Tuesday, December 21, 2010

Obesity and depression

Past research has shown that being obese can increase people's risk of depression by between 50 and 150%. However, a new study by researchers from the Group Health Research Institute in Seattle suggests that the relationship can work both ways and that treating fat people's depression can also help them lose weight. The study of 203 women, aged between 40 and 65 divided them into two groups. Both groups focused on weight loss but one group also included a treatment for depression. After six months 38% of the women whose depression symptoms had improved had lost at least 5% of their body weight compared to only 21% of those who showed little improvement. Unfortunately there was little further change in either the women's weight or their depression when they were assessed after 12, 18 and 24 months.

Naltrexone and alcoholism

Naltrexone is used in the treatment of alcoholism. It blocks the pleasurable feelings people get from drinking alcohol and reduces the motivation to drink. Michael Soyka and Suanne Roesner from the University of Munich reviewed 50 studies into the effectiveness of naltrexone covering a total of nearly 7,800 participants. They found that, compared to a placebo, people taking naltrexone were 17% less likely to return to heavy drinking. The trials tested naltrexone used in conjunction with counselling or a 12-step programme, like Alcoholics Anonymous, and the authors of the study warned that although it might help some people, it was not a miracle cure.

Eating disorders and mindfulness

Mindfulness - being aware of the present moment in an open and non-judgmental fashion - has become something incorporated into the treatment of more and more mental-health problems. People with eating disorders often have trouble regulating their emotional, cognitive and physical experiences and an inability to recognise when they feel hungry or full. Natasha Hepworth, who works in a private clinic in Melbourne, Australia, studied the effectiveness of a Mindful Eating Group in a study of 33 patients being treated there. The group was designed to increase the participants' awareness of hunger and satiety cues. After taking part in the group for 10 weeks the participants showed significant improvements in their scores on the Eating Attitudes Test-26 (EAT-26) assessment tool.

Hepworth, Natasha S. - A Mindful Eating Group as an Adjunct to Individual Treatment for Eating Disorders: a Pilot Study Eating Disorders, 19:6–16, 2011

Monday, December 20, 2010

Seniors, side effects and chemical cocktails

Older people who start taking antidepressants may already be taking other drugs for different problems. These drugs can interact with the antidepressants to create a number of side effects which can put people off taking antidepressants. Researchers from Thomson Reuters, the University of Southern California and Sanofi-Aventis studied 39,000 older people who started taking antidepressants between 2001 and 2006. More than 25% were prescribed antidepressants and another drug that could cause a major interaction and another 36% were at risk of less-severe drug interactions. The most common side effects caused by drug interactions were insomnia, somnolence and drowsiness which occurred in 2.6% of people with the next most common being dizziness (1.1%). Only 45% of people who had documented side effects refilled their prescription for the same antidepressant and a quarter stopped taking antidepressants altogether.

Schizophrenia and caeliac disease

People with schizophrenia are more likely to suffer from caeliac disease than the rest of the population. Scientists don't know why but a team of researchers from John Hopkins University in Baltimore looked into the prevalence of antibodies associated with gliadin, transglutinamase and endomysium - which are associated with caeliac disease - in a study of 2,301 people 1,401 of whom had schizophrenia. The researchers found that 23.1% of the schizophrenia patients had moderate-high levels of gliadin antibodies compard to 3.1% of the unaffected people. 5.4% of the schizophrenia patients had high levels of transglutaminase antibodies compared to 0.8% of the unaffected people.

Cascella, Nicola G. ... [et al] - Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population Schizophrenia Bulletin 37 (1), 94–100, 2011

Insight and psychosis

In a mental-health context insight can be defined as being aware that you have a mental-health problem; being aware that you need treatment and being aware that your symptoms are due to an illness. A team of Spanish researchers studied insight in a study of 110 patients with psychosis. They found that after two years of illness insight was poorer in people suffering from schizophrenia than in people suffering from other types of psychosis. The more severe people's psychosis the less insight they had. Being depressed when one develops psychosis; having poorer decision-making skills and a lower IQ, and going for a longer time without getting help were all associated with poorer insight as were reductions in frontal and parietal grey matter.

Parellada, Mara ... [et al] - Trait and state attributes of insight in first episodes of early-onset schizophrenia and other psychoses: a two-year longitudinal study Schizophrenia Bulletin 37 (1), 38–51, 2011

Spending cuts lead to revolving door for eating disorder patients

Spending cuts meant that many people with eating disorders are not admitted to an inpatient treatment programme until their weight has fallen to dangerously low levels. However, there has been little research into whether waiting this long to admit patients can affect their chances of recovering in the long run. Researchers from St George's Hospital in South London studied 82 people with anorexia being admitted to an eating-disorder ward. They found that people's weight when they were admitted to hospital didn't affect how much weight they put on during treatment. However, people who weighed less when they were admitted were kept in hospital no longer than those who were heavier meaning that, although they put on weight at the same rate, they were still lighter when they were discharged and were more at risk of having to go back to hospital within a year.

Sly, Richard and Bamford, Bryony - Why Are We Waiting? The Relationship Between Low Admission Weight and End of Treatment Weight Outcomes European Eating Disorders Review doi: 10.1002/erv.1061

Friday, December 17, 2010

Job losses and mental health - could they be less damaging than feared?

The economic downturn affecting large parts of the Western world has brought lots of job losses with it but new research from the New York University School of Medicine suggests that they may not have the effects on people's mental health that are sometimes feared. The researchers used data from 774 people in Germany who had been made redundant. The participants were taking part in the German Socioeconomic Panel Data study which collected information between 1984 and 2003. This allowed the researchers to collect data about the participants' happiness in the three years before they were made redundant and for four years afterwards. 69% had high and stable levels of life satisfaction before they lost their jobs. This group were more likely to be harder hit by being laid off but a year later their average life satisfaction had returned to pre-job-loss levels, even though this group was no more likely to get another job by the end of the study. 15% of the participants had actually been getting happier before being made redundant and this group showed only a levelling off of their happiness after losing their jobs. 13% were unhappy before losing work and their levels of happiness also stayed the same after getting laid off. 4% of people were becoming unhappier even before they lost their jobs. These people became even unhappier after they became unemployed but their happiness started rising again - albeit not to their original levels - by the third year of the study; this group was the least likely to be re-employed. Germany's economy is doing much better than many other European countries, however, and it has a reasonably generous welfare system so it would be interesting to see whether this research held true for other countries.

Are we right to go for happiness?

Most politicians and economists work on the assumption that economic growth is in itself a good thing. However, research by Richard Easterlin from the University of Southern California suggests that, whatever its other benefits, it does not bring happiness. Easterlin's study tracked the levels of happiness and economic growth in 37 countries over an average of 22 years. Even in countries such as Chile, China and South Korea were per capita income has doubled in less than 20 years levels of happiness were static, or in some cases slightly declining. Although richer countries, and within countries richer people, had higher levels of happiness there was absolutely no connection between economic growth and happiness over time.

Alzheimer's decay could start earlier than thought

Alzheimer's disease is thought to be caused by the build up of tangles, or plaques, of a protein called beta amyloid in the brain. However, researchers from Washington University School of Medicine in St Louis have found that in people who have a genetic variation linked to an increased risk of Alzheimer's disease the brain can start going downill even in the absence of amyloid plaques. The researchers studied 100 people with an average age of 62. None of them had amyloid plaques or any sign of the protein in their spinal fluid but half of them had a variation in the gene APOE4 which is linked to an increased risk of Alzheimer's. The participants with the genetic variation showed different functioning in a region of the brain - centred on a structure called the precuneus - called the default mode network. This region is thought to be connected to what the brain does when it is not thinking about anything in particular - wool-gathering or day-dreaming - but is also connected to lots of other regions so a deterioration here could have widespread effects on other thought processes.

Thursday, December 16, 2010

Cyber-bullying rife but short-lived

Researchers from the University of Valencia have been looking into the incidence of bullying via mobile phones and the internet. They surveyed 2,101 teenagers between the ages of 11 and 17. 24.6% of them had been bullied via their mobile and 29% via the internet. In most cases the bullying lasted for less than a month but in 4% of cases it lasted between three and six month, and in 3% more than a year. Younger children were more likely to experience bullying via this method than older ones and girls likelier than boys. The bullying often took the form of invasions of privacy, spreading of rumours, and social exclusion.

Mothers' depression and babies' health

Up to one in five women experiences depression during pregnancy and postnatal depression is also a common problem. Researchers from the University of Michigan studied 154 pregnant women, over the age of 20, who were tested for depression at 28, 32 and 37 weeks into their pregnancy and again when they gave birth. The researchers took blood samples from the babies' umbilical cords to measure the levels of stress hormones and assessed the babies' motor skills and responses to stimuli and stress when they were two weeks old. The study found that the babies born to women who were depressed had higher levels of stress hormones, decreased muscle tone and other neurological and behavioural differences.

Uncovering the roots of unconscious memory

In In Search of Lost Time Proust describes a whole host of memories suddenly brought back to him when he dips a madeliene biscuit into a cup of lime tea. Psychologists call this process unconscious memory and researchers from the University of California Davis believe that they have found the region of the brain responsible for it. The researchers compared people with amnesia who had damage to an area of the brain called the perirhinal cortex to a group of healthy people. They gave the subjects a long list of words and asked them to think of any pleasant associations they brought to mind; later they were asked to think up words in different categories such as 'furniture.' The participants had MRI scans as they took the tests and in the healthy participants, who performed better in the tests, the perirhinal cortex showed increased activity. The study ties in with other research which shows that Alzheimer's disease often attacks the perirhinal cortex before other brain areas.

'Conduct disorder' and juvenile delinquency

12 and 13-year-olds with 'conduct disorder' are much more likely to engage in violent and delinquent behaviour as teenagers. Researchers from the Universite de Montreal studied 4,125 children, following them over a number of years. They found that the 12- and 13-year-olds with conduct disorder who displayed violent behaviour were six times as likely to sell illicit drugs, nine times as likely to join a gang and 11 times as likely to carry a weapon; they were also eight times as likely to be arrested. Children with conduct disorder who weren't violent were also more likely to behave badly being three times as likely to sell illicit drugs, four times as likely to join a gang and three times as likely to mug someone using a weapon.

Wednesday, December 15, 2010

'Good' cholesterol and Alzheimer's disease

Researchers from Columbia University in New York have been looking into the links between 'good' cholesterol - high-density lipoprotein (HDL) - and Alzheimer's disease. They studied 1,130 adults in northern Manhattan none of whom had dementia or cognitive impairment at the start of the study. As the participants were followed over time there were 101 new cases of Alzheimer's disease. Having higher levels of HDL cholesterol was associated with a decreased risk of developing Alzheimer's even after adjusting for vascular (blood vessel) risk factors and cholesterol-lowering treatments. Being Hispanic and having diabetes at the start of the study both increased the risk of developing Alzheimer's.

Anger and anxiety

Some researchers think that anxiety and anger are linked and that a genetic predisposition to over-react to things, or to see them as a threat, leads some people to worry and fret, developing an anxiety disorder, while others become angry and lash out. Other people think that the anger felt by people with an anxiety disorder is due to the depression that they often also feel and not their anxiety. Researchers from Florida State University used information from 5,692 people who took part in the National Comorbidity Survey. They found that there was a link between anxiety and anger, independent of depression, but that post-traumatic stress disorder (PTSD) and panic disorder were 'not consistently associated with anger experience and expression.'

Hawkins, Kirsten A. and Cougle, Jesse R. - Anger problems across the anxiety disorders: findings from a population-based study Depression and Anxiety doi: 10.1002/da.20764

Acceptance and anxiety

When James Dean's character in Rebel Without a Cause is asked 'What are you rebelling against?' he replies 'What have you got?' and people with generalized anxiety disorder (GAD) feel much the same about worry. Acceptance-based behavioural therapy (ABBT) promotes the acceptance rather than the avoidance of uncomfortable emotions, persuades people that they can usefully channel these emotions and gets them to confront the situations that make them fearful. A team of researchers from the University of Massachusetts studied 31 people, half of whom were put on a waiting list and half of whom received ABBT. The people who received ABBT had significantly fewer difficulties in regulating their emotions and felt less fear about their emotional responses as well as being less bothered by uncertainty; improvements that were maintained when they were followed up after three and nine months.

Treanor, Michael ... [et al] - Acceptance-based behavioral therapy for GAD: effects on outcomes from three theoretical models Depression and anxiety doi: 10.1002/da.20766

Fear and psychopathy

Children with psychopathic traits feel emotions less strongly and have less empathy for other people and recent research suggests that they may feel fear less than other people. A team of researchers from the National Institute of Mental Health in the U.S. investigated this issue in a study of 42 children aged between 10 and 17, 18 of whom had psychopathic traits. The children were asked to talk about how they felt during five recent 'emotionally evocative' events. The study found that psychopathy was associated with feeling less fear and fewer symptoms of sympathetic nervous system arousal such as a pounding heart or sweaty palms.

Marsh, Abigail A. ... [et al] - Adolescents with psychopathic traits report reductions in physiological responses to fear Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2010.02353.x

Tuesday, December 14, 2010

Mums, dads and social anxiety

Social anxiety disorder can lead to depression and anxiety and can impede people's functioning in jobs and relationships. It is often thought to run in families but the genetic risk is modest suggesting that parenting and environment play a part too. Researchers know very little about how upbringing affects children's chances of developing anxiety disorder but some researchers think that the way in which children interpret what is going on around them and the influence their parents have on this could play a part. A team of researchers from the University of Amsterdam in the Netherlands looked into this issue further in a study of 144 children aged between eight and 12. The children were presented with a series of ambiguous social scenarios in which either the father or the mother acted anxiously or confidently. In children who were highly socially-anxious the father's behaviour had a greater influence on their levels of confidence or anxiety but for children who had average or low levels of social anxiety the mother's role was more important. The results suggest that fathers could have an important role to play in boosting the confidence of socially-anxious children.

Bogels, Susan, Stevens, Juliette and Majdandzic, Mirjana - Parenting and social anxiety: fathers’ versus

mothers’ influence on their children’s anxiety in ambiguous social situations Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2010.02345.x

Monday, December 13, 2010

Violent crime - keeping it in the family

Violent behaviour can be made more likely by sociological, biological and psychological factors. All of these affect families as well as individuals and it is no surprise that violent crime tends to run in families. Researchers from the Karolinska Institutet in Stockholm looked into this in a study of 12.5 million people. They found that first degree (i.e. from the same nuclear family) relatives of people who had committed a violent crime were 4.3 times as likely as average to have been violent themselves while more distant relatives were 1.9 times as likely. By comparing people who lived with their biological families to those who had been adopted the researchers found that both genetic and environmental factors raised the risk of developing violent behaviour. A family risk of violence was stronger among women; in higher socio-economic groups and in those who had behaved violently early in life. Some crimes like arson - where being the sibling of an arsonist made people 22.4 times as likely to commit arson themselves - ran particularly strongly in families.

Frisell, T., Lichtenstein, P. and Langstrom, N. - Violent crime runs in families: a total population study of 12.5 million people Psychological Medicine (2011), 41, 97–105

Ethnicity and PTSD

To be diagnosed with post-traumatic stress disorder (PTSD) people have to have experienced a traumatic event, to have developed symptoms and to have sought help from - and been diagnosed by - medical professionals. Researchers don't really know whether these factors vary between different ethnic groups so a team from Harvard School of Public Health surveyed 34,653 people in an attempt to find out. Black people were most likely to develop PTSD over the course of their life (8.7%) than White people (7.4%) and Hispanic people (7%) with Asian people (4%) being the least likely. Overall White people were more likely to experience trauma but Black and Hispanic people were more likely to have suffered child abuse or domestic violence; and Asians, Black men and Hispanic women had a higher risk of war-related events than White people. Among those who had experienced trauma Black people were 22% more likely and Asian people only two-thirds as likely to develop PTSD. All minority groups were less likely to seek treatment for PTSD than White people and fewer than half of minorities with PTSD sought treatment.

Roberts, A. L. ... [et al] - Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States (2011), 41, 71–83.
Psychological Medicine

Measuring the burden of care

As more and more mentally-ill people are looked after in the community the responsibility for looking after them tends to fall on their relatives. A team of researchers from Karlstad University in Sweden looked into the 'burden of care' of 226 relatives from the Norwegian National Association for Families of Mentally-Ill Persons. They found that the relatives were 'burdened' and also reported poor health, with women experiencing a greater burden than men. For relatives who were single, divorced or widowed the burden of care was greater and health was poorer - and financial troubles and frequent phone calls with the mentally-ill relative made matters worse. The researchers also looked into the relatives' sense of coherence - the degree to which they found life to be comprehensible, manageable and meaningful - and found that this was lower in people who felt more of a sense of burden and had poorer health.

Weimand, Bente M. ... [et al] - Burden and Health in Relatives of Persons with Severe Mental Illness: A Norwegian Cross- Sectional Study Issues in Mental Health Nursing, 31:804–815, 2010

Wednesday, December 08, 2010

Child abuse and alcohol problems

Child abuse is a big public-health problem with 794,000 confirmed cases in the U.S. in 2007. It is a risk factor for a number of different problems including alcohol abuse, but less is known about this link in boys than in girls. Researchers from the University of Southern California, Los Angeles studied 3,527 men aged between 17 and 56. Approximately 9% of the participants reported childhood maltreatment - defined as serious neglect or physical or sexual abuse occurring before the age of 15. Those who had been abused were 74% more likely to develop an alcohol problem.

Young-Wolff, K.C. ... [et al] - Accounting for the association between childhood maltreatment and alcohol-use disorders in males: a twin study Psychological Medicine (2011), 41, 59–70

Coping style and psychotherapy

People tend to cope with problems and difficulties in different ways. Some people bottle things up and become anxious and depressed while others show less sympathy to others, behave insensitively and become angry. Psychologists call these techniques internalizing and externalizing respectively. Psychotherapists are increasingly trying to tailor their treatments to individual patients - whether it be their preferences about treatment, or cultural, social or religious background - and a team of researchers from the University of Palo Alto looked into whether tailoring treatment to coping style would make it more effective. They reviewed 12 studies, covering a total of 1,291 people and found that people who externalized their problems did better with treatments that targeted their behaviour while people who internalized them did better with treatments designed to help them get insights into their thought processes.

Beutler, Larry E. ... [et al] - Coping style Journal of Clinical Psychology: in session 67(2), 1-8 

Psychosis and suicide

The long-term risk of suicide after a first episode of psychosis is unknown although most researchers think it is probably higher than the rate in the rest of the population. Researchers from the Institute of Psychiatry, King's College London studied 2,723 people in Camberwell, London; Nottingham and Dumfries and Galloway (Scotland) following them for 11 years after their first episode of psychosis. They found that although the rate of suicide was highest in the first year after becoming ill the increased risk persisted for years. Over the course of the study suicide among the participants occured nearly 12 times more than would be expected among the general population. 53 of the participants killed themselves over the course of the study, 49 more than would have been expected in a similar group of unaffected people. Even after ten years the suicide rate among the participants was four times as high as in the general population.

Dutta, Rina ... [et al] - Reassessing the long-term risk of suicide after a first episode of psychosis Archives of General Psychiatry 67(12), December 2010, 1230-1237

Bipolar disorder and recovery from depression

Some researchers think that people with depression who also show some of the symptoms of bipolar disorder are less likely to respond well to treatment. A team of researchers led by Roy H. Perlis from Harvard Medical School looked into this issue in a study of 4,041 people taking part in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. They found that irritability and symptoms of psychosis (delusions and hallucinations) at the start of the study were significantly associated with poorer treatment outcomes but other symptoms of bipolar disorder and a family history of the condition weren't.

Perlis, Roy H. ... [et al] - Association between bipolar spectrum features and treatment outcomes in outpatients with major depressive disorder Archives of General Psychiatry doi:10.1001/archgenpsychiatry.2010.179

Monday, December 06, 2010

Charting the path from childhood delusions to mental illness

Although only around 1% of people suffer from full-blown schizophrenia or psychosis hallucinations or delusional beliefs - psychotic-like experiences (PLEs) - are more common and some psychologists think they are a risk factor for developing mental illness. One study found that 11-year-olds who reported a PLE were 16 times more likely to be diagnosed with schizophrenia when they were 26. For most people PLEs decline as they grow up but in a few people they persist, or even get worse. A team of researchers from the Institute of Psychiatry, King's College London looked into this is in a study of 409 teenagers who were studied four times at six-month intervals. They found that the teenagers whose PLEs were persistent suffered frequent victimization and higher levels of depression and anxiety. Those whose PLEs increased were more likely to smoke and use cannabis and cocaine.

Mackie, C. J., Castellanos-Ryan, N. and Conrod, P.J. - Developmental trajectories of psychotic-like

experiences across adolescence: impact of victimization and substance use Psychological Medicine (2011), 41, 47–58

Child poverty and mental distress

Adults who are poor are also more likely to suffer from depression and anxiety, however, despite what common sense might suggest the research into how poverty affects the mental health of children and young people is inconclusive. A team of French researchers used information from a study of 941 people. The participants in the study were aged between four and 18 when it started in 1991 and were followed up in 1999. The study found that the children from low-income families in 1991 were 74% more likely to suffer from anxiety and depression in 1999. Children in families whose income either decreased or stayed persistently low between 1991 and 1999 were 2.44 times more likely to suffer from psychological distress.

Melchior, Maria ... [et al] - Family income and youths' symptoms of depression and anxiety: a longitudinal study of the French Gazel youth cohort Depression and anxiety 27(12), 1095-1103

Tough childhoods, emotional reactivity, depression and anxiety

To some extent everybody suffers from stress but some people seem to get more worked up about it than others, something psychologists call emotional, or stress, reactivity. Psychologists have known for a long time that adverse childhood experiences can make people more prone to suffer from depression and anxiety as adults and some think that increased emotional reactivity is one of the ways it might do this. A team of researchers from Harvard School of Public Health looked into this in a study of 268 men who were studied from late adolescence over a seventy-year period. They found that people with better overall childhood environments and a greater number of environmental strengths were at a smaller risk of developing depression or anxiety as adults. Families from poorer backgrounds and with childhood environments characterized by greater conflict and adversity had higher emotional reactivity and higher emotional reactivity in turn predicted the development of adult mood and anxiety disorders.

McLaughlin, Katie A. ... [et al] - Childhood social environment, emotional reactivity to stress, and mood and anxiety disorders across the life course Depression and anxiety 27(12), 1087-1094

Helping children with autism by teaching them to be copycats

As most children develop they acquire the ability to imitate other people, pay attention to the same things and reflect others' moods - something psychologists call socially-synchronous behaviour. Unfortunately children with autism do not develop in this way and although there is evidence to suggest that early interventions can help children with autism improve their social skills there have been no trials of methods for 'enhancing socially-engaged imitation.' A team of researchers from the U.S., led by Rebecca J. Landa from John Hopkins University in Baltimore, studied 50 toddlers with autism. All the toddlers took part in a programme to improve their social skills but half of them also received extra help with 'interpersonal synchrony.' Those who were taught how to imitate other people doubled the number of times they copied others, made more eye contact and developed better social skills overall.

Landa, Rebecca J. ... [et al] - Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2010.02288.x

Friday, December 03, 2010

Parenting programme lays firm foundations

The birth of a child can bring stress and conflict to couples as well as joy and happiness. The Family Foundations programme aims to foster attitudes and skills related to positive family relationships such as emotion regulation, temperament and positive parenting. Researchers from Penn State University studied the effectiveness of the programme comparing a group of parents around the birth of their first child who received eight sessions of it (four before birth and four after) to a control group. The study found that the parents who took part in the programme had lower levels of stress and depression and higher levels of confidence in their parenting abilities; they also supported each other more and showed more effective parenting styles with less over-reaction and less use of corporal punishment.

Smoking and mental health - feeling glum and giving up

Giving up smoking could be as good for people's mental health as it is for their bodies despite the fact that people often say they smoke because it makes them feel less anxious or depressed. Researchers from Brown University in Rhode Island studied 236 men and women who were trying to give up. 99 of them never managed to give up at all, 33 managed to give up for the whole 28 weeks of the study and the rest gave up temporarily. Those who managed to quit temporarily had fewer depression symptoms when they weren't smoking but after they had relapsed their mood got worse, in some cases ending up worse than before they had stopped. The participants who never gave up were the unhappiest of all the groups whereas the ones who managed to abstain over the whole course of the study were the happiest to begin with and remained at the same level of happiness throughout.

Brain scan could help with autism diagnosis

A test which can diagnose autism accurately could help children with the condition get help and support as soon as possible. Researchers from McLean Hospital in Boston and the University of Utah used MRI scans to look at how people's brains worked in a study of 60 men and boys aged between eight and 26. Half of the participants had 'high-functioning' autism and half were unaffected. The study found that the participants with autism had differences in their superior temporal gyrus and their temporal stems - areas which are involved with language, emotion and social skills. In autistic participants the white matter fibres in the superior temporal gyrus were more organised on the right-hand side but it was the other way around for unaffected people. The test had an accuracy rate of 94% which is very good compared to other methods although the participants were much older than the usual age for diagnosing autism which is around three.

One in seven young U.S. women suffering from depression

Researchers from the U.S. Centers for Disease Control and Prevention in Atlanta have been using national data to assess the prevalence of depression and serious psychological distress (SPD) among young, non-pregnant women aged between 18 and 44. They found that 14% of them - about one in seven - suffered from current depression and 2.7% suffered from SPD. Older age, less education, being single and being unemployed were all risk factors for depression and SPD. Women with depression were less likely to be diagnosed if they were aged 18-24, weren't white, had children, lived in an urban area or were employed.

Thursday, December 02, 2010

Goals and grief

It's normal to feel grief and sadness after the death of a loved one yet for some people the effects can be much worse. People who go on to develop what psychologists call prolonged grief disorder (PGD) experience persistent yearning for their lost loved ones, difficulty in accepting their loss, numbness and a shattered sense of identity. Paul A. Boelen from Utrecht University in the Netherlands looked into how people's goals and wishes for the future affected their grieving process in a study of 160 bereaved people. The participants in the study were asked to write down seven important personal goals and to complete questionnaires designed to measure their levels of PGD and depression. The study found that more severe PGD was associated with goals which were less specific, felt to be - at least partially - beyond people's control, and which had a lower perceived likelihood of being achieved. Mourners with more PGD had goals that were associated with loss and feelings rather than with work, education or relationships.

Boelen, Paul A. - Personal Goals and Prolonged Grief Disorder Symptoms Clinical Psychology & Psychotherapy doi: 10.1002/cpp.731

Friday, November 26, 2010

Diabetes and depression

There is good evidence of a link between diabetes and depression and new research from the Harvard School of Public Health suggests that the link could work in both directions. The researchers studied 65,381 women who were aged between 50 and 75 in 1996. The women filled out a questionnaire about their medical history at the start of the study and every two years thereafter. Over the course of the study 2,844 of the women developed type 2 diabetes and 7,415 developed depression. The women with depression were about 17% more likely to develop diabetes, even after taking into account other risk factors such as physical activity and weight, while the women with diabetes were 29% more likely to develop depression.

Pathological gambling and suicide

People with gambling problems are not only at risk financially they are also far more likely to kill themselves. 5% of people who kill themselves are pathological gamblers and gamblers are three times more likely to kill themselves than people who don't bet. Researchers from the Universite de Montreal studied 122 suicides which took place between 2006 and 2009, 49 of whom were pathological gamblers. The gamblers had twice as many personality disorders as the other suicides and were three times less likely to seek help before they killed themselves.

Study gives thumbs up to Canadian family intervention

There has been a lot of research recently into ways in which the Government, health services and other public bodies can intervene early in the lives of disadvantaged children to help them do better later on in life. One such initiative is the Better Begginings, Better Futures project which has recently been studied by researchers from Queen's University in Ontario, Canada. The researchers compared 959 children, 601 of whom were between four and eight and took part in the project and 358 of a similar age who formed a control group. Follow-up data on the children was collected when they were in years 3, 6, 9 and 12 at school. The study found improvements in social and school functioning in the children who took part in the project and fewer emotional and behavioural problems at school. By year 12 the children who took part in the study were less likely to have committed a property crime and their parents were reporting greater feelings of social support, happier marriages and better family functioning. The project proved cost-effective as the Government ended up spending less money helping each child because they did better in the long term.

Study backs religious and spiritual therapies

Religion can be defined as adherence to a belief system and practices associated with a tradition in which there is agreement about what is believed and practiced whereas spirituality can be defined as a more general feeling of closeness and connectedness to the sacred. In recent years psychotherapists have been trying to incorporate both - where appropriate and where the patient wants it - into psychotherapy. A team of researchers from Virginia Commonwealth University reviewed 46 studies, covering a total of 3,290 people, into the effectiveness of 'religious accommodative' and 'nonreligious spirituality' therapies. They found that patients receiving these therapies showed greater improvements in psychological and spiritual outcomes than those receiving alternative secular therapies.

Worthington, Everett L. ... [et al] - Religion and Spirituality Journal of clinical psychology: in session 67(2), 1--11

Thursday, November 25, 2010

Resistance, reactance and psychotherapy

Despite expressing a sincere wish to recover some patients behave in almost exactly the opposite way from that suggested by their psychotherapist - something sometimes called patient resistance. However, a team of researchers from Palo Alto University in California thought that patient resistance was a term which was too pejorative to patients and decided to call it patient reactance instead in an acknowledgement that the therapist's approach could also play a part in this happening. The researchers looked at 12 studies into this issue covering a total of 1,102 participants. They found that those patients who were more inclined to follow their therapist's advice benefited more from a more directive approach (i.e. being told what to do) whereas patients who had high levels of resistance/reactance benefited more from a nondirective approach.

Beutler, Larry E. ... [et al] - Resistance/Reactance Level Journal of Clinical Psychology: in session Vol. 67(2), 1-10 (2011)

Child abuse and drug addiction

Child abuse is known to be a risk factor for a number of different mental-health problems and antisocial behaviour. Researchers from the Albert Einstein College of Medicine in New York studied 143 people in an attempt to find out more about this. 48 of them were child molesters, 25 were recovering opiate addicts and the rest formed a healthy control group. The participants were asked whether they had suffered adult sexual advances while they were children or if they had had sexual intercourse with someone at least five years older before they were 13. The participants who were child molesters or recovering opium addicts had lost their virginity at a younger age than the healthy controls. However, while the child molesters were more likely to have been abused themselves the recovering addicts were no more likely to have suffered child abuse than the control group. But, this was a relatively small study and a number of other researchers have found a link between child abuse and drug addiction.

Cohen, Lisa J. ... [et al] - Comparison of Childhood Sexual Histories in Subjects with Pedophilia or Opiate Addiction and Healthy Controls: Is Childhood Sexual Abuse a Risk Factor for Addictions? Journal of Psychiatric Practice 16(6):394-404, November 2010

Tuesday, November 23, 2010

New approach bears dividends after 7/7 attacks

People caught up in attacks by terrorists often suffer from psychological as well as physical trauma yet studies of what happened after events like the 1995 Oklahoma City bombings and the 9/11 attacks show that those caught up in them do not always contact their GP or get the help they need. Following the July 2005 attacks in London the U.K.'s Department of Health set up a Trauma Response Programme. They used contact details of people known to have been caught up in the attacks from a variety of sources including the telephone help-line NHS Direct, hospitals, charitable relief funds and the police. People received a letter or a telephone call and a brief two-page questionnaire designed to ascertain mental-health problems. At the same time a media campaign advertised the programme and encouraged individuals to contact it. The programme contacted 910 people of whom 596 filled out the questionnaire. 217 people were adjudged to need treatment and they received either trauma-focused cognitive behaviour therapy or eye-movement desensitization and reprocessing (EMDR). The treatments were found to be very effective and gains made in treatment were maintained one year later.

Brewin, C. R. ... [et al] - Outreach and screening following the 2005 London bombings: usage and outcomes (2010), 40, 2049–2057
Psychological Medicine

Most people don't stay the course with antidepressants

Most people who take antidepressants give them up before they are supposed to. Researchers from the Catalan Institute of Health studied 7,525 people who were starting antidepressant treatment. They found that 56% stopped taking their medication during the first four months and only 25% continued their treatment for more than 11 months. Only 22% of the sample completed their treatment although women were more likely to carry on taking the pills than men and those who took more than one kind of medication stuck with their pills better than those who just took antidepressants. Doctors recommend taking antidepressants for at least six months.

Premature babies have more problems at six

Children born between 34 and 36 weeks into their mothers' pregnancies could be at greater risk of developing cognitive and emotional problems. Researchers from Michigan State University studied a group of children born between 1983 and 1985 and compared at what stage during their mothers' pregnancies they were born to information collected when they were six. The children born between 34 and 36 weeks had lower levels of cognitive performance and higher levels of behavioural problems even after accounting for socioeconomic factors and maternal IQ.

Talking and trauma

Talking or writing about trauma that one might have experienced (emotional disclosure) is widely seen as being therapeutic for people but the evidence about this is mixed and the best way of achieving it is unclear. Researchers from Wayne State University in Detroit looked into this issue in a study of 214 people who had 'unresolved stressful experiences.' Some of the participants formed a control group while the rest of them had a 30-minute session of either written or private spoken disclosure, talking to a passive listener or talking to an active facilitator. After six weeks both the disclosure groups and the control group showed similar reductions in stress i.e. disclosure had no more effect than the passage of time. However, those people who had spoken or written about their experiences did show more post-traumatic growth; something defined as finding meaning in the experience, changing one's priorities, seeing new possibilities, increasing understanding and appreciation of life, improving relationships and making spiritual changes. There was no difference between the different methods of disclosure in the amount of post-traumatic growth they engendered.

Slavin-Spenny, Olga M. ... [et al] - The Effects of Different Methods of Emotional Disclosure: Differentiating

Post-Traumatic Growth From Stress Symptoms Journal of Clinical Psychology  DOI: 10.1002/jclp.20750

Monday, November 22, 2010

Genes and anorexia

A team of researchers from the Center for Applied Genomics at The Children's Hospital of Philadelphia has been looking into the genetics of anorexia nervosa. They studied 4,736 people, 1,003 of whom had anorexia and compared their genes. The study found that variations in two genes - OPRD1 and HTR1D - increased the risk of developing the condition. However, most scientists think that although genes might increase the risk of developing mental-health problems the true causes of these conditions lie in a combination of genetics and people's upbringing and experiences.

Girls less likely to be diagnosed with autism even if their symptoms are just as bad

Girls are less likely to be diagnosed with autism than boys even if their symptoms are just as bad. Previous research has shown that boys are four times as likely to have autism than girls but not everyone with symptoms of autism receives a diagnosis. Researchers from the universities of Bristol and Exeter used information from the Avon Longitudinal Study of Parents and Children to look into this issue further. They found that even in children with similar levels of autism symptoms boys were more likely to be diagnosed with the condition. Although autistic symptoms were worse in children with older mothers these children were much more likely to receive a diagnosis suggesting that older mothers might be better at identifying problems in their children and more confident in dealing with health professionals. Ethnic origin, social class and marital status did not predict an increase in either autism diagnosis or symptoms.

Albumin and cognitive decline

Having a protein called albumin in one's urine can be a symptom of disease and new research suggests that it could also be linked to cognitive decline. Researchers from Brigham and Women's Hospital in Boston studied 1,200 women over 70 who were tested on their cognition and provided urine samples. The women were assessed every two years until they had been tested three times. The women who had albumin in their urine suffered cognitive decline at a rate between two and seven times quicker than would be expected during the normal ageing process. In another study researchers from Stanford University studied 19,399 people over 3.8 years, 1,184 of whom developed cognitive impairment. The people with albumin in their urine were 31-57% more likely to develop cognitive impairment.

Friday, November 19, 2010

PTSD and cardiovascular disease

Researchers from the Greater Los Angeles Veterans Administration Center have been strengthening the research linking post-traumatic stress disorder (PTSD) to heart disease. The researchers looked at the medical records of 286,194 veterans, 637 of whom had scans showing the thickness of their arteries. About three quarters of the veterans with PTSD had hardening of the arteries compared to 59% of those without PTSD. The veterans with PTSD were nearly two-and-a-half times more likely to die (of all causes) during the course of the study. Among the veterans with calcium build up in their arteries those with PTSD had a 48% greater risk of death overall and a 41% greater risk of dying fom cardiovascular disease.

Body clocks, genes and depression

People suffering from depression can often suffer from sleep problems as well, particularly waking up early in the morning and not being able to get back to sleep again. Researchers from Ohio State University compared 30 people with a history of depression to 30 people who had never had it. They looked into levels of a substance called messenger RNA related to four genes which help govern people's body clocks. The participants who had had depression had a higher level of activity in the 'Clock' gene suggesting that they had a problem with their body clocks.

HRT and dementia

Researchers from the Kaiser Permanente health organization in the U.S. have been looking into the effects of hormone therapy on women's risk of developing dementia. They took a large sample of women and asked them about their hormone use during middle age and old age; 1,524 of the women were diagnosed with dementia during the course of the study. The study found that women who took the hormones in both middle age and old age had a similar risk of dementia while women who took hormones only in old age had a 48% higher risk of developing it. Women who took hormones only in middle age had a 26% lower risk of developing dementia.

Delayed gratification and ADHD

One could say that the ability to delay gratification - not to want everything right here and right now - is one of the hallmarks of becoming a mature, civilized human being, albeit one sadly missing from a lot of people. The inability to take the long-term view is sometimes thought to be one of the symptoms of attention-deficit hyperactivity disorder (ADHD) and a team of researchers from Oregon Health & Sciences University sought to test this theory in a study of 58 seven-to-nine-year-olds. The children were asked whether they wanted to receive a smaller sum of money straight away or a larger one at some point in the future. Once the effect of IQ was taken into account the children with ADHD were no more likely to opt for instant gratification than the children without it.

Wilson, Vanessa B. ... [et al] - Delay discounting of reward in ADHD: application in young children

Journal of Child Psychology and Psychiatry doi:10.1111/j.1469-7610.2010.02347.x

Wednesday, November 17, 2010

Old musicians stave off brain decay

The auditory cortex is the part of the brain that deals with processing sound and new research from the University of Toronto suggests that in older musicians it might be better preserved than in other adults of a similar age. The researchers studied a group of musicians and a group of non-musicians on an active-listening task - where they were told to focus on the sounds - and a passive listening task where they carried out another activity. During the tests the researchers used electroencephalography to measure the activity in the participants' brains. During the periods of attentive listening the older musicians' brains performed as well as younger adults whereas the older participants who weren't musicians showed a decline with age.

Energy drinks and drink problems

Students often drink so-called energy drinks, which contain large amounts of caffeine, so they can either study or stay up longer socialising. However, new research by scientists at the University of Maryland suggests that they could also lead to more students developing a drink problem. The researchers studied more than a 1,000 students who were asked about their consumption of energy drinks and alcohol over the last year. Those who drank energy drinks once a week or more were more likely to get drunk at an earlier age and drink more per drinking session, and were more likely to develop alcohol dependence than those who used them less. The researchers thought that this was in part because the energy drink counteracted some of the effects - if not the damage - of the students' drinking.

Getting to grips with the neuroscience of Alzheimer's

Researchers from Rush University Medical Center in Chicago have been using MRI scans to investigate what happens in people's brains when they develop Alzheimer's disease. They followed 52 people with mild cognitive impairment, often seen as a forerunner of dementia, over five to six years; 23 of them went on to develop full-blown Alzheimer's. The researchers concentrated on a region deep within the brain called the substantia innominata. They found that although this region was unaffected the parts of the cerebral cortex (which is responsible for reasoning and memory) that received signals from it were significantly thinner in those people who went on to develop Alzheimer's.

Children's memories and trauma

Psychologists have researched how people's memories of a traumatic event can effect how likely they are to develop post-traumatic stress disorder (PTSD) as a result of it. They've found that among adults with PTSD and acute stress disorder (ASD) trauma memories are fragmented and disorganised; are expressed more through the senses than words, and show increased emotional content. However, there has been much less research into how this process works in children. Researchers from the Institute of Psychiatry, King's College London studied 50 children being treated in hospital after an assault or a road-traffic accident. Some of the children developed ASD while others didn't and the children were asked to write the story (or narrative), both of the traumatic event itself and of another event which was unpleasant, but not traumatic. The children with ASD had significantly higher levels of disorganization in their trauma narrative compared to children without ASD and with their own non-trauma narrative. For all the children trauma narratives had significantly higher sensory content and lower positive emotion content than the comparison story. The severity of the children's ASD symptoms was significantly predicted by the level of disorganisation in the trauma narrative and the child's negative appraisals (e.g. 'this event has ruined my life,' 'I'm going mad to feel like this.') of the event.

Salmond, C. H. ... [et al] - The nature of trauma memories in acute stress disorder in children and adolescents Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02340.x

Tuesday, November 16, 2010

Mothers' mental health and children's feeding problems

Mothers' eating disorders, depression and anxiety are all known to cause feeding difficulties in their children, however, there have been few studies investigating how eating disorders interact with mothers' other mental-health problems to create feeding difficulties in children. A team of researchers from the Institute of Psychiatry, King's College London studied 10,902 women taking part in the long-term Avon Longitudinal Study of Parenting and Children. They found that mothers having an eating disorder had a direct effect on children's feeding problems and also had an indirect effect by making women more depressed and anxious. Having a child with feeding difficulties also increased the mothers' distress over time.

Micali, Nadia ... [et al] - Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study Journal of Child Psychology and Psychiatry DOI: 10.1111/j.1469-7610.2010.02341.x

Homeless youngsters' drug problems

Compared to other young people homeless youngsters are more likely to start taking drugs at a younger age and to take them more often. However, little research has been done into the specific factors that lead homeless youngsters into drug taking. A team of researchers from the University of California, Los Angeles looked into this issue in a sample of 156 homeless youngsters, aged between 15 and 25. They found that the youngsters who perceived their health as being worse and who had poorer coping strategies were more likely to have bigger drug problems.

Nyamathi, Adeline ... [et al] - Correlates of Substance Use Severity Among Homeless Youth Journal of Child and Adolescent Psychiatric Nursing, 23(4), 214–222

Schizophrenia, metabolic syndrome and quality of life

Metabolic syndrome is a collection of factors that can add to people's risk of developing heart disease and other health problems and includes having a pot belly, high cholesterol, being overweight, having high blood pressure and having difficulty controlling one's blood sugar. People with schizophrenia are prone to developing metabolic syndrome, partly because the drugs they take make them put on weight. A team of Spanish researchers looked at the effects of metabolic syndrome on quality of life in a study of 136 people with schizophrenia, of whom 49 had metabolic syndrome. They found that the older people were, the longer they had been ill and the longer they had taken antipsychotics the more likely they were to have metabolic syndrome. Metabolic syndrome was also associated with a lower quality of life and mobility problems. Quality of life was negatively affected most strongly by age but also by metabolic syndrome and mobility problems.

Tomás Sánchez-Araña Moreno ... [et al] - Quality of life in a sample of schizophrenic patients with and without metabolic syndrome Journal of Psychiatric Intensive Care (2010), 6(2): 101-108

Reducing seclusion on mental-health wards

People with severe mental-health problems are sometimes locked in a room on their own for the protection of themselves and other people. This practice is known as seclusion and is very controversial with critics seeing it as degrading and traumatising. There is also the risk that patients might get hurt as they struggle to avoid being placed in the rooms and may come to harm as they are left in isolation; and there are also worries that seclusion can damage people's mental health. In the U.S. a treatment known as sensory modulation is used to reduce the incidence of people being placed in seclusion; this can include weighted blankets, multisensory treatment rooms - which might contain paintings, music and reading material - portable music players and optical lamps. At the same time clinicians often try to assess which things might trigger people to become severely agitated and what the patients themselves feel would be the best things to calm them down. A team of researchers from the Alfred Hospital and Monash University - both in Melbourne - studied the use of sensory modulation and an assessment scheme called Safety Tool in a 30-bed psychiatric intensive-care unit. Before the use of these techniques 65% of the patients had previously been secluded but after their introduction only 26% were. 76% of the staff on the unit thought that Safety Tool should be part of standard care.

Lee, Stuart J. ... [et al] - Sensory assessment and therapy to help reduce seclusion use with service users needing psychiatric intensive care Journal of Psychiatric Intensive Care 6(2) 83-90

Friday, November 12, 2010

Major review backs family interventions for schizophrenia

People with schizophrenia are more likely to suffer a relapse if they come from families where they experience high levels of criticism and hostility and where family members blame themselves for the sufferer's illness. There are a number of ways in which psychologists and health professionals try to reduce these emotions but their effectiveness has not been proven. A team of researchers led by Fiona Pharaoh from Oxford and Buckinghamshire Mental Health NHS Foundation Trust reviewed 53 trials of these techniques involving a total of 4,708 patients. They found that family interventions led to a reduction in relapses, significantly reduced hospital admissions, improved patients' social functioning and encouraged them to take their medication.

Motivation, depression and psychotherapy

Over the last 20 years researchers have begun to recognise that other factors - apart from the kind of treatment used and the nature of people's mental-health problems - affect whether psychotherapy gets people better or not. Two of the most important factors are the therapeutic alliance - the relationship between a psychotherapist and their client - and autonomous motivation which is defined as the extent to which people feel they have gone into treatment of their own free will and without external pressure. A team of researchers from the University of Toronto and McGill University in Montreal studied 74 people being treated for depression who each received 16 sessions of interpersonal therapy. Their study found that overall both the therapeutic alliance and autonomous motivation predicted remission from depression. However, for those patients whose depression was highly-recurrent autonomous motivation had no effect at all in whether they got better.

McBride, Carolina ... [et al] - Autonomous and controlled motivation and interpersonal therapy for depression: Moderating role of recurrent depression British Journal of Clinical Psychology Volume 49, Number 4, November 2010, 529-545

Internet therapy - how many people drop out?

The internet is used more and more to deliver treatment for mental-health problems and research has shown that internet-based treatment is effective for a number of different psychological conditions. However, there are worries about the number of people who drop out of internet-based treatment and researchers from Griffith University in Brisbane and Queensland University of Technology reviewed 19 studies into this issue carried out between 1990 and April 2009. The studies had dropout rates between two and 83% with the average rate being 31%. The researchers also found that there was little evidence to suggest which factors made it more likely that people would drop out of internet therapy.

Melville, Katherine M.; Casey, Leanne M.; Kavanagh, David J. - Dropout from Internet-based treatment for psychological disorders British Journal of Clinical Psychology 49 (4), November 2010, 455-471

Do worry guts children walk less?

Pedometers, which count the number of steps people take, are used both as a research method to monitor people's physical activity and a way of motivating people to take more exercise. In the course of their studies researchers have noted a phenomenon called reactivity in which people's activity increases in response to the fact that they are conscious of being monitored. This can be useful if the object of the exercise is to get people to become more active but not so good if the purpose is to measure people's activity as it distorts the results. Getting children to become more active is very important to prevent childhood obesity and researchers from Hong Kong University studied 156 children aged between nine and 12 to look at whether rehearsal - a tendency to constantly chew over upsetting experiences - is linked to increased pedometer reactivity. The researchers' theory was that the upsetting effect of being monitored would lead to a greater increase in activity in the children who were prone to more rehearsal as they would spend more time thinking about the implications of being monitored. In week one of the study this was, indeed, the case but by week three the children who 'rehearsed' more were showing a decrease in activity levels from week one and were taking far less exercise than average for children of their age group. The study showed both that the effects of reactivity were short-lived and that children who are sedentary may be more prone to dwell on things.

Ling, F. C., Masters, R. S. and McManus, A. M. , Rehearsal and pedometer reactivity in children. Journal of Clinical Psychology, n/a. doi: 10.1002/jclp.20745

Thursday, November 11, 2010

Autism, IQs and emotion recognition

Problems in recognising emotions have been seen as one of the main symptoms of autism but previous laboratory studies have produced mixed results and have had a number of flaws including a small sample size, participants with a narrow range of IQs and an over concentration on visual tests which ignores the ways in which people perceive emotions. A team of researchers led by Catherine R.G. Jones from the Institute of Education in London studied 156 teenagers comparing their ability to recognise emotions both in faces and in voices. They found 'no evidence of a fundamental emotion recognition deficit' in the teenagers with autism and both groups tended to make the same mistakes. The only emotion the teenagers with autism were worse at detecting was surprise. The most important factor in how well the youngsters did was IQ, with the teenagers with a higher IQ doing better on the tests.

Jones, C. R., Pickles, A., Falcaro, M., Marsden, A. J., Happé, F., Scott, S. K., Sauter, D., Tregay, J., Phillips, R. J., Baird, G., Simonoff, E. and Charman, T. A multimodal approach to emotion recognition ability in autism spectrum disorders. Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02328.x

Adoption, institutions and executive function

Previous research has shown that children who have spent at least some part of their life in an institution tend to have problems with executive function - which is defined as a combination of working memory, the ability to inhibit one's behaviour, forward planning and the ability to move from one task to another - and attention. Past research has concentrated on children aged between six and 11 so researchers at the University of Pittsburgh studied 418 children who had been adopted from institutions in Russia where they had been psychologically, but not physically, deprived. 130 of the children were pre-school age while the rest were older. The study found that the older the age the children had been adopted at the worse their executive function was and that those who were adopted after they were 18 months old had worse executive function than those who had been adopted when they were younger. The onset of adolescence was associated with a greater increase in executive function deficits for children adopted after 18 months than for those adopted when they were younger.

Merz, E. C. and McCall, R. B. Parent ratings of executive functioning in children adopted from psychosocially depriving institutions Journal of Child Psychology and Psychiatry doi: 10.1111/j.1469-7610.2010.02335.x

Problem-solving and binge eating

Previous studies have shown that people with eating disorders often have poor interpersonal problem-solving skills and a lot of therapy for these problems aims to improve these skills. However, there has been little research into problem-solving skills in people with binge-eating disorder. Researchers from the University of Freiburg in Germany compared 25 women with binge-eating disorder to 30 women who were overweight but who did not have a problem with binge-eating. The women were tested using a series of scenarios which were designed to measure their problem-solving abilities. These started with a problem and ended up with a solution but the women had to come up with the intervening steps themselves. The scenarios were: an argument with a partner; making friends in a new neighbourhood; being avoided by friends or difficulties with one's boss. The women with binge-eating disorder produced less effective and less specific solutions than the group without them and the worse their solutions were the more likely they were to binge.

Svaldi, J., Dorn, C. and Trentowska, M. - Effectiveness for interpersonal problem-solving is reduced in women with binge eating disorder European Eating Disorders Review doi: 10.1002/erv.1050

Publication History

Article first published online: 19 OCT 2010

Wednesday, November 10, 2010

Social cognition and schizophrenia

People with schizophrenia often have problems with their cognition, including what psychologists call social cognition - perceiving people's emotions, recognising social cues and working out what other people are thinking. A team of researchers led by Shaun M. Eack from the University of Pittsburgh studied 133 people in an attempt to find out more about this. 70 of the participants were relatives of people with schizophrenia and were therefore thought to be at greater risk of developing the condition themselves while the rest of them were unaffected controls. The 'at-risk' participants were significantly more likely to assign emotions to neutral faces and to assign the faces negative emotions. They also found it harder to ascertain emotions on faces that were expressing different moods. There was no link between other cognition problems and social cognition. The more people attributed meanings to neutral faces the greater their symptoms of developing schizophrenia were

Eack, Shaun M. ... [et al] - Social cognition deficits among individuals at familial high risk for schizophrenia 36 (6), 1081–1088, 2010
Schizophrenia Bulletin

Child abuse and psychosis

There is a growing recognition that having a difficult or traumatic childhood can increase the likelihood of people developing psychosis later in life but it is difficult to disentangle what types of trauma or abuse are linked to an increased risk. A team of researchers from the Institute of Psychiatry, King's College London looked into this further in a study of 428 people, 182 of whom had psychosis. The researchers asked people about difficulties and problems in their childhood and found that people with psychosis were three times more likely to report severe physical abuse by their mother before they were 12. There was also some - although not statistically significant - evidence that 'severe maternal antipathy' was linked to an increased risk of psychosis. However, paternal maltreatment and other forms of adversity were not linked to an increased risk of psychosis.

Fisher, H.L. ... [et al] - The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder Psychological Medicine (2010), 40, 1967–1978

Major review gives thumbs up to self-help

In guided self-help patients take home a standardized psychological treatment and work through it more or less independently. The treatment can be written down in a book or be available via a web site, television, video or audio and some support is given by a professional therapist or coach. P. Cuijpers from the VU University in Amsterdam reviewed 21 studies, including 810 participants, comparing face-to-face therapy with guided self-help. They concluded that guided self-help was just as effective as face-to-face therapy, that its effects lasted for a year and that people were just as likely to carry on with their treatment.

Cuijpers, P. ... [et al] - Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies Psychological Medicine (2010), 40, 1943–1957

Boosting self-esteem in patients with eating disorders

People with eating disorders can often have low self-esteem, difficulties in relating to others and feelings of dissatisfaction about their relationships. A team of researchers from Barcelona looked into the effectiveness of a group-therapy programme, aimed at boosting self-esteem and social skills, in a study of 160 patients attending a day-hospital treatment programme. At the start of the study the patients with bulimia had lower self-esteem and less confidence in their social skills. After eight sessions of therapy both those with bulimia and those with anorexia showed significant improvements in their perceptions of their physical appearance, their self-esteem, their happiness and their sociability with the patients with bulimia showing a greater improvement.

Lazaro, L. ... [et al] - Effectiveness of Self-esteem and Social Skills Group Therapy in Adolescent Eating
Disorder Patients Attending a Day Hospital Treatment Programme European Eating Disorders Review DOI: 10.1002/erv.1054

Tuesday, November 09, 2010

Parents' death and adolescent suicide risk

Most young people who lose a parent actually adjust remarkably well but a minority go on to develop mental-health problems which are, in turn, known to be a risk factor for suicide, something attempted by 5-8% of adolescents in Western societies. A Danish study - by researchers from the University of Southern Denmark and Odense University Hospital - looked into the links between parental death and suicide in a sample of 72,765 teenagers. They found that young people who had lost one biological parent had a 71% greater risk of going on to kill themselves than those whose parents were still alive while young people who lost more than one parent had a risk that was 2.7 times greater.

Jakobsen, Ida Skytte and Christiansen, Erik - Young people’s risk of suicide attempts in relation to parental death: A population-based register study Journal of Child Psychology and Psychiatry  (2010)doi:10.1111/j.1469-7610.2010.02298.x

9/11 and mental health

Hardly surprisingly the attacks of September 11, 2001 had a huge psychological impact on those who were caught up in them but most studies so far have focused on the prevalence of post-traumatic stress disorder (PTSD) and depression rather than other types of mental-health problem. Researchers from the University of Manitoba in Canada used data from the National Epidemiologic Survey on Alcohol and Related Conditions involving 34,683 people. The participants in the study were asked about their mental health and classified into four groups: no experience of 9/11; indirectly experienced 9/11 (i.e. watched it happen on television); close friend of family member injured or died in 9/11 and directly experienced and/or injured in 9/11. The study found that the more people had been exposed to 9/11 the more likely they were to develop mental-health problems including anxiety as well as PTSD and depression. People who had directly experienced 9/11 had six times the risk of developing PTSD, two-and-a-half times the risk of having an anxiety disorder and nearly double the risk of having any mental-health problem.

Christine A. Henriksen, James M. Bolton and Jitender Sareen - The psychological impact of terrorist attacks: examining a dose-response relationship between exposure to 9/11 and axis I mental disorders Depression and Anxiety 27: 993-1000 (2010)

Non-adherence and crisis in Newcastle

In the U.K. people with mental-health problems who are very ill are referred by community mental-health services to crisis-resolution home treatment (CRHT) services which decide whether to treat them themselves or to refer them on to hospital. Both these things are very expensive so anything which cuts down on their use could potentially save a lot of money. Researchers from Northumberland Tyne and Wear NHS Trust and Newcastle University looked into the impact of non-adherence (people not taking their drugs properly) on referral to CRHTs. They found that 30% of people referred to CRHTs had not been taking their medication properly in the month beforehand. These people were three times as likely to have a drug problem as well as a mental-health one and were two-and-a-half times as likely to be admitted to a psychiatric hospital.

Sreenath, San ... [et al] - Medication adherence in crisis? Journal of Mental Health, October 2010; 19(5): 470–474

One-day communities for personality disorder

The U.K. Government and mental-health services have been making attempts to improve services for people with personality disorders. Sometimes these involve residential therapeutic communities but day therapeutic communities which people take part in once a week are more adaptable, local and cheaper. Researchers from the University of Liverpool studied four one-day therapeutic communities in Manchester and Liverpool between November 2005 and July 2008 looking at patients' mental health, social functioning, self-harm and use of services. The patients reported their own levels of health and were assessed by experts. The researchers found that the centres improved the patients' mental health and social functioning but made only slight improvements in their levels of self-harm and their use of services.

Barr, Wally ... [et al] - Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder Journal of Mental Health, October 2010; 19(5): 412–421

Monday, November 08, 2010

How a pair of trainers could keep the college blues away

There is quite a lot of evidence to suggest that exercise improve one's mental health. However, most of the research done so far has concentrated on people who already suffer, to some extent at least, from depression and anxiety. A team of researchers from the University of Gloucestershire and the University of Hertfordshire investigated whether exercise could improve mental health in a sample of 100 students. Students are known to be at greater risk of developing mental health problems because of worries about their studies, finances and moving away from home and one study found that they were 64% more likely to experience symptoms of mental ill-health than other young people. The researchers found that those students who engaged in high levels of physical activity showed significantly lower levels of depression and anxiety than the medium- and low-physical-activity groups and the more the students exercised the less depressed and anxious they were.

Tyson, Philip ... [et al] - Physical activity and mental health in a student population Journal of Mental Health, 2010; 1–8, iFirst article

Why people do what the voices tell them to do

People who hear voices often report being given commands by them but not everyone obeys such commands. Researchers from the Adult Learning Disability Service in Prescot, Merseyside and the University of Manchester studied 49 people who were hearing voices. They classified the commands the participants had been given as benign, self-harm or harm-others. The study found that obeying their last self-harm command was associated with 'elevated voice malevolence,' worse symptoms and perceived negative consequences for non-compliance. Compliance with the last harm-others command was associated with more severe symptoms, worse perceived consequences for non-compliance and higher levels of social rank attributed to the voice.

Barrowcliff, Alastair L. and Haddock, Gillian - Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population Journal of Mental Health, 2010; 1–11, iFirst article

Getting better slowly or gradually - does it make a difference?

People having psychotherapy quite often make sudden gains, displaying abrupt and substantial improvements in symptoms from one session to the next. Sudden gains have been investigated in the context of randomised controlled trials (RCTs), tightly-controlled studies designed to compare one treatment with another, and in therapy carried out by experts but researchers from American University in Washington D.C. looked to see whether these gains could occur in other contexts. They studied 106 outpatients being treated in a university-based psychotherapy training clinic. Overall sudden gains were identified in 29% of the patients, gains which tended to occur early in therapy. However, the gains were more likely to be reversed than in RCTs which usually involve more-experienced therapists. 54% of the sample showed gradual gains which tended to occur later in therapy. Those patients who had had sudden gains did significantly better by the end of therapy than those who showed more gradual gains.

Greenfield, M. F., Gunthert, K. C. and Haaga, D. A. - Sudden gains versus gradual gains in a psychotherapy training clinic Journal of Clinical Psychology n/a. doi: 10.1002/jclp.20748

Getting to the bottom of why people worry

Generalised anxiety disorder (GAD), or chronic worrying, is the most common anxiety disorder and, in any one year, is thought to affect around 2.7% of the population. Two thought processes that are believed to underly GAD are intolerance of uncertainty and what psychologists call negative metacognitive beliefs - worry about worry. Intolerance of uncertainty is a predisposition to react negatively to an uncertain event or situation - to assume that the worst is going to happen. People who are intolerant of uncertainty assess ambiguous situations as being stressful, disturbing and unacceptable and show increased perceptions of threat in situations that are relatively harmless. Worrying about worrying can lead to unhelpful behaviour and ways of controlling one's thoughts that actually lead to more worry in the long-term. Researchers from Swinburne University of Technology in Melbourne studied 119 people in an attempt to investigate these issues further. Their study also looked into the effects of 'parentification' - a situation in which children end up looking after people who are supposed to be looking after them. The idea behind this was that these children are asked to carry out tasks that they are not really capable of which makes them less confident, and more anxious about, their ability to handle difficult situations in the future. The researchers found that intolerance of uncertainty and negative metacognitive beliefs were both associated with an increase in GAD symptoms. However, once the researchers had taken into account the effects of depression parentification was not associated with an increased propensity to worry.

Tan, Shary ... [et al] (2010) Metacognitive, cognitive and developmental predictors of generalised anxiety disorder symptoms Clinical Psychologist 14 (3), 84 - 89

Friday, November 05, 2010

New study - Omega-3s no help with Alzheimer's

Omega-3 fish oils do not slow the cognitive decline of people with Alzheimer's disease. Researchers from Oregon Health and Science University studied 215 people with mild to moderate Alzheimer's disease. Over 18 months 171 of them took fish-oil tablets while the rest took a placebo. The researchers tested the participants' cognitive abilities and, in a smaller group of participants measured their brain volumes with an MRI scanner. The researchers found that taking the fish oil had no beneficial effects on the participants' cognition and no effect on total brain volume. The authors concluded that "in summary these results indicate that DHA (docosahexanoic acid, an Omega-3 found in fish oil) supplementation is not useful for the population of individuals with mild to moderate Alzheimer disease."

Could meditation help preserve your DNA?

A new study by researchers at the University of California, Davis and the University of California, San Francisco has provided more evidence of the links between meditation, psychological wellbeing and health by measuring the levels of an enzyme called telomerase. The researchers studied 60 people comparing 30 who received meditation training with 30 from similar backgrounds who acted as a control group. Telomerase helps to repair telomeres which are sequences of DNA at the end of chromosomes; they function a bit like the bits of plastic at the end of shoelaces helping to stop the chromosomes wearing out. The researchers compared the levels of telomerase in the white blood cells of the meditating and non-meditating participants and found that telomerase activity was about a third higher in the white blood cells of the meditating group. The meditating participants had a greater sense of purpose in life and more mindfulness this led them to feel a greater sense of control over their life and surroundings and less neuroticism which in turn led to the increase in telomerase activity.

Genes, autism and neural connections

Scientists at the Scripps Translational Science Institute in San Diego have been using cutting-edge neuroscience to look into the links between genetics and autism. They used MRI (magnetic resonance imaging) brain scans to study 32 children who had a variation in a gene called CNTNAP2 which is associated with an increased risk of autism, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome and schizophrenia. Half of the children had been diagnosed with autism while half were unaffected. The researchers used the MRI scans to see what was going on in the children's brains while they carried out a language-learning task. Compared to children without the variation in the gene the children with it had a superfluity of connections in their prefrontal cortices and a lack of connections between the prefrontal cortex and the left side of the brain, which is connected with language.

Antiepileptic drugs and cognition

Women with epilepsy who take more than one drug to control their seizures may have children who perform less well at school. Researchers from Karolinska University Hospital and the University of Lund in Sweden studied 1,308,318 children born between 1973 and 1986; 1,235 of them were born to mothers with epilepsy who took more-than-one (429), one (641) or no (165) anti-epileptic drugs when they were pregnant. Those children who had been exposed to more than one anti-epileptic drug in the womb had an increase risk of not receiving a final grade upon completion of their schooling. However, those whose mothers had taken only one kind of anti-epileptic drug showed no decrease in performance.

Wednesday, November 03, 2010

The best way of learning something? Sleep on it.

Getting information into one's long-term memory has been compared to pouring water into a bottle with a narrow neck; it holds a lot but it is difficult to get it in in the first place. A new study by researchers at York University and Harvard Medical School suggests that one of the best ways of doing this could be to sleep on it. The researchers got two groups of volunteers to learn new words. One group learnt them in the evening and were tested in the evening. The group who slept on things, as it were, remembered more words and could recognise them faster. By studying these participants' brain waves the researchers found that it was deep sleep - rather than rapid-eye-movement (REM) or light sleep - that did most to consolidate memory. Sleep spindles, which are sharp bursts of activity reflecting information transfer between the neorcortex on the surface of the brain and the hippocampus deep within it, were particularly associated with memory consolidation.