Emetophobia and locus of control

Emetophobia is the fear of vomiting and can be triggered by seeing other people being sick or feelings of nausea in oneself. It can affect people's social, home and work life, can significantly affect leisure activities and may lead to women delaying becoming pregnant. A study of 149 people compared emetophobics, people with other phobias and people with no phobias. People with emetophobia were found to have a significantly higher internal locus of control than the other groups. People with a high internal locus of control are more likely to think that what happens to them in life and the state of their health are within their control than that they are affected by external factors, fate or genetics. The researchers suggested that emetophobics may have a fear of losing control and that their emetophobia is just a reflection of this alternative, underlying problem.

Davidson, Angela L., Boyle, Christopher and Lauchlan, Fraser - Scared to lose control ? General and health locus of control in females with a phobia of vomiting Journal of Clinical Psychology January 2008, 64(1), 30-39

9/11, stress and heart problems

Studies in the U.S. have documented a substantial short-term psychological response to the 9/11 attacks but their effect on physical health has received little attention. Extremely stressful events can increase people's risk of cardiovascular problems and in the weeks following 9/11 rates of heart problems increased significantly in New York City and the surrounding areas and comparable findings were reported in Florida suggesting that direct exposure to the attacks wasn't necessary to precipitate health problems. A U.S. study of people who had completed a health survey before 9/11, a web-based assessment of their stress levels 9-14 days after the attacks and follow-up surveys 1, 2 and 3 years later found that acute stress responses to the attacks were associated with a 53% increased incidence of cardiovascular problems over the following three years even allowing for other factors such as smoking, body mass index and diabetes. Individuals reporting high levels of acute stress immediately following the attacks reported an increased incidence of heart problems and high blood pressure. Among people reporting ongoing worry about terrorism after 9/11 high 9/11 related acute stress symptoms predicted an increased risk of heart problems 2-3 years after the attacks.

Holman, E. Alison ... [et al] - Terrorism, acute stress, and cardiovascular health : a 3-year national study following the September 11th attacks Archives of General Psychiatry January 2008, 65(1), 73-80

Mood disorders and substance abuse

Previous studies have shown a link between mood disorders and substance abuse but it is hard to untangle whether the mood disorders cause people to take drugs or their drug taking leads to mood disorders and it has also been hard to find out which particular types of mood disorders cause problems with which particular types of drugs. A study of 591 people in Switzerland which followed them from young adulthood over a twenty-year period looked into the links between different types of mood disorders and substance abuse problems. The researchers found that people with manic symptoms were at greater risk of developing problems with alcohol, cannabis and benzodiazepines later. Bipolar II disorder predicted alcohol and benzodiazepine problems while depression was only linked to problems with benzodiazepines.

Merikangas, Kathleen R. ... [et al] - Specificity of bipolar spectrum conditions in the comorbidity of mood and substance use disorders Archives of General Psychiatry January 2008, 65(1), 47-52

Negative affectivity and stress

Failure to cope with stress at work has been linked with a range of physical health problems such as gastrointestinal malfunction, musculo-skeletal problems and cardiovascular diseases as well as psychological problems such as anxiety, depression and burn out. Stress is a function of the relationship between an individual and his/her environment and individual differences can play an important part in this. One factor that is thought to be important in this is negative affectivity. People high in negative affectivity are more likely to report negative mood and emotional reactivity, have a negative view of themselves, have higher levels of emotionality and focus more on the negative aspects of situations. A study of 256 students in Australia measured their levels of negative affectivity and gave them tasks to do to see how well they coped with stress. They were given different amounts of time to do the task (high and low demand) and different amounts of freedom in the way they approached it (high and low control). Those participants with higher levels of negative affectivity had higher levels of post-task negative mood in response to high-demand conditions and had lower task satisfaction in response to high demand/low control situations. Participants with high levels of negative affectivity were more likely to use emotion-focused coping strategies such as minimizing the emotional threat posed by the stressor, wishful thinking and self-blame rather than problem-focused coping strategies.

O'Brien, Anne, Terry, Deborah J. and Jimmieson, Nerina L. - Negative affectivity and responses to work stressors: an experimental study Anxiety, stress and coping January 2008, 21(1), 55-83

School teachers and stress

Across different countries school teachers are among those professionals with the highest levels of job stress and burn out and many teachers retire early because of this. As well as contextual factors such as job demands and job resources research has now started to look at personality characteristics which may predict differences in teachers' stress and burn out and one characteristic that researchers believe plays an important role in creating stress is perfectionism. Perfectionism is a personality style characterized by striving for flawlessness and the setting of excessively high standards for performance accompanied by tendencies for overly critical evaluation of one's behaviour. Perfectionists often put great importance on the evalution of others and may perceive a great deal of pressure to excel because they have to live up both to their own high standards and to those of others. A study of 118 secondary school teachers in Germany found that there was a difference between striving for perfection and having a negative reaction to imperfection. Those teachers who strove for perfection tended to see things as a challenge rather than as a threat, to tackle problems constructively rather than trying to avoid them and were less prone to burn out. Those who had negative reactions to imperfection were more likely to see things as threats, not challengs, tended to aviod problems and were more likely to suffer from burn out. Pressure from students or students' parents was linked to burnout whereas pressure from colleagues was associated with a reduced sense of threat and a lower level of burnout.

Stoeber, Joachim and Rennert, Dirk - Perfectionism in school teachers: relations with stress appraisals, coping styles and burnout Anxiety, stress, and coping January 2008, 21(1), 37-53

Death, depression and drugs in the South of France

A study of 7,363 older people (average age 74) in the French cities of Bordeaux, Dijon and Montpellier looked into the links between depression, antidepressant use and mortality. The study found that depressed men using antidepressants had the greatest risk of dying with increasing depression severity leading to increased risk. Among women only severe depression in the absence of treatment was significantly associated with mortality.

Ryan, Joanne ... [et al] - Late-life depression and mortality: influence of gender and antidepressant use British Journal of Psychiatry 192: 12-18

Psychosocial interventions for relapse in bipolar disorder

Although drugs are the main method of treating bipolar disorder psychosocial interventions are also important to address issues such as medication adherence, awareness and understanding of the disorder, early identification of symptoms and coping skills. When combined with drug treatment they enable individuals to take a more active role in the management of their disorder and lead to improvements in mood stability, occupational and social functioning and quality of life. A review of psychosocial interventions found that cognitive behaviour therapy or group psychoeducation may be effective in relapse prevention in stable individuals. Family therapy was no more or less effective than individual psychosocial therapy or crisis management. There was no evidence that care management or integrated group therapy were effective in the prevention of relapse.

Beynon, Suzanne ... [et al] - Psychosocial interventions for the prevention of relapse in bipolar disorder: systematic review of controlled trials British Journal of Psychiatry 192: 5-11

Juvenile offenders and PTSD

Juvenile offenders often have high rates of mental illness and have often experienced trauma in their lives. A Japanese study of 64 female juvenile offenders aimed to describe the nature and extent of post-traumatic stress disorder (PTSD) and trauma exposure and its links with other psychosocial factors and mental-health problems. The prevalence for PTSD was 33% and 77% of the sample had been exposed to trauma. The offenders with PTSD had significantly higher risks of other mental illnesses. Depression and adverse parenting were associated with PTSD development and abnormal eating was also correlated with PTSD symptoms. Marked differences in the frequency and intensity of PTSD evaluation depending on the type of trauma experienced and other mental-health problems the offenders were suffering from were observed.

Ariga, Michi0 ... [et al] - Trauma exposure and posttraumatic stress disorder in delinquent female adolescents Journal of Child Psychology and Psychiatry January 2008, 49(1), 79-87

Inner speech and autism

Inner speech has been linked to higher-order cognitive processes including 'theory of mind', self-awareness and executive functioning all of which are impaired in people with autism who tend to report using visual rather than verbal thinking. A study of 45 children looked at whether they used visual or verbal methods in their short-term memory and compared autistic children with children with learning disabilities. The children were given a recall task involving some objects that looked alike and others which sounded alike. The idea was that those children who used verbal methods would get most confused with objects that sounded alike while those children who used visual methods would get most confused over objects that looked alike. The researchers found that mental age was more important than whether the children were autistic or not. Those children with a mental age over 7 used inner speech while those with a mental age of less than 7 used visual stimuli.

Williams, David, Happe, Francesca and Jarrold, Christopher - Intact inner speech use in autism spectrum disorder: evidence from a short-term memory task Journal of Child Psychology and Psychiatry January 2008, 49(1), 51-58

Antidepressants, beliefs and adherence

Although most guidelines about depression recommend continuation of medication for at least 8 months after symptom remission 50-80% of patients prescribed antidepressants either discontinue their medication prematurely or take it too inconsistently to derive any clinical benefit, which appears to increase the risk for relapse and recurrence. A large body of literature indicates that patients' beliefs and attitudes about medication predict medication adherence and treatment outcome. Despite this growing literature little is known about what underlies patients' beliefs about antidepressants. A U.S. study of 165 patients found that perceived necessity of antidepressants was associated with older age, more severe symptoms, longer anticipated duration of symptoms and the attribution of symptoms to a chemical imbalance. Perceived harmfulness was highest among patients who had not taken antidepressants before, who attributed their symptoms to random factors and who had an unclear understanding of depression. Neither belief - in the necessity or harmfulness of antidepressants - was significantly associated with sex, education, age at first depressive episode, presence of melancholia or anxiety, other mental-health problems or clinical settings.

Aikens, James E., Nease, Donald E. and Klinkman, Michael S. - Explaining patients' beliefs about the necessity and harmfulness of antidepressants Annals of Family Medicine 2008, 6: 23-29

Cortisol levels and marital satisfaction

Cortisol is a substance released by the adrenal glands under stressful conditions and is widely considered to be a reliable marker for an individual's response to, and recovery from, stress. Cortisol levels start high in the morning and steadily decline over the course of the day with intermittent rises as stressors arouse the adrenal gland. The slope of the hormone's daily decline is believed to be correlated with well-being, with steeper declines reflective of better health and shallower declines predictive of health problems. A study of 30 couples in Los Angeles asked them about their marital satisfaction, got them to monitor their stress levels throughout the day and monitored the participants' cortisol levels. The study found that cortisol levels dropped further among happily-married women than less happily married ones suggesting that those with poorer marriages didn't recover from the stresses and strains of the workplace as well. Long-term elevated cortisol levels have been associated with depression, burn-out, chronic fatigue syndrome, relationship problems and poor social adjustment. The men's cortisol levels declined just as quickly after work whether they were happily or unhappily married.

You can find out more about this research at

http://psychcentral.com/news/2008/01/02/marriage-distress-hinders-recovery-from-work-stress/1724.html

Religion and mental health

A study of 718 people in the U.S. looked into the links between religious activity and mental illness. The researchers found differences between men and women. Out of the 278 women who participated in the study 39% had always been religiously active whilst 51% had not been active since childhood. About 7% of the women who had always been religiously active met the criteria for generalized anxiety disorder compared to 21% of women who had stopped being religiously active. However, men who had stopped going to church were less likely to suffer from depression compared to men who were still religiously active.

You can find out more about this study at

http://psychcentral.com/news/2008/01/02/spirituality-linked-to-mental-health/1725.html

Divorce distances fathers

A long-term study of U.S. teenagers has found that while divorce did not seem to alter the closeness between children and their mothers it did lead to an increased sense of separation between children and their fathers. The children were interviewed at the beginning and end of a five-year period and the results from those whose parents stayed married were compared to the results from those whose parents divorced over the course of the study. All the children became less close to their parents as a natural part of adolescence but the proportion of children who reported a consistently close relationship with their father was much higher among those with still-married parents than among those with divorced parents. However, there was no significant difference in the change in closeness to mothers reported by youths in either group. Those children who maintained a close relationship with their father had a stronger bond with their mothers as well and a greater sense of overall well-being.

You can find out more about this research at

http://psychcentral.com/news/2008/01/10/divorce-can-distance-teens/1766.html

Problems, problems, problems : why one diagnosis doesn't always fit all

A study of 2,300 individuals by researchers at Rhode Island Hospital, U.S. used standardized interviews to evaluate a wide range of psychiatric disorders in a general, clinical outpatient practice. The researchers found that a majority of the patients had more than one mental-health problem and a third of them had at least three. Depression was the most common diagnosis, followed by social phobia. On average patients had 1.9 diagnoses. Patients with principal diagnoses of post-traumatic stress disorder (PTSD) and bipolar disorder had the most concurrent diagnoses. Major depression was the most common reason for seeking treatment, however, while social phobia was the second most common diagnosis in the study 95% of the people suffering from it came for treatment for another mental-health problem.

You can find out more about this research at

http://psychcentral.com/news/2008/01/14/psychiatric-patients-often-have-more-than-one-diagnosis/1776.html

Obesity and depression

A U.S. study of 4,641 women aged between 40 and 65 asked them about their height, weight, exercise levels, dietary habits and body image. The women also completed the Patient Health Questionnaire, a measure of depression symptoms. Women with clinical depression were more than twice as likely to be obese and obese women were more than twice as likely to be depressed. Obese women exercised the least, had the poorest body image and ate 20% more calories than thinner women. The links between obesity and depression held true even when the researchers took into account marital status, education, smoking and antidepressant use.

You can find out more about this research at

http://psychcentral.com/news/2008/01/14/association-between-depression-and-obesity/1777.html

Genes, depression and Russian mothers

Recent research into the causes of mental illness suggests that genetics and environment, rather than one or the other, interact to cause psychological problems. In depression an individual's genetic make-up can predispose some people to be more susceptible to the condition when they are confronted with negative life experiences. A study of 177 male adolescents in a juvenile detention centre in Russia looked at the presence of a gene involved in the transport of the neurotransmitter dopamine (which is believed to have an important role in depression), levels of depression and the influence of rejecting child-rearing by mothers such as physical punishment, hostility, lack of respect for the child's point of view and unjustified criticism in front of others. While neither the gene or rejecting mothers on their own predicted depression the presence of both together led to a higher risk for major depression and suicidal ideation.

You can find out more about this research at

http://psychcentral.com/news/2008/01/15/genetic-and-environmental-stimulus-for-depression/1781.html

Child abuse, depression, PTSD and risk-taking behaviour

A study of 113 women who injected drugs in Philadelphia looked into the links between childhood physical and sexual abuse, post-traumatic stress disorder (PTSD) and depression and high-risk sex and drug taking. 56% of the sample reported childhood sexual abuse and 68% childhood physical abuse. Out of the whole sample 23% suffered from depression while 53% suffered from both PTSD and depression (co-morbid). Childhood sexual abuse was associated with an increase in risk-taking behaviour but childhood physical abuse was not. Childhood sexual abuse was also associated with developing co-morbid PTSD and depression and co-morbid depression and PTSD was associated with increased risk-taking. Once co-morbid depression and PTSD were taken into account childhood sexual abuse was no longer associated with riskier behaviour suggesting that it was the increased risk of co-morbid PTSD and depression that led to higher levels of risk taking not childhood sexual abuse per se.

Plotzker, Rosalyn E., Metzger, David S. and Holmes, William C. - Childhood sexual and physical abuse histories, PTSD, depression, and HIV risk outcomes in women injection drug users : a potential mediating pathway. The American Journal on Addictions 2007, 16: 431-438

Interventions for adherence

Research supports the effectiveness of numerous pharmacological and psychosocial interventions for helping individuals with serious mental illness reduce psychiatric symptoms and build more satisfying and productive lives. Treatment non-adherence, however, remains a major obstacle to recovery with between forty and sixty per cent of people with a severe mental illness failing to engage in aftercare treatment. Non-adherence is associated with more serious symptoms, suicidality, violent behaviour, functional limitations, higher relapse rates and hospital recidivism. A team of researchers from Chicago looked at 31 studies into interventions designed to prevent non-adherence to treatment. They found that assertive/intensive case management improved outpatient treatment retention and that behavioural therapy enhanced medication adherence.

Lehner, Renanah K. ... [et al] - Outpatient treatment adherence and serious mental illness : a review of interventions American Journal of Psychiatric Rehabilitation 10(4), 245-274

Post-traumatic stress disorder and growth in wives and partners

Post-traumatic stress disorder (PTSD) can have many negative effects, not just on the people suffering from it but on their wives and partners as well. They can suffer from tension, physical illness, anxiety, depression, low self-esteem, loneliness, confusion, loss of control and self-blame. However, most women continue to cope and stay with their husbands and recent research has been addressing how they cope with their partners' problems. Research has found that they maintain a reservoir of good feelings towards their husbands from before their mental-health problems and that the experience of watching their husbands' daily struggle can deepen their appreciation of their courage and determination and enhance their love for them. Their husbands' struggle serves as an example which facilitates their coping and their husbands' difficulties were often seen as enhancing their sensitiveness towards their wives. The women also gained a sense of strength and empowerment from their own struggle to help their husbands and keep their families together. These unexpected gains from their partners' PTSD have been called post-traumatic growth. A study of 161 wives of veterans of the Yom Kippur war in Israel compared those married to former prisoners of war (who, for the purposes of the study were assumed to have suffered from more PTSD) with those married to other veterans of the conflict. The researchers also looked at the women's attachment styles. Attachment is the way in which we make and conduct relationships with other people. Those who show avoidant attachment prefer not to rely on or open up to other people, feel uncomfortable with intimacy and are less secure with depending on others and having others depend on them. Those who show anxious attachment tend to worry about whether their partner is available to them and responsive. People with secure attachment are comfortable with intimate relationships and see their partner as being responsive. They perceive themselves in a positive and coherent way, have good problem-solving skills, tend to view stressful situations optimistically and believe that others will help them in their time of need. The study found that the wives of former prisoners of war had both higher levels of distress and of growth than the wives of former veterans. The worse their husbands' PTSD the higher the wives' levels of growth and distress were. Those women with anxious and avoidant attachment styles suffered from more distress but also experienced more growth as a result of their husbands' PTSD.

Dekel, Rachel - Post-traumatic distress and growth among wives of prisoners of war : the contribution of husbands' post-traumatic stress disorder and wives' own attachment American Journal of Orthopsychiatry July 2007, 77(3), 419-426

Risperidone for depression in older adults

Mood disorders are a significant health care issue in the elderly and are associated with suffering, functional decline, compromised quality of life, care-giver burden and increased rates of suicide and service utilization. Persistent depression worsens the outcome of other illnesses and increases non-suicide mortality. Only a third of depressed older adults achieve remission with another 20% showing a partial improvement. Adding an atypical antipsychotic to an antidepressant is one of the alternatives available for people who have failed to respond to drug therapy and a U.S. study of 93 people compared the effectiveness of risperidone to a placebo in terms of delaying relapse and preventing it altogether. The group taking risperidone were just as likely to suffer a relapse as those taking a placebo but they did go over twice as long before becoming ill again as the placebo group.

Alexopoulos, George S. ... [et al] - Placebo-controlled study of relapse prevention with risperidone augmentation in older patients with resistant depression American Journal of Geriatric Psychiatry January 2008, 16(1), 21-30