Toxoplasma and schizophrenia

A study of 712 U.S. military personnel has found that those people who had been exposed to a parasite called toxoplasma gondii had a 24% higher risk of developing schizophrenia than their unaffected colleagues. Previous studies have shown a link between toxoplasma antibodies and schizophrenia but it has proved difficult to tell which of the diseases came first. Because the U.S. military routinely tests its active personnel for toxoplasma and stores the results in a central repository researchers were able to determine the time line between infection and a diagnosis of schizophrenia. Toxoplasma gondii is a common parasite carried by cats and farm animals and most infections with it occur early in life following an exposure to the parasite in cat faeces or undercooked beef or pork. Infections rarely cause symptoms but the parasite remains in the body and can reactivate after lying dormant for years. Not everyone who was infected with toxoplasma went on to develop schizophrenia suggesting that its effect can be affected by individual differences between its human hosts.

You can find out more about this research at

http://psychcentral.com/news/2008/01/17/parasite-may-lead-to-schizophrenia/1798.html

OCD : how intensive therapy can rewire the brain

A brain-scan study of people with obsessive-compulsive disorder (OCD) has shown that as little as four weeks of daily cognitive-behavioural therapy (CBT) can produce significant changes in activity in certain regions of the brain. Past brain-scan studies of people with OCD have demonstrated that elevated activity along the frontal-subcortical circuits of the brain decreases in response to treatment with serotonin reuptake inhibitors (SRIs) or CBT. However, clinical improvement of OCD symptoms was expected to require up to 12 weeks of behavioural therapy or medication. The therapy used in the trial was "exposure and response prevention" which gradually desensitizes people to things that provoke obsessional fears or worries. After four weeks of therapy the OCD patients showed significant improvements in OCD symptoms, depression, anxiety and overall functioning. The brain scans showed significant reductions in brain activity in the right and left thalamus after treatment and a significant increase in activity in an area of the brain called the right dorsal anterior cingulate cortex, a region involved in reappraisal and suppression of negative emotions.

You can find out more about this study at

http://psychcentral.com/news/2008/01/18/ocd-therapy-improves-brain-function/1802.html

Music therapy and depression

About 121 million people worldwide are believed to suffer from depression. This can be seen in disturbed appetite, sleep patterns and overall functioning as well as leading to low self-esteem and feelings of worthlessness and guilt. It can lead to suicide and is associated with a million deaths a year. Drugs and psychotherapy are the usual treatments but a review into the effectiveness of music therapy has shown that this could also be an avenue worth exploring. Four out of the five studies in the review found a beneficial effect but London art therapist Anna Maratos who was the lead author of the study warned that "we will only be able to be confident about the effectiveness of music therapy once some high quality trials have been conducted".

You can find out more about this research at

http://psychcentral.com/news/2008/01/23/music-therapy-beneficial-for-depression/1823.html

A quarrel a day keeps the doctor away

A long-term study of 192 couples in Michigan has found that in couples where both partners suppress their anger and brood about arguments the death rate is significantly higher than in couples where one or both partners express their anger and a resolution of the conflict is reached. The researchers studied the couples over 17 years and found that when both partners suppressed their anger earlier death was twice as likely. Of the 'suppressing' couples 23% both died during the study period, while in 27% of the couples one partner died in the study period compared to rates of 6% and 19% in the other couples. The study adjusted for age, smoking, weight, blood pressure, bronchial problems, breathing and cardiovascular risk.

You can find out more about this study at

http://psychcentral.com/news/2008/01/23/marital-fights-can-be-beneficial/1824.html

Major new study on ADHD reports

A large-scale, long-term study of Attention Deficit Hyperactivity Disorder (ADHD) has prompted experts to re-evaluate how they diagnose and treat the condition. ADHD is a common, chronic, behavioural disorder characterized by inattention, hyperactivity and impulsivity that is though to affect some 5-10% of school-age children worldwide. It has been associated with cognitive defects, particularly with working memory and inhibition which have been linked to overall intelligence and academic achievement. However, the study showed that these deficits were only present in about half of the adolescents diagnosed with ADHD. The study of 457 children in Finland tracked them from the early fetal period to adolescence (16 to 18). Despite the fact that children in Finland are rarely given medicine for the condition its prevalence, symptoms, psychiatric comorbidity (other mental-health problems experienced by the children) and cognition was the same as in the U.S. where children are much more likely to get drug treatment for the condition leading the researchers to pose questions about the effectiveness of pharmacological treatment. Other findings from the study included the fact that hyperactivity and impulsivity declined with age while inattention became more prominent. Two-thirds of the children continued to exhibit significant levels of inattentiveness and impairment into adolescence. ADHD was associated with increased rates of other psychiatric problems such as depression, anxiety, oppositional behaviour and conduct disorders and the rate of post-traumatic stress disorder was also higher in the children with ADHD. The researchers argued that ADHD should be regarded not as a discrete medical condition but as being at one end of a spectrum of behaviour in the same way that variables such as IQ, height and weight vary across a spectrum.

You can find out more about this research at

http://psychcentral.com/news/2008/01/23/experts-call-for-new-approach-to-adhd/1825.html

Childhood fears

Childhood fears are relatively common and can have a number of different causes. The onset and course of phobias and anxiety disorders have been associated with a concept known as anxiety sensitivity - subjectively-held beliefs about the negative consequences of being or becoming anxious, a 'fear of fear'. As well as factors in the children themselves their parents' problems and style of child-rearing can also influence children's levels of fear. Heightened parental anxiety is related to the onset and course of phobic and anxiety disorders in children and several studies have shown that children whose parents have panic disorder and/or agoraphobia are at high risk for the development of these disorders. Other studies have shown that parenting strategies typified by overprotection and overcontrol are related to the presence of fear and anxiety in children and parents of anxiety-disordered and phobic children have been rated by observers as granting less autonomy to their children than parents of non-anxious children. A U.S. study of 156 children found that overall age, gender, anxiety sensitivity and maternal ratings of an overly controlling parenting strategy were significant predictors of levels of fear but that maternal phobic anxiety was not a significant predictor. Anxiety sensitivity was a significant predictor of fear levels for both older and younger children and boys and girls. However, having an overly-protective mother was significant only for younger children and only for girls. Younger children and girls were more likely to be fearful than older children and boys.

Ollendick, Thomas H. and Horsch, Laura M. - Fears in clinic-referred children: relations with child anxiety sensitivity, maternal overcontrol, and maternal phobic anxiety. Behaviour Therapy December 2007, 38(4), 402-411

CBT and headaches

A study into the use of psychological therapies to relieve headaches compared the effectiveness of cognitive-behavioural therapy to that of temporal pulse amplitude (TPA) biofeedback training. In biofeedback training people are shown a visual representation of a physiological process e.g. heartbeat, blood pressure, brainwaves etc and asked to make a conscious effort to manipulate it in the right direction. The study found that CBT was highly effective with an average reduction of headaches from pre- to post- treatment of 68%, compared to 56% for biofeedback and 20% for a control group. Headaches continued to decrease up to a 12 month follow-up period for the CBT group. Improvement with CBT was associated with people's level of coping skills at the start of the study, their social support and physiological measures at rest and in response to stress.

Martin, Paul R., Forsyth, Michael R. and Reece, John - Cognitive-behavioural therapy versus temporal pulse amplitude biofeedback training for recurrent headache. Behavior Therapy December 2007, 38(4), 350-363

CBT for suicide prevention

Suicide and suicidal behaviour are serious public health issues. Suicide is among the 10 leading causes of death in most countries, and, for every suicide it is estimated that there are more than 30 non-fatal episodes of self-harm. A review of 28 studies looked into the effectiveness of cognitive-behavioural therapies in reducing suicide behaviour. Overall CBT had a highly significant effect but only for adults and only for individual rather than group treatments. There was also evidence for treatment effects, albeit reduced, over the medium term. However, the authors concluded that "although these results appear optimistic in advocating the use of CBT in ameliorating suicidal thoughts, plans and behaviours, evidence of publication bias [the tendency to publish only 'positive' studies) tempers such optimism".

Tarrier, Nicholas, Taylor, Katherine and Gooding, Patricia - Cognitive-behavioural interventions to reduce suicide behaviour: a systematic review and meta-analysis Behavior Modification January 2008, 32(1), 77-108

Autism : getting people to ask the right questions

Deficits in social and communication skills are characteristic of people with autism spectrum disorders. One of these deficits is an impairment in the ability of question asking and interventions for improving this ability are especially recommended for people with autism. A Dutch study looked at small-group training consisting of feedback and self-management aimed at improving question-asking skills in nine high-functioning adolescents with autism spectrum disorder. The training lasted six weeks with sessions being conducted once a week and lasting about an hour. The training consisted of verbal feedback and role-play during short simulated conversations and a table game. The therapy was found to be effective in improving question-asking skills, raising the percentage of 'correct' questions during conversation and increasing response efficiency. Participants and personal coaches evaluated the training as effective and acceptable.

Palmen, Annemiek, Didden, Robert and Arts, Marieke - Improving question asking in high-functioning adolescents with autism spectrum disorders: effectiveness of small-group training. Autism January 2008, 12(1), 83-98

Connectedness and depression down under

Connectedness is a sense of being cared for, personally accepted, valued and supported by others as well as enjoyment of and feeling attached to family, friends, school or workplace and the wider community. The four main protective factors promoting resilience in young people are family connectedness, school connectedness, religious affiliation or spirituality and beliefs in the norms of society. The more a young person has a sense of connectedness to their family, peers and school the less likely it is that they will engage in high-risk behaviours such as alcohol or drug abuse, or to develop anxiety, depression or suicidal thoughts. A study of 941 final-year (year 12) students in Victoria, Australia found high levels of depression, anxiety and stress with higher negative affect being associated with lower levels of family, peer and school connectedness. Negative affect 1 year after leaving school was predicted by negative affect and peer connectedness at year 12. The results of the study suggested that there were significant numbers of at-risk young people in their final year of school who felt lonely and disconnected from their peers and who maintained worrying levels of depression, anxiety and stress in their first year at university.

McGraw, Karen ... [et al] - Family, peer and school connectedness in final year secondary school students. Australian Psychologist March 2008, 43(1), 27-37

Parental bonding, anorexia nervosa and borderline personality disorder

It is generally agreed that the quality of parenting experienced in childhood affects personality development and is related to the development of mental-health problems in adulthood. Because specific problems might be linked to differences in the quality of maternal and paternal bonding between parent and child this aspect of the parent-child relationship is of particular interest. Researchers in Canada used a three-factor model of child-rearing to look into the links between parental bonding and borderline personality disorder (BPD) and parental bonding and anorexia nervosa. The first factor was care - the presence or absence of behaviours reflecting affection, warmth, empathy, understanding and closeness. The second was protectiveness or denial of psychological autonomy which ranged from overprotective, infantilising and intrusive child rearing at one extreme to over-permisiveness at the other and the third was authoritarianism or denial of behavioural freedom characterised by lack of parental encouragement of the child's independent behaviour at one end of the scale and permission for the child to exercise age-appropriate autonomous behaviour at the other. The researchers looked at the participants' ratings of their parents' behaviour on these three factors and compared 35 women with BPD, 34 with anorexia and 33 with no mental-health problems. Women with BPD reported very low levels of biparental care and significantly more paternal denial of behavioural freedom. Those with anorexia experienced more maternal denial of behavioural freedom. In terms of maternal bonding, lack of maternal care was the only factor to predict BPD ; for paternal bonding a combination of father's lack of care and denial of behavioural freedom predicted BPD.

Laporte, Lise and Guttman, Herta - Recollections of parental bonding among women with borderline personality disorder as compared with women with anorexia nervosa and a control group. Australian Journal of Psychology December 2007, 59(3), 132-139

Long-term prognosis for eating disorders

Anorexia nervosa and bulimia nervosa are serious mental illnesses. Follow-up studies of people with eating disorders suggest a spectrum of outcomes ranging from recovery to death but there is no consensus definition of remission, recovery or relapse. Estimates of remission or recovery from anorexia range from 31% to 76% while estimates of remission or recovery from bulimia range from 21% to 75%. A long-term study of 901 people with eating disorders which defined recovery as three consecutive years without symptoms found that after 10 years 11% of people with anorexia and 10% of people with bulimia had made a full recovery. After 15 years 16% of people with anorexia and 25% of people with bulimia had recovered. Initially the probability of recovery was greater for those with anorexia but as time went on people with bulimia had a higher probability of recovery.

Von Holle, Ann ... [et al] - Temporal patterns of recovery from eating disorder subtypes Australian and New Zealand Journal of Psychiatry February 2008, 42(2), 108-117

Clozapine : service users more positive than clinicians

The antipsychotic drug clozapine has been recognised to be particularly effective in the treatment of treatment-resistant schizophrenia and schizoaffective disorder. There are monitoring programmes and protocols to manage clozapine's potentially life-threatening side effects but the constant monitoring involved can be very intrusive. There are also other minor side-effects of the drug which can be unpleasant, inconvenient, and, at times, extremely embarassing. An Australian study of 27 people taking clozapine looked at their experience and perceptions of the drug and compared it to the perceptions of their treating clinicians. Consumers reported drooling mouth as the most prevalent and severe side effect whereas clinicians saw difficulty staying awake as the most prevalent side effect and sleeping too much as the most severe one. Most clinicians overestimated the prevalence and severity of clozapine side effects. Most clinicians and consumers agreed that clozapine lifted mood. Only 19% of consumers were unhappy about blood tests whereas 52% of clinicians estimated that consumers were unhappy about them. The study suggests that despite significant side effects and regular blood tests most stable consumers taking clozapine were happier and more satisfied with their treatment than many of the clinicians believed they were.

Hodge, Kay and Jespersen, Sean - Side-effects and treatment with clozapine: a comparison between the views of consumers and their clinicians. International Journal of Mental Health Nursing January 2008, 17(1), 2-8

Unemployment and suicide

Unemployment can damage psychological well-being by causing stress, triggering mental health problems and reducing self esteem. Involuntary and prolonged unemployment can induce suicide-related factors such as depression and a sense of hopelessness among the affected individuals and previous studies have consistently concluded that unemployment, directly or indirectly, leads to suicidal behaviour. A Hong Kong study compared 76 unemployed people who had killed themselves with 15 living unemployed people to see what factors led to some unemployed people being more at risk than others of commiting suicide. The researchers found that those who had killed themselves were more likely to be male, to have suffered from psychiatric illness and to have attempted suicide before. They also had acquired less competent social-problem-solving skills.

Wincey, S.C. Chan ... [et al] - Suicide and unemployment: what are the missing links? Archives of Suicide Research November 2007, 11(4), 327-335

Suicide post mortems : how accurate are friends' and families' memories ?

Post-mortem data about people who have commited suicide is usually gathered from a variety of available sources including friends and family (informants), medical and psychiatric records. While previous research has shown that informants can supply reliable information about patients' recent stressful life events it is unknown whether informants and patients provide concordant (in agreement) data about adverse early life experiences such as childhood sexual abuse. A U.S. study compared the accounts of 88 depressed patients over 50 with those of their informants who both completed items from the Childhood Trauma Questionnaire. Informants' reports of patients' severe sexual abuse histories were in high agreement with patients' reports, however, the level of agreement was significantly lower for 'milder' forms of sexual abuse.

Gamble, Stephanie A. ... [et al] - Concordance about childhood sexual abuse among depressed patients 50 and over and their family and friends. Archives of Suicide Research November 2007, 11(4), 321-326

Eating disorders and emotional responses to food

There are now thought to be strong links between emotions and eating disorders. People with anorexia have an intense fear of gaining weight and anorexics and obese women who binge eat have been found to have higher rates of alexithymia which is the inability to identify and express emotions. Negative emotions such as shame, guilt and disgust surround binge-eating and purging behaviours and eating disorders are often accompanied by mood and anxiety disorders. However, there have been fewer studies of people's responses to food per se. An Australian study of 629 secondary-school pupils and university students found that with increasing age people felt less emotion regarding food (either happiness, fear and disgust) but more dissatisfaction with their bodies. Compared to females males showed significantly higher levels of a 'happy' response to food. In adult females a 'fear' response to food was associated with increase levels of eating concern and body dissatisfaction.

McNamara, Caroline ... [et al] - Emotional responses to food, body dissatisfaction and other eating disorder features in children, adolescents and young adults. Appetite January 2008, 50(1), 102-109

Overweight and eating problems in recovering drug addicts

Overweight and dysfunctional eating patterns have been observed in people in recovery from drug and alcohol addictions. Overeating, binge eating, and the use of foods, especially those high in fats and sugars, as substitutes for alcohol and drug use have been reported. High rates of eating disorders have also been reported in this population but little is known about how substance users themselves experience food and eating in recovery and the roles that food plays during the recovery process. A qualitative study of 25 men recovering from drug and alcohol addiction in the U.S. found that the men's body mass index went up from 26 to 29 over the course of their recovery. Data analysis of interviews with the men revealed three main themes: excess weight gain, meaningful use of food, and disordered eating and a struggle to eat healthily that differed by recovery stage. Men in early recovery described dysfunctional eating practices such as mood and binge eating, the use of food as a substitute for drug use and the use of food to satisfy cravings. Men in mid-to-late recovery were concerned about their weight and distressed about efforts to lose weight. While food as a substitute for drugs, to regulate moods, alleviate boredom or satisfy cravings dominated early recovery, food and meals that provided structure and preparation for future living situations dominated later recovery.

Cowan, Jennifer and Devine, Carol - Food, eating and weight concerns of men in recovery from substance addiction. Appetite 50 (2008), 33-42

Alchohol and assaults in adolescence

Previous research based on college students has documented a strong relationship between alcohol and sexual assault but there has been limited research on the association between alcohol and sexual assault among adolescents. A U.S. survey of 1,037 teenagers found that alcohol was involved in approximately 12-20% of sexual assault cases. For girls the presence of alchohol during assault differed significantly based on the location at which the assault occured ranging from 6% at the victim's home to 29% at parties or at someone else's home. Alcohol-related assault among females was more likely to involve physical force than non-alcohol related assault.

Young, Amy ... [et al] - Alcohol-related sexual assault victimization among adolescents: prevalence, characteristics and correlates Journal of Studies on Alchohol and Drugs January 2008, 69(1), 39-48

Sober friends and drinking networks

Network support for drinking has been defined as the extent to which an individual's social network is supportive of his or her drinking behaviour. In contrast to general social support - which is often a predictive factor for many addictive disorders - network support for drinking has been consistently shown to predict negative outcomes for people dealing with alcohol problems. Interventions for people whose social networks are geared around drink have aimed at either decreasing the support for drinking or increasing the support for abstinence. A study of 952 outpatients being treated for drinking problems in Chicago compared the effects of cognitive behaviour therapy, motivational enhancement therapy and twelve-step facilitation (Alchoholics Anonymous) on preventing relapse in people with a high network support for drinking. Only twelve-step facilitation was effective in reducing drinking in this group suggesting that the social network of Alcoholics Anonymous meetings went some way to replacing the previous drinking network.

Wu, Johnny and Witkiewitz, Katie - Network support for drinking : an application of multiple groups growth mixture modeling to examine client-treatment matching Journal of Studies on Alcohol and Drugs January 2008, 69(1), 21-29

Attachment, aggression and borderline personality disorder

There has been a lot of research recently into the causes, course and treatment of borderline personality disorder (BPD) which is typically, but not always, characterized by impulsive aggression, sucidality and self-harm, extreme dysphoria, abandonment sensitivity, identity disturbance and unstable, angry affect. People with BPD have a high risk of suicide and self-harm. Attachment theory (and you can find out more about this by clicking on the link below) provides a useful framework for understanding and predicting critical aspects of personality disorder and anxious and avoidant attachment styles have been linked with both aggression and BPD. A study of 92 people diagnosed with BPD looked into the links between the disorder, attachment styles and aggression. There was a significant association between the more fearful forms of attachment and the more reactive form of aggression involving expectation of hostility from others. Self-harm was significantly associated with relational avoidance while anger and irritability were associated with relational anxiety.

Critchfield, Kenneth L. ... [et al] - The relational context of aggression in borderline personality disorder: using adult attachment style to predict forms of hostility Journal of Clinical Psychology January 2008, 64(1), 67-82

More information about attachment style can be found at

http://en.wikipedia.org/wiki/Attachment_in_adults