Social Work Today E-Zine

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