicating that "chunking" information in this way is not a learned strategy, but a fundamental aspect of the human mind.

In the team’s experiment, the 14-month-olds were shown four toys that were then hidden in a box. The children then were allowed to search for the missing toys. Sometimes, two of the four toys were secretly withheld in another place. The researchers observed how long the youngsters continued to search the box, the idea being that they would search longer if they remembered there were more toys yet to be found.

The researchers found the children would search longer when the four toys consisted of two groups of two familiar objects, cats and cars, and one of each type had been withheld. That indicated that the youngsters were using mental chunking as a way to recall more items at a time. The team also found that 14-month-olds can use spatial grouping cues to expand memory, in the same way that adults group digits when remembering phone numbers. When provided with such cues, the little ones could remember up to six objects.

The researchers’ results may have implications for educational strategies or for helping those who suffer short-term memory problems. But more directly, they show that the memory systems of young infants are surprisingly similar to those of adults.

— Source: Johns Hopkins University

The mammoth increase in the United States’ prison population since the 1970s is having profound demographic consequences that disproportionately affect black males. “This jump in incarceration rates represents a massive intervention in American families at a time when the federal government was making claims that it was less involved in their lives,” according to a University of Washington (UW) researcher who presented the findings at the annual meeting of the American Sociological Association.

Drawing data from various sources that looked at prison and general populations, Becky Pettit, a UW associate professor of sociology, and Bryan Sykes, a UW postdoctoral researcher, found that the boom in prison population is hiding lowered rates of fertility and increased rates of involuntary migration to rural areas and morbidity that is marked by a greater exposure to and risk of infectious diseases such as tuberculosis and HIV or AIDS.

These effects are most heavily felt by low-skill black males, and she said the disproportionately high incarceration rates among African Americans suggest the prison system is a key suspect in these demographic results. Pettit said well-documented facts—one in 100 Americans is behind bars in 2008, about 2.4 million people currently are incarcerated and nearly 60% of young black males who dropped out of high school have served time in jail—don’t seem to register with Americans.

In addition, she noted that the effects of an ever-growing criminal justice system extend beyond those who are serving sentences to include children, partners, and even entire communities. “It is in our own self-interest to be concerned. And certainly from a fiscal standpoint we have an interest. … This is a challenging public policy question.”

— Source: University of Washington

When combined with antipsychotic medications, the estrogen estradiol appears to be a useful treatment in women with schizophrenia, according to a report in a recent issue of Archives of General Psychiatry.

“Epidemiologic observations of sex differences in the onset and course of schizophrenia prompted exploration of estrogen’s role in schizophrenia,” the authors wrote. Jayashri Kulkarni, MBBS, MPM, FRANZCP, PhD, of The Alfred and Monash University and The Alfred Hospital in Australia, and colleagues conducted a randomized, double-blind study involving 102 women of child-bearing age with schizophrenia. For 28 days, 56 women were randomly assigned to receive 100 micrograms of estradiol daily via a skin patch and 46 women received a placebo skin patch in addition to their regular medications.

Psychotic symptoms, which include delusions and hallucinatory behavior, were assessed weekly with a commonly used scale. The group of women taking estradiol exhibited a greater improvement in psychotic symptoms over time than did the women taking antipsychotic medications alone. They also experienced a decline in positive symptoms—those that represent a distortion of normal functions. No difference was observed between the two groups regarding negative symptoms, those that occur when normal functions are lost or diminished.

“Estrogen’s neuroprotective and psychoprotective actions may be mediated by a variety of routes, ranging from rapid actions, including antioxidant effects and enhancement of cerebral blood flow and cerebral glucose utilization, to slower, genomic mechanisms, which may include permanent modification of neural circuits,” the authors wrote. “The lack of effect for negative symptoms is consistent with literature reporting that negative symptoms are less responsive to treatment than other symptoms of schizophrenia. It is possible that longer-term treatment is required for negative symptoms to respond to treatment.”

— Source: American Medical Association

Children and teens who get less sleep, especially those who spend less time in rapid eye movement (REM) sleep, may be more likely to be overweight, according to a report in a recent issue of Archives of General Psychiatry.

Xianchen Liu, MD, PhD, of the University of Pittsburgh School of Medicine department of psychiatry and Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center, and colleagues studied 335 children and adolescents aged 7 to 17 (an average age of 10.8). For three consecutive nights, participants’ sleep was monitored through polysomnography. Weight and height were measured to calculate body mass index (BMI).

A total of 49 participants (14.6%) were at risk for becoming overweight and 45 (13.4%) were overweight. Compared with children at a normal weight, those who were overweight slept about 22 minutes less per night and had lower sleep efficiency (percentage of time in bed that an individual is asleep), shorter REM sleep, less eye activity during REM sleep and a longer wait before the first REM period. After adjusting for other related factors, one hour less of total sleep was associated with two-fold increased odds of being overweight and one hour less of REM sleep was associated with three-fold increased odds.

“Given the fact that the prevalence of overweight among children and adolescents continues to increase and chronic sleep insufficiency becomes more prevalent in modern society, family- and school-based sleep interventions that aim to enhance sleep hygiene and increase sleep duration may have important public health implications for the prevention and intervention of obesity and type 2 diabetes in children,” the authors concluded.

— Source: American Medical Association

China’s rise as an economic powerhouse hasn’t come without a social cost. China is confronting the effects of the largest rural to urban migration in world history, the unintended consequences of its “one-child policy” and the plight of those left behind in rural villages without social services.

The University of Denver Graduate School of Social Work (GSSW) is supporting China’s efforts to reestablish a social work profession through a partnership dating back to 1994. What began as an effort to supply materials to China Youth University in Beijing has evolved into a partnership that encompasses exchanges of research, faculty, and students.

“China is beginning to recognize the need for a wide range of social services,” says GSSW Dean James Herbert Williams, who just returned from China. “Our long partnership allows committed Chinese social work professionals to take the best from 100 years of U.S. social work experience and adapt it to their needs.”

Their needs include typical urban issues seen in developing Western societies—domestic violence, drug use, and homelessness. But some of the country’s social problems are uniquely Chinese and require uniquely Chinese solutions. They must find a way to address individual needs in a collectivist culture. And they must find ways to deliver services efficiently and effectively to huge numbers of low-income Chinese spread densely through urban population centers and sparsely through rural villages.

“I think our work can really improve U.S.–China relations,” says Julie Laser, a GSSW professor. “If we know each other as human beings, we can bring our countries closer together.”

— Source: The University of Denver

The traumatic effect of watching a parent suffer abuse has been well documented. Children can be psychologically, physically, and emotionally damaged. Whether they witness it or experience it themselves, children growing up with violence in the home are more likely to develop psychological or behavioral disorders.

However, documentation of cases of families with intimate partner violence is largely based on the retrospective eye of children who experienced incidents at an older age. A new study funded by the Canadian Institutes of Health Research is looking at the effects of intimate partner violence on small infants and their mothers, focusing on the interaction between them.

“Most of what we know about family violence we know from those who recall the experience much later—often years following the experience,” says Jean Hughes, an associate professor at the Dalhousie School of Nursing and one of the investigators involved in the study. Hughes notes that while many children feel the effects of violence very strongly, others appear less affected—as if they rise above it.

The Mothering Study aims to create a new understanding of what behaviors and services help a mother to protect her young child or children from these lasting psychological and behavioral effects. Researchers want to learn how to better help women in abusive relationships, especially those with infants.

In order to do this, they are interviewing mothers, videotaping interactions between mother and child, and talking to service providers who help mothers in (or formerly in) abusive relationships. This includes talking to formal providers, such as doctors, as well as community providers such as shelters and support groups. Hughes stresses that there is complete confidentiality for all who participate.

— Source: Dalhousie University

A Johns Hopkins expert in HIV and how the AIDS virus hides in the body says antiretroviral drugs have stopped HIV from replicating, the first of three key steps needed to rid people of the virus.

In an address delivered at the XVII International Conference on AIDS, infectious disease specialist Robert Siliciano, MD, PhD, said current drug-combination therapies can stop HIV in its tracks, with some combos suppressing its ability to make copies to less than one in a billion. But, he said, progress is still needed in identifying where viral reservoirs persist and in finding ways to eliminate these HIV hiding places.

According to Siliciano, laboratory models that mimic HIV infection in these reservoir cells are key to finding drugs that can eliminate them. “We know now that HIV can be stopped,” he said. “Our next steps are to go after these reservoirs of HIV. And although much work needs to be done to find and eliminate them, infected people who have access to antiretroviral drugs and who take them as prescribed stand a good chance of leading normal lives.”

Siliciano pointed out that if antiretroviral drugs can be made more accessible, affordable, and less toxic, then infected people who take the drugs correctly will not develop AIDS. Included in the presentation are recent data from his team and researchers at the National Cancer Institute and the University of Pittsburgh, which shows that adding a fourth, more potent anti-HIV drug to existing antiviral combinations does not further suppress the number of HIV viral copies in the blood.

“Adding more drugs to current regimens will not further reduce the amount of virus in the blood,” said Siliciano. “We have already reached rock bottom in using drugs to stop HIV from replicating. The trace amounts of virus that remain are coming from viral reservoirs, not active replication of the virus.”

— Source: Johns Hopkins Medicine

The Health Department recently announced a new online campaign to engage teenagers grappling with depression, drugs, and violence and to encourage them to seek help. NYC Teen Mindspace, posted on MySpace, is the agency's first effort to promote health through Web-based social networking—a medium with great potential because of its popularity with young people. To see the campaign, visit www.myspace.com/nycteen_mindspace.

Though many teens experience mental health issues, they are often reluctant to acknowledge them and seek help. When asked who they are most likely to talk with when they feel sad, more than 20% of teens said they talk to no one, 31% said they would talk to a friend only, and just 32% said they would talk to an adult. The Mindspace page responds to these issues with interactive features that raise awareness and combat stigma by helping teens identify with peers and prompting them to seek help, including the following:

• Video blogs for teen characters featureing fictional, composite personalities, such as "Kyle," "Nicole," and "Stephanie," who chronicle their struggles through video posts.

• Opportunities to reach out for help by sending a confidential message to a mental health counselor from LifeNet or calling 800-LifeNet.

• Quizzes, polls, games, and fact sheets to test knowledge and compare feelings with those of peers.

• Music downloads. A standard piece of any popular page, this feature invites teens to express themselves by playing music to fit their moods.

— Source: New York City Department of Health and Mental Hygiene

Working overtime has a disproportionate impact on women in dual-earner households, exacerbating gender inequality and supporting the “separate sphere” phenomenon in which men are the breadwinners while women tend to the home, according to research presented at the annual meeting of the American Sociological Association.

“Women whose husbands work long hours are more likely to quit their jobs, yet men’s careers are not impacted when their wives put in long hours," says Youngjoo Cha, the study’s author and a doctoral candidate in sociology at Cornell University. “This suggests a potential return to the ‘separate spheres’ arrangement—breadwinning men and homemaking women—as long hours become increasingly common.”

Cha found that women whose husbands worked more than 60 hours per week were 44% more likely to quit their own jobs. However, there was no impact on husbands’ odds of quitting when wives worked long hours.

Results were even more pronounced when Cha isolated professional workers. Professional women were 52% more likely to quit their jobs when their husbands worked more than 60 hours per week. As in the case of all workers, overworking wives did not affect the employment status of professional men.

Among professionals, husbands were more than twice as likely as wives to work more than 50 hours per week (30% of husbands compared to 12% of wives). According to Cha, this suggests that in professional occupations, women are less likely to expect spousal support than men are.

— Source: American Sociological Association

The Utah state government’s implementation of a four day work week could result in higher job satisfaction and lower levels of work-family conflict, according to a new Brigham Young University (BYU) study. Those benefits translate into higher productivity, researchers say.

Rex Facer and Lori Wadsworth of BYU’s Romney Institute of Public Management examined the outcome of a Utah city’s transition to a schedule in which most employees worked four 10-hour days a week. Their paper appears in a recent issue of Review of Public Personnel Administration.

According to Facer, Utah cities embraced the new schedule to both save money on utilities and also to give citizens a wider range of times to access city hall. Now they are also reaping the morale and retention benefits among employees who save on fuel costs by commuting one fewer day each week.

BYU researchers found that even though four-day work week employees work the same number of hours per week as their traditional work-week counterparts, they reported being more satisfied with their jobs, compensation, and benefits, and were less likely to look for employment elsewhere in the next year.

Among the most significant findings was the four-day work week’s connection to conflicts between work and home. The four day work week employees were less likely to report that they come home too tired, that work takes away from personal interest, and that work takes time they would like to spend with family. Other studies have linked work-home conflict with low job performance and lessened productivity.

“The challenges of balancing work and home lives have become much more complex,” Facer says. “Finding ways to better manage work-family conflict is important in building stronger organizations and satisfied employee bases.”


— Source: Brigham Young University

Since 2003, Council on Social Work Education’s (CSWE) Commission on Global Social Work Education has granted its Partners in Advancing Education (PIE) for International Social Work Awards to individuals and social work programs demonstrating outstanding innovations in international social work education. This year’s winners, Frederic L. Ahearn and Southern Illinois University Carbondale, were selected based on their ability to advance the concepts, curricula, and programming in social work education.

Frederick L. Ahearn, Jr, DSW, a professor of social work at the Catholic University of America, was selected as a PIE recipient because of his ability to establish social work graduation programs in countries undergoing sociopolitical changes and his positive impact on other people, social policy, institutional building efforts, and the social work education structure on a global level. He has also strengthened international social work curricula in many U.S. universities and has authored content on migration, refugees, and internally displaced people.

Southern Illinois University-Carbondale’s School of Social Work is being recognized for its collaborative partnerships across the globe. Of particular note is its involvement with the United Nations Relief and Works Agency in providing a two-year certified education program for its 300 social workers and supervisors in Jordan, Lebanon, Syria, the West Bank, and Gaza.

— Source: Council on Social Work Education

Over the last decade, energy drinks—such as Red Bull, Monster, and Rockstar—have become nearly ubiquitous on college campuses. The global market for these types of drinks currently exceeds
$3 billion a year and new products are introduced annually. Although few researchers have examined energy drink consumption, a researcher at the University at Buffalo's Research Institute on Addictions (RIA) has been investigating links between energy drinks and public health concerns like substance abuse and risky behaviors.

A new research report, published online in the Journal of Adolescent Health, by RIA Research Scientist Kathleen E. Miller, PhD, examines the relationships between energy drink consumption and risk-taking in college students.

Miller's research validates and expands upon existing concerns about energy drink consumption: "The principal target demographic for energy drinks is young adults ages 18 to 25, but they're nearly as common among younger teens," she explains. "This is a concern because energy drinks typically contain three times the caffeine of a soft drink, and in some cases, up to 10 times as much."

Frequent energy drink consumers (six or more days a month) were approximately three times as likely than less-frequent energy drink consumers or nonconsumers to have smoked cigarettes, abused prescription drugs, and been in a serious physical fight in the year prior to the survey.

They reported drinking alcohol, having alcohol-related problems and using marijuana about twice as often as nonconsumers. They were also more likely to engage in other forms of risk-taking, including unsafe sex, not using a seatbelt, participating in an extreme sport, and doing something dangerous on a dare. The associations with smoking, drinking, alcohol problems, and illicit prescription use were found for white but not African American students.

Miller says she hopes to develop future research into the influence of personality traits, peer norms, and other factors that may influence the relationships among energy drink consumption, race, gender, and risk-taking. Better understanding of these relationships, she argues, may be useful in developing programs for preventing substance use and other health-compromising behaviors.

— Source: University at Buffalo

Nearly one half of women treated for breast cancer did not know that their odds of being alive after five years are roughly the same whether they undergo mastectomy or breast conserving surgery. Minority women were even less likely to be aware of this important factor of their treatment decision, according to a study from the University of Michigan (U-M) Comprehensive Cancer Center. Results of the study appeared in a recent issue of Health Services Research.

The researchers surveyed 1,132 breast cancer patients and asked them whether the chances of being alive five years after surgery were the same after a mastectomy or after lumpectomy with radiation, and whether the chance of breast cancer coming back after treatment was the same for the two surgeries.

Overall, only 51% responded correctly to the survival question, but the numbers varied significantly for minorities: 57% of whites answered correctly, 34% of African Americans knew their survival odds, and 37% of Latinas did.

The researchers found similar results for the recurrence question. Overall, 48% said they did not know the answer to the recurrence question, with African Americans and Latinas significantly more likely to answer “don’t know.” Research shows that both survival and recurrence are about the same for both surgical options.

“If women do not make an informed decision, they’re more likely to be dissatisfied down the road with the treatment they received,” says study author Sarah Hawley, PhD, a research investigator at the U-M Comprehensive Cancer Center.

— Source: University of Michigan Comprehensive Cancer Center

"No Child Left Behind,” the Bush administration’s education package, will continue no matter who wins the November presidential election. Its focus, however, will likely shift to early intervention programs, predicts Marcia Rock, PhD, an associate professor of special education at The University of Alabama.

"We will see a reemphasis on early intervention regardless of who moves into the White House,” says Rock.

“The early intervention research is unequivocal. We know, without question, that early intervention services improve outcomes for individuals with exceptionalities,” says Rock. “These changes that will take place will only strengthen those efforts by refocusing on our greatest needs and where we see our greatest results.”

“Instead of spending revenue widely across the board, we will be identifying areas that we know make a difference for children,” says Rock. “The goal of No Child Left Behind has always been to improve results for all children, and these changes will only strengthen those efforts by refocusing on our greatest needs and where we see our greatest results.”

— Source: University of Alabama

Eating tuna and other types of fish may help lower the risk of cognitive decline and stroke in healthy older adults, according to a study published in a recent issue of Neurology.

For the study, 3,660 people aged 65 and older underwent brain scans to detect silent brain infarcts, or small lesions in the brain that can cause loss of thinking skills, stroke, or dementia. Scans were performed again five years later on 2,313 of the participants. The people involved in the study were also given questionnaires about fish in their diets.

The study found that people who ate broiled or baked tuna and other fish high in omega-3 fatty acids (called DHA and EPA) three times or more per week had a nearly 26% lower risk of having the silent brain lesions that can cause dementia and stroke compared with people who did not eat fish regularly. Eating just one serving of this type of fish per week led to a 13% lower risk. The study also found people who regularly ate these types of fish had fewer changes in the white matter in their brains.

“While eating tuna and other types of fish seems to help protect against memory loss and stroke, these results were not found in people who regularly ate fried fish,” says Jyrki Virtanen, PhD, RD, with the University of Kuopio in Finland. “More research is needed as to why these types of fish may have protective effects, but the omega-3 fatty acids EPA and DHA would seem to have a major role.”

— Source: American Academy of Neurology

Experts have long believed that girls tend to internalize their problems, becoming depressed or anxious, while boys externalize, turning to violence against people or property.

But a new study, involving 2,549 youths who appeared before a juvenile court in five counties in Ohio, found that this oft-repeated idea didn’t hold true for African American youths. For them, whether they internalized or externalized depended not on gender, but on what was happening within their families. This study, published in a recent issue of the Journal of Marital and Family Therapy.

The results suggest more attention needs to be paid to the intersection of race, gender and family when it comes to dealing with troubled youth, says Stephen Gavazzi, PhD, coauthor of the study and professor of human development and family science at Ohio State University.

“If you look at most studies involving internalizing and externalizing among youth, they generally look at white, middle-class samples,” Gavazzi says. “Most research has not paid attention to race. And when studies do look at race, they are not likely to look at family and gender as well.”

In this study, the results showed that black girls and boys showed similar levels of externalizing and internalizing behavior, once family dysfunction was taken into account. In these families, boys and girls were more likely to show outward aggression if they lived in families with higher levels of dysfunction. Such a relationship was not found in white families.

“Family issues affect children in African American families differently than they do in white families,” Gavazzi says. “That is something that really hasn’t been found before.”

— Source: Ohio State University

Marin Institute, the alcohol industry watchdog, held a news conference to release the disturbing findings of its landmark report, The Annual Catastrophe of Alcohol in California, which will be published in Alcoholism: Clinical and Experimental Research. Such a comprehensive study has never been done in California. At the conference, digital clocks ticked away in real time the incredible economic costs ($1,200 per second or $38.4 billion annually), incidents of harm (100 per hour or 921,928 annually), and deaths (1 per hour or 9,439 annually).

Marin's study calculates that moderate-to-high alcohol consumption in California is costing roughly $1,000 per resident. By comparison, tobacco costs California approximately $550 per resident. The study also estimates $25.3 billion in lost productivity and reduced earnings.

"What makes these study results both so complex and so tragic is how alcohol-related harm takes so many forms and affects so many lives," said Michele Simon, JD, MPH, Marin Institute research and policy director. Simon coauthored the report with Ted Miller, PhD, of the Pacific Institute for Research and Evaluation, and Simon Rosen, Marin Institute research analyst.

The study also estimates an additional $48.8 billion in quality of life costs, due to the pain and suffering of victims and families. "These harms are not just economic, they are also deeply personal. Quantifying the pain and suffering endured by numerous people from alcohol harm may be the most compelling result of this study," Rosen added.

Marin Institute is calling for a number of steps to reverse the catastrophe, including higher alcohol taxes to reduce excessive consumption and the related harm and costs. While the harmful cost of alcohol is equal to $2.80 per drink, current alcohol taxes come to only 8 cents per drink.

— Source: Marin Institute

The life expectancy for patients with HIV has increased by more than 13 years since the late 1990s thanks to advancements in antiretroviral therapy, according to researchers at the University of Alabama at Birmingham (UAB) and Simon Fraser University in Vancouver, British Columbia. The study was published in The Lancet.

Improved survival has led to a nearly 40% drop in AIDS deaths among 43,355 HIV-positive study participants in Europe and North America, bolstering the call for improved anti-HIV efforts worldwide, the study authors say.

The authors looked at changes in life expectancy and mortality among the 43,355 HIV patients taking a cocktail of drugs called combination antiretroviral therapy (cART). Data was compiled from a total of 14 studies in Europe and North America.

“Since their introduction in 1996 cART regimens have become more effective, better tolerated and easier to follow,” says Michael Mugavero, MD, an assistant professor in UAB’s division of infectious diseases and a coauthor on the study.

The new study found cART yielded a 13.8-year life-expectancy increase. Despite the good results, the study found life expectancy for HIV patients is far lower on average than the general population, which includes all those with other chronic illnesses. For example, an HIV-positive patient starting cART at age 20 will live to 63, about 20 years shorter than the average life span of noninfected adults.

With nearly one half of all patients diagnosed with advanced HIV infection, the life expectancy benefits of cART are not fully realized, says Mugavero. Improved AIDS testing and increased access to care is needed.

— Source: University of Alabama at Birmingham

Up to three quarters of U.S. schools deemed failing based on achievement test scores would receive passing grades if evaluated using a less biased measure, a new study in Sociology of Education suggests.

Ohio State University researchers developed a new method of measuring school quality based on schools’ actual impact on learning. Using this impact measure, about three quarters of the schools now rated as “failing” because of low test scores no longer would be considered substandard. That means that in these schools mislabeled as failing, students may have low achievement scores, but they are learning at a reasonable rate and they are learning substantially faster during the school year than they are during summer vacation.

“Our impact measure more accurately gauges what is going on in the classroom, which is the way schools really should be evaluated if we’re trying to determine their effectiveness,” says Douglas Downey, PhD, coauthor of the study and a professor of sociology at Ohio State University. Downey conducted the study with Paul T. von Hippel, a research statistician in sociology at Ohio State.

Using achievement scores to measure school quality assumes that all schools have students with equivalent backgrounds and opportunities that will give them equal opportunities to succeed in school. And that’s obviously not true, von Hippel says.

The results suggest that states may have to reconsider how they evaluate schools under the federal No Child Left Behind Act, which emphasizes holding schools accountable for student achievement.

The study used data from the Early Childhood Longitudinal Study, a national survey conducted by the Department of Education. The analysis focused on 4,217 children in 287 schools. The survey measured children’s math and reading scores on four occasions: the beginning and end of their kindergarten year, and the beginning and end of first grade.

Comparing test scores from the beginning and end of first grade allowed the researchers to see how much children learn during the school year. They then were able to calculate how much faster students learned during the first-grade school year compared with when they were on summer vacation. This was the “impact” score that showed how much schools were actually helping students learn.

“If we evaluate schools that way, things change quite a bit as far as which ones we would identify as failing,” Downey says.

— Source: Ohio State University

The University of Texas School of Public Health Dallas Regional Campus researchers will survey 1,500 Mexican-American males living on the United States-Mexico border in Texas, New Mexico, Arizona, and California to examine their alcohol consumption and behavior. This research will then be compared with a sample of 1,500 Mexican Americans in Los Angeles and Houston who were surveyed as part of previous research.

“The border population is particularly interesting because it is exposed to underage drinking options, with Mexico’s legal drinking age being 18,” says Raul Caetano, MD, PhD, regional dean of the UT School of Public Health Dallas Regional Campus. “Along with age, we will be considering other factors such as religious affiliation, the Mexican culture’s influence, the cost of drinking, and male/female behavior comparisons.”

The researchers will explore the difference in the Mexican border population as compared with that of the nonborder population. The acculturation of the nonborder population will also be considered as a factor when examining Catholic or Protestant religious affiliation.

— Source: University of Texas Health Science Center at Houston

Asian American immigrants who came to the United States before they were 25 years old have poorer mental health than their compatriots who came when they were 25 or older, according to data from the first national mental health survey of Asian Americans.

The study is noteworthy because it shows that using traditional measures of socio-economic status—number of years of school and household income—to predict health outcomes is not accurate for individuals who immigrate when they are children or young adults, according to Janxin Leu, a University of Washington assistant professor of psychology and lead author of the study.

Immigrants who arrived in the United States before they were 25 attained higher levels of education and income than did older immigrants. However, 13% of the younger immigrants reported symptoms of an anxiety or depressive disorder in the previous 12 months compared with 9% of the over-25 group.

Leu and the other researchers found that what is called subjective social status was more accurate in predicting mental health outcomes than income or education. To calculate this, they told the people surveyed to imagine a ladder with 10 rungs containing individuals who had achieved the most on the top rung and those who were least successful on the bottom. Then they were asked to place themselves on the ladder in comparison with other people.

“The under-25 group experiences a lot of stress, the so called ‘long-reach of childhood’ that comes at a formative time of development,” Leu says. “It is important to understand the early development of mental health. Children who are bullied because they are immigrants, for example, may suffer long-term mental health consequences.”

— Source: University of Washington

While the 2008 summer Olympics in Beijing has elicited a rallying cry for human rights among high-profile activists and organizations outside China, ordinary Chinese citizens are mobilizing to fight for their rights inside the rapidly changing country, according to sociologist Ching Kwan Lee, PhD, a sociologist at the University of California-Los Angeles who studies rights activism in China and Chinese investments in Africa, in a recent issue of Contexts.

“Ordinary Chinese workers, homeowners, and farmers have emerged as unlikely activists in a quiet revolution that is filling the gaps between central government law-making and the rights violations and corruption of local governments,” says Lee. In contrast to traditional activism appealing to universal notions of human rights, this grassroots movement among everyday people in China invokes “the protection of lawful rights,” or weiquan. This activism focuses on specific rights prescribed by Chinese law, such as labor, property, and rural land rights.

According to Lee, growing unrest over social injustice, as well as wealth and power gaps in Chinese society—due to the country’s rapid economic development—has led to three decades of market reform and legal proliferation by the central government in Beijing.

“Today’s rights activism in China provides a look at the forces driving the near-total transformation of the most populace nation in the world,” Lee says. “Attention may shift away from China after the 2008 Olympic Games conclude, yet the struggles between economic growth and social stability; between authoritarian rule and a more responsive state and involved citizenry; and between local and central governments will continue to shape and define China for the long-term future.”

— Source: American Sociological Association

In one of the first studies to link molecular genetic variants to adolescent delinquency, sociological research published in a recent issue of the American Sociological Review identified three genetic predictors of delinquency that gain precision when considered together with social influences.

Sociologists from the University of North Carolina-Chapel Hill explored the interaction of genetics and social influences and identified three genetic polymorphisms that, when examined in the context of modulating social controls, are significant predictors of delinquency. These findings about gene–environment interactions suggest that certain genotypes and specific social control influences (eg, family characteristics and processes; popularity and friendship characteristics; school attendance factors) are mutually dependent on delinquency.

The present research is unique in that it systematically examines layers of social context simultaneously (ie, family dynamics, peer relations, and school-related variables) in relation to genetic factors. The study uses regression analysis to reveal nonintuitive and complex relations among the researched variables.

“While genetics appear to influence delinquency, social influences such as family, friends, and school seem to impact the expression of certain genetic variants,” says Guang Guo, PhD, the study’s lead author and a professor of sociology and faculty fellow at the University of North Carolina-Chapel Hill’s Carolina Population Center and Carolina Center for Genomic Sciences. “Positive social influences appear to reduce the delinquency-increasing effect of a genetic variant, whereas the effect of these genetic variants is amplified in the absence of social controls.”

“Our research confirms that genetic effects are not deterministic,” Guo says. “Gene expression may depend heavily on the environment.”

— Source: American Sociological Association

A different cutoff point on an existing mental function assessment may more effectively assess the risk of dementia in highly educated older adults, according to a report in a recent Archives of Neurology.

The most commonly administered screening test of cognitive function is known as the mini-mental state examination (MMSE). “The MMSE is used to screen patients for cognitive impairment, track changes in cognitive functioning over time and often to assess the effects of therapeutic agents on cognitive function,” the authors wrote. The maximum MMSE score is 30; a score of 24 or less is typically used to detect individuals with cognitive dysfunction.

Sid E. O’Bryant, PhD, of the Texas Tech University Health Sciences Center, and colleagues reviewed the MMSE scores of 1,141 participants (93% white, an average age of 75.9) in the Mayo Clinic Alzheimer Disease Research Center and Alzheimer Disease Patient Registry who reported having 16 or more years of education. These included 307 patients with dementia, 176 patients with mild cognitive impairment, and 658 control patients without dementia.

With the traditional cut score of 24 on the MMSE, 89% of the participants were accurately classified by dementia status. This score had a sensitivity of 66% and a specificity of 99% for the detection of dementia, meaning that an individual with a score of 23 or lower would be correctly identified as having dementia 66% of the time and an individual with score of 24 or higher would be correctly diagnosed as not having dementia 99% of the time. Raising the cut score to 27 changed the sensitivity to 89% and the specificity to 78%, correctly classifying 90% of the participants.

“Older patients who present with memory complaints (reported by themselves or others) who have attained a college degree or higher level of education and who score below 27 on the MMSE are at increased risk of cognitive dysfunction and dementia and should be referred for a comprehensive evaluation, including formal neuropsychological studies,” the authors wrote.

— Source: American Medical Association

Eighteen percent of school children who took part in two health surveys carried out a year apart admitted they had eating problems, according to research published in the latest Journal of Advanced Nursing.

Thirteen percent admitted eating problems in either the first or second survey and a further five percent reported problems in both surveys. Students who had ongoing eating problems were more likely to report multiple psychological problems and health complaints.

"For example we noticed that students who reported suffering from anxiety earlier in adolescence were 20 times more likely to have ongoing eating problems" says Lea Hautala from the Adolescent Psychiatry Clinic at the University of Turku, Finland. "And teenagers who were dissatisfied with their appearance only had recurring eating problems if they also reported anxiety earlier in adolescence."

Researchers from the University surveyed 372 students aged between 15 and 17, repeating the survey after one year with the same pupils; 57% were girls and 43% were boys. "A total of 66 students reported eating problems—23 only reported problems in the first survey, 24 only reported them in the second survey and 19 reported them in both surveys" she adds.

"Students who had previous problems with anxiety were much more likely to suffer sustained eating problems, while those who didn't have previous psychological problems only experienced temporary eating problems and dissatisfaction with their appearance.

"We also found that girls were twice as likely to report eating problems on one occasion than boys and five times more likely to have ongoing problems."

— Source: Journal of Advanced Nursing

The baby's smile that gladdens a mother's heart also lights up the reward centers of her brain, according to a Baylor College of Medicine (BCM) report that appeared in the journal Pediatrics.

The finding could help scientists figure out the special mother-infant bond and how it sometimes goes wrong, says Lane Strathearn, MBBS, an assistant professor of pediatrics at BCM and Texas Children's Hospital and a research associate in BCM's Human Neuroimaging Laboratory.

To study this relationship, Strathearn and his colleagues asked 28 first-time mothers with infants aged 5 to 10 months to watch photos of their own babies and other infants while they were in a functional magnetic resonance imaging scanner. In some of the photos, babies were smiling or happy. In others they were sad, and in some they had neutral expressions.

Researchers found that when the mothers saw their own infants' faces, key areas of the brain associated with reward lit up during the scans, signifying increased blood flow to that area. The areas stimulated by the sight of their own babies were those associated with the neurotransmitter dopamine. Specifically, the areas associated included the ventral tegmental area/substantia nigra regions, the striatum, and frontal lobe regions involved in emotion processing, cognition and motor/behavioral outputs.

"These are areas that have been activated in other experiments associated with drug addiction," says Strathearn. "It may be that seeing your own baby's smiling face is like a 'natural high.' Understanding how a mother responds uniquely to her own infant, when smiling or crying, may be the first step in understanding the neural basis of mother-infant attachment."

— Source: Baylor College of Medicine

Common genetic variations affecting nicotine receptors in the nervous system can significantly increase the chance that European Americans who begin smoking by the age of 17 will struggle with lifelong nicotine addiction, according to a study published in a recent issue of PLoS Genetics. The study highlights the importance of public health efforts to reduce the number of youths who begin smoking.

The researchers studied 2,827 long-term European American smokers. They assessed the level of nicotine dependence for all smokers, and recorded the age they began daily smoking, the number of years they smoked, and the average number of cigarettes smoked per day. DNA samples were taken from all smokers, and the researchers recorded the occurrence of common gene variations, grouped into four haplotypes, which had been identified earlier in a subset of participants.

They found that people who began smoking before the age of 17 and possessed two copies of the high-risk haplotype had a 1.6-fold to almost 5-fold increase in risk of heavy smoking as an adult. For people who began smoking at the age of 17 or older, presence of the high-risk haplotype did not significantly influence their risk of later addiction. The high-risk haplotype is common in the three study populations, and European American populations in general, ranging in frequency from 38% to 41%.

Although the authors caution that different haplotype frequencies would likely be observed in different ethnic populations, Robert Weiss, PhD, professor of human genetics at the University of Utah and lead author of the study explains, “We know that people who begin smoking at a young age are more likely to face severe nicotine dependence later in life. This finding suggests that genetic influences expressed during adolescence contribute to the risk of lifetime addiction severity produced from the early onset of tobacco use.”

— Source: University of Utah Health Sciences

Pediatricians can help prevent future violent behaviors in their patients with a brief, one-time office intervention during a routine exam, according to a new study published in a recent issue of Pediatrics. The study involved 5,000 families with children aged 2 to 11 and more than 200 providers at 137 practices.

"This concept of anticipatory guidance—that pediatricians can have a public health impact through a brief, one-time office intervention—is key," says Shari Barkin, MD, director of the division of general pediatrics at the Monroe Carell Jr. Children's Hospital at Vanderbilt, who designed and implemented the study with coauthors.

The research was based on changing factors previously shown to impact the risk of future violent behavior, such as: excessive media time (computer games and television often depicting violence), access to unsafely stored firearms, and corporal punishment. One group of parents received specific violence-prevention intervention; the other group received only printed literature on literacy promotion and no information related to violence prevention.

After six months, there was a significant increase in the number of caregivers limiting their children’s media time to fewer than two hours per day, with intervention group families watching, on average, 45 minutes less of media per day. Additionally, firearm owners exposed to the intervention in the study were twice as likely to store their firearms more safely. Use of time-outs was not significantly affected, but there was a decrease in families who reported corporal punishment, more in the intervention group than the control group.

"We showed that this type of dialogue between the pediatrician and the family, which only lasts three to four minutes, can motivate change," Barkin says.

— Source: Vanderbilt University Medical Center

The reported death of a woman at King's County Hospital in Brooklyn, NY, illustrates the dire need for more public services for individuals with mental illness, according to the American Psychiatric Association (APA).

According to news reports, a woman who was suffering from agitation and psychosis, was kept waiting in the emergency room for almost 24 hours because the hospital did not have a bed available for psychiatric patients. She collapsed onto the floor and then lay there for approximately one hour before emergency room personnel tried to revive her. Tragically, she died.

"The question is how and why hospital personnel could ignore a person who fell to the floor in an emergency room and stood by or walked around her while she died," says APA President Nada Stotland, MD. "Still, the lack of emergency services for psychiatric patients is only one part of an overall healthcare crisis, which extends to and includes mental health services.

A lack of funding has led to an ongoing shrinkage of the number of hospital beds for these individuals. At the same time, many times hospitals have no emergency room physician on duty that is qualified to handle mental health problems. The difficulty of accessing needed services may only intensify the sense of stigma many patients feel in seeking help for a psychiatric problem in the first place.

"The time to intervene is long before a person finds herself in the position of needing emergency help from a hospital that is ill-equipped to care for her," Stotland says. "The tragedy is that we know how to help these individuals recover and remain productive members of society; this suffering is needless and ends up costing society as much or more than adequate care would cost. Our society is failing to provide the most basic safety net for our most vulnerable citizens."

— Source: American Psychiatric Association

Pregnancy alone does not appear to be associated with an increased risk of the most prevalent mental disorders, according to a report in a recent issue of Archives of General Psychiatry. However, postpartum women may have a higher risk of major depressive disorder.

Oriana Vesga-López, MD, of New York State Psychiatric Institute, and colleagues analyzed data from interviews of 43,093 individuals who participated in a survey on alcohol, disorders, and related conditions. Of these, 14,549 were women (aged 18 to 50) who had been pregnant within the past year. Participants reported psychiatric disorders, substance use, and whether they had sought treatment.

Women who were pregnant at the time of the study had a lower risk of having any mood disorder, except major depression, than nonpregnant women. “Age, marital status, health status, stressful life events and history of traumatic experiences were all significantly associated with higher risk of psychiatric disorders in pregnant and post-partum women.” Women who had been pregnant within the past year had lower treatment-seeking rates for any psychiatric disorder within the past year and within their lifetime. “Most women with a current psychiatric disorder did not receive any mental health care in the 12 months prior to the survey regardless of pregnancy status,” the authors wrote.

Although pregnancy alone is not associated with an increased risk of the most common mental disorders, “groups of pregnant women with particularly high prevalence of psychiatric disorders were identified,” the authors wrote. These groups included women aged 18 to 25 living without a partner, widowed, separated, divorced, or never married and women who experienced pregnancy complications or stressful life events. “Given the critical importance of this life period for mothers and their offspring, urgent action is needed to increase detection and treatment of psychiatric disorders among pregnant and post-partum women in the United States.”

— Source: American Medical Association

A class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) appear to be associated with bleeding in the upper gastrointestinal (GI) tract, according to a report in a recent issue of Archives of General Psychiatry. The effects appear increased when antidepressants are combined with other stomach-harming medications and decreased when acid-suppressing agents are used.

Francisco J. de Abajo, MD, MPH, PhD, of the Spanish Agency for Medicines and Healthcare Products, and Luis A. García-Rodríguez, MD, MSc, of the Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain, studied 1,321 patients who had been referred to a specialist or hospitalized for upper GI bleeding between 2001 and 2005. These cases were compared with 10,000 control subjects who were the same age and sex but did not have upper GI bleeding.

Individuals with upper GI bleeding were significantly more likely than controls to be taking SSRIs (5.3% vs. 3.0%) or venlafaxine (1.1% vs. 0.3%). The risk of bleeding appeared to be increased further among those taking both SSRIs and other drugs known to be harmful to the GI tract, including nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. However, acid-suppressing agents were associated with a reduced risk of upper GI bleeding in those taking SSRIs or venlafaxine.

The researchers estimate that in patients not taking acid-suppressing agents, one individual per year would develop upper GI tract bleeding for every 2,000 patients taking these antidepressants. “When both SRIs [SSRIs and venlafaxine] and NSAIDs are concomitantly used, it would be sufficient to treat 250 patients per year for one case of upper GI tract bleeding to be attributed to such combination, and 500 patients per year if SRIs are concomitantly used with antiplatelet drugs,” the authors wrote.

— Source: American Medical Association

Vietnam veterans who experienced posttraumatic stress disorder (PTSD) were twice as likely to die from heart disease as veterans without PTSD, a new Geisinger study finds. In the study, published in a recent issue of Psychosomatic Medicine, Geisinger senior investigator Joseph Boscarino, PhD, MPH, examined the prevalence of heart disease, PTSD, and other problems in more than 4,000 Vietnam veterans.

The more severe the PTSD diagnosis, the greater the likelihood of death from heart disease, the study showed. Vietnam veterans with PTSD-—like chronic smokers—are at higher risk of early death from heart disease, Boscarino concluded. He equated PTSD to smoking two to three packs of cigarettes per day for more than 20 years.

PTSD causes the body to release stress hormones, which leads to the inflammation and damage to the arteries and cardiovascular system damage. Stress hormones also tend to reduce the amount of inflammation-reducing cortisol in the body—though researchers aren’t sure why. “Increased levels of stress hormones and less cortisol from PTSD are a bad combination,” Boscarino explains. “Basically, PTSD just cooks your arteries in this situation.”

Boscarino previously found that people with PTSD had dramatically higher rates of chronic health problems such as psoriasis, arthritis, and other inflammatory diseases. “The science is conclusively showing that if you suffer psychological trauma, it’s going to take a toll on your physical health,” Boscarino says. “Getting counseling today is critical to avoiding a related problem tomorrow.”

— Source: Geisinger Health System

How children respond to the smell of alcoholic beverages is related to their mothers’ reasons for drinking, according to a new study from the Monell Chemical Senses Center. When asked to smell both the odor of beer and an unpleasant odor and then indicate which they liked better, children of mothers classified as ‘Escape drinkers’ were more likely than children of Nonescape drinkers to select the unpleasant odor over beer.

“Children’s responses to odors provide us with a window into their emotions,” says study lead author Julie Mennella, PhD, a Monell biopsychologist. “When given a choice between beer and pyridine—the smell of rotten eggs—children of mothers who drink to relieve tension and worry choose pyridine as smelling better. That’s pretty powerful.”

In the study, which appears in the journal Alcohol, 145 aged 5 to 8 were presented with seven pairs of odors. One of the odors was always beer; the others were bubblegum, chocolate, cola, coffee, green tea, pyridine, and cigarette smoke. For each pair, the children indicated which odor they liked better.

Mennella notes that because odor information travels directly to areas of the brain that deal with nonverbal aspects of emotion and memory, studying children’s responses to odors provides insights into their emotional worlds.

Mennella comments that additional research is needed to determine whether children who dislike the odor of alcohol and experience it in a negative emotional context are more or less likely as adolescents or adults to seek out alcohol when stressed.

— Source: Monell Chemical Senses Center

A team of researchers at Northeastern University’s Institute on Race and Justice, in collaboration with Arizona State University and Sam Houston State University, has issued a report, titled “Understanding and Improving Law Enforcement Responses to Human Trafficking,” about the incidence of and response to human trafficking in the United States.

Lead by principal investigators Amy Farrell, PhD, an assistant professor and the associate director of the Institute on Race and Justice, and Jack McDevitt, associate dean for Research and Graduate Studies in the College of Criminal Justice, the researchers conducted a random survey of law enforcement agencies throughout the United States to better understand how agencies identify and respond to suspected cases of human trafficking. This survey provides the first comprehensive national look at how local, state, and county law enforcement agencies respond to human trafficking.

The first part of the report details how law enforcement agencies perceive human trafficking and how they investigate such cases. The survey was sent to a random sample of approximately 3,000 state, county, and municipal law enforcement agencies in the United States. The results indicate that all types of law enforcement agencies have investigated at least one case of human trafficking, but local law enforcement agencies perceive human trafficking as rare or nonexistent in their jurisdiction. In addition, agencies in larger jurisdictions are more likely to distinguish human trafficking as a problem in their area, as evidenced by the fact that more than one half of the agencies serving large jurisdictions have investigated human trafficking cases.

The study also looked at the multiagency human trafficking task forces to better understand how the federal government is working to bring together federal, state, county and local law enforcement agencies to combat human trafficking. There are currently 39 task forces functioning nationally with a focus on a victim-centered response. The study found that when a task force is involved, a case of human trafficking is more likely to be investigated, resulting in higher rates of arrests and federal charges than nontask force agency human trafficking reported cases.

The data show some common obstacles among multiagency task forces, including defining and identifying human trafficking victims and a lack of communication among task force group members. Other issues that arose were how to align common goals when certain members have other responsibilities, as well as the complexity and length of time that is involved with human trafficking cases.

— Source: Northeastern University

The National Association of Social Workers (NASW) has elected Jim Kelly, PhD, ACSW, LCSW as its president. He brings more than 25 years of social work education experience to the NASW presidency. Kelly is the provost and executive vice president of Menlo College in Atherton, CA. He is a tenured social work educator, having worked for many years in the California State University system most recently as a professor, associate vice president of continuing and international education, and interim provost at California State University, East Bay.

“Dr. Kelly brings a wealth of talent and experience to the leadership of NASW. His diverse background and widespread experience as a social work educator will be a great benefit to the progress of NASW,” says Elizabeth J. Clark, PhD, ACSW, MPH, executive director of NASW.

Kelly has been actively involved with NASW serving as president of NASW's California Chapter, and has been active in the Tennessee, Massachusetts, and Hawaii chapters. In 1987, he was named NASW's Social Worker of the Year.

“NASW's most important function is to advocate for the social work profession on behalf of our clients. As a community, we must continue to attain the highest professional standards, protect client and practitioner rights, and improve health and human service systems of care.” says Kelly. “I hope that as president of NASW I can work with all social workers to advance the profession and to provide more for individuals, families, and communities.”

— Source: National Association of Social Workers

Gun-related homicide among young men rose sharply in the United States in recent years even though the nation’s overall homicide rate remained flat, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. Between 1999 and 2005, homicide involving firearms increased 31% among black males aged 25 to 44 and 12% among white males of the same age. The study is published online in the Journal of Urban Health.

“The recent flatness of the U.S. homicide rate obscures the large increases in firearm death among males ages 25 to 44, especially black males,” says Susan Baker, MPH, coauthor of the study and a professor with the Bloomberg School’s Center for Injury Research and Policy.

For the study, Baker and her colleagues analyzed data from the Web-based Injury Statistics Query and Reporting System, which includes information on injury-related deaths and mortality rates per 100,000 population from 1981 to 2005. Mortality data by urbanization level was obtained through the Wonder System at the Centers for Disease Control and Prevention.

According to the study, the overall homicide rate remained between 6.0 and 6.1 deaths per 100,000 from 1999 to 2005, except for an increase in 2001 attributed to the terrorist attacks of September 11. The researchers found significant increases in the rate of firearm homicide for white males aged 25 to 34 and for black males aged 25 to 44.

The increase in firearm homicide for males aged 25 to 44 was not distributed evenly throughout the country. The most significant increases occurred in Alabama, California, Michigan, Minnesota, Nebraska, Nevada, New Jersey, Ohio, Pennsylvania, Texas, and Washington. The other states did not see significant change. Additionally, most of the increases occurred in and around large metropolitan areas.

— Source: Johns Hopkins Bloomberg School of Public Health

Pregnant women who receive treatment for substance abuse early in their pregnancy can achieve the same health outcomes as pregnant women with no substance abuse, according to a Kaiser Permanente study published online in the Journal of Perinatology.

“This program can happen everywhere and should become the gold standard for women who are pregnant and using cigarettes, alcohol, or other drugs,” says study lead author Nancy C. Goler, MD, an OB/GYN and Kaiser Permanente regional medical director of the Early Start Program for the organization’s Northern California operations. “The study’s big finding was that study participants treated in the Early Start program had outcomes similar to our control group, women who had no evidence of substance abuse.”

The study compared 2,073 pregnant women who were screened, assessed, and received ongoing intervention during pregnancy through the Early Start program from 1999 to 2003 to women in three other groups: 156 women who were screened but did not accept assessment or treatment; 1,203 women were screened, assessed, and received brief intervention only; and a control group of 46,553 women who showed no evidence of substance abuse.

The study found the risk of stillborn, placental abruption (when the placental lining separates from the mother’s uterus), preterm delivery, low birth weight, and neonatal ventilation were dramatically higher for the 156 untreated substance abusers than the 2,073 women in the Early Start program

“The sooner women ask for help, the better the health outcomes will be for themselves, and their babies. My message to all pregnant women, as well as women who are trying to conceive, is to stop all alcohol, cigarette, and drug use,” says Goler.

— Source: Kaiser Permanente

More than one half of older adults complain about having difficulties sleeping. Most don't bother seeking treatment. Those who do usually turn either to medications, which can lead to other health problems, or behavior therapies, which are costly and often not available close to home. Now, University of California, Los Angeles (UCLA) researchers report in the journal Sleep that practicing tai chi chih promotes sleep quality in older adults with moderate sleep complaints.

In the study, 112 healthy adults ranging in age from 59 to 86 were randomly assigned to one of two groups for a 25-week period: The first group practiced 20 simple tai chi chih moves; the other participated in health education classes that included advice on stress management, diet, and sleep habits.

The study found that the tai chi chih group showed improved sleep quality and a remission of clinical impairments, such as drowsiness during the day and inability to concentrate, compared with those receiving health education. The tai chi chih participants showed improvements in their own self-rating of sleep quality, sleep duration, and sleep disturbance.

The lead study author, Michael Irwin, MD, the Norman Cousins Professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA and director of the UCLA Cousins Center for Psychoneuroimmunology, notes that 58% of adults aged 59 and older report having difficulty sleeping at least a few nights each week. "Poor sleeping constitutes one of the most common difficulties facing older adults," says Irwin.

— Source: University of California, Los Angeles

Expansion of Medicaid's Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program in California has significantly improved children's access to mental health services, reports a study in a recent issue of Medical Care.

The gains appear greatest in rural communities and areas with historically low levels of state funding for mental health services, where children living in poverty have high rates of mental health issues that are not appropriately treated. The lead author was Lonnie R. Snowden, PhD, of University of California, Berkeley.

Under a 1995 expansion of the EPSDT program, mental health benefits were "carved out" from other EPSDT benefits and assigned to California county mental health plans. Mental health benefits paid by Medi-Cal (the California Medicaid program) increased sharply after the expansion—from $121 million in 1994 to 1995 to $446 million in 1999 to 2000—with increased use of outpatient treatment and reduced use of crisis services.

The current study focused on how the changes affected children's access to mental health services—a major goal of the EPSDT expansion. The analysis included data from 53 county mental health plans from 1992-93 to 2001-02.

— Source: Wolters Kluwer Health: Lippincott Williams & Wilkins

Hearing loss is about twice as common in adults with diabetes compared with those who do not have the disease, according to a new study funded by the National Institutes of Health (NIH) that was published in the Annals of Internal Medicine.

"Hearing loss may be an under-recognized complication of diabetes. As diabetes becomes more common, the disease may become a more significant contributor to hearing loss," says senior author Catherine Cowie, PhD, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), who suggested that people with diabetes should consider having their hearing tested. "Our study found a strong and consistent link between hearing impairment and diabetes using a number of different outcomes."

The researchers discovered the higher rate of hearing loss in those with diabetes after analyzing the results of hearing tests given to a nationally representative sample of adults in the United States. The test measured participants' ability to hear low, middle, and high frequency sounds in both ears. The link between diabetes and hearing loss was evident across all frequencies, with a stronger association in the high frequency range. Mild or greater hearing impairment of low- or mid-frequency sounds in the worse ear was about 21% in 399 adults with diabetes compared with about 9% in 4,741 adults without diabetes. For high frequency sounds, mild or greater hearing impairment in the worse ear was 54% in those with diabetes compared with 32% in those who did not have the disease.

"The link between diabetes and hearing loss has been debated since the 1960s or before, and our results show that a relationship exists even when we account for the major factors known to affect hearing, such as age, race, ethnicity, income level, noise exposure, and the use of certain medications," notes Kathleen Bainbridge, PhD, of Social & Scientific Systems, Inc.

— Source: National Institutes of Health

The American Psychiatric Association (APA) applauds House passage of the Medicare Improvements for Patients and Providers Act, which overhauls key features in Medicare coverage of treatment for mental health, most notably by reducing the discriminatory 50% coinsurance patients must pay for outpatient mental health services to the same 20% copayment charged for all other Medicare Part B services. The House passed HR 6331 by a vote of 355 to 59.

In addition to ending the disparity with mental health care out-of-pocket costs, HR 6331 includes numerous provisions that will strengthen the Medicare program, and block a scheduled 10.6% cut in payments to physicians and other health professionals through 2009.

Since the Medicare program was established some 40 years ago, enrollees using outpatient psychiatric services have by law had to pay an effective copayment of 50%—two-and-a-half times the customary 20% copayment paid for other Medicare Part B services.

"The House showed great foresight in taking steps to finally end 40 years of discrimination against patients just because they need mental health treatments," says Nada Stotland, MD, MPH. "It is unconscionable to require the elderly and disabled to pay half the cost of their mental health care out of pocket. This change makes social and economic sense. The APA will continue to advocate for this legislation until it becomes law."

Action now shifts back to the Senate, which has yet to reach agreement on a bill of its own.

— Source: American Psychiatric Association

Young children show evidence of smart and flexible behavior early in life—even though they don’t really know what they’re doing, new research suggests. The study appears in a recent issue of the journal Child Development.

In a series of experiments, scientists tested how well 4- and 5-year-olds were able to rely on different types of information to choose objects in a group. In some situations, they were asked to choose objects based on color and in some cases based on shape. Results showed children could be trained to choose correctly, but still didn’t know why shape or color was the right answer in any particular context.

“Children have more powerful learning skills than it was thought previously,” Vladimir Sloutsky, coauthor of the study and a professor of psychology and human development and the director of the Center for Cognitive Science at Ohio State, says. “They can show evidence of flexible learning abilities without conceptual knowledge and without being aware of what they learned.”

Sloutsky says, “these children were not aware of what they learned. They didn’t know how they were making the correct choices.” The findings have implications for theories of how children learn and develop their cognitive abilities, he says.

“Children learn implicitly. They don’t need complex conceptual knowledge to show evidence of smart, flexible behavior.”

— Source: Ohio State University

A survey conducted by the World Health Organization (WHO) research consortium looked at patterns in the use of alcohol, tobacco, cannabis, and cocaine in 17 countries representing all six WHO regions (the Americas, Europe, Asia, the Middle East, Africa, and Oceania).

"These findings add to our understanding of substance abuse world-wide, and suggest that drug use is still a major problem in this country, pointing to the need for more effective prevention interventions," says Elias A. Zerhouni, MD, NIH director.

Among the significant findings of this study were:

• Across countries and across the drug types in this survey, drug use is becoming more common over time.

• Males were more likely than females to have used all drug types in all countries and all age groups.

• Younger adults were more likely than older adults to have used these substances.

• Those with higher incomes were more likely to have used legal and illegal drugs.

• Alcohol had been used by the vast majority of survey participants in the Americas, Europe, Japan, and New Zealand, compared to smaller proportions in the Middle East, Africa and China.

• Alcohol use by age 15 was far more common in European countries than in the Middle East or Africa.

• Lifetime tobacco use was most common in the United States (74%), Lebanon (67%), Mexico (60%), and the Ukraine (61%), followed by the Netherlands (58%).

— Source: National Institute on Drug Abuse

Psychosocial influences such as stress, depression, and trauma have been neglected in biomedical and treatment studies involving people infected with HIV, yet they are now known to have significant health impacts on such individuals and the spread of AIDS, according to a University of North Carolina (UNC) at Chapel Hill scientist.

Now, a comprehensive update on those influences in the current issue of the journal Psychosomatic Medicine offers a wake-up call and should give infectious disease physicians and other healthcare practitioners working with HIV-infected persons information to improve patient outcomes, says Jane Leserman, PhD, a sociologist, a professor of psychiatry in the UNC School of Medicine and coeditor of the special journal issue.

“A huge amount of research has been done in our field around these psychosocial influences, yet we felt not all medical professionals working with HIV-infected persons were aware of this body of knowledge,” Leserman says. “We hope this special issue will serve as a catalyst for healthcare providers to address these problems as part of standard HIV care, and to stimulate collaborations between biomedical and biobehavioral clinicians and researchers working as a team to address the quantity and quality of life for these patients.”

Recent large, long-term studies show that HIV and AIDS patients with chronic depression and trauma are about twice as likely to die from AIDS-related causes, Leserman says.

“No one argues about the importance of following the numbers—immune cell counts and levels of the virus in the blood—nor should they,” Leserman says. “But there is substantial and consistent evidence that depression, stressful life events, and trauma account for some of the variability in HIV disease course. That can’t be ignored.”

— Source: University of North Carolina at Chapel Hill School of Medicine

According to a new study in a recent issue of the Journal of Applied Social Psychology, if someone have a tendency to become upset while driving, they’re more likely to be the kind of parent who explodes in anger at their kids’ sports matches.

Research by kinesiology PhD student Jay Goldstein of the University of Maryland School of Public Health found that ego defensiveness, one of the triggers that ignites road rage, also kicks off parental “sideline rage,” and that a parent with a control-oriented personality is more likely to react to that trigger by becoming angry and aggressive.

By surveying parents at youth soccer games in suburban Washington, DC, Goldstein found that parents became angry when their ego got in the way. “When they perceived something that happened during the game to be personally directed at them or their child, they got angry.” says Goldstein. “That’s consistent with findings on road rage.”

And the parents who Goldstein defines as control-oriented were far more likely to take something personally and flare up at referees, opposing players, and even their own kids, than autonomy-oriented parents, who take greater responsibility for their own behavior.

“In general, control-oriented people are the kind who try to ‘keep up with the Joneses,’” Goldstein says. “They have a harder time controlling their reactions. They more quickly become one of ‘those’ parents than the parents who are able to separate their ego from their kids and events on the field.”

However, Goldstein says, even autonomy-oriented parents get angry, and when they do, ego defensiveness is the trigger. “While they’re more able to control it, once they react to the psychological trigger, the train has already left the station.”

— Source: University of Maryland, College Park

To accelerate the translation of basic discoveries about HIV into advances in vaccine design and evaluation, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has formed a new Vaccine Discovery Branch within the Vaccine Research Program in the Division of AIDS (DAIDS).

"There is broad scientific consensus that designing a safe and effective vaccine to prevent HIV infection will require enormous advances beyond present-day knowledge," says NIAID Director Anthony S. Fauci, MD. "The NIAID Vaccine Discovery Branch will help remove fundamental obstacles to achieving this goal by focusing intensively on the development and sharing of new knowledge critical to vaccine development."

The new branch is dedicated to monitoring scientific developments in multiple fields related to HIV vaccine discovery, building more bridges between basic researchers and HIV vaccine designers, identifying gaps in knowledge pertinent to a preventive HIV vaccine, and promoting research to fill those gaps.

"Cross-fertilization of HIV/AIDS research with the fields of genetics, structural biology, systems biology, and others could open up new perspectives on how to overcome major obstacles to HIV vaccine design," says DAIDS Director Carl W. Dieffenbach, PhD. "The Vaccine Discovery Branch will be in an ideal position to spot these opportunities, promote the translation of new knowledge about HIV and foster fruitful research collaborations."

— Source: National Institutes of Health

Research is shedding new light on what happens in the brains of children and adults affected by clinical depression and schizophrenia, according to Washington University in St. Louis studies.

Joan L. Luby, MD, an associate professor of child psychiatry and founder and director of Washington University School of Medicine's early emotional development program, is currently investigating the efficacy of a new treatment program for clinically depressed children as young as age 3—a time of significant neurobiological change when there is the potential to alter the course of depression later in life.

Starting with a large-scale study funded by NARSAD and the National Institute of Mental Health, Luby and her team identified anhedonia—the inability to experience pleasure from activities and play—as a key symptom of depression in very young children. Another common symptom is that depressed children often use play to explore themes about death and sometimes even suicide.

"We learned that depressed children don't derive pleasure from the same things as a typical 3- to 5-year-old child," said Luby. "They're less joyful when they encounter the pleasures of daily life."

"The normal developmental curve for any child is very steep at this point in life and being depressed and dysfunctional for a long period of time could actually impair normal development," Luby explained. "It's very important that we find a safe way to help them get better and to prevent future episodes."

Living with schizophrenia: overcoming emotional and motivational challenges

New research findings may also pave the way for new therapies to regulate the memories and emotions of people with schizophrenia, one of the most debilitating psychiatric disorders, suggests Deanna M. Barch, Ph.D., director of the Silvio Conte Center for Neuroscience Research at Washington University.

Barch, an associate professor of psychology in Arts & Sciences and of psychiatry and radiology in the School of Medicine, is now focusing on the emotional and motivational problems that affect how people with schizophrenia function on a daily basis. Her studies complement other NARSAD-funded research, which showed people with schizophrenia can be assisted in remembering things if they are given proper cues and memory aids.

— Source: Washington University in St. Louis

People with psychiatric illnesses, including children, who are admitted to the hospital from the emergency department (ED) can wait 24 hours or longer for an inpatient bed, principally because of a lack of psychiatric beds, according to findings reported by the American College of Emergency Physicians (ACEP).

“’Boarding’ [the practice of holding admitted patients in the emergency department instead of moving them to an inpatient bed] is an appalling fact of life in our nation’s emergency departments, and too often our most vulnerable patients—psychiatric patients in this instance—bear the biggest burden,” says Linda L. Lawrence, MD, ACEP’s president.

Of the 328 ED directors who responded to the survey, almost 80% said their hospital “boards” psychiatric patients in the ED. Thirty percent said their hospitals board psychiatric patients between eight and 24 hours, and more than one quarter said that their hospitals board children with psychiatric illnesses for that long.

The main reasons given for boarding of psychiatric patients in the ED are the lack of in-house inpatient psychiatric beds, and either absence or inability of any facility to accept transfers of these patients. Sixty percent of respondents said their ED does not have a dedicated area in the ED for psychiatric patients.

“People with psychiatric emergencies have nowhere else to turn, and they are suffering,” says Lawrence. “The harmful delays that they experience in the emergency department compound the delays that everyone else experiences as well. About three quarters of survey respondents agreed that psychiatric patients in the emergency department require more nursing and other resources than nonpsychiatric patients. This problem affects every emergency patient.”

— Source: American College of Emergency Physicians

Children and teens with attention-deficit/hyperactivity disorder (ADHD) who were treated with the herb St. John’s wort did not have any greater improvement in ADHD symptoms compared with those who received placebo, according to a study in a recent issue of The Journal of the American Medical Association.

Wendy Weber, ND, PhD, MPH, of Bastyr University in Kenmore, WA, and colleagues conducted a clinical trial of St. John’s wort (Hypericum perforatum) with 54 children and adolescents with ADHD, aged 6 to 17, to determine whether this agent was effective in lessening the severity of ADHD symptoms. Twenty-seven participants were randomly assigned to receive 300 mg of H perforatum standardized to 0.3% hypericin (a compound derived from H perforatum) and 27 participants received a matched placebo, three times daily for eight weeks. Other medications for ADHD were not allowed during the trial.

The researchers found that there were no significant differences between the two groups in the change in ADHD rating scale scores from the start of the trial to week 8 and in change in scores rating inattentiveness and hyperactivity. There was also no difference in the proportion of participants who were rated as much or very much improved regarding ADHD symptoms on another measurement scale. No statistically significant difference was found between the two groups in the proportion of participants who experienced 1 or more rash, nausea/vomiting, headache, or sunburn during the trial.

“To our knowledge, this is the first placebo-controlled trial of H perforatum in children and adolescents. The results of this study suggest that administration of H perforatum has no additional benefit beyond that of placebo for treating symptoms of child and adolescent ADHD,” the authors wrote.

— Source: American Medical Association

Contrary to the popular perception of a so-called “opting out revolution,” new sociological research in a recent issue of the American Sociological Review reveals that professional women’s employment rates have continually pushed higher over time, and that the employment gap between mothers and childless women is shrinking.

To determine the truth behind the opting out phenomenon described in mass media reports, sociologist Christine Percheski, PhD, examined trends among college-educated women born between 1906 and 1975 and found that professional women’s employment levels have made steep gains over time, especially for mothers of young children and women in historically male professions.

Despite anecdotal reports of successful working women returning to the home to assume child care responsibilities, less than 8% of professional women born since 1956 leave the workforce for a year or more during their prime childbearing years, according to the study.

Percheski’s research shows that the number of women with young children who work full time year-round has increased steadily, growing from a rate of 5.6% of women born 1926 to 1935 (referred to as the “Baby Boom Parents” by Percheski), to 38.1% of women from Generation X (born 1966 to 1975). More professional Generation X mothers of young children were working full time year-round than their counterparts in any previous generation.

“Contrary to an opt-out revolution, professional women—including mothers of young children—are working more than ever,” said Percheski. “Despite this increase in women’s employment, we can not assume that combining professional work and family life is easy for most women. Indeed, many working women successfully combine these roles by making great personal sacrifices, including curtailing their sleep, civic involvement or leisure time.”

— Source: American Sociological Association

Persons with treated type 2 diabetes are at increased risk for developing depression, while a more modest association was found between persons with depression and the risk of diabetes, according to a study in a recent issue of The Journal of the American Medical Association.

The prevalence of clinical depression and the presence of elevated depressive symptoms are higher among persons with diabetes compared with the general population. These associations may be related to increased risk of depressive symptoms in individuals with diabetes, increased risk of type 2 diabetes in individuals with depressive symptoms, or both. It is unclear whether type 2 diabetes is a risk factor for increased symptoms of depression. “A diagnosis of diabetes or the burden of dealing with its complications might also lead to symptoms of depression,” the authors wrote.

Researchers used measures of fasting blood glucose and depressive symptoms to test whether elevated depressive symptoms predicted incident type 2 diabetes and whether participants with type 2 diabetes at the beginning of the study were more likely to develop increased symptoms of depression than participants without diabetes. The study included men and women age 45 to 84 years who enrolled in 2000 to 2002 and were followed up until 2004 to 2005.

The researchers found that treated type 2 diabetes was associated with a 52% higher risk of developing elevated depressive symptoms. Individuals with untreated type 2 diabetes were not at increased risk.

In examining the development of type 2 diabetes among individuals with and without elevated depressive symptoms, the incidence of type 2 diabetes over 3.2 years was 22.0 per 1,000-person years for those with elevated depressive symptoms and 16.6 for those without elevated depressive symptoms. Thus, there was a significant association between higher levels of symptoms of depression and incident diabetes; however, the association was no longer statistically significant following adjustment for lifestyle factors.

“Our findings of an association in participants with treated but not untreated type 2 diabetes suggests that the psychological stress associated with diabetes management may lead to elevated depressive symptoms,” the authors wrote.

— Source: American Medical Association

New evidence shows that the brains of adults with autism are “wired” differently from people without the disorder, and this abnormal pattern of connectivity may be responsible for the social impairments that are characteristic of autism. Researchers also found that the most severely socially impaired subjects in the study exhibited the most abnormal pattern of connectivity among a network of brain regions involved in face processing.

“This study shows that these brain regions are failing to work together efficiently,” says Natalia Kleinhans, a research assistant professor of radiology and lead author of the paper published in the journal Brain. “Our work seems to indicate that the brain pathways of people with autism are not completely disconnected, but they are not as strong as in people without autism.”

The research team examined connectivity in the limbic system, or the network of brain regions that are involved with processing social and emotional information. Participants in the study included 19 high-functioning adults with autism who had IQs of at least 85. They ranged in age from 18 to 44 and were compared with an age- and intelligence-matched sample of 21 typically developed adults. Each participant had his or her brain scanned while looking at pictures of faces or houses. Participants were shown four series of 12 pictures of faces and a similar number of series showing houses. Each individual picture was seen for three seconds. Occasionally the same face or house picture was repeated, and participants were told to press a button when this occurred.

There was no significant difference on the two groups’ performance, because the task was so basic. However, the two groups exhibited different patterns of brain activity. The researchers focused on the fusiform face area of the brain, a region that is involved in face identification. Compared with the participants with autism, the typically developing adults showed significantly more connectivity between the fusiform face area with the left amygdala and the posterior cingulate. In addition, autistic participants who had the largest social impairment showed the lowest level of connectivity between the right fusiform face area and the left amygdala and increased connectivity between the right fusiform face area and the right inferior frontal gyrus.

“This study shows that the brains of people with autism are not working as cohesively as those of people without autism when they are looking at faces and processing information about them,” says Kleinhans.

— Source: University of Washington

Employees who work overtime are at increased risk of anxiety and depression, suggests a study in a recent issue of Journal of Occupational and Environmental Medicine. Elisabeth Kleppa and colleagues of the University of Bergen, Norway, analyzed data on work hours from a larger study of Norwegian men and women. Symptoms of anxiety and depression were assessed using a standard screening questionnaire. Anxiety and depression scores were compared for 1,350 workers who worked 41 to 100 hours per week; and approximately 9,000 workers who worked normal hours, 40 hours or less.

Working overtime was associated with higher anxiety and depression scores among both men and women. The rate of questionnaire scores indicating "possible" depression increased from about 9% for men with normal work hours to 12.5% for those who worked overtime. For women, the rate of possible depression increased from 7% to 11%. In both sexes, rates of possible anxiety and depression were higher among workers with lower incomes and less-skilled jobs.

The relationship between overtime and anxiety/depression was strongest among men who worked the most overtime—49 to 100 hours per week. Men working such very long hours also had higher rates of heavy manual labor and shift work and lower levels of work skills and education.

— Source: Wolters Kluwer Health: Lippincott Williams & Wilkins

Women can make inroads into male-dominated management ranks as companies that downsize restructure their scaled-back workforces, according to new research by a University of Illinois sociologist.

John Dencker says the findings are surprising because downsizing whittles the pool of jobs available for both men and women, but also show that firms apparently make an effort to balance gender inequities during staff shakeups.

“It might be that they try to make up for past inequalities or they may be aware of other firms that have had legal difficulties and want to make sure they don’t run into the same problems,” says Dencker, a professor in the University of Illinois’ Institute of Labor and Industrial Relations.

But women’s gains during downsizing are short lived, says Dencker. omen entered management ranks at rates up to 25% higher than men in some grade levels after downsizing, which created supervisory openings as older male managers took company-offered buyouts, he says.

But the gap closed within a year or two as management jobs became scarcer in the aftermath of restructuring, according to the study, which appears in a recent issue of the American Sociological Review.

“Everybody’s rates of promotions slowed after downsizing because there simply weren’t as many positions to promote people into,” Dencker said. “With fewer positions available, promoting women more rapidly than men would be more visible and the company may have been concerned about how male managers would react.”

— Source: American Sociological Association

In a recent issue of Nature, Mayo Clinic researchers report that agents known as gamma-secretase modulators (GSM) work to reduce production of long pieces of the amyloid beta protein (Abeta) that readily stick together and form clumps, and increase production of shorter Abeta that can inhibit the longer forms from sticking together. This is critical because only when Abeta aggregates and accumulates is it harmful and can trigger Alzheimer’s disease, the researchers say.

“So, as these compounds lower the amount of the bad, longer, sticky Abeta peptides in the brain, they increase the quantity of shorter Abeta peptides that may protect against development of Alzheimer’s disease,” says senior author Todd Golde, MD, PhD, chair of the department of neuroscience at Mayo Clinic in Jacksonville.

Not only that, GSM agents actually stick to the Abeta already in the brain, keeping it from aggregating. A hallmark of Alzheimer’s is formation of “plaques” and other assemblies of Abeta protein in the brain, which are believed to damage neurons in complex ways that are not yet fully understood, researchers say. “Surprisingly, this means that these compounds may do three things that may be beneficial with respect to Alzheimer’s disease: they inhibit production of long Abeta, block aggregation of Abeta, and increase production of shorter Abeta peptides that may in turn inhibit Abeta aggregation,” says the study’s lead investigator, Thomas Kukar, PhD.

As exciting as these discoveries are, the investigators also found that GSMs work in a way that has not been seen before in other drugs. “Most drugs target enzymes, which act on proteins, or cell surface receptors, which proteins bind to,” Kukar says. “These agents work on the structure, or substrate, of the protein itself, which had not been believed to be druggable.”

“This broadens the notion of what drugs can do, and therefore, has wide reaching implication for future drug discovery for many different disorders,” Golde says.

— Source: Mayo Clinic

A major report by the National Alliance on Mental Illness (NAMI) reveals most Americans are unfamiliar with Schizophrenia. "Americans are not sure what to think about schizophrenia," says NAMI executive director Mike Fitzpatrick, MSW. "They know schizophrenia is a medical illness affecting the brain, but it is largely misunderstood. There are gaps in knowledge and access to treatment. Misinformation, misperceptions, and misunderstanding represent a public health crisis."

Approximately two million Americans live with schizophrenia. Two thirds do not receive treatment, even though the disease can be managed successfully. The survey found the average age at onset was 21, but a nine-year gap exists between symptoms and treatment.

• 85% of Americans recognize schizophrenia as an illness, 79% believe that with treatment, people with the diagnosis can lead independent lives, but only 24% are familiar with it. Many cannot recognize symptoms or mistakenly believe they include "split" or multiple personalities (64%).

• 79% want friends to tell them if they have schizophrenia, but only 46% say they would themselves. Even with treatment, 49% are uncomfortable with the prospect of dating a person with schizophrenia.

• Among people living with schizophrenia, 49% said doctors take their medical problems less seriously, even though the report notes that the death rate from causes like heart disease or diabetes is 2 to 3 times that of the general population.

— Source: National Alliance on Mental Illness

Adults who were placed in a private, enhanced foster care program as teenagers appear to have significantly fewer mental disorders, ulcers, and cardiometabolic problems (diabetes, hypertension, or heart disease) but more respiratory disorders than those who were placed in public programs, according to a report in a recent issue of Archives of General Psychiatry.

Ronald C. Kessler, PhD, of Harvard Medical School, Boston, and colleagues assessed 479 adults (an average age of 23.7 to 25.6) who were placed in foster care between 1989 and 1998, when they were aged 14 to 18. The private program had caseworkers with higher levels of education, lower caseloads, higher salaries, and access to a wider range of services for youth than those in public programs. The private program also offers financial assistance with higher education to alumni.

The adult alumni of the private program, when compared with those of the public program, were less likely to have experienced foster parent neglect, physical abuse, or sexual abuse. In addition, over the previous year, they
had 44.7 fewer mental disorders and 20.1 fewer physical disorders per 100 individuals; were less likely to report major depression (11.3% vs. 24.3%), anxiety disorders (28.8% vs. 43%) and substance abuse disorders (5.1% vs. 11.1%); and were less likely to have had ulcers (7.4% vs. 13%) and cardiometabolic conditions such as diabetes, hypertension or heart disease (14.9% vs. 22.6%) but more likely to have had respiratory conditions (28.8% vs. 17.9%).

The results suggest that similar analyses should be performed on public and private programs nationwide to pinpoint particular core program components that lead to positive effects. “This information could then be used to develop a blended model program for implementation in demonstration sites and subsequent dissemination to public programs throughout the country if state and federal legislatures could be convinced of the importance of this undertaking,” they conclude.

— Source: American Medical Association

A new study of self-assessed job satisfaction, gender and ethnicity in the U.S. military finds that African American and Latino men and women have higher job satisfaction than white men, says Jennifer Hickes Lundquist, PhD, of the University of Massachusetts Amherst.

In civilian society minorities consistently express lower job satisfaction. 
The survey, which covers active-duty personnel, is published in a recent issue of the American Sociological Review.

Overall, African American women have the highest levels of job satisfaction in the military, followed by African American men, Latinas, Latinos, and white women, Lundquist says. She says a key to the findings is that the military has more social and economic equality than the civilian job market, and that is why racial and ethnic minorities and women report higher job satisfaction.

“Military service can be quite demanding, requiring lengthy family separations and allowing the employee far less freedom and autonomy than civilian jobs,” Lundquist says. “It’s not surprising then that white males tend to have lower job satisfaction in the military than in civilian jobs. But what’s striking is that minorities express more satisfaction in military jobs than they do in civilian jobs. This makes a strong case for the continued position of disadvantage for minorities in many civilian jobs.”

Lundquist based her findings on data drawn from the Pentagon’s Survey of Active Duty Personnel (SADP). The data was collected by mail in 1999. The sample size was 30,489 people. She notes that a more recent SADP has just been made available, but she used the earlier one because it was taken prior to the wars in Iraq and Afghanistan and represents the experiences of active duty personnel in the military during peacetime.

— Source: University of Massachusetts Amherst

Research by Cornell University faculty members suggests that aggression and violence that occurs between residents themselves may be a prevalent and serious problem.

Karl Pillemer, PhD, director of the Cornell Institute for Translational Research on Aging at the College of Human Ecology has coauthored two articles in Aggression and Violent Behavior and in the Journal of the American Geriatrics Society on "resident-to-resident mistreatment." Both studies report that verbal and physical aggression between residents is common and problematic, and that more research is necessary to identify risk factors and preventative measures.

"Anyone who spends much time in a nursing home will observe arguments, threats and shouting matches among residents, as well as behaviors like pushing, shoving, and hitting," Pillemer says. The studies found 35 different types of physical and verbal abuse between residents at a large urban nursing home. Screaming was the most common form of aggression, followed by such physical violence as pushing and punching or fighting.

In related work, the authors found that 2.4% of residents reported personally experiencing physical aggression from another resident and 7.3% reported experiencing verbal aggression over just a two-week period. Most respondents rated the events as moderately or extremely disruptive to daily activities.

In another study, 12 nurse-observers identified 30 episodes of resident-to-resident aggression on just a single eight-hour shift, 17 of which were physical. Research also indicates that victims are more likely to be male, have behavioral problems like wandering and be cognitively impaired.

— Source: Cornell University

Adolescents attending college six months after completing high school are significantly less likely to engage in risky sexual behavior than those who do not go to college, according to the first study to directly compare the two groups.

The University of Washington (UW) study, published in a recent issue of the Journal of Adolescent Health, also compared risky sexual behavior of teens living at home and those who established their own residences and found no significant differences between the groups, says Jennifer Bailey, a research scientist with the UW’s Social Development Research Group and lead author of the paper.

“No one has compared typical teens before, because we stop being so concerned about their sexual behavior after they leave high school,” says Bailey. “But it is important that we know what they are doing because late adolescence and the early 20s are the peak times for acquiring a sexually transmitted infection.

“HIV is a big risk. Chlamydia can affect fertility. The prevalence of gonorrhea and chlamydia are increasing. And some forms of human papillomavirus are related to cervical and other cancers. So it is important that we know what puts young people at risk for these sexually transmitted infections and what social structures may help protect them.”

The study found that college students were more likely to always use a condom and less likely to engage in casual sex or high-risk sex than teens who did not attend a two- or four-year college.

Overall, the study showed that:
23% of the college students reported inconsistent condom use compared with 35% of the noncollege subjects; 15% of the college students engaged in casual sex vs. 29% of the others; 5% of the college students had high-risk sex vs. 16% of the others; 53% of the college students engaged in sex in the previous month vs. 70% of the others.

— Source: University of Washington

Alcoholism is a devastating disease in part because of the ‘symptom’ of heavy drinking but more so because of the extensive harm it causes physical organs, such as the heart and liver, as well as significant damage to one’s quality of life.

In a landmark study published in a recent issue of the Archives of Internal Medicine, addiction experts led by a University of Virginia (UVa) Health System team have found that topiramate, an effective therapeutic medication, not only decreases heavy drinking, but it also lowers all liver enzymes, plasma cholesterol, body mass index (BMI), and systolic and diastolic blood pressure—all of which tend to increase with heavy drinking and pose such serious health risks as heart disease and cirrhosis.

Researchers also found that topiramate, compared with placebo, decreases certain adverse psychosocial effects caused by alcohol dependence.

“What topiramate offers alcoholic-dependent individuals is a future of improved health and quality of life,” says lead author Professor Bankole Johnson, DSc, MD, PhD, MPhil, FRCPsych, chairman of the UVa department of psychiatry and neurobehavioral sciences. “This medication provides real hope for millions of alcoholics and their families that they can beat their addiction.”


The FDA has approved topiramate for seizures and migraine headaches, but it is not currently approved for treating alcohol dependence. Ortho-McNeil Neurologics, Inc., manufactures topiramate and provided study funding.

— Source: University of Virginia Health System

People who are dependent on alcohol are also likely to smoke cigarettes. Many experts believe that it’s important to counsel alcohol-dependent individuals to give up smoking as well as drinking—not just to improve their health, but also to increase their chances of staying sober, reports a recent issue of the Harvard Mental Health Letter.

It is a common worry that trying to quit smoking and drinking at the same time will undermine treatment for alcohol dependence. However, most studies have reported that efforts to quit smoking either have no impact on maintaining sobriety or actually increase success of alcohol treatment.

There are no smoking cessation guidelines specifically for alcohol-dependent adults. For now, the best option is to follow the federal guidelines for treating tobacco dependence, which recommend a combination of counseling and medication.

A major and still unresolved question is whether it’s better to give up smoking and drinking together, or whether it’s better to tackle one addiction at a time. Researchers have found that when smoking cessation support was delayed by six months, study participants were more likely to remain sober compared with those who received concurrent treatment for both addictions. But a follow-up analysis found that this may have been true only for white people in the study.

Michael C. Miller, MD, editor in chief of the Harvard Mental Health Letter, notes that no single approach is best for every person struggling with both alcohol and nicotine addiction. Whether an individual quits smoking during alcohol treatment or later, it's a net health gain.

— Source: Harvard Health Publications

Women born after 1944 began drinking alcohol at younger ages than their elders, and that appears to have put them at greater risk for alcoholism, according to researchers at Washington University School of Medicine in St. Louis.

The new research, published in a recent issue of Alcoholism: Clinical & Experimental Research, focuses on the ages at which men and women began to drink. 
The researchers compared data from two surveys of alcohol use: the National Longitudinal Alcohol Epidemiologic Survey, gathered in 1991 and 1992, and from the National Epidemiologic Survey on Alcohol and Related Conditions, which was compiled 10 years later.

On average, women born before 1944 began drinking at age 20. Those born after that started drinking alcohol at age 17, and they had a 50% to 80% greater risk for alcohol dependence, the researchers found.

"We had previously noted that women were catching up with men in their rates of drinking and alcohol dependence, and this earlier age at which they began drinking helps explain that finding," says Richard A. Grucza, PhD, an assistant professor of psychiatry and the first author on the study. "An early age at the onset of drinking is a strong predictor of subsequent alcohol dependence. About one in three individuals who start drinking at age 17 or younger become alcohol dependent. For those who wait until age 21 or older, that number is one in ten."

— Source: Washington University in St. Louis

The use of daytime bright lighting to improve the circadian rhythm of older persons was associated with modest improvement in symptoms of dementia, and the addition of the use of melatonin resulted in improved sleep, according to a study in a recent issue of The Journal of the American Medical Association.

“In elderly patients with dementia, cognitive decline is frequently accompanied by disturbances of mood, behavior, sleep, and activities of daily living, which increase caregiver burden and the risk of institutionalization,” the author wrote. These symptoms have been associated with disturbances of the circadian rhythm, which is related influenced by environmental light and the hormone melatonin.
The researchers found that bright light lessened cognitive deterioration by a relative 5%, reduced depressive symptoms by a relative 19% and diminished the gradual increase in functional limitations by a relative 53%.

Melatonin supplementation reduced the time to fall asleep by a relative 19% and increased total sleep duration by 6%, but adversely affected caregiver ratings of withdrawn behavior and mood expressions. The addition of bright light improved the adverse effect on mood. In combination with bright light, melatonin reduced aggressive behavior by a relative 9%.

“In conclusion, the simple measure of increasing the illumination level in group care facilities [improved] symptoms of disturbed cognition, mood, behavior, functional abilities, and sleep. Melatonin improved sleep, but its long-term use by older individuals can only be recommended in combination with light to suppress adverse effects on mood. The long-term application of whole-day bright light did not have adverse effects, on the contrary, and could be considered for use in care facilities for elderly individuals with dementia,” the authors wrote.

— Source: American Medical Association

Contrary to popular notions about what is normal or healthy, new research has found that it is okay not to express one's thoughts and feelings after experiencing a collective trauma, such as a school shooting or terrorist attack.

In fact, people who choose not to express their feelings after such an event may be better off than those who do talk about their feelings, according to Mark Seery, PhD, an assistant professor of psychology at the University at Buffalo and lead author of a study to appear in a recent issue of Journal of Consulting and Clinical Psychology.

The study investigated the mental and physical effects of collective traumas on people who are exposed to a tragedy but who do not experience a direct loss of a friend or family member. It focused on people's responses to the terrorist attacks of September 11, 2001, but the results may generalize to include responses to other collective traumas.

The findings have important implications for expectations of how people should respond in the face of a collective trauma affecting a whole community or even an entire nation, says Seery,

Seery says the results should not be interpreted to mean that expressing one's thoughts and feelings is harmful or that if someone wants to express their emotions they should not do so. "It's important to remember that not everyone copes with events in the same way, and in the immediate aftermath of a collective trauma, it is perfectly healthy to not want to express one's thoughts and feelings," he says.

—Source: University at Buffalo

About 2.1 million teens aged 12 to 17 experienced a major depressive episode in the past year, according to a new nationwide report by the Substance Abuse and Mental Health Services Administration (SAMHSA). For almost one half of the teens, depression drastically reduced their abilities to deal with aspects of their daily lives, the report said.

Overall, 8.5% of adolescents, the equivalent of one in every 12, experienced a major depressive episode, but there were striking differences by gender, with 12.7% of females and 4.6% of males reporting the conditions.

"Fortunately, depression responds very well to early intervention and treatment," says SAMHSA Administrator Terry Cline, PhD. "Parents concerned about their child's mental health should seek help with the same urgency as with any other medical condition. Appropriate mental health care can help their child recover and thrive."

The report is based on combined data from the 2004 to 2006 National Surveys on Drug Use and Health involving responses from 67,706 people aged 12 to 17 throughout the United States. The survey is based on a scientific random sample of households throughout the United States, and professional field representatives personally visit each household to conduct the survey.

— Source: Substance Abuse and Mental Health Services Administration

A study published in Experimental Psychology by a University of South Carolina psychology researcher provides a better understanding of why language—talking and listening, including on a cell phone—interferes with visual tasks, such as driving.

In two different experiments, associate professor of psychology Amit Almor, PhD, found that planning to speak and speaking put far more demands on the brain’s resources than listening.

“We measured their attention level and found that subjects were four times more distracted while preparing to speak or speaking than when they were listening,” says Almor of the 47 people who participated in the experiment. “People can tune in or out as needed when listening.”

“I anticipate the effect to be even stronger and more dynamic because, in conversation, people have the urge to contribute,” says Almor. “In conversation, we compete with the other person. I suspect that the greater the urge to speak, the greater the distraction from the visual task.”

Almor placed the participants in a circular, surround-sound environment in which the speakers were hidden and the voice shifted from the front, rear, or either side. He found that participants could complete the visual task in front of them more easily when the projected voice also was in front.

“Either people are used to face-to-face communication or, when they engage in a language task, they create a mental representation in their mind and place the voice somewhere in space,” Almor says. “In this case, that space is in front of them, which suggests that it may be easier to have all things that require attention occupy the same space.”

— Source: University of South Carolina

Exposure-based therapy, in which recent trauma survivors are instructed to relive the troubling event, may be effective in preventing the progression from acute stress disorder to posttraumatic stress disorder (PTSD), according to a report in a recent issue of Archives of General Psychiatry.

Richard A. Bryant, PhD, of the University of New South Wales, Sydney, Australia, and colleagues conducted a randomized controlled trial involving 90 patients who developed acute stress disorder following a nonsexual assault or motor vehicle crash between March 2002 and June 2006. Thirty participants each were randomly assigned to five weekly 90-minute sessions of exposure therapy or cognitive restructuring, while the remaining 30 were put on a waitlist for treatment. All the patients were assessed at the beginning of the study, after six weeks and six months following treatment.

Sixty-three participants completed the study. After completing treatment, fewer patients in the exposure therapy group (10, or 33%) met criteria for PTSD than patients in the cognitive restructuring group (19, or 63%) or the wait-list group (23, or 77%). At the six-month follow-up, fewer patients in the exposure therapy group (11, or 37%) met criteria for PTSD than patients in the cognitive restructuring group (19, or 63%), and 14 patients (47%) in the exposure group vs. four patients (13%) in the cognitive restructuring group achieved full remission.

Exposure therapy may be more effective than cognitive restructuring because it eases the anxiety associated with the traumatic memory and corrects the belief that the memory must be avoided, in addition to encouraging self-control by managing the exposure exercise, the authors noted. “The current findings suggest that direct activation of trauma memories is particularly useful for prevention of PTSD symptoms in patients with acute stress disorder,” they concluded. “Exposure should be used in early intervention for people who are at high risk for developing PTSD.”

— Source: American Medical Association

In the year following a stroke, patients who received the medication escitalopram or participated in a problem-solving therapy group had a lower risk of depression compared with patients who received placebo, according to a study in a recent issue of The Journal of the American Medical Association. Depression occurs in more than one half of stroke patients, according to background information in the article

Robert. G. Robinson, MD, of the University of Iowa, Iowa City, and colleagues assessed the efficacy of the antidepressant drug escitalopram or problem-solving therapy compared with placebo pills for the prevention of depression among 176 stroke patients.

The researchers found that participants who received placebo were 4.5 times more likely to develop depression than patients who received escitalopram (22.4% vs. 8.5%), and 2.2 times more likely to develop depression than patients who received problem-solving therapy (11.9%). “Based only on the frequency of depression onset during the one year of treatment, 7.2 acute stroke patients would need to be treated with escitalopram to prevent one case of depression and 9.1 acute stroke patients would need to be treated with problem-solving therapy to prevent one case of depression,” the authors wrote.

“The clinical implications of our findings are that patients who are given escitalopram or problem-solving therapy following acute stroke may be spared depression and perhaps its adverse consequences,” the authors concluded.

— Source: American Medical Association

Community interventions would significantly increase the vaccination rates among hard to reach and at-risk populations such as sex-workers or shut-ins during a flu pandemic or national shortage, new research shows

During such times, immunizing hard-to-reach populations could be challenging but important, says Sandro Galea, a study author and an associate professor at the University of Michigan School of Public Health. Unvaccinated populations may serve as undetected reservoirs of infection and spread the disease to other populations. The paper is highlighted in a recent issue of the American Journal of Public Health.

During the 2004-2005 flu vaccine shortage, the vaccination rate for the general population was double the rate for hard to reach populations, at 42% and 21% respectively. Among the 21%, the people most likely to be vaccinated had ties to a primary care doctor, Galea says.

Low vaccination rates and barriers to healthcare place populations, such as substance abusers, sex workers, undocumented immigrants, the homeless and elderly shut-ins, at high risk for the flu. Additionally, the likelihood that the flu could be fatal is higher among those populations.

Researchers surveyed 6,826 participants from February to October 2005, and 37% were members of hard-to-reach populations. Researchers intervened on three different levels: by contacting individuals, by working in different neighborhoods, and through community organizations.

Methods of intervention included disseminating project information; giving presentations at meetings; and offering street-based and door-to-door vaccinations during two flu seasons.

— Source: The University of Michigan School of Public Health

Cyberbullying, the sending or posting of harmful or cruel text or images, using the Internet or other digital communication devices, affects almost half of today's teens. Cyberbullying messages and images may be posted on personal Web sites or blogs, or transmitted via e-mail, discussion groups, chat, instant messenger, text, and smart phones.

Cyberbullies, mostly aged 9 to 14, use the anonymity of the Web to dispense pain without witnessing the consequences. Many cyberbullies are unrepentant, and their numbers are staggering, especially in affluent areas where technology is prominent.

Cyberbullying may be more harmful than traditional bullying because: 
there is no escape, cyberbullying runs 24/7; the hurtful material can be globally distributed and is often irretrievable; the bullies can be anonymous; children avoid telling their parents, fearing greater retribution, as well being forbidden to use the Internet.

To prevent cyberbullying, teach children to:
report negative messages to parents or teachers;
not pass along negative messages to others; block electronic messages from cyberbullies; and respect the rights and feelings of others in cyberspace.

— Source: Binghamton University, State University of New York

Asthma is associated with higher suicidal thoughts with attempted suicide, but does not seem to be linked with suicidal thoughts without attempts, according to a report published this month in Annals of Allergy, Asthma & Immunology.

Cigarette smoking and concurrent mental health conditions may independently account for significant proportions (but not all) of the association between asthma and suicidal thoughts with attempts noted Diana E. Clarke, MSc, PhD, of the Johns Hopkins University School of Public Health in Baltimore, and colleagues.

The study examined data on 5,692 individuals 18 years and older from the U.S. National Comorbidity Survey Replication. Approximately 12% of the sample had a history of asthma. The estimates of lifetime prevalence for suicidal ideation without and with attempts and asthma were 8.7%, 4.2%, and 12.0%, respectively, and occurred more frequently in women that men. Despite adjustments for cigarette smoking, concurrent mental health conditions and common sociodemographic factors, a statistically significant association remained between asthma and suicide thoughts and attempts.

Investigators suggest that asthma may be associated with the more severe form of suicidal behavior, but not the milder forms of suicidal thoughts without attempts.

“Researchers have speculated that the relationship between asthma and suicidal behaviors is possibly because of ensuing mood and anxiety that results from disability and discomfort associated with asthma, which can be a lifelong disease,” they noted. “Individuals might have frequent thoughts of death with increasing severity solely because they have a potentially life-threatening illness.”

— Source: American College of Allergy, Asthma and Immunology

Symptoms of depression and posttraumatic stress disorder (PTSD) among caregivers of deceased lung transplant patients are four-to-five times more prevalent than in the average population, according to researchers who analyzed the stress levels of caregivers, as well as their perceptions of the transplant recipients’ quality of dying and death. Their findings were presented at the American Thoracic Society’s 2008 International.

“We found that caregivers reported that their loved one’s symptoms were poorly controlled and that the quality of the dying and death process was worse than that of other populations. In addition, family members who perceived that their loved one had either a lower quality of dying and death or poorly controlled pain symptoms, were more likely to have symptoms consistent with PTSD,” said Cynthia Gries, MD, MSc, of the division of pulmonary and critical care medicine at the University of Washington School of Medicine in Seattle.

“Most people don’t realize that prior to wait-listing a patient as a lung transplant candidate, a caregiver plan must exist to support the patient through the entire process,” said Gries. That process can be lengthy and grueling for the caregiver as well as the patient, resulting in much higher rates of depression and PTSD symptoms.

“The caregivers we studied had rates of depressive symptoms of 21% and of PTSD symptoms of 32%, compared to the average in the general population of 6% to 7%,” she continued. “This suggests that there is a significant burden of psychological symptoms in family members which has previously been unrecognized.”

— Source: American Thoracic Society

Teenage girls of all ethnic and socioeconomic backgrounds still experience sexism and sexual harassment—but cultural factors may control whether they perceive sexism as an environmental problem or as evidence of their own shortcomings.

A study of 600 girls between the ages of 12 and 18, from California and Georgia, including young women who identified as Latina (49%), White (23%), African American (9%), Asian American (7.5%), and multiethnic or other (7.5%) was conducted by researchers Christia Brown, PhD, an assistant professor in the department of psychology at the University of Kentucky College of Arts and Sciences, and Campbell Leaper, PhD, a professor in the department of psychology at the University of California Santa Cruz. Participants were asked about experiences with sexual harassment and any discouraging comments they received in traditionally male-dominated areas such as math, science, computers, and sports.

The researchers found that girls have different levels of understanding of sexism and sexual harassment, which may affect reporting data. Older girls and those from a lower socioeconomic background reported more sexism than did their peers. Latin and Asian American girls reported less sexual harassment than did girls of other ethnic groups. Girls who had been exposed to feminist ideas, either through the media or an adult such as a mother or teacher, were more likely to identify and report sexist behavior than were girls who had no information about feminism. Girls who reported feeling pressure from their parents to conform to gender stereotypes were also more likely to perceive sexism. Girls who felt atypical for their gender and/or were unhappy with stereotypical gender roles were most likely to report sexism and harassment.

Brown and Leaper note that it is important for girls to be able to identify sexism and sexual harassment as environmental factors, lest they attribute negative experiences to their own faults and suffer erosion of self-esteem. Frequent sexual harassment may lead girls to expect and accept demeaning behaviors in heterosexual romantic relationships, and sexist remarks.

— Source: University of Kentucky

Infants and toddlers whose mothers are severely depressed are almost three times more likely to suffer accidental injuries than other children in the same age group, according to a study recently published in the Journal of Pediatric Psychology. The study suggests that proper treatment for depression would improve the mothers’ health and the health of young children.

In his study, David Schwebel, PhD, director of the University of Alabama at Birmingham Youth Safety Lab, examined the difference between mothers with severe, chronic depression and those who were moderately depressed as their children grew from birth to first grade.

A likely cause for the link between severe maternal depression and young children’s injury risk is that chronically depressed mothers may not appropriately safeguard the physical environments that children engage in, Schwebel says. Another cause may be that symptoms of depression include inattention, poor concentration, and irritability, which “might lead to poor or inconsistent supervision and enforcement of safety-related rules,” he adds.

Schwebel used a sample of 1,364 mothers included in the National Institute of Child Health and Human Development Study of Early Child Care. The mothers were periodically asked to list all their children’s injuries that had required professional medical treatment. Also, on four occasions during the study, the mothers were asked to rate how often they experienced symptoms of depression.

Only 2.5% of the mothers in the sample reported severe, clinical depression and 15.5% reported being moderately depressed. The researchers found that young children, from birth to 3 years, whose mothers suffered severe, chronic depression, were three times more likely to experience accidental injuries than infants and toddlers whose mothers were only moderately depressed.

— Source: University of Alabama at Birmingham

Music has a universal ability to tap into our deepest emotions. Unfortunately, for children with Autism Spectrum Disorders (ASD), understanding emotions is a very difficult task. In an innovative study led by Istvan Molnar-Szakacs, a researcher at the University of California, Los Angeles, Tennenbaum Center for the Biology of Creativity, music will be used as a tool to explore the ability of children with ASD to identify emotions in musical excerpts and facial expressions.

In this study, Molnar-Szakacs will use “emotional music” to engage the brain regions involved in emotion processing. “Our hypothesis is that if we are able to engage the brain region involved in emotion processing using emotional music, this will open the doorway for teaching children with ASD to better recognize emotions in social stimuli, such as facial expressions.”

The overarching goal of the study is to gain insights about the causes of autism. “The study should help us to better understand how the brain processes emotion in children with autism; that in turn will help us develop more optimal interventions. Importantly, this study will also help us promote the use of music as a powerful tool for studying brain functions from cognition to creativity.”

“The hope, of course, is that this work will not only be of scientific value and interest, but most of all, that it will translate into real-life improvements in the quality of the children's lives,” says Molnar-Szakacs.

— Source: University of California, Los Angeles, Health Sciences

A new study of homeless youth suggests that treating substance abuse and mental health problems may not be enough to help get teens off the streets. Instead, researchers found that creating more opportunities for work, education, and medical care were the most important factors in reducing homelessness.

"It looks like the predictors of homelessness might be different than the predictors of exiting homelessness. So that means prevention targets should be different from intervention targets," says Natasha Slesnick, PhD, lead author of the study and an associate professor of human development and family science at Ohio State University.

The research was recently published in the Journal of Youth and Adolescence. The study was conducted between 2001 and 2005 and is one of the first to look at the predictors of homelessness in youth, as most of the research on the homeless focuses on adults. Research focused on 180 homeless youth between 14 and 22 years old who accessed New Mexico drop-in centers.

The study found that youth who engaged in high-risk behaviors were more likely to remain homeless and be more resistant to change. These teens and young adults reported participating in the most dangerous behaviors including unprotected sex, multiple sex partners, and intravenous drug use.

For these youth, more intensive one-on-one treatment was successful in reducing their homeless days after six months. These sessions focused on identifying and treating the individual's drug use and mental health problems, such as depression or suicidal behaviors.

"We have to figure out how to engage those kids who are linked to the street subculture and reengage them back into society through education, employment, and other more socially valued activities," Slesnick says.

— Source: Ohio State University

The first national study of Asians living in the United States shows that for some individuals, strong ties to their ethnicity can guard against the negative effects of racism. For others, strong ties to ethnicity can actually make the negative effects of discrimination worse. And the mental health effects of such discrimination may shift over a lifetime as Asian Americans continue to examine their ethnic ties, say researchers.

Using the first nationally representative sample of Asian adults in the United States, lead author Tiffany Yip, PhD, of Fordham University, and colleagues examined whether ethnic identity protected a person against the negative effects of discrimination and whether age and birthplace also played a role. The findings were published in a recent issue of Developmental Psychology.

The researchers controlled for socioeconomic status, gender, age at immigration, and where the participants lived. Overall, the researchers found that discrimination was associated with psychological distress; respondents said they felt depressed more often if they had been discriminated against.

The analysis uncovered an unexpected result when the researchers looked at age and whether the participant was born in the United States. For those born outside the United States, embracing one’s ethnic identity did not guard against the negative effects of discrimination on psychological wellness. However, for Asians born in the United States, ethnic attachment did affect whether discrimination made people feel more distressed, and its effect varied by age. “Among adults in their 40s, feeling strongly about their own background can counteract the negative effects of discrimination.” says Yip.

— Source: American Psychological Association

How should you eat as you get older? Which foods are likely to keep you most healthy and which ones should you limit? Is it possible to eat well and stay within a healthy weight? These and other questions are addressed in "Eating Well as You Get Older," the latest topic to be added to NIHSeniorHealth, the health and wellness Web site developed by the National Institute on Aging (NIA) and the National Library of Medicine.

"Eating well is vital at any age, but as you get older, your daily food choices can make an important difference in your health. Good nutrition is one component of an overall strategy to stay healthy," says Richard J. Hodes, MD, director of the NIA, which developed the content for the topic on NIHSeniorHealth. Eating a well-planned, balanced mix of healthy foods every day may help prevent heart disease, type 2 diabetes, bone loss, some kinds of cancer, and anemia.

However, eating healthy may not always be easy for older adults. Changing appetites, slower metabolism, eating alone, buying ready-to-eat meals, and living on a fixed income can affect the quality of one's food choices. Yet our need for healthy foods does not diminish with age. As we age, our bodies still require essential nutrients to help us maintain function, and most of those nutrients are found in foods.

"It is important for older adults to select foods that provide them with the nutrients and energy they need for healthy, active living," says Hodes. "NIHSeniorHealth is a valuable source of information on this important issue."

— Source: National Institutes of Health

The influence of genetics increases as young women transition from taking their first drink to becoming alcoholics. A team of researchers at Washington University School of Medicine in St. Louis found that although environment is most influential in determining when girls begin to drink, genes play a larger role if they advance to problem drinking and alcohol dependence.

The researchers studied 3,546 female twins aged 18 to 29 to separate the influences of genes and environment in the development of alcohol dependence. Their findings appear in a recent issue of Alcoholism: Clinical & Experimental Research.

The study found that females who had their first drink at an earlier age were more likely to develop serious alcohol problems. The researchers found that all transitions were attributable in part to genetic factors, increasing from 30% for the timing of first drink to 47% for the speed at which women progressed from problem drinking to alcohol dependence. But genetics did not explain everything.

"Even when genetic factors are most influential, they account for less than half of the influence on drinking behavior," says lead author Carolyn E. Sartor, PhD, a postdoctoral research fellow at the School of Medicine.

— Source: Washington University in St. Louis

Would you rather support research for a disease that affects 30,000 Americans a year or one that affects just .01 percent of the U.S. population?

The numbers represent about the same number of people, but how you answered explains how you understand numerical information, according to a psychology professor at Kansas State University. "People are comfortable with simple frequencies and percentages," says Gary Brase, an associate professor of psychology at Kansas State.

"Everybody can understand five, six, 10, 20, or even 100, and percentages like 30% or 40%. We have a really good sense of how much that is. But it's really large numbers that we don't have nailed down exactly. If you say there were 20,000 people at a concert versus 30,000 people, we don't have a good sense of how much bigger that is exactly."

Brase says this research suggests that people prefer working with frequencies. "When you want to persuade, you're interested in whole numbers and using a large reference class like the U.S. or world population," Brase says. "Take the numbers of people who have a rare disease. The percentage could be a tiny amount. But it also could be an impressive number if you consider a large population. You get something that sounds like an important issue."

The opposite, Brase says, is doing something like saying that a person has a .0001 percent chance of getting that disease. "People really are not understanding the numbers," Brase says. "All they get out of that information is that it's a really, really tiny amount."

For people to really understand an issue, Brase says perhaps the best approach is to present numerical information in as many ways as possible.

— Source: Kansas State University

Workers who reported increased work flexibility from one year to the next also had fewer absences for illness and improved job commitment, according to new research from Wake Forest University School of Medicine. In addition, these workers were less likely to say that health problems affected their job performance.

The study’s results, based on a health survey completed by 3,193 employees of a large multinational pharmaceutical company, are reported in the current issue of the Psychologist-Manager Journal.

“This study provides evidence that flexibility is associated with health or well-being over time,” says Joseph G. Grzywacz, PhD, senior author and an associate professor of family medicine. “For managers, the results suggest that implementing flexible work arrangements can contribute to the bottom-line.”

The researchers analyzed data obtained from health risk appraisals to determine how increases or decreases in perceived flexibility from one year to the next were associated with various factors. Workplace flexibility refers to workers’ ability to modify where, when, and how long job-related work is performed. There are two main types of flexibility: location, such as telecommuting, and schedule, such as flextime and job sharing.

Results indicate that an increase in perceived flexibility was associated with a decrease in sickness absences and work-related impairment, and improved job commitment. Decreases in perceived flexibility over the year were associated with a significant increase in impairment and reduced job commitment, but had little impact on absence.

“These results strengthen the evidence suggesting that programs and policies that promote flexibility in the workplace may have beneficial health effects for workers,” says Grzywacz.

— Source: Wake Forest University Baptist Medical Center

A new report released by the Centers for Disease Control and Prevention (CDC) provides a detailed summary of a full year of data from 16 states concerning all types of violent deaths collected by the CDC’s National Violent Death Reporting System (NVDRS). The report provides information about the circumstances surrounding these violent deaths.

The findings in the April 11, 2008 Morbidity and Mortality Weekly Report Surveillance Summaries, provide data on violent deaths from 16 U.S. states for 2005. Although NVDRS operates in 17 states, this report includes 2005 data from 16 states. Data from California are not included because NVDRS has been implemented in a limited number of California counties.

The report shows that the majority of violent deaths were suicides (56.1%), followed by homicides and deaths involving legal interventions (29.6%), violent deaths of undetermined intent (13.3%), and unintentional firearm deaths (0.7%).

Other findings from the report include: rates of violent death were highest for persons aged 20 to 24; rates of violent death by suicide were highest for persons aged 75 to 84 and 45 to 54 (17.0 and 16.9, respectively); mental health problems were the most commonly noted circumstance for suicide; although 42% of suicide victims were diagnosed with mental health problems, only 33% were known to be receiving treatment at the time of death; suicides by current and former military personnel comprised 20% of all suicides; the home was the most common location of violent death for all manners of death; homicides were precipitated primarily by an argument over something other than money or property, or in conjunction with another crime; relationship problems or intimate partner violence were precipitating factors for many forms of violence.

— Source: The National Violence Prevention Network

Some kids with autism may have a genetic defect that affects the muscles, according to research that will be presented at the American Academy of Neurology annual meeting in Chicago.

The study looked at 37 children with autism spectrum disorders who were evaluated for mitochondrial disease, which causes muscle weakness and prevents a child from being able to participate in physical activities and sports. Mitochondrial disease occurs when genetic mutations affect the mitochondria, or the part of the cell that releases energy.

A total of 24 of the children, or 65%, had defects in the process by which cells produce and synthesize energy in the muscles, or oxidative phosphorylation defects in the skeletal muscles.

“Most children with autism spectrum disorders do not have recognizable abnormalities when you look at genetic tests, imaging, and metabolic tests,” said study author John Shoffner, MD, owner of Medical Neurogenetics, LLC in Atlanta, GA, and member of the American Academy of Neurology. “But a subset of these children does have significant defects in this area. Identifying this defect is important for understanding how genes that produce autism spectrum disorders impact the function of the mitochondria.”

— Source: American Academy of Neurology

Parents of children with autism were roughly twice as likely to have been hospitalized for a mental disorder, such as schizophrenia, than parents of other children, according to an analysis of Swedish birth and hospital records by a University of North Carolina (UNC) at Chapel Hill researcher and colleagues in the United States and Europe. The study appeared in a recent issue of the journal Pediatrics.

“We are trying to determine whether autism is more common among families with other psychiatric disorders. Establishing an association between autism and other psychiatric disorders might enable future investigators to better focus on genetic and environmental factors that might be shared among these disorders,” says study author Julie Daniels, PhD, an assistant professor in the UNC School of Public Health’s epidemiology and maternal and child health departments.

“Earlier studies have shown a higher rate of psychiatric disorders in families of autistic children than in the general population,” she says. “We wanted to see if the parents of autistic children were more likely to be diagnosed with mental disorders. Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism. We also saw higher rates of depression and personality disorders among mothers, but not fathers.”

The study examined 1,237 children born between 1977 and 2003 who were diagnosed with autism before age 10, and compared them with 30,925 control subjects matched for gender, year of birth and hospital. The large sample size enabled researchers to distinguish between psychiatric histories of mothers versus fathers in relation to autism. The association was present regardless of the timing of the parent’s diagnosis relative to the child’s diagnosis.

— Source: University of North Carolina at Chapel Hill

Older adults with low blood levels of vitamin D and high blood levels of a hormone secreted by the parathyroid glands may have a higher risk of depression, according to a report in a recent issue of Archives of General Psychiatry.

Witte J. G. Hoogendijk, MD, PhD, and colleagues at Vrije Universiteit Amsterdam Medical Center in the Netherlands measured blood levels of vitamin D and parathyroid hormone and assessed symptoms of depression among 1,282 community residents aged 65 to 95. Of those individuals, 26 had a diagnosis of major depressive disorder, 169 had minor depression and 1,087 were not depressed. The average blood vitamin D level was 21 nanograms per milliliter and the average parathyroid hormone level was 3.6 picograms per milliliter.

Blood vitamin D levels were 14% lower in individuals with major and minor depression (averaging 19 nanograms per milliliter) compared with non-depressed participants (averaging 22 nanograms per milliliter). In addition, parathyroid hormone thyroid levels were an average of 5% higher in those with minor depression (averaging 3.72 picograms per milliliter) and 33% higher in those with major depressive disorder (averaging 4.69 picograms per milliliter) than in those who were not depressed (averaging 3.53 picograms per milliliter).

The findings may be important to patients because both low blood vitamin D levels and high parathyroid hormone levels can be treated with higher dietary intake of vitamin D or calcium and increased sunlight exposure. “Moreover, the clinical relevance of the present study is underscored by our finding that 38.8% of men and 56.9% of women in our community-based cohort had an insufficient vitamin D status,” they conclude. Additional studies are needed to determine whether changes in levels of vitamin D and parathyroid hormone precede depression or follow it.

— Source: American Medical Association

Major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH). The study was published in a recent issue of the American Journal of Psychiatry.

In the study, Ronald C. Kessler, PhD, of Harvard University, and colleagues analyzed data from the 2002 National Comorbidity Survey Replication (NCS-R), a nationally representative study of Americans aged 18 to 64. Using data from 4,982 respondents, the researchers calculated the amount of earnings lost in the year prior to the survey among people with serious mental illness (SMI).

Eighty-six percent of respondents reported earning income in the previous year. But those with SMI reported earning significantly less—around $22,545—than respondents without SMI, who averaged $38,852. Although men with SMI took a greater hit in earnings than women with SMI, men still earned more overall than women with and without SMI.

By extrapolating these results to the general population, the researchers calculated that SMI costs society $193.2 billion annually in lost earnings. The researchers attributed about 75% of this total to the reduced income that people with SMI likely earn, while 25% is attributed to the increased likelihood that people with SMI would have no earnings.

"The results of this study confirm the belief that mental disorders contribute to enormous losses of human productivity," says Kessler. "Yet this estimate is probably conservative because the NCS-R did not assess people in hospitals or prisons, and included very few participants with autism, schizophrenia or other chronic illnesses that are known to greatly affect a person's ability to work. The actual costs are probably higher that what we have estimated."

— Source: The National Institutes of Health

Today, one out of very 12 people aged 65 and older will experience a decline in their ability to remember, think clearly, reason, and make daily decisions. The decline in memory and mental abilities may be subtle, but it limits quality of life and oftentimes leads to depression.

James Siberski, MS, an assistant professor, geriatric-care manager certificate program director, and coordinator of the Gerontology Education Center for Professional Development at Misericordia University, and colleague Margie Eckroth-Bucher, RN, an associate professor of nursing at Bloomsburg University; are leading the research with Misericordia students in a six-month study to better understand how to treat people with memory problems and who have a decreased ability to think clearly. The study will also determine what effects the activities might have on any symptoms of depression.

Researchers divided volunteers into two sections, a treatment group and control group. The treatment group is involved in the specific research activities, while the control group volunteers participate in the examinations, but maintain their normal schedule of activities.

The treatment group’s results from the mental status and cognitive ability examinations are entered into a computer that records the scores for each participant and exercise. The information will also be used to determine if the program’s activities had an effect on any individuals.

“This study is an important first step in understanding how routine daily activities might have a positive effect on the aging mind," says Siberski. “With our aging population and baby boomers nearing retirement, it is vitally important for health care providers to find proven tools that slow down the deterioration of an older person’s cognitive abilities."

— Source: Misericordia University

For children of divorce, what happens after their parents split up may be just as important to their long-term well being as the divorce itself. A new study found that children who lived in unstable family situations after their parents divorced fared much worse as adults on various measures compared with children who had stable post-divorce family situations.

“For many children with divorced parents, particularly young ones, the divorce does not mark the end of family structure changes—it marks the beginning,” says Yongmin Sun, coauthor of the study and an associate professor of sociology at Ohio State University’s Mansfield campus. “A stable family situation after divorce does not erase the negative effects of a divorce, but children in this situation fare much better than do those who experience chronic instability”

The study appears in a recent issue of the Journal of Marriage and Family. Data for this study came from the National Education Longitudinal Study, which surveyed thousands of students across the country beginning in 8th grade in 1988, when they were about 14 years old. They were surveyed again in 1990, 1992 and then again in 2000 when they were about 26 years old.

In the two divorced family groups, children may have lived in single-parent families or ones with a stepparent. The key for this research was whether that arrangement—whichever it was—changed between the ages of 14 and 18. The researchers compared how children in these groups fared on measures of education, income, and poverty in 2000 when they were 26.

Results showed that young adults who grew up in stable post-divorce families had similar chances of attending college and living in poverty compared with those from always married families. But they fared less well on measures of the highest degree obtained, occupational prestige, and income. However, the young adults who lived in unstable family situations after their parents divorced did worse on all measures. In fact, they fared more than twice as poorly on most measures compared with their peers who had stable family situations.

— Source: Ohio State University

For years, the only concept of drug abuse counseling was for patients to meet face-to-face with a therapist. Scientists are now convinced we can add a computer to that picture. The first randomized controlled trial that combined a computer-learning program with traditional counseling showed a longer period of abstinence from drugs than for those patients who had counseling alone. The study, conducted by researchers from the Yale University School of Medicine, was recently published in the American Journal of Psychiatry.

All participants received standard treatment at the clinic, which consisted of weekly individual and group drug counseling sessions. They were all English-speaking adults who met the diagnostic criteria for substance dependence, including alcohol, cocaine, opioids, or marijuana. Those who were randomized to the computer program were led through six modules in a range of formats, including movies of actors demonstrating coping skills in realistic situations and opportunities for patients to review and practice the new skills. The modules covered several core concepts, including understanding and changing patterns of substance abuse, coping with craving, refusing offers of drugs and alcohol, problem-solving skills, identifying and changing thoughts about drugs and alcohol, and improving decision-making skills.

During the study period, participants’ self-reports of illegal drug use were verified through urine toxicology screens that were obtained at every assessment visit. Those who used the computer-based program submitted significantly fewer drug-positive urine specimens and tended to have longer periods of abstinence during treatment compared to patients who only met with a counselor.

With this computerized approach, treatment can be tailored to the needs of the individual, selecting specific topics, modifying speed of presentation and repetition of modules as necessary. The research team plans to use the program for more refined studies of the individual CBT components as well as to determine whether or not it could be effective when delivered alone, rather than as an adjunct to standard treatment.

— Source: The National Institute on Drug Abuse

Major companies are creating a wide variety of programs to help employees deal with the global HIV/AIDS epidemic, according to a report released today by The Conference Board, the global business research and membership organization.

The report finds that 82% of the 134 major firms surveyed have HIV/AIDS programs aimed at helping employees already suffering from the disease or at risk of infection. The study is based on a survey of 134 leading health-benefits and human resources executives, as well as in-depth interviews with directors of company HIV/AIDS programs and attorneys specializing in disability and HIV/AIDS law. More than two thirds of the surveyed companies have been affected by HIV/AIDS, with one fifth of these firms anticipating a growing impact of this epidemic over the next three years.

Worldwide, the number of people living with HIV rose from 29 million in 2001 to 33.2 million in 2007. Forty percent of new cases are among individuals 15 to 24, the age at which employees are just entering the workforce and will require ever greater medical care throughout their working lives. Companies feel the impact of HIV/AIDS in many ways. Fewer skilled workers and managers, greater absenteeism and turnover, and higher healthcare and insurance costs can reduce productivity and increase expenses.

“While there is no cure, medical advances have made it possible for people with the disease to live longer, achieve better quality of life, and be more productive, both at home and in the workplace,” says Henry Silvert, research associate at The Conference Board and author of the report. “In response to this new reality, and faced with an expected growth of new infections, more companies have been stepping up efforts to provide programs that effectively meet the needs of their employees living with the disease, or the risk of infection.”

— Source: The Conference Board

Because children often witness spousal abuse, pediatricians have two reasons to routinely screen their patients’ mothers or other caregivers for signs of such physical and emotional domestic violence, a study from the Johns Hopkins Children’s Center suggests. Brief screening is not only a step to protecting a spouse or a partner, it also can reduce the very real collateral health risks experienced by children who see or hear such abuse, the investigators say.

In a report on the study published online in the Journal of Pediatrics, the researchers say nearly one fourth of 133 women screened during their visit to the primary pediatric clinic at Hopkins Children’s reported being abused by their partners. Among the 30 women who reported abuse by their spouses or partners, more than one half (17) said at least one child in the home saw or heard the abuse, researchers found.

The findings also highlight the importance of combining questions that capture both physical and emotional abuse, researchers say, adding that pediatricians should be especially alert to depression and signs of emotional abuse in parents, because they are frequently harbingers of physical violence.

The researchers say, ideally, all parents should be screened but there are signs that require special attention, including frequently missed appointments, signs of depression in the child and/or parent or caregiver and recurring symptoms in children for which no physical cause is found, such as unexplained headaches or stomach aches.

— Source: Johns Hopkins Medicine

Parents are more likely to punish their teenager’s risky sexual activity when there are younger kids in the family, driven by a desire to set a strict example for these siblings, says new game theory research from the University of Maryland, Duke University, and The Johns Hopkins University.

Their study, published in a recent issue of the Economic Journal concluded that the exercise of parental control is effective in modifying the risky adolescent behavior. This is especially true in the case of the older children, who expect stronger penalties because their parents are making an example of them.

To test their theory, they analyzed existing survey data from the U.S. Bureau of Labor Statistics. The National Longitudinal Study of Youth tracked more than 11,000 Americans for over 16 years (1979 to 1994). Specifically they focused on the rate of pregnancy and the teen dropping out of high school. To estimate parental sanction, they measured whether the teen was allowed to remain at home and level of financial support after reaching age 18.

*Having one additional younger sibling lowers the likelihood of an adolescent dropping out of high school by 3 percentage points. This amounts to one eighth of the average dropout rate of the sample (24%).

*The probability of parental financial support to a rebellious child is significantly lower if the family still has another child under age 18. For example, the probability of parents providing free room and board is 4.5 percentage points lower to an adult child who dropped out of school and 9.5 percentage points lower to an adult daughter who had a baby as a teen. These reductions are sizable given the sample average of living with parents after age 18 is about 20 percent.

“Parents often worry about how forceful of a stand to take in response to their older children’s behavior,” says Hopkins sociologist Lingxin Hao, PhD. “Our study finds that some parents are successfully using this strategy.”

— Source: University of Maryland, College Park

Americans grow happier as they grow older, according to one of the most thorough examinations of happiness in America. The study also found that baby boomers are not as content as other generations, African Americans are less happy than whites, men are less happy than women, happiness can rise and fall between eras, and that with age the differences narrow.

“Understanding happiness is important to understanding quality of life. The happiness measure is a guide to how well society is meeting people’s needs,” says Yang Yang, an assistant professor of sociology at the University of Chicago and author of the article published in a recent issue of the American Sociological Review.

The research relies on data that social scientists consider the gold standard of happiness research—responses to questions about contentment with overall life gathered in the General Social Survey of the National Opinion Research Center.

Yang charted happiness across age and racial groups and found that among 18-year-olds, white women are the happiest, with a 33% probability of being very happy, followed by white men (28%), black women (18%) and black men (15%). Differences vanish over time, however, as happiness increases. Black men and black women have just more than a 50% chance of being very happy by their late 80s, while white men and white women are close behind.

The length of the survey helped determine how different people in the same generational group fared. The baby boom generation were the least happy among those surveyed. “This is probably due to the fact that the generation as a group was so large, and their expectations were so great, that not everyone in the group could get what he or she wanted as they aged due to competition for opportunities. This could lead to disappointment that could undermine happiness,” Yang says.

— Source: University of Chicago

Although fewer of them undergo surgery, lung cancer patients in their 80s fare equally well following surgery as their younger counterparts, researchers report. The findings offer doctors potentially valuable guidance in treatment options for elderly patients, according to researchers.

A research team from the Hoag Cancer Center in Newport Beach, California, observed 1,293 patients with lung cancer, 482 of whom underwent surgical treatment. The oldest patients were more likely to be male. Older patients were also more likely to have localized disease.

Overall, the rate of surgery did not differ by age group. However, when primary lung cancer was considered separately, only 31.7% of patients older than the age of 80 underwent surgery for their primary lung cancer compared with 38.5% of patients younger than the age of 80. For patients with non-small cell lung cancer, the rate of surgery was 64% for those older than the age of 80 and 83% for those younger than the age of 80. For patients with regionally advanced disease, the rate of surgery for patients aged 80 or older was 35% compared with 49% for those younger than the age of 80.

The five-year survival rate following surgery was 62% for those patients older than the age of 80 compared with 53% for those aged 70 to 79 years. Among patients aged 60 to 69 years and 50 to 59 years, the survival rate was 63%. For the youngest patients, those younger than the age of 50, the survival rate was 79%.

“Although a smaller proportion of patients over the age of 80 underwent this type of surgery, their survival rate was comparable to the younger age groups,” says lead author Robert O. Dillman, MD, medical director of the Hoag Cancer Center in Newport Beach, CA.

— Source: American Association for Cancer Research

For families who provide care to Alzheimer's patients, stress and isolation can be a burden that's hard to carry. A University of Iowa (UI) researcher is conducting an Internet-based study to see if writing about their thoughts and feelings about care-giving can be a strategy to help those family caregivers reduce their stress.

Family members who provide care for patients with Alzheimer's or other conditions of memory loss will be asked to write about their experiences related to their care-giving roles for 20 minutes on three occasions during a week. Participants in the study may write in their homes or wherever they have access to a computer that is most convenient to them.

Participants in the study do not need to be "good writers" or worry about spelling or grammar because it is the effect of the writing that is being studied. As a means to measure the effect of the writing on reducing stress, study participants also will be asked to complete five questionnaires.

Howard Butcher, PhD, an associate professor of nursing and the principal investigator of the UI Informatics Initiative-funded study, will evaluate whether expressing stress and other emotions in writing is a helpful way to deal with the often difficult emotions of caring for a loved one with Alzheimer's disease or a condition that involves problems with memory.

— Source: University of Iowa Health Sciences

An annual summer vacation or special summer time event for families can help in establishing a tradition that fosters togetherness and creates shared experiences for families, according to Barbara Fiese, PhD, a professor and the chair of the psychology department at Syracuse University and a clinical and developmental psychologist.

While family life has changed significantly in the last half century, family traditions—such as a summer vacation or outing—are just as important now as they were back when father knew best, according to Fiese. "My research has found that family rituals such as this may provide feelings of belonging and closeness related to mental and physical health," she says. "Just remember that while high-tech gadgets such as portable gaming devices, MP3 players, and DVD players are fun diversions, they should not monopolize the attention of individual family members during the whole trip or activity. Instead, consider finding a way to use the technology to create a shared experience, such as creating a family playlist for the MP3 player."

In her most recent book, Fiese discusses various research literatures and draws on her own studies to show how family routines and rituals influence physical and mental health, translate cultural values, and may even be used therapeutically. From bedtime stories to a special summer trip, she relates such occasions to significant issues including parenting competence, child adjustment and relational well-being.

"Rituals and family traditions are particularly important and convey that 'this is who we are' as a group and provide continuity in meaning across generations," she adds.

— Source: Syracuse University

Schoolchildren who required surgery as infants for congenital heart disease (CHD) run a significant risk of having problems with inattention and hyperactivity, and often require remedial services in school. “These children are at risk for academic and behavior problems, and our findings reinforce how important it is to provide them with ongoing follow-up and neurodevelopmental screening,” says study leader Amanda J. Shillingford, MD, a pediatric cardiologist at The Children’s Hospital of Philadelphia.

The researchers, who reported their findings in a recent issue of Pediatrics, studied a group of 109 children, aged five to 10, who had undergone cardiac surgery for complex congenital heart disease at Children’s Hospital when they were newborns. Of that group, 53 children—nearly one half—were receiving remedial services at school, and 15% were in special education classrooms.

Based on questionnaire responses from their parents and teachers, although the majority of the children with CHD scored in the normal range, the rates of high-risk scores for inattention and hyperactivity were three to four times greater than those found in the general population.

Previous studies at The Children’s Hospital of Philadelphia and other centers found that school-aged children with complex CHD tended to have normal cognitive abilities but were at risk for problems in visual and motor skills, as well as impairments in speech, language, and executive functioning (executive functioning refers to capacities for attention, planning, decision-making, and problem-solving).

“As survival rates have improved,” says Shillingford, “the important longer-term issue is quality of life for patients and their families as they reach school age and beyond.”

— Source: Children's Hospital of Philadelphia

Anticholinergic drugs, such as medicines for stomach cramps, ulcers, motion sickness, and urinary incontinence, may cause older people to experience greater decline in their thinking skills than people not taking the drugs, according to research presented at the American Academy of Neurology 60th Anniversary Annual Meeting in Chicago.

The study looked at the effects of taking a medication with anticholinergic properties on the annual change in thinking abilities of 870 Catholic nuns and clergy members who were an average of 75 years old. All of the participants were part of the Rush Religious Orders Study, an ongoing, longitudinal, clinical study of older people without dementia.

All of the participants underwent annual cognitive tests and reported their medication use for an average follow up period of eight years. During the study, 679 people took at least one medication with anticholinergic properties. The study found those people who took anticholinergic drugs saw their rate of cognitive function decline 1.5 times as fast as those people who did not take the drugs.

“Our findings point to anticholinergic drugs having an adverse impact on cognitive performance in otherwise normal, older people,” said study author Jack Tsao, MD, DPhil, an associate professor of neurology at Uniformed Services University in Bethesda, MD, and a member of the American Academy of Neurology. “Doctors may need to take this into account before prescribing these commonly used drugs.”

Tsao sayis more research is needed to determine the mechanism behind the rapid memory loss apparently associated with anticholinergic drugs and to identify which drugs, in particular, may be more likely to impair cognition.

— Source: American Academy of Neurology

New Orleans residents who lost their homes in Hurricane Katrina were five times more likely to experience serious psychological distress a year after the disaster than those who did not. That is one of the findings from a study presented at the annual meeting of the Population Association of America in New Orleans. The study, conducted by University of Michigan researcher Narayan Sastry, PhD, and Tulane University's Mark VanLandingham, PhD, examines the mental health status of pre-Katrina residents of the City of New Orleans in the fall of 2006—one year after the hurricane.

A total of 144 individuals participated in the pilot study, including many who moved away from the area after the disaster and had not returned a year later. The researchers examined how the extent of housing damage was related to psychological distress a year after the disaster. They found that those who lost their homes were five times more likely than those who did not to have serious psychological distress. In all, about 66% of the respondents reported that their homes were badly damaged or unlivable.

"Our findings suggest that severe damage to one's home is a particularly important factor behind socioeconomic disparities in psychological distress, and possibly behind the levels of psychological distress," Sastry said. "These effects may be partly economic, because, for most families who own their home, home equity is the largest element of household wealth.

"Apart from the financial losses, severely damaged or destroyed housing may prevent people who want to return to New Orleans from doing so because they lack a place to live,” he added. “The magnitude and permanence of a housing loss suggests that for many people, the psychological consequences of this experience could be profound and lasting."

— Source: University of Michigan Institute for Social Research

Right now, about half of all people who take medicine for an anxiety disorder don't get much help from it. And doctors have no definitive way to predict who will, and who won't, benefit from each anti-anxiety prescription they write. But a University of Michigan (U-M) Medical School researcher and his team are working to bring more certainty to how doctors and patients choose anxiety treatments, by probing the connection between brain activity, genetics, and medication.

In a paper in the Journal of Neuroscience, K. Luan Phan, MD, an assistant professor of psychiatry at U-M and the Veteran’s Affairs Ann Arbor Healthcare System, and his former University of Chicago colleagues reported intriguing findings from a brain imaging study in occasional, nondependent, marijuana users.

In a placebo-controlled design, they made the findings after giving the volunteers delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana, and exposing them to photographs of emotional faces, which served as signals of social communication. The study results, which showed that THC reduces the response to threat in the amygdala, allowed the researchers to zero in on an area of the brain that might serve as a good target for new antianxiety drugs.

Now, with a new clinical trial that is currently seeking participants, Phan is searching for more clues as to how anxiety treatment could be tailored to the individual patient, to give the best chance that a treatment will work for him or her.

"These two studies are trying to get to the same goal: to find better treatments for anxiety disorders that affect millions of Americans and seriously interfere with their functioning," says Phan.

— Source: Journal of Neuroscience

Use of medications that are linked to increased risk of falls in the elderly can be reduced through careful review of patient files in the electronic health record (EHR), new Geisinger research shows. Psychoactive drugs such as antianxiety medicines impact a person’s neurochemistry and may predispose elderly patients to falls, which are a major cause of injury and death in the elderly.

Geisinger pharmacists and geriatricians recently reviewed the medication records of several hundred elderly patients using Geisinger’s advanced, $90 million EHR.

After the review, the patient’s primary care doctor received an e-mail that contained medication recommendations tailored to individual patients. Elderly patients used fewer psychoactive medications after their cases were reviewed, which has the potential to reduce falls, according to a Geisinger study in a recent Journal of General Internal Medicine.

“Our research shows the importance of documenting a person’s medication lists,” Geisinger Director of internal medicine and lead study lead author Valerie Weber, MD, says. “The electronic health record is a great tool for monitoring a person’s medication and avoiding usage problems.”

— Source: Geisinger Health System

Employees ultimately determine the success of a business transition, but too often companies fail to take into account the angst of the surviving workforce.

There are a number of consequences harmful to the organization that can result from a poorly implemented transition. Employees can become distracted from their work and spend valuable work time venting their feelings about the changes and become less committed and loyal to the organization, even, in some cases, sabotaging the company by not sharing information, being less collaborative, and treating customers badly. They can also become risk aversive not wanting to be involved in something for which they may be held accountable.

Employees also experience anger, usually directed at leadership; fear of losing their job in the next wave of downsizing; sadness for losing friends and colleagues; and heightened stress caused by increased workloads that can lead to excessive drinking and problems at home.

Marks and Kenneth De Muese of Lominger International, a Minneapolis-based consulting firm, say that many of the negatives of transitions can be reversed if management acknowledges the very real human emotions and reactions to planned changes.

First of all, employees need to be alerted to the changes being planned. Studies have shown that people are less resistant to change if they are informed at the beginning of the process what to expect. Management must communicate honestly and directly, which will lessen the distress employees are experiencing, and provide a clear vision of where the changes will lead. “Employees need to know the strategy and how the goals are going to be achieved and what their role will be in the process,” says Marks.

It’s a good idea for management to hear what their employees have to say about the transition, so managers should hold “vent” meetings where employees can talk about their concerns, fears, and thoughts about the transition. “There’s going to be considerable conversation about something that is big in their work lives, so give them an opportunity to do so,” he advises.

One way to relieve employee anxiety, says De Meuse, is for organizations to provide stress management programs. “Not enough organizations offer these programs, yet stress is a natural emotion that people experience when having to adapt to a new situation and it is the enlightened company that recognizes this,” he says.

— Source: Society for Industrial and Organizational Psychology

New research in monkeys suggests the feasibility of treating cocaine addiction with a “replacement” drug that mimics the effects of cocaine but has less potential for abuse—similar to the way nicotine and heroin addictions are treated.

Paul Czoty, PhD, the lead author and an assistant professor of physiology and pharmacology at Wake Forest University School of Medicine says the quest to develop a treatment for cocaine addiction has been ongoing for decades with little success. “While we have medications for heroin and tobacco abuse, there is no FDA-approved treatment for cocaine,” he adds.

For the study, a monkey was taught to press levers multiple times to obtain food or a cocaine injection. With each injection, the number of required lever presses increased so that the animal had to work harder for the cocaine.

“This procedure measures the strength of the reinforcing effects of drugs,” says Czoty. “Each injection requires more and more work and eventually it gets to the point where it’s not worth it to the monkey because more than 1,000 presses are required.”

Access to cocaine was then removed and the monkey was treated intravenously with an amphetamine 24 hours per day. When reexposed to cocaine one week later, a dramatic decrease in responding for cocaine was observed. They tested three different doses of amphetamine and found that a moderate dose was most effective. Although the treatment also decreased lever-pressing for food—which could be predictive of side effects in humans—this effect disappeared within one week while the effect on responding for cocaine injections persisted for up to one month.

“This was a very positive finding, exactly what we had hoped to see,” says Czoty. “Cocaine use was significantly reduced, by about 60%.”

— Source: Wake Forest University Baptist Medical Center

Children who are neglected before their second birthday display higher levels of aggressive behavior between the ages of 4 and 8, according to a University of North Carolina at Chapel Hill study published in the journal Pediatrics.

Early child neglect may be as important as child abuse for predicting aggressive behavior, researchers say. Neglect accounts for nearly two thirds of all child maltreatment cases reported in the United States each year, according to the Administration for Children and Families.

“The lack of attention devoted to the problem of neglect—the so-called ‘neglect of neglect’—is a long-standing concern in the child welfare field,” says study coauthor Jon Hussey, research assistant professor of maternal and child health in the UNC School of Public Health and a fellow at the Carolina Population Center. “Despite being more common than abuse, we know relatively little about the impact of neglect on children.”

More than 1,300 children from four cities and one Southern state are participating in the longitudinal study, which is coordinated by the UNC Injury Prevention Research Center (IPRC). All were known to have been maltreated or were at risk of maltreatment. They were monitored from birth through the age of 8. Aggression was based on perceptions of the child’s primary caregiver, who was interviewed when the child was aged 4, 6, and 8.

“This isn’t the first time we’ve seen evidence suggesting that in some circumstances, neglect can be as harmful to children as abuse,” says Hussey. “Understanding the consequences of early childhood neglect will help us plan programs and other interventions to benefit these children throughout their lives.”

— Source: University of North Carolina at Chapel Hill

Children and teens who spend more than a couple of hours a day on average in front of a TV, video, or computer screen, are more likely to be overweight than their peers who limit their screen time.

We Can! (Ways to Enhance Children's Activity and Nutrition), a science-based national education program from the National Institutes of Health (NIH) to help children ages 8-13 stay at a healthy weight, is working with the Center for Screen Time Awareness (CSTA) and other national and community organizations to raise public awareness about the negative impact of excessive screen time. CSTA is a leading nonprofit organization focused on the impact of electronic media on society, health, education, family, and community.

Turnoff Week, April 21-27, is an excellent time to start limiting recreational screen time and boosting physical activity and healthier living.

"We know that the more time a child spends in front of the TV or computer, the more likely he or she is to be overweight," says Acting U.S. Surgeon General Steven K. Galson, MD, MPH. "Kids are spending more time sitting in front of screens every day than they do anything else except perhaps sleeping. For Turnoff Week, we are asking parents to turn off the screens and get active with their kids."

Although the Turnoff Week awareness campaign formally lasts only seven days each year, Galson adds, "We encourage parents to regularly limit recreational screen time to fewer than two hours a day."

— Source: The National Institutes of Health

With the founding of a new Depression Center at the University of Colorado Denver School of Medicine, a national effort to link centers focused on depression and bipolar disorder has shifted into full gear.

The new Colorado center, on the Anschutz Medical Campus in Aurora, CO, joins the University of Michigan (U-M) Depression Center—which since 2001 has been the nation's only comprehensive center devoted to patient care, research, education, and public policy in depression and related disorders.

The two centers—and new centers now being planned at more than a dozen universities across the country—will soon form a National Network of Depression Centers (NNDC). The NNDC will make it easier for psychiatrists, psychologists, social workers, and other mental health professionals to share information and best practices, and to team up for major projects.

"Ever since we at Michigan launched our center, we had a vision of a national network that would help transform the way depression and bipolar illnesses are treated, studied and viewed in the United States and around the world," says John Greden, MD, the executive director of the U-M Depression Center. "This is why we initiated contact with a number of universities that we knew had excellent depression and bipolar programs, and the desire to take steps to found a dedicated center. Now that the network is forming, we're eager to share with them what we have learned in our first seven years—and to learn from them as well."

— The University of Michigan Depression Center

A history of neglect or abuse in childhood appears to be associated with depression and inflammation in adulthood, a combination that may increase cardiovascular risk, according to a report in a recent issue of Archives of General Psychiatry.

Andrea Danese, MD, MSc, of King’s College London, and colleagues studied 1,000 New Zealand residents born between 1972 and 1973. Assessments were carried out every two years between ages 3 and 15, then again at ages 18, 21, 26 and 32. Childhood maltreatment—including rejection by a child’s mother, harsh discipline, physical or sexual abuse or disruptive changes in caregivers—was identified through parental reports during childhood years, objective observations of behavior and participants’ own reports once they reached adulthood. At age 32, participants underwent physical examinations as well as clinical interviews to diagnose depression.

Individuals with current depression and a history of childhood maltreatment were more likely to have a high level of inflammation at age 32, as measured by the presence of the chemical high-sensitivity C-reactive protein in the blood. Those with depression but no history of childhood maltreatment did not have this increased risk. “The elevated inflammation levels in individuals who were both depressed and maltreated were not explained by correlated risk factors such as depression recurrence, low socioeconomic status in childhood or adulthood, poor health, or smoking,” the authors write.

“Information about experiences of childhood maltreatment may help to identify depressed individuals with elevated inflammation levels and, thus, greater risk of cardiovascular disease,” the authors conclude. “In turn, the early recognition of the health risk associated with maltreatment history might help to address pressing needs for the care of depressed individuals such as the reduction of the effect of depression on comorbid [co-occurring] medical illness.”

— Source: American Medical Association

Two University of Oregon doctoral students dove into issues of transgender identities—in the workplace and professional counseling—and surfaced with a call for psychologists and vocational counselors to not only treat but to act as advocates for their clients—and to help end discrimination in the workplace.

"One of the main points of our paper is that not only do we need to be, as vocational psychologists or career counselors, working with transgender people at an individual level to help them get hired, but we also need to be doing a lot of social advocacy work—working with employers and workplaces—improving antidiscrimination policies and doing legal advocacy," says lead author Maya Elin O'Neil.

The study, coauthored by their doctoral adviser Ellen Hawley McWhirter, a professor of counseling psychology, provides transgender-issue terminology related to gender identity, suggestions for addressing problems of both clients and on-the-job difficulties and lists available resources—filling a void in both the academic literature and support possibilities. The study appeared in a recent issue of the Journal of Career Development.

"We've had lots of requests for reprints of the article from people who have heard about it, and they've repeatedly said that there is nothing out there about the workplace angle," O'Neil says. Request for copies have come from psychologists, vocational counselors, university administrators, especially those dealing with diversity issues and planning, and even workforce managers, says coauthor Alison Cerezo.

"When a gender-variant client presents for career counseling, it is important for the career counselor to assess whether she or he is competent to provide the services requested," the authors wrote. "In the case of personal aversion to gender-variant individuals, a referral should be made, followed by continued education, supervision, and personal exploration of the topic in preparation for future clients."

— Source: University of Oregon

Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) have found posttraumatic stress disorder (PTSD) is associated with more hospitalizations, longer hospitalizations, and greater mental healthcare utilization in urban primary care patients. These findings appear in the current issue of Medical Care.

The researchers interviewed a sample of primary care patients to examine overall prevalence of traumatic exposure and select behavioral health outcomes in addition to PTSD, including major depression, substance dependence, and chronic pain. The interview included demographic questions, the Composite International Diagnostic Interview (version 2.1 PTSD module), the Chronic Pain Definitional Questionnaire, the Patient Health Questionnaire (to measure depression), and the Composite International Diagnostic Interview-Short Form (for drug and alcohol dependence).

Among the participants, the researchers found that 80% had one or more trauma exposures. Compared with participants with no trauma exposure, subjects exposed to trauma were significantly more likely to be males, unmarried, have substance dependence and depression. They also had more mental health visits than those with no trauma exposure.

Among the participants, 22% had current PTSD. Compared with participants without PTSD, those with PTSD were significantly more likely to be female, to have an annual income of less than or equal to $20,000, have substance dependence and depression. PTSD participants also had more hospitalizations and mental health visits.

According to the researchers, among urban primary care patients PTSD is associated with greater healthcare use: both mental health visits and hospitalizations. "Unexpectedly, trauma exposure by itself was not associated with increased healthcare utilization apart from mental health visits, a finding which was attenuated after adjusting for PTSD," says lead author Anand Kartha, MD, an assistant professor of medicine at BUSM. "This may be due to the fact that the nontraumatized to whom we are comparing the traumatized patients, have complex social milieu leading to high utilization," adds Kartha.

— Source: Boston University

Whether or not Hillary Clinton wins the Democratic nomination for president, the question of how much being a woman helped or hurt her campaign will linger for a long time.

"People don't like to have their expectations violated, and that is the challenge Hillary faces," says Judi McLean Parks, PhD, a professor of organizational behavior at the Olin Business School at Washington University in St. Louis. "The character traits we associate with people in leadership positions are stereotypically masculine, such as being assertive or competitive."

However, the characteristics we tend to association with women—such as being facilitative or caring—are not at all what we think of as leadership traits. McLean Parks has studied the differences in perceptions of male and female leaders, and says that Clinton faces an uphill battle trying to overcome people's expectations.

"If you (as a woman) behave in a masculine manner, then in some way or another, I'm going to think less of you, find you less likeable, and be less likely to hire you—all because you have violated the expectations of what a woman is supposed to be like," McLean Parks says.

The theory that Clinton is more likely to attract women than men doesn't necessarily hold up, she says. Both men and women tend to apply the same standards to female leaders. The good news for Clinton is that over the past 15 to 20 years research has found that women's attitudes toward female leaders are changing much faster than men's attitudes.

Still, the evidence of the expectations people have for women is prevalent. McLean Parks notes that pundits and commentators on news programs are much more likely to criticize Clinton for being angry or strident than they would the male candidates.

"In order to be seen as capable she's going to have to violate some expectations that go along with her gender. I think it's so telling when the pundits say that they like Hillary when she's vulnerable. But then think of the idea of commander in chief. Do you want your commander in chief to be vulnerable? No."

— Source: Washington University in St. Louis

Although individuals with depression may be more likely to develop Alzheimer’s disease, symptoms of depression do not appear to increase in the years before a diagnosis is made, according to a report in a recent issue of Archives of General Psychiatry. This suggests that depression is not a consequence of developing Alzheimer’s disease but may instead be a risk factor for dementia.

Robert S. Wilson, PhD, of Rush University Medical Center, Chicago, and colleagues studied 917 older Catholic nuns, priests, and monks who did not have dementia beginning in 1994. Participants had a yearly clinical evaluation that included a neurological examination, cognitive (thinking, learning, and memory) testing and classification of Alzheimer’s disease or mild cognitive impairment. They also completed a 10-item scale assessing their symptoms of depression.

At the beginning of the study, 53.6% of participants reported no symptoms of depression, 23.9% reported one symptom, 9.7% reported two, 6.1% reported three and 6.8% reported four or more. During follow-up, 190 individuals developed Alzheimer’s disease. Those with more symptoms of depression at the beginning of the study were more likely to develop Alzheimer’s disease.

However, “those who developed Alzheimer’s disease showed no increase in depressive symptoms before the diagnosis was made, and this finding was not modified by age, sex, education, memory complaints, vascular burden, or personality,” the authors write. “Among those without cognitive impairment at baseline, depressive symptoms did not increase in those who subsequently developed mild cognitive impairment.”

Symptoms of depression may be associated with changes in the brain that reduce its resistance to dementia, the authors write. “Understanding the mechanisms linking depressive symptoms with dementia could suggest novel approaches to delaying dementia onset because animal research suggests diverse means by which the adverse effects of chronic stress may be modified.”

— Source: American Medical Association

Expanded use of palliative care services is associated with enhanced communications between families and caregivers, improved symptoms management, and better quality of life for children dying from cancer, according to study by researchers at Dana-Farber Cancer Institute and Children's Hospital Boston. Published in a recent issue of the Journal of Clinical Oncology, the study's findings also suggest that the parents were more likely to feel they were prepared for their children's end-of-life medical problems.

"Historically, there has been resistance to palliative care and hospice care in the United States, in part because some people feel that using these services is associated with hopelessness and giving up," says lead author Joanne Wolfe, MD, MPH, director of Pediatric Palliative Care at Dana-Farber and Children's Hospital. "This is changing, however, as more people—caregivers, patients, and families alike—become more familiar with the goal of these services, which is to help each patient live the best possible life."

The retrospective study involved surveying parents and reviewing the medical records of 119 children cared for at Dana-Farber or Children's Hospital and who died from cancer between 1997 and 2004. These data were compared with the findings from a similar parent survey and medical records review of 102 Dana-Farber and Children's cancer patients who died between 1990 and 1997. The study's goal was to determine whether greater focus on palliative care on the local and national levels would affect patterns of care, care planning, and patients’ quality of life.

Wolfe and her colleagues identified notable changes in the patterns of care. Medical record reviews indicated a 40.7% increase in documented discussions about home or hospice care in the follow-up study (76% of medical records included a note that palliative care options were discussed with the family, up from 54%). There also was a 16.4% increase in do-not-resuscitate orders (78%, up from 67%). The proportion of children who died at home remained similar between the two studies, but, in the second study, there was a 42.1% decrease in the proportion of the children who died in the intensive care unit (22%, down from 38%).

Although the follow-up study indicated that while children were proportionately as likely to experience fatigue, pain, shortness of breath, or anxiety, they suffered less from the symptoms, with the exception of fatigue.

— Source: Dana-Farber Cancer Institute

New Saint Louis University research found that although white women are more likely to drink or binge drink prior to pregnancy, African American women are less likely to reduce drinking during pregnancy, which may be linked to a higher rate of fetal alcohol syndrome (FAS) among the population.

“Lack of education and awareness about the dangers of drinking during pregnancy is a big problem not just among the at-risk populations, but also among healthcare providers,” says Leigh Tenkku, PhD, director for research in the department of community and family medicine at Saint Louis University and a study author. “There are still misconceptions that drinking in moderation during pregnancy is OK.”

The researchers compared the drinking patterns of 280,000 pregnant and non-pregnant women aged 18 to 44 using data collected in a nationwide telephone survey from 2001 to 2005 by the Behavioral Risk Factor Surveillance System. Demographic information including pregnancy status, age, race, education, income, marital status, cigarette smoking, and alcohol consumption helped determine who is more likely to drink during pregnancy.

The researchers found that African American women were less likely to reduce alcohol consumption during pregnancy than white women (other races were excluded for the purpose of this study). And while all pregnant women in the sample drank less than the nonpregnant women, women aged 34 to 44 were less likely to reduce alcohol consumption than younger women.

While women with a high school education reported the greatest number of drinks per month when not pregnant, the study found that they drank the least during pregnancy. This suggests that education and access to information on the dangers of drinking during pregnancy, not prepregnancy alcohol consumption, is a better indicator of who is more likely to drink during pregnancy.

— Source: Saint Louis University Medical Center

The nature of common fears changes during childhood and adolescent development, according to a report in a recent issue of Archives of General Psychiatry. Two hypotheses have been proposed regarding genetic risk factors for these fears. “The ‘developmentally stable’ hypothesis predicts that a single set of genetic risk factors impacts the level of fears at age 8 years and these same genes constitute the only genetic influences on fear-proneness throughout development,” the authors write. “By contrast, the ‘developmentally dynamic’ hypothesis predicts that genetic effects on fear-proneness will vary over time.”

Kenneth S. Kendler, MD, of the Virginia Commonwealth University School of Medicine, Richmond, and colleagues studied 2,490 twins born in Sweden between 1985 and 1986. The twins were assessed for their level of fear four times between the ages of 8 and 20.

Fears naturally divided into three categories, and overall, genetic factors influenced all three categories, but did not remain stable over time. “We identified one set of genetic risk factors that act in childhood and have a steep decline in influence with age,” the authors write. “Furthermore, we see evidence for new sets of genetic risk factors ‘coming on line’ in early adolescence, late adolescence and early adulthood.”

As the twins aged, the effects of their shared environment on their fears diminished and the influence of their individual environment increased. “This is an expected pattern given that adolescence is a time of declining influence of the home environment as individuals spend less time with family and progressively make their own world, spending more time with friends,” the authors write.

— Source: American Medical Association

As part of the largest study of its kind ever conducted, a team led by eating disorders expert Walter Kaye, MD, a professor of psychiatry and the director of the University of California (UC) San Diego Eating Disorders Program, will begin enrolling families of adolescent anorexic patients in a trial to determine the type of family treatment plan most effective in fighting the disease. The study is likely to provide much-needed guidance to clinicians in the treatment of adolescent anorexia nervosa.

UC San Diego is one of seven international sites that will participate in the trial. Patients and their families will be randomly assigned to one of two groups. One group will receive “systemic family therapy,” an approach that more closely represents the type of family therapy typically practiced in the community. This therapeutic approach focuses on the dynamic of the family, rather than the individual, particularly in relation to the issues that bring them to therapy. This approach views eating difficulties as arising from the relationships and interactions that develop between individuals in the family.

The second, called “Maudsley” behavioral family therapy empowers the parents to take control of the patient’s eating and rejects the notion that a fundamental psychological problem exists within the family. Parents learn strategies to break the anorexic individual’s cycle of refusing food.

“We may find that different approaches work better for patients with a particular profile,” says Kaye. As part of the study, characteristics and core symptoms such as a drive for thinness or anxious, obsessional and perfectionist traits, will be examined. In addition, the researchers will look at the effects of the drug fluoxetine (commonly known as Prozac) as compared with a placebo as an aid to maintaining normal weight by reducing anxiety, obsessional behavior, and other eating disorder-related symptoms.

— Source: University of California, San Diego Health Sciences

New research from the University of New Hampshire Crimes Against Children Research Center finds that child sexual abuse cases in the criminal justice system take an unusually long time to be prosecuted and resolved. This is concerning because a prolonged court process has been shown to be detrimental to a child victim’s recovery and ongoing mental health.

According to the study, over half of all cases took more than a year from indictment to conclusion with one third of cases taking more than two years or were still pending unresolved after two years. The American Bar Association says the standard time for felony prosecutions should be about six months, a deadline that was met by just 20% of the cases.

“We can do better than this,” Walsh says. She urged judges, prosecutors, and police to make these cases a priority; to set and meet deadlines for each phase of each case; and to track and publish the amount time it takes to prosecute cases in various jurisdictions.

The research, conducted by Wendy Walsh, a research assistant professor of sociology at the center, is in a recent issue of Child Maltreatment. The study analyzed a sample of 160 cases of child sexual abuse in three communities served by the Dallas County District Attorney in Dallas, TX.

“If the media and the public knew how long these cases were taking, it might provide the kind of accountability that would speed things up,” she says.

— Source: University of New Hampshire

Competitive environments can disrupt children’s ability to form social relationships, which in turn may hurt their academic potential, according to researchers at the University of Minnesota-Twin Cities. Cary J. Roseth, PhD, David W. Johnson, PhD, and Roger T. Johnson, PhD, reviewed the last eight decades of research on how social relationships affect individual behavior and achievement. Their findings are published in a recent issue of Psychological Bulletin.

The researchers examined 148 studies that compared the effects of cooperative, competitive, and individualistic goals on early achievement and peer relationships among 12- to 15-year-olds. The studies included more than 17,000 adolescents from 11 countries and used four multinational samples. No one was excluded from the analysis because of gender, nationality, or academic or physical ability.

According to the studies, adolescents in classrooms that supported cooperative learning—studying together to complete a project or prepare for an exam—got along better with their peers, were more accurate on academic tests, and achieved higher scores on problem-solving, reasoning, and critical thinking tasks compared with adolescents who were in classrooms geared toward competitive learning.

The findings suggest that when teachers structured their classrooms more cooperatively, students felt more support and connection with their peers, had better success on academic tests and tasks, and sustained higher levels of achievement because of the better peer relations, says Roseth, the lead author.

This may also hold true for the adult worker whose organization supports cooperative interactions, Roseth says. “Some research has shown that high performing teams that cared about each other or had individuals who felt they had a good friend among them in business and industry succeeded in being more productive and effective.”

— Source: American Psychological Association

A new study from Tufts University shows that while the "digital divide" may be narrowing in terms of access to the Internet, a significant "digital skills divide" is emerging. "Parents' access to childrearing information appears to be on the rise, in large measure because of the Web," says Fred Rothbaum, PhD, a professor in the Eliot-Pearson department of child development at Tufts University.

"Unfortunately, the rise in Web use has been accompanied by a pronounced 'digital divide' involving socio-economic status [SES] differences in Web use, Web skills, and Web satisfaction. This gives rise to concerns about the quality of information lower SES parents are accessing."

Rothbaum and colleagues examined socio-economic status differences in parents' Web use, skills, and satisfaction, and found the higher the socio-economic status, the greater the time spent on the Web and the more sophisticated the search and evaluation skills. Their findings were published in a recent issue of the Journal of Applied Developmental Psychology.

After parents completed their Web search, researchers asked them how confident they were that the information they found was trustworthy. Confidence levels did not vary between socio-economic groups, but the reasons for their confidence did differ. More than 40% of parents in the higher socio-economic group said that they were more likely to trust sites associated with a credible organization, such as a university or research organization, compared to 26% of middle SES parents, and 16% of low SES parents.

"SES differences in parents' abilities to find and evaluate Web-based child development information may mean that low SES parents are more likely to obtain information from dubious websites that fail to provide research-based information," the researchers wrote in the study.

— Source: Tufts University

While analyzing data from Saskatchewan health databases, Lauren Brown, a researcher with the University of Alberta’s School of Public Health, found people with a history of depression had a 30% increased risk of type 2 Diabetes.

Brown then studied the medical history of 2,400 people who were diagnosed with depression and were taking antidepressants to determine whether there was a clear correlation between that disease and type 2 Diabetes. She divided the group into four categories: those who took antidepressants that were considered older therapies, patients who were using newer treatments, those using a combination of both an old and new treatments, and people who were switching medications.

What she found was the risk of diabetes almost doubled for the patients who were using two types of therapies at the same time, tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Brown says people are usually prescribed multiple medications “if they have severe depression or if they are having a problem finding the right therapy.”

Brown believes these results, and results of previous studies demonstrating an increased risk of type 2 diabetes in people with depression, emphasize the need for regular screening for type 2 diabetes in people with depression, particularly those taking more than one antidepressant. She also encourages diabetes and depression organizations to educate their members about this link.

— Source: University of Alberta

Previous research has shown that participating in extracurricular activities protects young men and women from risky behaviors and delinquency. This theory was confirmed in a recent study from researchers at Northeastern University’s College of Criminal Justice, but the results also offered a different perspective on how the same activities affect young men and women differently. These, and other results, were published in a recent issue of Crime & Delinquency.

While it was previously believed that participation in sports would decrease delinquency in boys, it actually did not have a significant protective effect. However, the reverse was true for girls, whose risk for delinquent behavior was reduced significantly if they took part in sports. Other activities, such as church and after-school community activities, decreased the risk of delinquency in boys, but not for girls.

“This study set out to identify the factors that lead young men and women to fall into serious delinquency and risky behaviors,” said Sean Varano, PhD, an assistant professor of criminal justice at Northeastern. “We know that girls and boys have a number of different experiences as they mature, and it is important to understand those differences so that informed decisions can be made on how to protect them.”

— Source: Northeastern University

Workers who frequently change employers risk negative consequences to their paychecks, according to new research published in a recent issue of the American Sociological Review. To determine the impact of career mobility on worker’s wages, sociologist Sylvia Fuller of the University of British Columbia examined data from the 1979 National Longitudinal Survey of Youth, tracking nearly 6,000 workers during their first 12 years in the labor market.

Despite the frequent job moves made by young Americans today, Fuller’s research suggests that workers who frequently change jobs generally end up earning less than their more stable counterparts. “The past 30 years have seen the erosion of long-term employment, and young people are increasingly told to expect ongoing employer changes throughout their careers,” says Fuller. “However, this research examines the cumulative changes workers make, or are forced to make, and demonstrates that these career moves may not always result in higher earnings.”

By and large any benefits of job mobility accrue mainly in a worker’s early career. Fuller finds that both men and women typically experience substantial mobility during their early careers, although women change employers slightly less frequently than men. Fuller’s research indicates that mobility can be a wage asset when it is concentrated in the early years of employment and not coupled with layoffs, discharges, employment gaps or family-related leave. In this case, moderate or even high levels of mobility can lead to equal or better wage outcomes than stability.

— Source: American Sociological Association

Parents and coaches can make youth sports a fun, learning experience or a nightmare, according to sport psychologists at the University of Washington (UW). But to achieve the former, sports officials and organizations must provide more training programs, especially for parents, according to Frank Smoll, PhD, and Ron Smith, PhD, who have been studying the youth sport experience and designing programs to improve it for a quarter of a century.

“There has been a drive in the last 20 years to teach coaches how to create a healthy psychological environment for young athletes. A culture has been created and there is an expectation that coaches will receive training. Unfortunately, too many moms and pops are all too willing to assume they don’t have a role in youth sports. However, they should support what trained coaches are trying to do. Parents and coaches working together are a powerful combination,” Smoll says.

The UW researchers recently demonstrated the effectiveness of this approach in a study of 151 boys and girls playing in two different basketball leagues. The average age of the athletes was 11.6 years. Coaches in one league participated in a training workshop emphasizing a Mastery Approach to Coaching developed by Smoll and Smith.

This method emphasizes teaching youngsters about personal improvement, giving maximum effort, having fun, sportsmanship, and supporting their teammates, rather than a winning-at-all-costs approach. Parents participated in a companion Mastery Approach to Parenting in Sports workshop that explained how to apply the mastery principles and how they can reduce performance anxiety in their children. Coaches and parents in the second, or control, league were not offered the workshops.

“This combined approach helps both parents and coaches to create a mastery-oriented climate,” says Smoll. “We don’t ignore the importance of winning because it is an important objective in all sports. But we place winning in its proper perspective. As a result, young athletes exposed to the mastery climate were able to concentrate more and they had less worries about their performance. Their bodies also reacted more positively. They were less tense, had fewer queasy stomachs and they didn’t experience feeling tight muscles.”

— Source: University of Washington

Girls who gossip and exclude others from their cliques are often labeled as popular by their classmates, and nearly all high school cliques are divided along racial lines, according to University of Alabama at Birmingham sociologist Casey Borch, PhD. She coauthored the study with Antonius Cillessen, PhD, at the Radboud Universiteit Nijmegen and the University of Connecticut, to determine how aggression, popularity, and academic achievement influenced membership in cliques. The study will be published as a chapter in the forthcoming book Modeling Dyadic and Interdependent Data in Developmental Research later this year.

The researchers surveyed nearly 600 boys and girls, starting in the 4th grade through the 12th grade, in a public school system in a working class community in the Northeast from 1995 to 2004. The study found that physical aggression helped popularity in the earlier grades but not as the children grew older. Membership in physically aggressive cliques tended to decline over time whereas membership in cliques where students gossiped, spread rumors, and excluded others, which is called relational aggression, remained constant over time.

In fact, the study found that behaviors such as gossiping and spreading rumors increased the perceived popularity, or social visibility, of the students over time, Borch says. “So how well known you are is enhanced by one’s ability to be relationally aggressive. So a lot of popular kids may not be well liked, but they are relationally aggressive and their peers think that they are popular. So it makes some sense that relational aggression is a chosen tactic used by adolescents interested in popularity.

“The ‘mean girls’ effect suggests that girls engage more in this type of behavior more than boys,” says Borch, “and as a rule, they do, but the people who gain more from this behavior are minority boys. Minority boys who are relationally aggressive gained a lot more popularity over time than any other group, although, they were less likely to use the behavior.

— Source: University of Alabama at Birmingham

Gifted black students often underachieve in school because of efforts to "act black," new research has found, offering insights into the achievement gap between black and white students in the United States and why black students are under-represented in gifted programs.

"Part of the achievement gap, particularly for gifted black students, is due to the poor image these students have of themselves as learners," says study author Donna Ford, a professor of special education and the Betts Chair of Education and Human Development at Vanderbilt University's Peabody College.

"Our research shows that prevention and intervention programs that focus on improving students' achievement ethic and self-image are essential to closing the achievement gap." The research, one of the first to examine the concept of "acting black," was published in a recent issue of Urban Education.

Ford and coauthors Gilman Whiting and Tarek Grantham set out to determine how gifted black students achieve compared to their white counterparts, what can be learned about the achievement gap by studying these students, and how gifted students view "acting black" and "acting white." They surveyed 166 black 5th- through 12th-graders identified as gifted in two Ohio school districts.

Most of the students were familiar with the terms "acting white" and "acting black." They described "acting white" as speaking properly, being smart or too smart, doing well in school, taking advanced courses, being stuck up, and not acting your race. Terms they used to describe "acting black" were having a "don't care" attitude, being laid back, being dumb or uneducated, and pretending not to be smart.

"Tragically, only one student (surveyed) indicated acting black was positive. Instead, the gifted black students … believe that acting black means lacking in intelligence, placing a low priority on academics, speaking poorly, behaving poorly, and dressing in ill-fitting clothes," they wrote. "The gifted black students clearly hold negative stereotypes about blacks, namely their attitudes, behaviors and intelligence."

— Source: Vanderbilt University

The hardest part of caring for loved ones with Alzheimer’s-type disorders is not the everyday practical challenge, but rather the emotional impact of losing the patients’ support and companionship as the disease robs them of their faculties, according to new research at the University of Indianapolis. “You are losing and grieving while you’re providing the care, because Charlie isn’t Charlie anymore,” says Jacquelyn Frank, associate professor at the University of Indianapolis’s Center for Aging & Community. She says the results point toward new avenues of service that could be provided by community-based support agencies.

Frank gathered responses from more than 400 dementia caregivers around Indiana, most of them spouses and adult children of Alzheimer’s patients. She is continuing to analyze data from the survey’s 100-plus items, but she was struck immediately by the responses to this open-ended question: “What would you say is the biggest barrier you have faced as a caregiver?”

Though the respondents’ language varied, a computer analysis found that more than 80% of them touched on a common theme: “letting go of the person we used to know,” as one person wrote, or “watching your loved one slip away and forget who people are.”

The comments illustrate two previously noted but seldom-studied phenomena seen in those caring for the terminally ill. “Anticipatory grief” is the pain of losing a loved one, felt in advance of the patient’s death. “Ambiguous loss” is the discordant feeling that comes from interacting with a patient who is physically alive but no longer seems present socially or psychologically.

— Source: University of Indianapolis

A new discovery could change future diagnosis and therapy of depression. Researchers from the University of Illinois at Chicago (IUC) College of Medicine have discovered that a change in the location of a protein in the brain could serve as a biomarker for depression, allowing a simple, rapid, laboratory test to identify patients with depression and to determine whether a particular antidepressant therapy will provide a successful response. The research is published in a recent issue of the Journal of Neuroscience.

"This test could serve to predict the efficacy of antidepressant therapy quickly, within four to five days, sparing patients the agony of waiting a month or more to find out if they are on the correct therapeutic regimen," says Mark Rasenick, PhD, UIC distinguished university professor of physiology and biophysics and psychiatry.

Rasenick said the discovery could help millions who suffer from undiagnosed depression or receive unsuccessful treatment. "We discovered that in depressed individuals a signaling protein is located in specific areas of the cell membrane called lipid rafts," he says. This protein, called Gs alpha, activates adenylyl cyclase, a link in signal transduction, and is responsible for the action of neurotransmitters such as serotonin.

"This new study shows that in depressed humans, Gs alpha protein is confined in lipid rafts, where it's less likely to mediate the action of neurotransmitters, and that antidepressants have the opposite effect," Rasenick says.

"In simple language—we may be able to tell you if you are depressed and more importantly, whether you are responding to the chosen antidepressant therapy."

— Source: University of Illinois at Chicago

Generous donors are poised to give the University of Michigan (U-M) Depression Center $1.5 million to fund advanced research on bipolar disorder, through two challenge grants that are designed to encourage smaller donations by individuals —especially those whose families and friends have been affected by bipolar disorder.

If the challenge is met, U-M scientists and their colleagues will have $3 million to pour into research on a disease that traps 5.7 million Americans on a medical roller coaster of manic highs and depressed lows that can be debilitating or even fatal.

Donations of any size will be dedicated exclusively to further the work of the Heinz C. Prechter Bipolar Research Fund. Prechter was an automotive pioneer who fell victim to suicide in 2001 after battling bipolar disorder on and off for decades, even while building a successful business and attracting the admiration of friends and family.

The two challenge grants come from the World Heritage Foundation-Prechter Family Fund, which has pledged up to $1 million, and the Herrick Foundation, which has pledged up to $500,000.

Every dollar received as part of the challenge will fuel the search for the specific genes that make a person vulnerable to developing bipolar disorder, and that cause the disease to run in some families.

— Source: University of Michigan Health System

Depressed heart attack patients have a higher risk for sudden death in the months following a heart attack. Now a team led by researchers from Washington University School of Medicine in St. Louis has found that the risk continues for many years. "There's a two- to four-fold increase in a person's risk of dying following a heart attack if they also happen to be depressed," says Robert. M. Carney, PhD, lead author of the new study and professor of psychiatry at Washington University. "Previously we thought the impact of depression was strongest for the first three to six months following a heart attack and then gradually dropped off within a couple of years. Instead, we found that the effect lasts for at least five years."

Carney, with colleagues from Duke University Medical Center, Harvard University, Yale University, the National Heart, Lung and Blood Institute (NIH) and the Mayo Clinic, followed more than 750 heart attack patients for five years. The findings will appear in an upcoming issue of the Journal of Affective Disorders and are currently available online.

Patients followed in the study had participated in the NIH-funded project Enhancing Recovery in Coronary Heart Disease Patients. A little less than half were diagnosed with depression. In the five years following a heart attack, 106 patients died. Of those, 62 had been diagnosed with depression, while 44 had not. In gauging the effects of depression, the investigators also considered other risks including age, smoking, hypertension, gender and diabetes.

"We found that after adjusting for those risk factors, depression continues to play a statistically significant role," he says.

— Source: Washington University in St. Louis

Do you remember the seventh song that played on your radio on the way to work yesterday? Most of us don’t, thanks to a normal forgetting process that is constantly culling inconsequential information from our brains. Researchers at the Buck Institute now believe that this normal memory loss is hyper-activated in Alzheimer’s disease (AD) and that this effect is key to the profound memory loss associated with the incurable neurodegenerative disorder.

Last year, this same group of researchers found that they could completely prevent Alzheimer’s disease in mice genetically engineered with a human Alzheimer’s gene—“Mouzheimer’s”—by blocking a single site of cleavage of one molecule, called amyloid precursor protein (APP). Normally, this APP site is attacked by molecular scissors called caspases, but blocking that process prevented the disease.

Now they have studied human brain tissue and found that, just as expected, patients suffering from AD clearly show more of this cleavage process than people of the same age who do not have the disease. However, when they extended their studies to much younger people without Alzheimer’s disease, they were astonished to find an apparent paradox: these younger people displayed as much as ten times the amount of the same cleavage event as the AD patients. The researchers now believe they know why.

The Buck Institute study implicates a biochemical “switch” associated with that cleavage of APP, causing AD brains to become stuck in the process of breaking memories, and points to AD as a syndrome affecting the plasticity or malleability of the brain. The study, recently published in the Journal of Alzheimer’s Disease, provides new insight into a molecular event resulting in decreased brain plasticity, a central feature of AD.

“Young brains operate like Ferraris – shifting between forward and reverse, making and breaking memories with a facility that surpasses that of older brains, which are less plastic,” said Dale Bredesen, MD, Buck Institute faculty member and leader of the research group. “We believe that in aging brains, AD occurs when the ‘molecular shifting switch’ gets stuck in the reverse position, throwing the balance of making and breaking memories seriously off kilter.”

— Source: Buck Institute for Age Research

Workplace bullying appears to inflict more harm on employees than sexual harassment, say researchers. “As sexual harassment becomes less acceptable in society, organizations may be more attuned to helping victims, who may therefore find it easier to cope,” says lead author M. Sandy Hershcovis, PhD, of the University of Manitoba. “In contrast, nonviolent forms of workplace aggression such as incivility and bullying are not illegal, leaving victims to fend for themselves.”

Hershcovis and coauthor Julian Barling, PhD, of Queen’s University in Ontario, Canada, reviewed 110 studies conducted over 21 years that compared the consequences of employees’ experience of sexual harassment and workplace aggression. Specifically, the authors looked at the effect on job, coworker and supervisor satisfaction, workers’ stress, anger and anxiety levels, as well as workers’ mental and physical health. Job turnover and emotional ties to the job were also compared.

The researchers found that workplace aggression has more severe consequences than sexual harassment. Employees who experienced bullying, incivility, or interpersonal conflict were more likely to quit their jobs, have lower well-being, be less satisfied with their jobs, and have less satisfying relations with their bosses than employees who were sexually harassed, the researchers found. Furthermore, bullied employees reported more job stress, less job commitment, and higher levels of anger and anxiety. No differences were found between employees experiencing either type of mistreatment on how satisfied they were with their coworkers or with their work.

“Bullying is often more subtle, and may include behaviors that do not appear obvious to others,” says Hershcovis. “For instance, how does an employee report to their boss that they have been excluded from lunch? Or that they are being ignored by a coworker? The insidious nature of these behaviors makes them difficult to deal with and sanction.”

— Source: American Psychological Association

The theory that depression is caused by a chemical imbalance is often presented in the media as fact even though there is little scientific evidence to support it, according to a new study coauthored by a Florida State University visiting lecturer.

Jeffrey Lacasse, a Florida State University doctoral candidate and visiting lecturer in the College of Social Work, and Jonathan Leo, PhD, a neuroanatomy professor at Lincoln Memorial University in Tennessee, found that reporters who included statements in news articles about depression being caused by a chemical imbalance, or a lack of serotonin in the brain, were unable to provide scientific evidence to support those statements. Their findings were published in the journal Society.

Lacasse and Leo spent about a year in late 2006 and 2007 monitoring the daily news for articles that included statements about chemical imbalances and contacting the authors to request evidence that supported their statements. Several reporters, psychiatrists, and a drug company responded to the researchers’ requests, but Lacasse and Leo say they did not provide documentation that supported the chemical imbalance theory.

The researchers add that several of the responses received from reporters seem to suggest a fundamental misunderstanding of the theory’s scientific status. The Diagnostic and Statistical Manual of Mental Disorders, which almost all psychiatrists use to diagnose and treat their patients, clearly states that the cause of depression and anxiety is unknown, according to Lacasse and Leo.

“Patients might make different choices about the use of medications and possibly use alternative approaches to their distress if they were fully informed,” Lacasse says. “We believe the media can play a positive role by ensuring that their mental health reporting is congruent with scientific literature.”

— Source: Florida State University

Teens who can recognize and resist the persuasive tactics used in alcohol ads are less likely to succumb to alcohol advertising and peer pressure to drink. The results of a three-year study of inner-city middle school students by Weill Cornell Medical College researchers appears online in the journal Addictive Behaviors. Previous research has shown the connection between advertising and adolescent alcohol use as well as the influence of peers in promoting adolescent alcohol use.

Results were taken from surveys of over 2,000 predominantly African American adolescents from 13 inner-city junior high schools in New York City over three years. The study found that seventh graders better able to be critically aware of advertising—something the study terms "media resistance skills"—were significantly less likely to drink alcohol as ninth graders.

These same seventh graders were more likely to have developed better skills for resisting peer pressure by the eighth grade, further reducing their likelihood of drinking. Armed with media resistance and peer refusal skills (saying "no"), these students were less likely to succumb to advertising and peer pressure to drink alcohol subsequently in the ninth grade.

— Source: NewYork-Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

Home to one of the largest intensive intervention and diagnostic centers for autism, Nationwide Children’s Hospital has long been recognized as a leader in autism intervention efforts. Now the Center for Autism Spectrum Disorders at Nationwide Children’s Hospital is also setting the standard for the care of siblings of children with autism.

While much time and attention is focused on the child with autism, brothers and sisters of autistic children may have feelings that are difficult to express: sadness that an autistic sibling can’t learn things that others take for granted, anger and frustration over recurring behavioral problems, or pride when a sibling with autism learns a basic but important life skill.

As a result, in 2007 Nationwide Children’s began offering a program called Sibshops, designed to teach coping skills and provide support for siblings of children who are physically ill or have special needs. Unlike most Sibshops programs, Nationwide Children’s has tailored its program specifically for brothers and sisters of autism patients.

“The strains autism places on families are very real and can be extremely difficult,” says Jacquie Wynn, PhD, director of the Center for Autism Spectrum Disorders at Nationwide Children’s and a member of the faculty at The Ohio State University College of Medicine. “By helping siblings cope with the effects of autism, we help heal and strengthen the entire family.”

— Source: Nationwide Children's Hospital

Doctors may one day be able to control alcohol addiction by manipulating the molecular events in the brain that underlie anxiety associated with alcohol withdrawal, researchers at the University of Illinois at Chicago (UIC) College of Medicine and the Jesse Brown VA Medical Center report a recent issue of the Journal of Neuroscience.

"The association of anxiety with increased alcohol use is a key factor in the initiation and maintenance of alcohol addition," says Subhash Pandey, PhD, UIC professor of psychiatry and director of neuroscience alcoholism research and the study’s lead author.

Previous research has shown that people with inherently high levels of anxiety are at an increased risk of becoming alcoholics. In addition, withdrawal of alcohol in chronic users is often accompanied by extreme anxiety. "Alcoholics may feel a need to continue to drink alcohol in an attempt to self-medicate to reduce their anxiety and other unpleasant withdrawal symptoms," says Pandey.

Pandey and his colleagues have discovered the molecular basis for the link between anxiety and alcohol addiction, which may help in identifying new therapeutic strategies for the treatment of alcohol addiction. The researchers found that a protein within neurons in the amygdala controls the development of alcohol withdrawal symptoms and drinking behaviors in laboratory animals by changing the shape of the neurons. This change in shape affects the communication between neurons, leading to changes in behavior.

— Source: University of Illinois at Chicago

About one in four women who have tested positive for the human immunodeficiency virus (HIV) expect pregnancy and motherhood to be a part of their future, according to a study in a recent issue of the journal AIDS and Behavior.

A woman’s age at the time she learns of her HIV status appears to influence this decision. Women in an Ohio State University study who learned of their HIV infection when they were under age 30 were almost four times more likely to say they wanted to become pregnant than were women who were over 30 when they learned they had HIV.

Researchers say the findings point to a need for clinicians to be aware that women with HIV might be struggling with decisions about motherhood—a relatively new phenomenon accompanying the increase in HIV-positive women of childbearing age and the longer survival rates among patients who receive treatment.

“We shouldn’t assume that women aren’t going to become pregnant or don’t want to become pregnant now that they have HIV. That’s an erroneous assumption,” says study coauthor Julianne Serovich, a professor and the chair of human development and family science at Ohio State. “Clinicians should be routinely discussing pregnancy with HIV-positive women of childbearing age.”

— Source: Ohio State University

Patients who prefer to be highly involved in their treatment don't necessarily have better luck managing chronic health conditions, a new study suggests.

A research team based at the Veterans Affairs (VA) Iowa City Health Care System and the University of Iowa surveyed 189 veterans with high blood pressure to determine the patients' preferences for involvement in their healthcare. They discovered those who wanted an active role in their treatment had higher blood pressure and cholesterol over a 12-month span than those who wanted a less active role.

The study, published this week in the Annals of Behavioral Medicine, was led by Austin Baldwin, PhD, a post-doctoral fellow in the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the VA Iowa City Health Care System and an adjunct assistant professor of psychology in the UI College of Liberal Arts and Sciences.

"The intuitive assumption is that the more involved people are with their health, the better they'll be at managing chronic conditions. We found evidence to the contrary," Baldwin says. "Those who preferred a more 'patient-centered' or active role actually had higher blood pressure and lipid levels. Those who preferred a 'provider-centered' approach, in which the doctor is more authoritative, did better at managing their blood pressure and lipid levels."

"The upshot of this research is that there isn't a one-size-fits-all approach. It's nice to think if we give everyone Treatment X, they're all going to do well," Baldwin says. "But individual differences and preferences are important, and the value of studying this is to understand how these preferences can influence treatment adherence and ultimately influence people's health."

— Source: University of Iowa Health Sciences

For adolescents with depression not responding to an initial treatment with a selective serotonin reuptake inhibitor (SSRI), switching medications and adding cognitive behavioral therapy resulted in an improvement in symptoms, compared with just changing medications, according to a study in a recent issue of The Journal of the American Medical Association.

David Brent, MD, of the University of Pittsburgh, and colleagues examined the relative efficacy of medication type, cognitive behavioral therapy (CBT), and the combination of both for the treatment of resistant adolescent depression. The randomized controlled trial, conducted from 2000 to 2006, included 334 patients, aged 12 to 18, with a primary diagnosis of major depressive disorder who had not responded to a two-month initial treatment with an SSRI. For 12 weeks, participants were randomized to one of four treatments: switched to a second, different SSRI; switched to a different SSRI plus CBT; switched to venlafaxine (a selective serotonin and noradrenergic reuptake inhibitor [SNRI]; or switched to venlafaxine plus CBT.

“In this study of adolescents with moderately severe and chronic depression who had not responded to an adequate course of treatment with an SSRI antidepressant, switching to a combination of CBT and another antidepressant resulted in a higher rate of clinical response [54.8%] than switching to another medication without CBT [40.5%]. There was no differential effect between switching to another SSRI [47.0%] or to venlafaxine [48.2%],” the authors write.

— Source: American Medical Association

People are more likely to stay in a substance abuse treatment program when they are legally advised or ordered to participate, a new study by the University of Michigan shows. The use of legal coercion must be carefully considered, as it may affect a person's recovery from a substance use disorder, says Brian Perron, an assistant professor in the University of Michigan School of Social Work and lead author.

Legal coercion is often used to leverage substance abuse treatment among people who would otherwise not participate voluntarily. These individuals are required or recommended by an attorney or someone in the criminal justice system (court, jail, or probation officer) to seek treatment.

The study, which included responses from 2,694 people who abused alcohol or drugs, examined the influence of legal coercion on retention in substance abuse treatment in three different settings: short-term residential, long-term residential, and outpatient treatment. About 40% of outpatient treatment was due to coercion, compared to short-term residential (31%), and long-term residential treatment (26%). Persons in outpatient treatment had the highest dropout rate at nearly 65%. Short-term and long-term treatments were 28% and 44%, respectively.

"These figures reveal a significant loss of the limited dollars that are available in publicly funded treatment," he says. Coercion of any type removes the decision-making power from clients, which might result in them receiving substandard care or services of poorer quality services.

— Source: University of Michigan School of Social Work

Kids seem to grow into the ability to act in pursuit of goals outside of what they can immediately sense sometime around the age of 3, according to a study published in a recent issue of the Journal of Experimental Psychology: General. Researchers found that by around age 3, children appear to shape their behavior in response to the outcomes they’ve come to expect. Anticipated outcomes that they value move them to act more than do outcomes that they don’t—a hallmark of emerging autonomy.

At the University of Cambridge, psychologists trained 72 children between 18 months and 4 years old, divided into three 10-month age bands (averaging 1.3 to 2.2 years, 2.3 to 3.075 years, and 3.08 to 4 years) to touch a red or green butterfly icon on a touch-screen display to see different cartoon video clips. The children came to associate one butterfly with one cartoon sequence and the other butterfly with another.

After that, the experimenters devalued one of the outcomes by showing that sequence repeatedly, until the children became bored with it. The researchers then retested the children. Relative to the younger children, those who were 32 months (nearly 3 years) and older touched the butterfly for the less-valued cartoon significantly less often than they touched the butterfly for the more novel cartoon.

“One possible interpretation is that the period between 2 and 3 years of age brings about a transition in behavioral control from stimulus-outcome learning to fully intentional goal-directed action,” the authors write. In other words, by age 3, children can pursue specific goals even if they cannot directly sense those goals, which may now be more abstract. These older toddlers are sensitive to how goals change in value, begin to internalize their relationship to and control over events, and start to act in ways that will help them reach the goals they value most —such as more exciting cartoons.

— Source: American Psychological Association

The age-related memory condition known as mild cognitive impairment (MCI) disrupts day-to-day life and relationships more than was once believed, gerontology researchers at Virginia Tech have discovered.

Karen Roberto, PhD, director of the Center for Gerontology at Virginia Tech, and Rosemary Blieszner, PhD, associate director, set out to determine the issues and needs of families responding to MCI. After interviews with 99 families, the research identified three types of responses from people diagnosed with MCI. “Some elders were strategists; their memory loss was apparent to them and they wanted to find out all they could about what it is, why it is occurring, and what they could do about it. They had already begun working through potential changes in their lives,” the researchers report.

Older adults in the second group appeared more uncertain. They did not appear to recognize that they have memory changes and did not understand why they needed to be tested. And a few older adults appeared troubled by their condition. “They are not accepting of the memory changes. Although they did not acknowledge problems willingly, we sensed that they realize things were not quite right.”

The second interview was a year later to learn how families were coping.

“Care partners reported distress at having to take on the other person’s responsibilities, or at the changes in the marriage or parent-child relationship. There was also frustration at the changes in daily routine,” Roberto says.

“The care partner experiences a loss of independence and a loss of time for personal interests,” says Blieszner. “The definition of MCI has been that it does not significantly affect daily life—but sometimes that is not true.”

— Source: Virginia Tech (Virginia Polytechnic Institute and State University)

Congress is being asked to help the nation's 600,000 professional social workers better serve families and communities in need. U.S. representative Edolphus Towns has introduced a bill that will establish a Social Work Reinvestment Commission to study policy issues associated with recruitment, retention, research, and reinvestment in the profession of social work, and will support replicable programs of excellence throughout the country.

The United States is experiencing unprecedented levels of human, social service, and healthcare needs. These needs now transcend social and economic strata, affect the old and the young, and place tremendous burdens on those in the middle. As a result, millions of Americans, from all walks of life, are served daily by social workers.

H.R. 5447 will create a commission to research social work's impact in practice areas such as aging, child welfare, military and veteran's affairs, mental and behavioral health and disability, criminal justice, and health. It will also study issues facing the profession, including fair market compensation, high social work educational debt, and social work safety, as well as state level social work and reciprocity agreements. These recommendations will be presented to Congress and the Executive Branch.

H.R. 5447 will support demonstration grants related to workplace improvements, social service research, social work education and training, and programs of excellence. These competitive demonstration grants will support efforts underway within both the private and public sectors, at colleges and universities, and within community-based organizations that already administer programs in high need, high demand areas.

— Source: National Association of Social Workers

A test developed by National Institutes of Health (NIH) scientists could greatly extend the survival of infants with Menkes disease, a rare, otherwise fatal disorder of copper metabolism. The scientists devised a test to diagnose the condition early, when the chances for successful treatment are greatest. A study appearing in a recent issue of The New England Journal of Medicine describes how the scientists devised the test to diagnose the condition early, when the chances for successful treatment are greatest.

Menkes disease occurs in about one in 100,000 newborns and is caused by a defect in a gene that regulates copper levels in the body, explained Stephen G. Kaler, MD, lead author of the study. In their research, Kaler and his coworkers evaluated male infants who were considered to be at risk for Menkes disease.

Based on catecholamine levels, the researchers predicted 12 male newborns would develop Menkes disease and administered the copper-containing drug, beginning at a very early age. DNA studies of the ATP7A gene confirmed the diagnosis in each case. The infants were given the copper injections for three years, receiving two shots daily for the first year and one shot a day during the second and third years. Because long-term exposure to copper can damage the kidneys, the copper injections were stopped after 3 years. The researchers followed the infants throughout childhood to track their survival rates and mental development. Those who received injections soon after birth had a much greater survival rate when compared with a previously documented group of Menkes disease infants who had not received early copper injections.

The boys varied in their response to the copper treatment. Two developed relatively normally, whereas the remainder had varying degrees of developmental impairment. When Kaler and his coworkers examined the nature of the defect in the boys' ATP7A gene, they found that boys with particular alterations in the gene responded better to the copper injections than did boys with other defects in the gene. They demonstrated that the ATP7A genes of the boys who had the best clinical responses to the copper injections retained some rudimentary capacity to regulate copper.

— National Institutes of Health

People taking medication for depression typically see a lot of improvements in their symptoms during the first few months, but lagging behind other areas is a sense of hopefulness, according to a University of Michigan Health System study that appears in a recent issue of General Hospital Psychiatry.

For many in the study, feelings of hopefulness did not improve until several weeks, or even months, after depressive symptoms lifted, says lead author James E. Aikens, PhD, associate professor in the department of family medicine at the University of Michigan Health System.

“The finding suggests that some patients may become unduly pessimistic and stop adhering to an already-helpful therapy,” he notes. This finding is troubling, he says, because in addition to the possibility of stopping medication, hopelessness is a strong risk factor for suicide.

Aikens and his team studied 573 patients with depression from 37 practices. They were given an antidepressant: fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft). They were assessed one, three, six, and nine months after the treatment began. Overall, patients’ depression responded rapidly to medication, with 68% of their improvement occurring by the end of the first month, and 88 percent by three months. The patients experienced the majority of their improvement in several areas during this time period, including positive emotions and work and social functioning.

With hopefulness, however, the improvement was much more gradual. Physicians may want to consider cognitive-behavioral strategies, such as teaching patients to identify and challenge the pessimistic thoughts that usually accompany depression, and encouraging them to engage in activities that may improve their mood, Aikens says.

— Source: University of Michigan Health System

Mirroring a trend among the general public, an increasing number of people with disabilities regularly use wireless technologies, including cell phones—and find them easier to use. But a number of people with disabilities cite a need for improved functionality of wireless devices, such as a feature to enable service dogs to call for help in an emergency, according to the initial results of a survey funded by the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research.

Wireless device ownership increased 13%—from 72% to 85%—among people with disabilities from the first generation of the survey of user needs—conducted from 2001 to 2006—and the current survey, which began in April 2007. Also, more than three fourths of respondents last year reported that their wireless devices are easy or very easy to use, compared with only half of those who responded to the earlier survey. Still, 73% said they likely would change wireless service providers, if necessary, to get additional features that enhance accessibility.

“The data these consumers share through our research helps our wireless industry partners meet customers’ needs and also helps identify applications useful to people without disabilities,” says survey project director Jim Mueller of the Wireless Rehabilitation Engineering Research Center, a collaboration between Atlanta-based Shepherd Center and the Georgia Institute of Technology. “We are not encouraging the wireless companies to make special products. We want products that will work for everyone.”

— Source: Shepherd Center

When it comes to job hiring or career advancement, a common phrase is “it’s not just what you know, it’s who you know,” but research on weight-based bias suggests “it’s how you look.”

A recent study conducted at Wayne State University in Detroit, MI, shows that obesity can and does have a denigrating effect in the workplace. “There are a whole set of stereotypes that go along with being overweight, and a lot of them transfer into the workplace in terms of people’s judgment about others’ abilities and appearance in relation to job performance,” says doctoral candidate Cort Rudolph.

Researchers have studied the effects of weight-based bias in the workplace for more than 30 years, and Rudolph has completed a meta-analysis of many of the findings. “The results have been consistent. People who are overweight are viewed more negatively in the workplace than those who are of average weight, which is not surprising based on what we know about weight-based stereotypes,” he says.

In his study he found that stereotypes are most prominent in the initial selection process. Body weight seems to be less of a factor at the performance evaluation stage, and stereotypes have a minimum influence when it comes to promotions. He also found that weight-based bias seems to be stronger as the amount of interaction with others, like customers, increases. For example, the effects of negative stereotypes appear more significant for face-to-face sales positions.

— Source: Society for Industrial and Organizational Psychology

The Binghamton University Masters of Social Work program has been awarded $75,000 to develop an innovative program that prepares social workers to specialize in older adult care. Known as the Hartford Partnership Program for Aging Education, Binghamton will adopt a model developed by the New York Academy of Medicine’s Social Work Leadership Institute. The program addresses the growing demand for social workers as the United States faces an aging population that is expected to triple by 2050.

“We are thrilled to have been awarded this grant and to be able to expand our efforts towards increasing competence in gerontological social work in the Southern Tier,” says social work department chair Laura Bronstein, MSW.

The Hartford Partnership Program for Aging Education works to build collaborations between universities and community agencies to offer students hands-on and varied experience caring for older adults across a range of settings. The program differs from traditional MSW programs as it offers students’ field rotations rather than experience in a single agency setting during their academic year placement.

The program at Binghamton will begin in the fall of 2008 and will fund a faculty field instructor, a researcher and MSW interns to provide services to these local participating agencies. "This grant affords both the students and our community with invaluable resources,” says Jennifer Marshall, director of field education in the social work department.

— Source: Binghamton University, State University of New York

Middle-aged women who suffered physical or sexual abuse as children spend up to one third more than average in healthcare costs, according to a long-term study of 3,333 women that appears online in the Journal of General Internal Medicine. Even decades after the abuse ended, these women used health services at significantly higher rates than did nonabused women, the research found.

“What’s remarkable is that women with an average age in their late 40s still suffer consequences from abuse that occurred decades ago,” says Amy Bonomi, associate professor of human development and family science at Ohio State University, who led the study.

Women who had no history of abuse spent an average of $2,413 a year (in 2004 dollars) on healthcare costs. Women who were sexually abused only paid an average of $382 (16%) a year more, those who were physically abused spent $502 (22%) more, and women who suffered both types of abuse spent $790 (36%) a year in additional healthcare costs.

Bonomi says the results reinforce the need for abuse prevention programs that target parents of young children who are at risk of child abuse. Soon-to-be parents should also receive attention. In addition, the findings suggest healthcare professionals should screen adults for child abuse history, particularly people with high levels of healthcare service use.

— Source: Ohio State University

Even though federal welfare-reform legislation calls for case workers to screen for domestic violence and most states have agreed to implement this requirement, only 9% of women applying for Temporary Assistance to Needy Families were screened for domestic violence, according to data from a University of Washington (UW) study.

An analysis of 782 transcripts of in-person interviews between case workers and clients in four states by researchers from the UW’s School of Social Work showed that slightly more than 1% of the women actually received effective screening that resulted in them revealing that they were victims of domestic violence. Of the analyzed transcripts, only 73 cases indicated any screening for domestic violence.

“This is not about bad case workers. This lack of screening is an institutional problem that existed across states, across different welfare offices and different workers,” says lead author Taryn Lindhorst, a UW associate professor of social work.

To improve the situation in the welfare office, the UW researchers said that a major cultural shift in welfare organizations is needed, including requiring welfare offices to report to Congress the number of women they identify as victims of domestic violence and the services they provide to them.

“Welfare workers need to see screening for domestic violence as part of their responsibility. To do that they need training and they need to be rewarded for helping clients, even if this means that they remain on the welfare rolls. Right now, they are only being held responsible for how many people they remove from their caseloads, not how many they assist,” Lindhorst adds.

— Source: University of Washington

Many may have been surprised by an Indiana Black Expo report detailing how nearly eight in 10 black children in Indiana are born to unwed parents.

Lorraine Blackman, PhD, wasn't among them. It is a situation she has been studying. Blackman knows all too well the consequences behind the headlines and numbers. She specializes in family life education and in shaping social policies to help families function better.

The untold story is that white children born to unwed mothers face challenges similar to those of black children of unwed mothers, Blackman says. Recent statistics show there are 1.4 million whites living in poverty in Indiana with 208,000 white mothers in homes without a husband.

Blackman and her students created a series of prevention and coping tips to address the issue. To prevent out-of-wedlock births among their children, parents, for example, should talk to their children openly about human sexuality and take parenting as well as healthy marriage classes. Children who grow up with both of their biological parents are at less risk of out-of-wedlock pregnancies, poverty, and a host of other social problems.

In addition, adolescents need to focus on a plan for their lives to help them understand that having children early can be an impediment to "living out their life dreams." Tips for single mothers include preventing future pregnancies. Community leaders need to review existing policies and laws so they don't discourage people from getting married. Under existing rules, couples that marry might find they lose certain benefits like food stamps if they are married.

— Source: Indiana University-Purdue University Indianapolis

Geisinger research finds that veterans suffering from posttraumatic stress disorder (PTSD) are as likely to have long-term health problems as people with chronic disease risk factors such as an elevated white blood cell counts and biological signs and symptoms. However, few healthcare providers screen for PTSD in the same way as they screen for other chronic disease risk factors.

“Exposure to trauma has not only psychological effects, but can take a serious toll on a person’s health status and biological functions as well,” says Geisinger Senior Investigator Joseph Boscarino, PhD, MPH. “PTSD is a risk factor for disease that doctors should put on their radar screens.”

For this study, Boscarino examined the health status of 4,462 male Vietnam-era veterans 30 years after their military service. Results are being published in a recent edition of the Journal of Nervous and Mental Disease.

The study finds that having PTSD was just as good an indicator of a person’s long-term health status as having an elevated white blood cell count, which can indicate a major infection or a serious blood disorder such as leukemia. While these disease markers are measured with a blood test, PTSD is commonly measured with a psychological test or a mental health examination.

Although therapy doesn't necessarily have to be extensive, Boscarino says it should occur shortly after a person has experienced a traumatic event. Early treatment may be critical to avoiding depression, PTSD, and substance abuse-related problems following trauma.

— Source: Geisinger Health System

By Sam Maron, LSW, MSW

As an Orthodox Jewish social worker on the staff of a small Jewish family and children’s agency, I had been hired to provide services to Orthodox Jewish families in the area. But I had also developed a yen to serve other ethnicities as well—not only my own.

So at a staffing meeting when this case—that will always be tucked in a special pocket of my heart—was presented as a newly received case crying out for my services—I nearly handed it back to my colleagues.

“But Sam,” said one of my female colleagues, astonished that I would turn back such a client, “he needs you! This is an Orthodox Jewish boy who is suicidal. This boy needs your help.” Little did she know how her zealousness made the difference. Had she not been insistent that I accept this client, I probably would have refused. I was just at a point in my career at which I resented being stereotyped as the agency’s “Orthodox social worker.”

A 16-year-old studying at a yeshiva (a Jewish educational institution of higher learning) in the agency’s service area, “this boy,” as my colleague had put it, was indeed suicidal as I had found out in my initial session with him.

His Rebbe (rabbi, teacher)—a tall, slender man dressed in black whose height belied his gentleness and warmth—brought the boy for his first session and waited patiently in our small waiting room as I worked with him. The boy—who I’ll call Josh—opened up as we played a game of Connect Four.

All he wanted, he told me, was to be close to his father, who had died an untimely death, the result of a major heart attack. He just wanted his father to take him to a baseball game. He had been sent to the yeshiva since it specialized in working with boys from exceptional backgrounds and getting them back to mainstream yeshivas.

But his father had pushed him away. His father—a brilliant scholar and prolific author—felt so pressured to produce more and more books that he became distant from his wife and children.

Like her son, his mom was also depressed and suicidal. She had overdosed and was running out in front of traffic trying to kill herself. Her three-year-old daughter—emulating mom’s behavior—was following suit. Small wonder as I worked with Josh, 50 miles away they were also in therapy.

As Josh opened up, he shared his plans to kill himself

Back in his dorm, he conceded, he had a rope and knife and was contemplating either suicide by hanging or slashing his wrists. I thanked G-d that this case came my way. My colleague was right. It would have been difficult for another professional to help him.

That night—the night of our first session—where he made this disclosure—his Rebbe and I accompanied him back to his dorm room. He showed us the rope and knife and we were able to persuade him to give it to us for disposal. More importantly, he agreed to contract for safety and to continue to see me regularly.

Josh and I got to know each other well. He shared with me, as we played Connect Four, how his father once pushed him down the steps of their home after he tried in vain to ask his dad to take him to a Sunday afternoon baseball game. For Josh that would become the proximal event of his life—the experience of being slapped away, cast away by the man who he looked up to and loved more than anyone else in the world.

But as our relationship developed, I hoped I succeeded in showing him that it was okay to forgive himself for his mixed up feelings—the simultaneous anger toward his dad for his rejection and love for his role as father; the guilt he carried for hating him while still wishing they could have had a relationship; and that gap, that chasm, between his dad’s public image of a successful, well-adjusted scholar and Josh’s image of him as a driven maniac. Just as importantly, we agreed, it was okay for Josh to forgive his father, and, if one day—he could do so—to focus on what good times they had as well.

At our last session, he thanked me for my efforts and shared with me that he enjoyed our time together. His Rebbe—to my surprise—also thanked me and said he had really come to understand the important role played by social service professionals. To my amazement, the Rebbe said he had witnessed a remarkable emotional maturation in Josh as our sessions ensued.

I left the area and agency to take an administrative position elsewhere. Six years later, I had come back to a neighboring county to serve as its first part-time Jewish Family & Children’s Service social worker.

As I left to drive home on a Friday afternoon for our Sabbath, I stopped in a local kosher delicatessen to pick up some deli meats for my family. In line behind me, a tall, handsome young man called out, ‘Mr. Maron, is that you? It’s me, Josh.”

Startled and in utter disbelief, I stepped out of line to greet Josh, looking at him in amazement as we hugged each other.

“I’m a chussan, Mr. Maron,” he told me (meaning he had become betrothed and would be married soon). I owe you so much.”

“No,” I told him, as tears flowed down my face. “I owe you so much.”

In that wonderful moment, which I will forever cherish, I realized you could work in our field for an eternity and never get such a chance to help someone and see the results of your efforts.

The case I didn’t even want had blossomed into manhood.

— Sam Maron, LSW, MSW, is a senior mental health emergency services coordinator in the acute services unit in the department of behavioral health and mental retardation services in Philadelphia, PA.

Most online sex offenders are adults who target teens and seduce victims into sexual relationships. They take time to develop the trust and confidence of victims, so that the youth see these relationships as romances or sexual adventures. The youths most vulnerable to online sex offenders have histories of sexual or physical abuse, family problems, and tendencies to take risks online and offline, the researchers say.

The study, published in a recent issue of American Psychologist, was based on three surveys—two comprising telephone interviews of a combined 3,000 Internet users between the ages of 10 and 17; first in 2000 and again in 2005; and one involving 612 interviews with federal, state, and local law enforcement officials in the United States between October 2001 and July 2002.

“Most Internet-initiated sex crimes involve adult men who are open about their interest in sex,” says Janis Wolak, JD, lead author of the study. “The offenders use instant messages, e-mail and chat rooms to meet and develop intimate relationships with their victims. In most of the cases, the victims are aware that they are talking online with adults.”

Wolak and her colleagues say more effort should be directed at helping teens appreciate the drawbacks and inappropriateness of romantic relationships with adults. These efforts should include frank discussions of the dynamics of Internet-initiated sex crimes. Since many of the victims do not have good relationships with parents, ways to reach vulnerable teens directly, through sources they find credible, need to be found.

— Source: American Psychological Association

While Spanish-speaking telenovelas (TV Soap Operas) may be a bit over the top, but they also reflect real life and society—including recent story lines about gay parenting. With recent studies showing that Latino gay and lesbian couples have higher adoption rates than other same-sex couples, it’s no coincidence that gay adoption has appeared in two recent novelas, "Barreras de Amor," and “Amar Sin Limites.”

“The trend in telenovelas of portraying gay and lesbian couples with adopted children is a cultural phenomenon and an extension of how gays and lesbians are carrying ‘La Familia’—the utmost Latino cultural value—into their lifestyles,” says Eduardo Morales, PhD, professor of the California School of Professional Psychology (CSPP) at Alliant International University at San Francisco.

Recent statistics from New York’s National Gay and Lesbian Task Force Policy Institute and National Latino/a Coalition for Justice underscore the trend with key findings of same-sex couples in Florida:

• Male same-sex couples where both partners are Hispanic raise children at more than three times the rate (58%) than white non-Hispanic male same-sex couples (19%).

• Female same-sex couples in which both partners are Hispanic raise children at more than twice the rate (66%) of white non-Hispanic female same-sex couples (32%).

• More Hispanic female same-sex couples (54%) report raising at least one child under the age of 18, compared to Hispanic married opposite-sex couples (70%) and Hispanic cohabiting opposite-sex couples (59%).

— Source: Alliant International University

Adolescents who watch professional wrestling on television are more likely to be involved in violence, sex without birth control, and other risky behaviors, reports a recent study in the Southern Medical Journal.

The more often young people watch wrestling, the higher their rates of risky behaviors, according to the new report. Although no cause-and-effect relationship can be implied, "[W]e can only conclude that as the frequency of watching wrestling increases or decreases, the health risk behavior associated with it also changes," write Robert H. DuRant, PhD, and colleagues of Wake Forest University, Winston-Salem, NC.

The study was based on a telephone survey of 2,300 young people, aged 16 to 20, across the United States. Twenty-two percent of males and 14% of females said they had watched professional wrestling on television over the past two weeks.

The frequency of watching professional wrestling was related to increased rates of several violent and risky behaviors, after adjustment for other factors. For example, survey respondents who said they had tried to hurt someone with a weapon watched 67% more wrestling than those who had not tried to hurt anyone. Those who had engaged in sex without birth control watched wrestling 42% more frequently than those who used birth control. Smokers watched wrestling 31% more often than nonsmokers.

"Youth who watch wrestling are exposed to a barrage of images of severe violence without the expected negative consequences, the degrading of women, sexuality connected with violence, and extreme verbal intimidation and abuse between wrestlers and their female escorts and/or women wrestlers," the researchers write.

— Source: Wolters Kluwer Health: Lippincott Williams & Wilkins

New findings show that parental drinking both directly influences adolescent drinking, as well as indirectly through adolescent perceptions of parenting, especially monitoring and discipline received. The results are published in a recent issue of Alcoholism: Clinical & Experimental Research.

Researchers examined data from 4,731 adolescents (2,402 males, 2,329 females) and their parents (87% with data from both parents, 13% with data from only one parent), gathered through an ongoing Finnish population-based, developmental twin study of health-related behaviors and correlated risk factors. Parents were asked about their frequencies of alcohol use and intoxication, as well as their lifetime prevalence of alcohol-related problems. Adolescents reported on perceptions of the parenting that they received, as well as their own prevalence of alcohol use and intoxication at 14 and 17.5 years of age.

The findings were twofold: first, among the parenting dimensions examined, monitoring and discipline played the strongest intermediary role in associations between parental and adolescent drinking behaviors; and second, the magnitude of this mediating role was much stronger during early adolescence, whereas parental drinking had more direct associations with their offspring's drinking in later adolescence.

— Source: Shawn J. Latendresse, PhD, Virginia Commonwealth University; Michael Windle, PhD, Emory University

A diverse coalition of 13 national organizations has joined in a renewed effort to protect the safety and emotional well-being of students, including those who are at higher risk because of their sexual orientation. The group of education, health, mental health, and religious organizations recently released “Just the Facts About Sexual Orientation and Youth: A Primer for Principals, Educators, and School Personnel.”

The publication serves as a guide for employees who confront sensitive issues involving gay, lesbian, and bisexual students. It is intended to help school administrators foster safe and healthy school environments, in which all students can achieve to the best of their ability. “Just the Facts” includes the most recent information from professional health organizations, as well as up-to-date information on the legal responsibility of school officials to protect students from anti-gay harassment. “Just the Facts” has been mailed to all 16,000 public school superintendents in the United States.

The coalition issued the following joint statement:

“The opportunity for students to learn is diminished when they do not feel safe or supported at school. In addition to assault and harassment, gay, lesbian and bisexual students experience high rates of emotional distress, suicide attempts, and substance abuse. These factors hinder their emotional and social development, as well as their ability to succeed in school. It is our responsibility to provide accurate and factual information. We believe this publication will be a valuable tool to help educators, administrators and others concerned with caring for America’s students.”

— Source: National Association of Social Workers

Children with autism have normal-size heads at birth but develop accelerated head growth between six and nine months of age, a period that precedes the onset of many behaviors that enable physicians to diagnose the developmental disorder, according to new research from the University of Washington’s Autism Center.

The study also indicates that this aberrant growth is present in children who have the early onset form of autism as well as those later diagnosed with the regression type of the disorder, according to Sara Webb, who led the research.

“We know there are a number of risk factors for autism, and if we can pinpoint them we have better ways of identifying children at risk so we can get them into prevention or monitoring,” says Webb, a UW research assistant professor of psychiatry and behavioral sciences.

“This abnormal or accelerated rate of head circumference growth is a biological marker for autism. It occurs before the onset of behavioral symptoms at 12 months of age.

“By itself, head growth is not an indicator of autism,” she says, “because kids are going to be getting bigger and development is so variable. However, if you notice it and some of these other symptoms, it is a red flag to seek evaluation.”

— Source: University of Washington

Jeffrey M. Jenson and William A. Dieterich of the University of Denver’s Graduate School of Social Work studied more than 1,100 fourth- and fifth-grade students in 28 elementary schools in Denver public schools. One group was exposed to a bullying prevention program called “Youth Matters” (YM). A second control group of students was not.

Self-reported bully victimization among students taking the “Youth Matters” curriculum decreased 20% compared with a 10% drop from students in the control group. The results are detailed in a recent issue of Prevention Science.

Students in the Jenson-Dieterich study who participated in the “Youth Matters” curriculum received training in four 10-week modules over the course of two academic years. The curriculum focused on two themes: issues and skills related to bullying and other forms of early aggression.

In skills instruction, students learned how to use social and interpersonal skills to decrease the likelihood of being bullied by classmates. They also were taught ways to stand up for themselves and others, and instruction in asking for help when confronted by a bully. The goal of the training was to teach students how to use these skills to stay out of trouble, build positive relationships, make good decisions and avoid anti-social behavior.

“Understanding the consequences of bullying from both a bully and victim perspective is emphasized in training sessions,” Jenson reports. “Our findings point to the importance of social and emotional skills in reducing bullying.”

— Source: Dick Jones Communications

Employees who do not have a clear understanding of how their jobs fit into the overall work picture of their organization are more likely to exhibit carelessness and the inability to make clear distinctions on which aspects of their job are most important when making ratings about their work assignments, according to a study conducted by two DePaul University industrial-organizational psychologists. Their findings were published in the fall issue of Personnel Psychology.

“This study clearly shows that employees vary greatly with regard to how accurately they understand the critical function of their jobs,” say Erich C. Dierdorff and Robert S. Rubin, both professors in the Kellstadt Graduate School of Business at DePaul.

How workers perceive the requirements associated with their jobs and the value of performing those jobs can provide key information to human resource practitioners. Such knowledge can aid in several human resource functions, including job redesign, job evaluation, training needs, and performance management.

“This is information that can help in analyzing jobs so that the right kinds of people can be hired to fill those positions. Job information is important, not only in recruiting and hiring, but also in setting compensation rates and conducting performance reviews,” says Dierdorff.

It is incumbent upon the organization to assure that job and personnel-related decisions are being made on high quality information, he added.

— Source: Society for Industrial and Organizational Psychology

Mental Health America has released results of the first national online survey to examine overall healthcare in mental health settings from the perspective of both people with schizophrenia and psychiatrists. Results showed that although both groups are aware of actions to improve overall health and quality of life, they are not discussing such actions to the extent possible.

Mental Health America conducted the survey in response to recent data showing that people with serious mental illnesses die at least 25 years earlier than the general population, largely due to preventable medical conditions. Nationwide, rates of chronic illnesses such as heart disease and diabetes are at epidemic levels. Nowhere is this public health dilemma more evident than in people with serious mental illnesses such as schizophrenia, who die at nearly twice the rate of the rest of the population from heart disease and diabetes.

While 40% of survey respondents have private health insurance, they still report significantly higher rates of chronic illnesses than the general population. Forty-four percent and 23% of all respondents reported being obese and having diabetes, respectively, compared with 26% and 8% of the general population.

While many psychiatrists report asking or discussing general health issues with their patients, 83% of psychiatrists cited lack of time during patient visits as the main obstacle to providing overall care; 74% feel they are not as well equipped to address the patient’s overall health as are primary care physicians. Eighty-two percent of consumer respondents feel that treatment of their overall health, not just their mental illness, is important to their recovery. Yet 48% expect their psychiatrist to focus exclusively on their mental health, rather than overall and mental health.

— Source: Mental Health America

Children of women who undergo an extremely stressful event—such as the death of a close relative—during the first trimester of pregnancy appear more likely to develop schizophrenia, according to a report in a recent issue of Archives of General Psychiatry.

Ali S. Khashan, MSc, of the University of Manchester, England, and colleagues used data from 1.38 million Danish births occurring between 1973 and 1995. Women were linked to close family members using a national registry, and the same registry was used to determine if any of these relatives died or received a diagnosis of cancer, heart attack, or stroke during each mother’s pregnancy. Their children were followed from the 10th birthday through June 30, 2005, or until they died, moved out of the country, or developed schizophrenia.

During the study period, mothers of 21,987 children were exposed to the death of a relative during pregnancy, 14,206 were exposed to a relatives’ serious illness during pregnancy and 7,331 of the offspring developed schizophrenia. The risk of schizophrenia and related disorders was approximately 67% greater among the offspring of women who were exposed to the death of a relative during the first trimester. However, death of a relative up to six months before or any other time during pregnancy was not related to risk for schizophrenia in the child, nor was exposure to serious illness in a relative. The association between a family death and risk of schizophrenia appeared to be significant only for individuals without a family history (parents, grandparents or siblings) of mental illness.

— Source: American Medical Association

Senators Tom Harkin (D-Iowa) and Chuck Hagel (R-Neb.) have introduced the Armed Forces Suicide Prevention Act (S. 2585), which will enhance the suicide prevention programs of the Department of Defense (DoD) by requiring the Secretary of Defense to review and evaluate current prevention efforts across the Armed Forces and make necessary changes to increase suicide prevention within the DoD.

Some of the most notable provisions in the Armed Forces Suicide Prevention Act include the following:

• resources to be provided to the DoD to fight and reduce the stigma among members of the Armed Forces and their families associated with mental health concerns and to encourage individuals to seek help;

• increased lifesaver training of the DoD health care community and family support professionals related to the recognition of risk factors for suicide, identification of signs and symptoms of mental health concerns and to combat stress and crisis management;

• utilization of crisis response teams within units to prevent and respond to traumatic events;

• postdeployment follow-up assistance which will be made readily available to family members and peers of the Armed Services on mental health problems, substance use, and financial and relationship difficulties, including the national suicide prevention hotline; and

• resources to be provided to the DoD to examine innovative and effective strategies to recruit qualified uniformed mental health professionals.

— Source: SPAN USA

Results of an early study suggest that dairy-free diets and unconventional food preferences could put boys with autism and autism spectrum disorder (ASD) at higher than normal risk for thinner, less dense bones when compared with a group of boys the same age who do not have autism.

The study, by researchers from the National Institutes of Health and Cincinnati Children's Hospital Medical Center, was published online in the Journal of Autism and Developmental Disorders. The research team that conducted the study was led by Mary L. Hediger, PhD, a biological anthropologist in the National Institute of Child Health and Human Development's division of epidemiology, statistics, and prevention research.

The researchers believe that boys with autism and ASD are at risk for poor bone development for a number of reasons. These factors are lack of exercise, a reluctance to eat a varied diet, lack of vitamin D, digestive problems, and diets that exclude casein, a protein found in milk and milk products. Dairy products provide a significant source of calcium and vitamin D. Casein-free diets are a controversial treatment thought by some to lessen the symptoms of autism.

"Our results suggest that children with autism and autism spectrum disorder may be at risk for calcium and vitamin D deficiencies," Hediger says. "Parents of these children may wish to include a dietitian in their children's healthcare team, to ensure that they receive a balanced diet."

Hediger stressed that the current study results need to be confirmed by larger studies. Until definitive information is available, however, it would be prudent for parents of children with autism and ASD to include a dietitian in their care, particularly if the children's diets do not include dairy products or they are not otherwise eating a balanced diet, she says.

— Source: The National Institutes of Health

Parents with adolescent-age children want healthcare providers to do more than just check blood pressure, listen to their heart, and provide any necessary vaccinations—they also want providers to talk with their kids about issues related to sexuality, diet, drug abuse, and tobacco use, according to a report released today by the University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health.

The National Poll on Children’s Health—which asked parents of 11- to 17-year-old children to rate 18 health-related topics for healthcare providers to address during an adolescent’s routine check-up—found that diet/nutrition, exercise/sports, and the physical changes of puberty were the overall top three issues parents want discussed, followed by drugs, tobacco, sexually transmitted diseases, and depression/suicide.

The National Poll on Children’s Health sought to find out which topics parents feel are the most important for healthcare providers to cover during check-ups, and if those topics varied by a child’s race/ethnicity, gender, and age. “There is enough variation in parents’ opinions based on their child’s age, race and gender that, rather than adopting a one-size-fits-all approach, it makes the most sense to encourage parents to tell their child’s doctor what topics they want to have addressed during visits,” says Amanda F. Dempsey, MD, PhD, MPH, a member of the CHEAR Unit team in the Division of General Pediatrics at C.S. Mott Children’s Hospital.

— Source: University of Michigan Health System

Martha Ann Bell, associate professor of psychology in the College of Science at Virginia Tech, and her research team are studying how cognitions and emotions are related in children and how this relationship changes as children develop from infancy into their preschool years. Their research is the first of its kind to track this type of information over several years. The group has launched phase two of a study funded by the National Institutes of Health (NIH) and has received additional NIH funding to significantly increase the sample size.

Bell focuses on working memory, it’s something even infants can do and is especially important when children enter school and begin developing reading and math skills. Her emotion focus looks closely at certain autonomous, rather than conscious, temperament characteristics.

The first phase of Bell’s research involved randomly selected infants who visited the lab at five months of age and again at 10 months. The babies were fitted with heart-rate patches and EEG caps and were given developmentally appropriate tasks to perform. These included memory tasks, attention tasks, and emotion tasks. In addition, parents complete several questionnaires as a means of assessing their children’s overall temperament and behavior. The same children return to the lab at ages 2, 3, and 4.

This data indicated a definite change in brain activity when working memory tasks were presented to the infant. It also demonstrated that individual differences in working memory functioning were related to individual differences in brain electrical activity and temperament in infancy.

— Source: Virginia Tech

David Chu (not his real name), a Vietnam-native, arrived in Philadelphia with his family at the age of 3 with little knowledge of the language or region. The family brought with them the view that mental illness is something other than a medical condition, a largely Asian notion.

“Many Asian cultures use herbs to manage the symptoms of mental illness, never getting to the root cause of the problem,” says Helen Luu, director of the Asian Behavioral Health program at Hall-Mercer Community Mental Health Center. “Mental health and behavioral issues are not recognized as medical problems in many Asian cultures. Medication and hospitalization are a last resort, if available.” Family members are often shunned or hidden from the public if they are believed to have a mental or behavioral illness.

The program consists of a multilingual team of five case managers providing social rehabilitation, translation services, case management, counseling, psychiatric services, and community outreach specifically designed for the Asian population. Case managers help bridge language and cultural barriers, working with clients from Hong Kong, China, Cambodia, Vietnam, Laos, and Indonesia. The program currently has about 260 active clients, aged 18 to 80.

For David Chu, diagnosed with bipolar disorder at the age of 20, the program offered the specialized support needed, including how to accept the illness, be compliant in taking medication, and to maintain open communication with my doctors. His case worker, fluent in Vietnamese, was also instrumental in explaining his illness to his parents, who carry a much stronger shame around mental illness from their Vietnamese upbringing. “My parents still have a hard time accepting my illness, but have a greater understanding as a result of my involvement in the Asian Behavioral Health program,” Chu says.

— Source: University of Pennsylvania School of Medicine

Scientists have discovered that cocaine-related images trigger the emotional centers of the brains of patients addicted to drugs—even when the subjects are unaware they’ve seen anything. The study was published recently in the journal PLoS One.

A team of researchers at the University of Pennsylvania, led by Anna Rose Childress, PhD, showed cocaine patients photos of drug-related cues like crack pipes and chunks of cocaine. The images flashed by in just 33 milliseconds—so quickly that the patients were not consciously aware of seeing them. Nonetheless, the unseen images stimulated activity in the limbic system, a brain network involved in emotion and reward, which has been implicated in drug-seeking and craving.

To verify that the patterns of brain activity triggered by the subconscious cues reflected the patients’ feelings about drugs, Childress and her colleagues gave the patients a different test two days later, allowing them to look longer at the drug images. The patients who demonstrated the strongest brain response to unseen cues in the fMRI experiment also felt the strongest positive association with visible drug cues. Childress notes, “It’s striking that the way people feel about these drug-related images is accurately predicted by how strongly their brains respond within just 33 milliseconds.”

— Source: The National Institutes of Health

Green Chimneys has been named the recipient of National Network for Youth’s 2008 Agency of the Year Award in recognition of the vital role the organization plays in the healthy development of youth, families, and communities. Founded in 1947, Green Chimneys serves more than 3,500 children, teens, and families annually through a wide assortment of programs.

“Through its innovative programming, Green Chimneys gives hundreds of children and their families the tools that enable them to regain a sense of self-worth, positively experience and reclaim their youth, and plan for the future as independent, positive, and productive adults,” says Victoria Wagner, president and CEO of National Network for Youth.

There are 2.5 million disconnected, unaccompanied, and/or homeless youth in the United States. Since the awarding of its first federal Runaway and Homeless Youth grant in 2000, Green Chimneys has worked tirelessly on behalf of homeless and runaway gay, lesbian, bisexual, transgender, and questioning youth (LGBTQ). As one of the first mainstream agencies to acknowledge a need for LGBTQ specific programming, Green Chimneys has provided foster care and homeless youths programs for LGBTQ and allies for the last 20 years.

“Green Chimneys is the oldest homeless youth housing program specifically for LGBTQ youths in NYC,” says James Bolas of Empire State Coalition of Youth and Family Services. “This program has always taken an inclusive approach to services, even to the extent that they would not restrict their housing services to only LGBT identified youth only, but opened their services to homeless youth who were allies as well, and create a supportive community environment,”

— Source: Green Chimneys

Couples in which both the husband and wife suppress their anger when one attacks the other die earlier than members of couples where one or both partners express their anger and resolve the conflict, according to preliminary results of a University of Michigan (UM) study.

Researchers looked at 192 couples over 17 years and placed the couples into one of four categories: both partners communicate their anger; in the second and third groups one spouse or partner expresses while the other suppresses; and both the husband and wife suppress their anger and brood, says lead author Ernest Harburg, professor emeritus with the UM School of Public Health and the psychology department. The study is a longitudinal analysis of couples in Tecumseh, MI.

Of the 192 couples studied, 26 pairs both suppressed their anger and there were 13 deaths in that group. In the remaining 166 pairs, there were 41 deaths combined. In 27% of those couples who both suppressed their anger, one member of the couple died during the study period, and in 23% of those couples both died during the study period. That's compared to only 6% of couples where both members of the relationship died in the remaining three groups combined. Only 19% in the remaining three groups combined saw one partner die during the study period.

— Source: University of Michigan

A new UCLA study shows that only approximately one half of children diagnosed with attention-deficit hyperactivity disorder (ADHD) exhibit the cognitive defects commonly associated with the condition. The study also found that in populations where medication is rarely prescribed to treat ADHD, the prevalence and symptoms of the disorder are roughly equivalent to populations in which medication is widely used. The results of the first large, longitudinal study of adolescents and ADHD, conducted among the population of northern Finland, appeared in several papers in a recent Journal of the American Academy of Child and Adolescent Psychiatry.

In adolescence, ADHD is generally associated with cognitive deficits, particularly with working memory and inhibition, which have been linked to overall intelligence and academic achievement. Interestingly, the study showed that these deficits are only present in roughly one half of adolescents diagnosed with ADHD.

Part of the explanation may lie in the common method for diagnosing the disorder. The researchers found that ADHD is an extreme on a normal continuum of behavior that varies in the population. Its diagnosis, and thus its prevalence, is defined by where health professionals "draw the line" on this continuum, based on the severity of the symptoms and overall impairment.

Researchers also found surprising results regarding the effectiveness of medicine in treating ADHD. In contrast to children in United States, youth in northern Finland are rarely treated with medicine for ADHD, yet the 'look' of the disorder—its prevalence, symptoms, psychiatric comorbidity, and cognition—is relatively the same as in the United States, where stimulant medication is widely used. The researchers point out that this raises important issues about the efficacy of the current treatments of ADHD in dealing with the disorder's long-term problems.

— Source: University of California, Los Angeles (UCLA), Health Sciences

Individuals who experienced severe stress-related symptoms in response to the terrorist attacks on September 11, 2001, appear more likely to have been diagnosed with heart problems over the following three years, according to a report in a recent issue of Archives of General Psychiatry.

E. Alison Holman, FNP, PhD, of the University of California, Irvine, and colleagues studied a national sample of 2,729 adults. Of these, 95% (2,592) had completed an online health assessment before the terrorist attacks. About nine to 14 days following the attacks, they responded to a Web-based survey regarding their acute stress responses, such as anxiety, dissociative symptoms (feeling detached from oneself or the world) or a reexperiencing of the event. Participants were then surveyed yearly about their health for three years.

Before the attacks, 21.5% of the participants had been diagnosed with a heart ailment; three years after the attacks, the rate had increased to 30.5%. “Acute stress responses to the September 11, 2001, attacks were associated with a 53% increased incidence of cardiovascular ailments over the three subsequent years, even after adjusting for pre-September 11, 2001, cardiovascular and mental health status, degree of exposure to the attacks, cardiovascular risk factors (i.e., smoking, body mass index, and number of endocrine ailments), total number of physical health ailments, somatization [the conversion of psychological symptoms into physical symptoms], and demographics,” the authors write.

“These findings highlight the possibility that acute stress reactions may indicate subsequent vulnerability to potentially serious health problems,” they conclude.

— Source: American Medical Association

The University of Illinois at Chicago has received a $2.4 million grant from the National Institutes of Health to investigate the impact of anti-smoking television advertising on youth, young adult, and adult smoking behaviors.

"The grant will enable us to match 10 years of Nielsen Media Research data to population surveys that include information about smoking behavior," says Sherry Emery, principal investigator of the study and senior research specialist at the UIC Institute for Health Research and Policy. "We will examine how exposure to a variety of ads, in different areas of the United States across time, is related to smoking and quitting behaviors."

UIC researchers will use multi-level statistical models to combine ad ratings data from Nielsen with data on individual-level smoking behavior and state-level tobacco control policies.

Researchers will also examine the impact of recent reductions in state-sponsored anti-smoking media campaigns. In recent years, ads for drug cessation aids have multiplied and tobacco industry-sponsored ads have shifted focus by marketing to adults.

"The tobacco industry has switched their focus of marketing to youth to marketing to young adults because it's legal," says Emery. "We're very interested in learning about adult smoking behaviors because after the age of 25 is when people start quitting, and a lot of these ads try to motivate people to quit smoking."

— Source: University of Illinois at Chicago

Older adults who are lesbian, gay, or bisexual (LGB) have “a history of caregiving” that creates networks of people who support each other during their senior years, according to a questionnaire study of 199 LGB seniors. The study, published in a recent Journal of Gay & Lesbian Social Services, found that more than two thirds of the participants had provided care to one or more people during the previous five years.

“These findings contradict old myths about elderly gay people leading lonely lives of quiet desperation,” says Robert-Jay Green, PhD, executive director of the Rockway Institute, a national center for LGBT research and public policy. “LGB seniors create vibrant communities of care that overcome the difficulties posed by discrimination or by greater levels of rejection from their biological families.”

Thirty-eight percent of participants reported they had received care from others (who were not healthcare professionals) during the previous five years. Sixty-seven percent had provided care to others. The illnesses for which participants provided care were HIV/AIDS, 30%; cancer, 29%; muscular/skeletal illnesses, 21%; cardiovascular disease, 19% and other chronic illnesses associated with aging, 26%. Having received help was strongly related to providing help. Of those who had received help, 76% had taken care of others. Of those who had not received help, 60% had taken care of others. More than three quarters stated that they were willing to provide care to LGB people in the future.

The researchers observed that networks of support are especially significant for LGB seniors, who may be physically or emotionally distant from their biological family, may be closeted, or may fear or suffer discrimination based on their sexual orientation. Many of these LGB seniors may not know for certain who will provide care in a crisis, or they face financial issues because they are not covered under partner health plans as would be true for married heterosexual couples.

— Source: Alliant International University

New research from Vanderbilt University reveals that children learn the solution to a problem best when they explain it to their mom. “We knew that children learn well with their moms or with a peer, but we did not know if that was because they were getting feedback and help,” Bethany Rittle-Johnson, the study’s lead author and assistant professor of psychology at Vanderbilt’s Peabody College of education and human development, says. “In this study, we just had the children’s mothers listen, without providing any assistance. We’ve found that by simply listening, a mother helps her child learn.”

Rittle-Johnson believes the new finding can help parents better assist their children with their schoolwork, even when they are not sure of the answer themselves. Although the researchers used children and their mothers in the study, they believe the same results will hold true whether the person is the child’s father, grandparent, or other familiar person.

“The basic idea is that it is really effective to try to get kids to explain things themselves instead of just telling them the answer,” she says. “Explaining their reasoning, to a parent or perhaps to other people they know, will help them understand the problem and apply what they have learned to other situations.

“We saw that this simple act of listening by mom made a difference in the quality of the child’s explanations and how well they could solve more difficult problems later on,” Rittle-Johnson adds.

— Source: Vanderbilt University

“Any practitioner prescribing opioids for chronic use should be accountable for having a strategy in place if medication abuse or addiction occurs,” says Peggy Compton, RN, PhD. “Providing daily opioid pain relievers without suitable addiction expertise or support in place puts both the pain-management practitioner and patient at risk for poor outcomes.”

Unfortunately, the common practice of discharging patients from opioid therapy when there are concerns about substance abuse or addiction can do significant harm; not just to patients, but also affecting their families, the healthcare system, and society at large. Such practice should be avoided, Compton, an associate professor of Nursing at the UCLA School of Nursing, urges. Her report, "Should Opioid Abusers Be Discharged From Opioid-Analgesic Therapy?", is exclusively published at www.Pain-Topics.org.

In her report, Compton stresses that instead of denying patients their pain-relieving opioids, working partnerships between addiction and pain specialists should be developed, with the pain practitioner continuing treatment for pain while also playing a role in addiction treatment. This does not require the pain-management practitioner to become an addiction specialist; however, pain practitioners should be involved in, rather than draw away from, addiction treatment for their patients with chronic pain who have need for such services.

Participation by pain practitioners not only enhances therapy for chronic pain but provides them a unique opportunity to help stem the significant public health problem of opioid abuse and addiction. In the report, Compton outlines specific steps for any healthcare provider to follow.

— Source: Pain Treatment Topics

Bisexuality in women appears to be a distinctive sexual orientation and not an experimental or transitional stage that some women adopt “on their way” to lesbianism, according to new research published by the American Psychological Association.

The study of 79 non-heterosexual women over 10 years found that bisexual women maintained a stable pattern of attraction to both sexes. In addition, the research appears to have debunked the stereotype that bisexual women are uninterested in or unable to commit to long-term monogamous relationships. Results of the research were published in a recent issue of Developmental Psychology.

University of Utah psychologist Lisa M. Diamond, PhD, who conducted the study, used interview data collected five times over a decade from 79 women who identified as lesbian, bisexual, or unlabeled. The subjects initially ranged in age from 18 to 25.

Among Diamond’s findings:

• Bisexual and unlabeled women were more likely than lesbians to change their identity over the course of the study, but they tended to switch between bisexual and unlabeled rather than to settle on lesbian or heterosexual as their identities.

• By year 10, most of the women were involved in long-term (i.e., more than a year in length) monogamous relationships—70% of the self-identified lesbians, 89% of the bisexuals, 85% of the unlabeled women and 67% of those who were then calling themselves heterosexual.

“This provides further support for the notion that female sexuality is relatively fluid and that the distinction between lesbian and bisexual women is not a rigid one,” Diamond wrote.

— Source: American Psychological Association

Although discomfort in social situations and drinking are both recognized features of college life, the complex relationship between social anxiety and drinking is not well understood. Research by University of Arkansas psychologist Lindsay Ham into motives for drinking shows that drinking to cope, in particular, can be associated with drinking problems for socially anxious college students.

“It appears that drinking motives, particularly coping motives, have promise of providing a greater understanding of the social anxiety-drinking relationship,” Ham says. The research, published in a recent issue of the Journal of Anxiety Disorders, could aid in identifying and helping college students at risk for alcohol problems. “Recent research has shown some counterintuitive results,” Ham says. “Although social anxiety and drinking are closely related in general society, several studies found little or no relationship for college populations.”

Ham and her colleagues from the University of Nebraska-Lincoln studied drinking motives of 239 undergraduate students to clarify the ways social anxiety affected drinking behaviors. They began by administering four established tests, one to identify a student’s level of social anxiety, another to assess drinking motives, and two tests to measure quantity and frequency of drinking and drinking-related problems. The researchers analyzed their data to explore whether drinking motives might operate differently at different levels of social anxiety.

“In the mid- to high-level social anxiety groups, drinking to cope predicted drinking patterns,” Ham says. “When these students said they were drinking to cope, then there were more drinking problems.”

— Source: University of Arkansas, Fayetteville

Same-sex couples are just as committed in their romantic relationships as heterosexual couples, say researchers who have studied the quality of adult relationships and healthy development. Their finding disputes the stereotype that couples in same-sex relationships are not as committed as their heterosexual counterparts and are therefore not as psychologically healthy. These results are featured in a recent issue of Developmental Psychology.

The study examined whether committed same-sex couples differ from engaged and married opposite-sex couples in how well they interacted and how satisfied they were with their partners. Evidence has shown that positive interactions improve the quality of relationships in ways that foster healthy adult development.

Results showed that same-sex relationships were similar to those of opposite-sex couples in many ways. All had positive views of their relationships but those in the more committed relationships (gay and straight) resolved conflict better than the heterosexual dating couples. And lesbian couples worked together especially harmoniously during a laboratory task.

The notion that committed same-sex relationships are “atypical, psychologically immature, or malevolent contexts of development was not supported by our findings,” says lead author Glenn I. Roisman, PhD. “Compared with married individuals, committed gay males and lesbians were not less satisfied with their relationships.”

Furthermore, says Roisman, “Gay males and lesbians in this study were generally not different from their committed heterosexual counterparts on how well they interacted with one another, although some evidence emerged the lesbian couples were especially effective at resolving conflict.”

— Source: American Psychological Association

In a study that may significantly advance the understanding of how cognitive-behavioral therapy affects the brain, researchers have shown that significant changes in activity in certain regions of the brain can be produced with as little as four weeks of daily therapy in patients with obsessive-compulsive disorder (OCD). The discovery could have important clinical implications, according to principal investigator Sanjaya Saxena, MD, director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego (UCSD) School of Medicine, whose findings were published online in Molecular Psychiatry.

“The study is exciting because it tells us more about how cognitive-behavioral therapy works for OCD and shows that both robust clinical improvements and changes in brain activity occur after only four weeks of intensive treatment," says Saxena. He and colleagues at the David Geffen School of Medicine at UCLA made two novel discoveries in their study of 10 OCD patients and 12 control subjects.

“First of all, we discovered significant changes in brain activity solely as the result of four weeks of intensive cognitive-behavioral therapy,” says Saxena. “Secondly, these changes were different than those seen in past studies after a standard 12-week therapeutic approach using SRI medications or weekly behavioral therapy.”

The normal control subjects received no treatment and were scanned twice, several weeks apart, and metabolic changes in the brain were compared between the two groups. After four weeks of therapy and without any changes in medication, the OCD patients showed significant improvements in OCD symptoms, depression, anxiety, and overall functioning.

— Source: University of California, San Diego Health Sciences

Bariatric surgery is the most effective weight loss option for people who are severely obese. However, the surgery involves substantial risks and requires a lifelong commitment to behavioral change. People eligible for the surgery often have a history of mental health problems or eating disorders. Therefore, patients must be prepared mentally as well as physically before surgery, reports the Harvard Mental Health Letter.

The psychological aspects of bariatric surgery are less well understood than the physical risks and benefits. Although the surgery is generally associated with improved mental health and quality of life, postsurgical psychological and behavioral changes are less predictable than physical changes.

The Harvard Mental Health Letter notes that mood disorders such as depression and anxiety affect many people who are eligible for bariatric surgery. The weight loss following surgery generally improves mood, at least initially. In studies, depression and anxiety scores were reduced significantly one year after surgery, but tended to be higher two and four years later. And some research has found higher-than-expected rates of suicide among surgery patients.

Eating disorders, such as binge eating, also affect many people considering bariatric surgery. And a highly controversial theory—as yet unproven—is that bariatric surgery may cause some people to lose weight but then “transfer” their food addiction to some other harmful addiction. Surgery may change the rate at which alcohol is absorbed, which may increase the risk of dependence in people who are vulnerable to becoming addicted. All of these factors underscore the need for mental health treatment before and after surgery.

— Source: Harvard Mental Health Letter

In their new book Meeting the Needs of Children with Disabilities, researchers Laudan Y. Aron and Pamela J. Loprest detail the challenges facing children with disabilities and their parents when these families try to navigate the multiple, complex public service systems intended to meet their multifaceted needs. The authors underscore that while not a homogeneous group, children with disabilities are more likely than other children to live in poverty, live with only one parent, and have parents who are in poor health or unemployed.

The authors observe that several unconnected systems address children's medical, educational, and financial needs separately. However, each child often has multiple needs that are interconnected. For example, special education services are often less effective if a child lacks needed medical services or is hungry. Aron and Loprest write, "Programs and government systems tend to think narrowly about the specific area of need they focus on, while these children's and families' needs are broad."

Aron and Loprest also explain the incongruities and complexities among the federal and state services for this special population. Systems vary in terms of application processes, eligibility standards, and breadth of services, and there are numerous barriers to access. "The fragmentation of the current child disability service system makes it difficult for families to understand what benefits are available, how to access them, and how to piece together supports that best match their children's needs," write Aron and Loprest. The researchers note very little coordination of services among the top three federal programs for children with disabilities: Medicaid, special education, and Supplemental Security Income.

— Source: Urban Institute

Psychological studies of lesbian and gay couples reveal two key factors that promote healthier relationships and provide examples for all couples: flexibility about gender roles, and equal division of parenting and household tasks. “It all comes down to greater equality in the relationship,” says Robert-Jay Green, PhD, executive director of the Rockway Institute and a nationally recognized researcher in both family issues and gay, lesbian, bisexual, and transgender relationships.

In a series of studies Green conducted, lesbian couples were found to be emotionally closer than gay male couples who, in turn, were found to be emotionally closer than heterosexual married couples. Lesbian and gay male couples also showed dramatically more flexibility in the way they handled rules and roles in the relationship. Thus they avoided the traditional division of labor and division of expressive versus instrumental roles toward which heterosexual couple typically evolve over time despite their best intentions, especially after the birth of children.

“Our research found that the most successful couples demonstrate closeness and flexibility,” says Green. “We found high levels of both characteristics in 79% of lesbian couples, 56% of gay male couples, but in only 8% of heterosexual married couples. Clearly, the more egalitarian approach taken by same-sex couples is an advantage that could benefit straight couples too,” he concludes.

— Source: Alliant International University

People given a biological and genetics-based explanation for the causes of anorexia nervosa were less likely to blame people with anorexia for their illness than those given a sociocultural explanation, a University of North Carolina at Chapel Hill study published in the online version of the International Journal of Eating Disorders found.

In the UNC study, 115 undergraduate nursing students were first given a questionnaire that asked about the participants’ prior level of contact with people with anorexia nervosa. Then each was given a one-page information sheet. Roughly one half received an information sheet that emphasized what is currently known about the biological and genetic contributions to the development of the disorder. The other one half received an information sheet that emphasized sociocultural explanations for the causes of the illness.

After the students read the information they were given a second questionnaire in which they were asked to indicate on a seven-point scale the extent to which eight factors contributed to the development of anorexia. The results showed that individuals in the group given the sociocultural explanation were more likely to agree with the statement, “They are to blame for their condition.” They were also more likely to agree that parenting, vanity, and lack of social support were causes of anorexia nervosa.

The study concluded that “people who were presented with even minimal information about the biological and genetic underpinnings of (anorexia nervosa) did tend to blame people with anorexia for their condition less than are those who were only informed of the sociocultural factors that may contribute to the disorder.”

— Source: University of North Carolina at Chapel Hill

Middle-aged women are much more likely to be depressed if they are obese, and vice versa, a new study published in a recent issue of General Hospital Psychiatry finds. Rising excess weight goes along with less physical activity, higher calorie intake—and depression—according to the research.

Depression and obesity likely fuel one another, says lead author Gregory Simon, MD. “When people gain weight, they’re more likely to become depressed, and when they get depressed, they have more trouble losing weight.”

Researchers interviewed 4,641 female health plan enrollees, aged 40 to 65, by phone. The women responded to items on height, weight, exercise levels, dietary habits and body image. They also completed the Patient Health Questionnaire, a measure of depression symptoms. Women with clinical depression were more than twice as likely to be obese, defined as having a body-mass index (BMI) of 30 or more; likewise, obese women were more than twice as likely to be depressed.

Moreover, women with BMIs at or above 30 exercised the least, had the poorest body image and ingested 20 percent more calories than those with lower BMIs. The depression-obesity association held even when the researchers controlled for marital status, education, tobacco use and antidepressant use.

— Source: Health Behavior News Service

Autism cases continued to increase in California after the mercury-containing preservative thimerosal was eliminated from most childhood vaccines, according to a report in a recent issue of Archives of General Psychiatry. This suggests that exposure to thimerosal is not a primary cause of autism.

Robert Schechter, MD, MSc, and Judith K. Grether, PhD, of the California Department of Public Health, Richmond, studied the prevalence of children with autism in California from 1995 through March 2007. They used data provided by the California Department of Developmental Services, which administers a statewide system of centers that serve individuals with autism and other developmental problems.

“The estimated prevalence of autism for children at each year of age from 3 to 12 years increased throughout the study period,” the authors write. Per 1,000 children born in 1993, 0.3 had autism at the age of 3, compared with 1.3 per 1,000 births in 2003. The highest estimated prevalence—4.5 cases per 1,000 births—was reached in 2006 for children born in 2000. “Although insufficient time has passed to calculate the prevalence of autism for children 6 years and older born after 2000, the prevalence at ages 3 to 5 years has increased monotonically for each birth year since 1999, during which period exposure to thimerosal has been reduced,” they continue.

— Source: American Medical Association

The physical and emotional strains placed on the family of a childhood cancer patient can be extremely difficult, especially for siblings. That’s why one of the nation’s largest pediatric cancer centers, located at Nationwide Children’s Hospital, created the Sibling Support Program. The comprehensive, family-focused course has been named one of the best in the country by SuperSibs, the national organization dedicated to supporting brothers and sisters of childhood cancer patients.

“Understandably, so much attention is focused on the ill child,” says Micah Skeens, PNP, Sibling Support Program Coordinator at Nationwide Children’s Hospital. “However, healthy kids struggle to understand their own emotions as well as the stress on their parents. This program helps the entire family cope and support each other.”

The 12-week program is designed to decrease anxiety, stress and guilt while increasing communication. Siblings participate in group discussions and workbook activities, sharing emotions, and learning coping and communication techniques.

Nationwide Children’s offers the following tips to help siblings cope with illness:
• Be informed by learning about the illness and treatment.
• Talk about change and its effect on your family.
• Share feelings and talk openly with one another.
• Support each other during stressful times.
• Take care of yourself, and don’t forget to make time for rest, relaxation, and fun.

— Source: Nationwide Children's Hospital

For many companies, turnover is more than just losing employees. Ryan Zimmerman, a Texas A&M University industrial-organizational psychologist, says it is an investment loss because time and money are often devoted to employee recruiting and training. Therefore, obtaining low turnover rates are a common goal of employers. Rather than concentrating on keeping employees once hired, research shows that it is important to focus on hiring the right people from the start—people who are less likely to quit.

By closely looking at individual characteristics of prospective employees, “there is proven research that shows certain people are more likely to be habitual quitters, where others will tend to stay at a job no matter what,” says Zimmerman. To better understand why people quit their jobs, Zimmerman conducted a meta-analytic study on turnover and its relationship to individuals’ personalities. His findings are published in an issue of Personnel Psychology.

Zimmerman’s research focuses on three key characteristics that can be measured in an individual: agreeableness, conscientiousness, and emotional stability. People who are more agreeable are less likely to leave a job because they go with the flow and tend to be concerned about what others think, he says. Conscientious people usually have a strong work ethic and are more dependable and reliable, which Zimmerman describes as characteristics of a committed employee. As for being emotionally stable, these individuals are also less likely to quit a job because they are apt to be more calm and secure.

“By focusing on hiring individuals who are higher on these traits, organizations can reduce the amount of turnover they have,” Zimmerman says. “An organization can actually avoid turnover before an employee is even hired by looking at the personality traits ahead of time.”

— Source: Society for Industrial and Organizational Psychology

Using new approaches, an interdisciplinary team of scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City has gained a view of activity in key brain areas associated with a core difficulty in patients with borderline personality disorder—shedding new light on this serious psychiatric condition.

"It's early days yet, but the work is pinpointing functional differences in the neurobiology of healthy people versus individuals with the disorder as they attempt to control their behavior in a negative emotional context. Such initial insights can help provide a foundation for better, more targeted therapies down the line," explains lead researcher David A. Silbersweig, MD, a professor of psychiatry and neurology at Weill Cornell Medical College. The findings are featured in this month's issue of the American Journal of Psychiatry.

The Weill Cornell team used a special functional MRI (fMRI) activation probe that they developed to eliminate much of that interference. This paved the way for the study, which included 16 patients with borderline personality disorder and 14 healthy controls. The team also used a tailored fMRI neuropsychological approach to observe activity in the subjects' ventromedial prefrontal cortex as they performed what "go/no go" tests. These rapid-fire tests require participants to press or withhold from pressing a button whenever they receive particular visual cues. In a twist from the usual approach, the performance of the task with negative words (related to borderline psychology) was contrasted with the performance of the task when using neutral words, to reveal how negative emotions affect the participants' ability to perform the task.

As expected, negative emotional words caused participants with borderline personality disorder to have more difficulty with the task at hand and act more impulsively—ignoring visual cues to stop as they repeatedly pressed the button.

"We confirmed that discrete parts of the ventromedial prefrontal cortex—the subgenual anterior cingulate cortex and the medial orbitofrontal cortex areas—were relatively less active in patients versus controls," Silbersweig says. "These areas are thought to be key to facilitating behavioral inhibition under emotional circumstances, so if they are underperforming that could contribute to the disinhibition one so often sees with borderline personality disorder."

— Source: NewYork-Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

School is supposed to be a safe haven for students, but 30% of U.S. adolescents in grades six through 10 are involved in physical aggression, verbal harassment, or other forms of mistreatment—whether as bullies or victims. In a new study recently published in the Journal of Adolescent Health, lead author Jorge Srabstein, MD, a child psychiatrist at Children’s National Medical Center, and colleagues looked at the content of current state statutes addressing school bullying.

What’s the good news? Before 2003, a previous study found that 15 states had enacted antibullying laws. As of June 2007, 35 states have laws that address harassment, intimidation, and bullying at school, covering an estimated 77% of the 38 million students enrolled in public schools. Despite this progress, the authors found that only 25 states have defined bullying, harassment, or intimidation, and states do not always rely on the same concepts.

Antibullying laws should provide an unambiguous and inclusive explanation of bullying based on an accepted, evidence-based definition of the problem, the authors say. “A clear definition of bullying makes it easier to explain to students what specific behaviors are unacceptable and why,” Srabstein says. “Additionally, it makes clear to all adults involved what is meant by bullying, so they can educate and enforce unambiguous standards of conduct,” he says.

The researchers found that 21 states have legislation that addresses the link between bullying and serious adverse health effects on individuals and communities. Twenty-three states prohibit bullying and 24 states have indicated that their local school boards should have the opportunity or requirement to develop bullying prevention programs, Srabstein says. Only 16 states—covering about 32% of public school students—have legislation that includes basic antibullying public health principles, such as a clear definition of bullying and its link to health risks, the prohibition of bullying, and the need for antibullying prevention programs.

— Source: Health Behavior News Service

A new study of combat-exposed Vietnam War veterans shows that those with injuries to certain parts of the brain were less likely to develop posttraumatic stress disorder (PTSD). The findings suggest that drugs or pacemaker-like devices aimed at dampening activity in these brain regions might be effective treatments for PTSD. The results of his study appear online in Nature Neuroscience.

Jordan Grafman, PhD, a senior investigator at the National Institute of Neurological Disorders and Stroke, and members of his lab studied 193 veterans registered with the Vietnam Head Injury Study and 52 veterans with combat exposure but no head injury. The participants were classified as either having developed PTSD at some point in their lifetime or having never developed PTSD. Computerized tomography scans were used to map their brain injuries.

By comparing the distribution of brain injuries between the PTSD group and the non-PTSD group, the researchers found two regions where damage was rarely associated with PTSD: the amygdala, a structure important in fear and anxiety, and the ventromedial prefrontal cortex (vmPFC), an area involved in higher mental functions and planning.

In another level of analysis, the researchers compared the prevalence of PTSD in subjects who had damage with either the amygdala or vmPFC, subjects who had damage to other parts of the brain and non-head-injured subjects. PTSD occurred in a similar fraction of subjects in the last two groups—40% and 48%, respectively. In contrast, PTSD occurred in only 18% of subjects with damage to the vmPFC and zero (out of 50) subjects with damage to the amygdala. The occurrence of other anxiety disorders was not affected by damage to the amygdala or vmPFC. "It appears that if you have damage to either of those areas, you're not likely to develop PTSD," says Grafman.

— Source: The National Institutes of Health

Asking emergency department patients about their alcohol use and talking with them about how to reduce harmful drinking patterns is an effective way to lower rates of risky drinking in these patients, according to a nationwide collaborative study supported by the National Institute on Alcohol Abuse and Alcoholism and the Substance Abuse and Mental Health Services Administration. A report of the study appears in a recent issue of the Annals of Emergency Medicine.

The study enrolled more than 1,100 patients with all levels of risky drinking and emergency room visit type. The primary intervention consisted of a brief negotiated interview (BNI) that emergency practitioners performed with each member of the intervention group. Patients in the intervention group also received a written handout explaining low-risk drinking and a referral list of alcohol treatment providers. Patients in the control group received only the low-risk drinking handout and referral list.

The BNI is a conversation between emergency care providers and patients that involves listening rather than telling, and guiding rather than directing and typically takes less than 10 minutes to complete.

Researchers contacted members of each group three months later to assess any changes in drinking habits. The intervention group reported drinking three fewer drinks per week than the controls, and more than one third of individuals in the intervention group reported drinking at low-risk levels, compared with about one fifth of those in the control group.

"This study demonstrates that a broad group of emergency practitioners can learn how to perform the intervention and that it is effective across multiple practice sites," says coauthor Gail D'Onofrio, MD, professor and chief of emergency medicine at Yale University. "The emergency department visit is often the only access to care for many patients and thus is an ideal opportunity to begin the conversation regarding unhealthy alcohol use."

— The National Institutes of Health

People with clinical addictions know first-hand the ravages the disease can take on almost every aspect of their lives. So why do they continue addictive behaviors, even after a period of peaceable abstinence? Some answers appear rooted in regions of the brain active during decision making.

“It’s perhaps not just that people are slaves to pleasure, but that they have trouble thinking through a decision,” says Charlotte Boettiger, an assistant professor of psychology at the University of North Carolina at Chapel Hill, and lead author of a recent study in the Journal of Neuroscience that took a novel tack in addiction imaging research.

“Our data suggest there may be a cognitive difference in people with addictions,” Boettiger says. “Their brains may not fully process the long-term consequences of their choices. They may compute information less efficiently.”

The study also found that a variant of the COMT gene, which controls the level of the neurotransmitter dopamine in the cortex, was associated with a tendency to make impulsive decisions and with high activity in certain brain areas during decision making.

“What’s exciting about this study is that it suggests a new approach to therapy. We might prescribe medications, such as those used to treat Parkinson’s or early Alzheimer’s disease, or tailor cognitive therapy to improve executive function,” says Boettiger.

— Source: University of North Carolina at Chapel Hill