What predicts risky behaviour in adolescence

Health-risk behaviours like substance use (alcohol, tobacco and drugs) and risky sexual behaviour become more common in adolescence. Children with behaviour problems are thought to be more likely to engage in high-risk behaviour but it is unclear which types of behaviour problems lead to risky behaviour. A Dutch study of 309 children which followed them from the ages of 4-5 to 18 found that physical aggression was the most important factor in predicting risky behaviour. 'Status violations' (e.g. running away from home and truancy) predicted an increased risk of smoking and soft drug use while 'property violations' also predicted an increased likelihood of risky behaviour.

Timmermans, Maartje, Lier, Pol A.C. van and Koot, Hans M. - Which forms of child/adolescent externalizing behaviors account for late adolescent risky sexual behavior and substance use?
Journal of Child Psychology and Psychiatry April 2008, 49(4), 386-394

Cyberbullying - the facts

Cyberbullying has received a lot of press coverage lately but research into it is at an early stage. Two studies of secondary school pupils in London looked into cyberbullying. The first study had 92 pupils and included focus groups while the second involved 533 pupils. Both studies found cyberbullying less common than traditional bullying but still significant. It happened more often outside school than inside and phone and text message bullying were the most common forms. The impact of cyberbullying was felt to be as bad as traditional bullying. 'Happy slapping' while rarer was perceived to have a more negative impact. Most cyberbullying was done by one or a few pupils usually from the same year group; it often lasted for just a week but sometimes much longer. Being a 'cybervictim' - but not a 'cyberbully' - was correlated with Internet usage. Pupils recommended blocking/avoiding messages and telling someone as the best coping strategies but many cybervictims had told nobody about it.

Smith, Peter K. ... [et al] - Cyberbullying: its nature and impact in secondary school pupils Journal of Child Psychology and Psychiatry April 2008, 49(4), 376-385

The power of positive thinking

How people interpret events and challenges can be very significant for their happiness and mental health. Positive affect expresses enthusiasm, activity, alertness, control, commitment and seeing difficulties as challenges with a general disposition towards a positive outlook and a satisfactory perception and appraisal of potentially stressful events. Negative affect is associated with measures of neuroticism and negative emotionality as well as marked symptoms of stress. High negative affect is associated with subjective complaints, poor coping and anxiety whereas high positive affect is associated with sociability, control, helpful behaviour, feelings of duty, accuracy, care in decision-making and positive attitude over time and circumstance. High positive affect individuals experience a greater appreciation of life, more security and self-confidence, more social relations and assertiveness and greater satisfaction with their friends. They are often described as passionate, happy, energetic and alert. Two Swedish studies looked at the influence of positive and negative affect on people's physical and psychological health. The first study was of 122 high-school students, aged between 17 and 19 and the second study was of 208 office workers aged between 27 and 61. The participants were divided into four groups on the basis of personality tests: 'self-fulfilling' - those high in positive affect and low in negative affect, 'high affective' - those high in both positive and negative affect, 'low affective' - those low in positive and negative affect and 'self-destructive' - those low in positive affect and high in negative affect. The participants were also asked about their psychological and physical health. 'Self-fulfilling' individuals were found to have 'markedly better health profiles' than the other three groups.

Archer, Trevor ... [et al] - Influence of affective personality on cognition-mediated emotional processing: need for empowerment European Journal of Psychiatry 2007, 21(4), 248-262

Adolescent immigrants - part II

A Norwegian study of 341 young immigrants from different ethnic groups looked into their mental-health problems to see which groups were most vulnerable and what the risk factors were. The immigrants came from Iran, Somalia, Sri Lanka and Vietnam. The Somalis and Tamils (from Sri Lanka) had less problems than the Iranians and Vietnamese. The most important factors in whether the youngsters experienced problems were school-related problems, self-efficacy and intergenerational conflicts.

Oppedal, Brit - Psychosocial profiles as mediators of variation in internalizing problems among young immigrants with origins in countries of war and internal conflict European Journal of Developmental Psychology March 2008, 5(2), 210-234

Adolescent immigrants - what helps them to stay out of trouble?

A study of 1,081 adolescent, ethnically German immigrants from Russia and Kazakhstan found that about 10% of them experienced severe difficulties settling into life in Germany. They felt discriminated against in various aspects of their lives and failed at school. However, there were a few young people who functioned surprisingly well and the researchers set out to find which factors lay behind this. Financial assets, language competence and a shorter residence in Germany all protected against delinquency. The level of education of the children's fathers was also found to have an effect but the more educated the father was the more likely the children were to have problems. The researchers speculated that this might be because of the problems educated fathers experienced working in jobs below their intellectual capabilities.

Schmitt-Rodermund, Eva and Silbereisen, Rainer K. - Well-adapted adolescent ethnic German immigrants in spite of adversity: the protective effects of human, social and financial capital European Journal of Developmental Psychology March 2008, 5(2), 186-209

Why you should keep going round to see Mum and Dad

The links between social support and mental health are now well-established but less is known about specific dimensions of social support and social networks. A Europe-wide study of 15,469 people over the age of 50 looked into how their children affected older people's mental health. The study found that childless men and women had more depressive symptoms and that fewer contacts with children was associated with an increased number of depressive symptoms. Older men and women living with a spouse or partner had the lowest levels of depression and the presence of a spouse or partner was more relevant for the mental health of older people than the presence of, or contact with, their children.

Buber, Isabella, Engelhardt, Henriette - Children's impact on the mental health of their older mothers and fathers: findings from the Survey of Health, Ageing and Retirement in Europe European Journal of Ageing, 2008, 5, 31-45

Social anxiety disorder in childhood

Social anxiety disorder (SAD) is characterized by a marked and persistent fear of one or more situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The feared situations are avoided or are endured with intense anxiety or distress. In children the most feared social situations usually include those where the child is expected to speak (e.g. talking to peers, reading aloud in class, joining in a conversation) but also other situations such as musical or athletic performances. However, it is unclear whether children with SAD have a distorted perception of their own abilities or whether they do actually have worse social skills than other children. A Norwegian study of 150 children compared those with social anxiety to those with ADHD and a healthy control group. The researchers found that those children with SAD did have a lower verbal IQ and worse motor skills than other children.

Kristensen, Hanne and Torgessen, Svenn - Is social anxiety disorder in childhood associated with developmental deficit/delay? European Child and Adolescent Psychiatry March 2008, 17(2), 63-72

Autism, ADHD and facial recognition

Theory of mind comprises thought processes that enable the behaviour and experiences of others to be recognized, understood, predicted and communicated. People with autism have great problems with theory of mind and can often find it hard to recognise people's emotions from their faces. Children with Attention Deficit Hyperactivity Disorder (ADHD) also find it hard to match facial expressions to emotions. Autism can be accompanied by increased inattention, hyperactivity and impulsivity and genetic, neuropsychological and brain-imaging studies suggest links between autism and ADHD. A German study of 99 children between the ages of 6 and 18 found that 52% of the autistic children also met the criteria for a diagnosis of ADHD. The children with ADHD were worse at recognising facial expressions than a healthy control group and both the children with pure ADHD and pure autism were worse than average at recognising emotions.

Sinzig, Judith, Morsch, Dagmar and Lehmkuhl, Gerd - Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? European Child and Adolescent Psychiatry 2008, 17, 63-72

Detection and untreated psychosis

People suffering from their first episode of psychosis often experience long periods of untreated psychosis before coming into contact with psychiatric services. The duration of untreated psychosis (DUP) averages 1-2 years but the longer DUP is the worse people's prognosis. An early detection programme and a comprehensive information campaign have been shown to be effective in reducing DUP. A Danish study of 552 people looked at what happened in Copenhagen where an early detection team was established in 1998 without an accompanying information campaign. The study found that the mean DUP was a year and that the early-detection team on its own had had no effect in reducing it. However, more people who had some symptoms of psychosis, without the full-blown disorder, had been referred for treatment.

Nordentoft, Merete ... [et al] - Does a detection team shorten duration of untreated psychosis? Early Intervention in Psychiatry 2008, 2, 22-26

Early intervention for psychosis - long-term effects

Psychotic disorders lead to an increased risk for suicide, particularly during the early course of the illness. Up to a third of first-episode psychosis patients attempt suicide prior to commencing treatment and as many as 15% do so in the first 1-2 years of treatment. Early intervention and treatment for psychosis is, therefore, seen as very important. An Australian study of 7,760 people with psychosis aged between 15 and 29 found that 8.5 years after treatment there was no difference in suicide rates between those who had and had not received early intervention. However, after adjusting for other socio-demographic, clinical and treatment factors suicide risk was lower by 50%, in the first three years after treatment, for the group who had received early intervention. A history of inpatient treatment, more days of treatment per annum and a shorter time to establish a psychiatric diagnosis were all associated with an increased risk of suicide. People who weren't working but who weren't looking for a job either were at less risk than those who were unemployed and looking for work.

Harris, Meredith G. ... [et al] - Impact of a specialized early psychosis treatment programme on suicide. Retrospective cohort study Early Intervention in Psychiatry 2008, 2, 11-21

Drug treatment drop-outs

Studies have shown that the drop-out rate from treatment for opiate addiction is around 30-40%. A study of people dropping out of opiate treatment in Stockholm found that only 20% of them had a detailed treatment plan and only 20% participated in their own treatment planning. None of the drop-outs were enrolled in a methadone or buprenorphine programme (aimed at weaning them off heroin) at admission. Having a treatment plan at intake improved the odds of not dropping out thirteen-fold but perceiving fewer positive aspects of drug use increased the risk of dropout by a factor of 12.6. Patients with sketchy or no treatment planning at intake, no maintenance treatment and a low score on positive aspects of drug use were 7.5 times more likely to drop out. Drop-outs lacked a close maternal relationship and had insecure attachment patterns which made contact difficult with social services and substance-abuse-treatment providers.

Berman, A. H. ... [et al] - Hopeless patients? A study of illicit opiate users who drop out from in-patient detoxification Journal of Substance Use April 2008, 13(2), 121-130

Dual diagnosis in South Africa

People with drug problems often have co-occuring mental-health problems as well. A study of 419 people at a private rehabilitation centre in Johannesburg found that 57.1% of them had a mental-health problem. 155 had a mood disorder, 40 had an anxiety disorder, 39 had ADHD, 35 had an eating disorder, 8 had a conduct disorder and 5 had schizophrenia. ADHD was linked to cannabis-related disorders and polysubstance (more than one drug) dependence. Anxiety-related disorders were linked to alcohol abuse and mood disorders were linked to cocaine.

Fabricius, V., Langa, M. and Wilson, K. - An exploratory investigation of co-occuring substance-related and psychiatric disorders Journal of Substance Use April 2008, 13(2), 99-114

Attributional style and depression

A person's attributional style is the way in which they ascribe causes to events in their lives. People who regard the causes of negative events as global, stable and internal (due to their own shortcomings) are more likely to develop depression. Some researchers believe that this negative attribution is itself a symptom of depression (mood-related) while others believe it is a permanent outlook (trait-related) that may be due to genetic factors. A study of 213 people in Cardiff compared depressed people and their siblings to a control group of unaffected people and their brothers and sisters. The researchers found that attributional style had more to do with current mood than trait-related factors. However, the tendency to blame oneself for negative events was related to having had a prior episode of depression suggesting that depression can have a 'scarring' effect predisposing people towards a negative view of events. People who had experienced minor difficulties were found to have a more positive attributional style suggesting that minor life events are protective against pessimistic attributions.

Ball, Harriet A., McGuffin, Peter and Farmer, Anne E. - Attributional style and depression British Journal of Psychiatry April 2008, 192(4), 275-278

Folate and depression in older people

Low levels of folate and vitamin B12 and high levels of a substance called homocysteine have been found to be associated with depression in a number of studies although not all studies have found this link. A Korean study of 521 people aged 65 and over measured participants' levels of these substances and followed them over 2-3 years to see who developed depression. The researchers found that lower levels of folate and vitamin B12 and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow up. Incident depression was associated with a decline in vitamin B12 and an increase in homocysteine levels over the follow-up period.

Kim, Jae-Min ... [et al] - Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression British Journal of Psychiatry April 2008, 192(4), 268-274

Help-seeking behaviour and depression in adolescence

It is widely recognised that adolescence is a developmental period with fluctuating levels of psychological distress often in the form of depression and anxiety. Seeking appropriate help for these psychological problems before they become severe can reduce adolescents' risk for developing more severe psychological problems such as suicidal thoughts. However, only about a third of young people with mental-health problems receive professional mental-health care. One reason for this is a phenomenon called help negation in which people become more withdrawn and less likely to seek help from others as they become more depressed. A study of 1,766 children between the ages of 12 and 18 in Australia found that the more depressed children were the less likely they were to seek help from their parents. The researchers found a 'consistent trend for students to report being more likely to seek help from no one as depressive symptoms increased'.

Wilson, Coralie Joy, Rickwood, Debra and Deane, Frank Patrick - Depressive symptoms and help-seeking intentions in young people Clinical Psychologist November 2007, 11(3), 98-107

Eating disorders, denial and deception

Denial of illness is a serious stumbling block for the detection, assessment and treatment of eating disorders. A survey by Belgian researchers of 401 ex-eating-disorder patients found that they had made a variety of attempts to conceal their eating disorder : making excuses to avoid eating together, methods to give the false impression of having eaten, avoidance of being weighed and falsifying weight. Often these methods were described as a deliberate strategy. Information about possible health risks had little or no impact on most respondents who were familiar with the notion of an eating disorder but did not apply it to themselves. Many believed that they would have recognised their eating disorder earlier if they had had a clinician who was familiar with this disorder.

Vandereycken, Walter and Humbeeck, Ina Van - Denial and concealment of eating disorders: a retrospective survey European Eating Disorders Review March-April 2008, 16(2), 109-114

Eating disorders and personality disorders

Previous research on the links between eating disorders and personality disorders has varied greatly in its findings although there is a general understanding that personality disorders are common among eating-disorder patients. A study of 545 eating-disorder patients in Denmark found that 29.5% of them had one or more personality disorders - less than the researchers were expecting to find. Personality disorders, in particular borderline personality disorder, were more common among people with bulimia.

Godt, Kristine - Personality disorders in 545 patients with eating disorders European Eating Disorders Review March-April 2008, 16(2), 94-99

Amphetamines in Volvo country

A zero-tolerance law for driving under the influence of drugs (DUID) was introduced in Sweden in 1999. This led to a huge increase in the number of blood samples sent off for toxicological analysis and a study of 26,556 cases of DUID found that 60% of the samples contained some form of amphetamine together with either legal or illegal drugs. In just under a quarter of the cases amphetamine was the only substance found in the blood sample. 85% of the amphetamine users were men who tended to be a few years older than the women. The mean age of ecstasy users was 26 - about ten years younger than the average age of the other amphetamine users.

Jones, Alan Wayne, Holmgren, Anita and Kugelberg, Fredrik C. - Driving under the influence of central stimulant amines: age and gender differences in concentrations of amphetamine, methamphetamine and ecstasty in blood Journal of Studies on alcohol and drugs March 2008, 69(2), 202-208

Drink, drugs and driving

A survey of 27,616 people in the U.S. looked into the links between the age at which people first started drinking, alcohol dependence, drug taking and driving under the influence of drink or drugs. All the sample were drinkers. 22% of the sample had used drugs, 10% had driven under the influence of drugs and 1% had been in a crash because of their drug use. Starting to drink at a young age and being alcohol-dependent were both associated with an increased risk of using drugs and becoming drug-dependent. Being drug and alcohol-dependent were both associated with an increased risk of driving under the influence of drugs and being involved in a drug-related accident.

Hingson, Ralph W., Heeren, Timothy and Edwards, Erika M. - Age at drinking onset, alcohol dependence, and their relation to drug use and dependence, driving under the influence of drugs, and motor-vehicle crash involvement because of drugs Journal of Studies on Alcohol and Drugs March 2008, 69(2), 192-201

Facial recognition in schizophrenia

For most people recognizing a face is a natural and effortless process. Because of the importance of facial recognition a distinct and highly efficient brain system has developed for processing and utilizing facial information. In schizophrenia impairments in recognizing faces has been reported and such impairments may play a crucial role in poor social interactions in patients. Facial recognition is known to be particularly sensitive to inversion (being upside down) and a study of 57 people in the U.S. looked at facial recognition and inversion effects in people with and without schizophrenia. The researchers found that people with schizophrenia were significantly worse at recognising primitive line drawings of people's faces, either upside down or the right way up. However, they were as good at recognizing trees both ways up suggesting there was something specific to facial recognition which they had trouble with.

Chen, Yue ... [et al] - Inefficient face detection in schizophrenia Schizophrenia Bulletin 34(2), 367-374