Psychobulletin

2009 ÖSS Sonuçları

2009-07-07T02:58:00.000-07:00

2009 ÖSS sonuçları için aşağıdaki bağlantıyı kullanabilirsiniz.

2009 ÖSS sonuçları

Aging: Vitamin D Levels Tied to Dementia Risk

2009-02-24T13:51:00.000-08:00

Low blood levels of vitamin D may be associated with an increased risk for dementia, a British study has found.
Scientists measured blood levels of the vitamin in a representative sample of 1,766 people over 65 and assessed their mental functioning with a widely used questionnaire. About 12 percent were cognitively impaired, and the lower their vitamin D level, the more likely they were to be in that group. Compared with those in the highest one-quarter for serum vitamin D, those in the lowest were 2.3 times as likely to be impaired, even after statistically adjusting for age, sex, education and ethnicity. Men showed the effect more strongly than women.
“The cause of dementia is not vitamin D deficiency,” said David Llewellyn, a research associate at Cambridge University and the study’s lead author. “It’s a very complicated disease. But while further research is needed, vitamin D supplementation is cheap, safe and convenient, and may therefore play an important role in prevention.”
According to background information in the study, which appears online in The Journal of Geriatric Psychology and Neurology, vitamin D receptors are present in a variety of cells, including neurons and the glial cells associated with them. That suggests that the vitamin may play a role in brain development and the protection of neurons.

Parents Need Help Coping, Too

2009-02-24T13:50:00.001-08:00

Detroit Free Press -
Here is some advice for dealing with anxiety and uncertainty after job and financial losses.
-- Volunteer. Susie Kamen, a Michigan social worker, says volunteering is a way to avoid isolation, develop skills and be part of a community.
-- Network. Don't retreat. "When people feel stressed, they isolate themselves. Having a good social network is a coping mechanism," says Britta Roan, a psychologist who works as a career counselor at the University of Michigan-Dearborn. "And, most people find new jobs through a contact."
-- Be a support network. When you share what you know, you feel like you're making a contribution. "You'll also feel a resilience," Roan says.
-- Get something done. Set a goal for each day. Break a big task like finding a job into smaller steps, says Roan. Try to schedule a lunch or a coffee once a week for "informational interviewing," where you approach a contact not for a job interview, but to find out about fields that interest you.
-- Take a class. In whatever you want. It can open new avenues to you, and help you feel prepared for the future - because you're aiming for tomorrow instead of stewing over the ruins of today.
-- Start a gratitude list. Count your blessings and put them on paper. "Ask yourself what's really working in your life" - and write it down, says Kamen. "When we focus on things that are working, we feel a little better. It opens us up to other opportunities. It expands our thinking."
-- Talk to someone. Talk to a friend, a pastor, a counselor, even a stranger in a coffee shop about the common anxiety we're all sharing.
-- Connect. Consider a connection to spirituality or religion, whatever appeals to you, Kamen says.
-- Exercise. Try yoga. Try meditation techniques (sign up for classes at community colleges). Go for a walk. "Stress has a physical impact on us that's not favorable," Kamen says.
-- Reflect, don't ruminate. Constantly rehashing downer events keeps us stuck in negativity, says Ethan Kross of the University of Michigan. If you revisit the bad memory, try taking a few steps back and watch the past unfold. In your mind, refer to yourself in the third person. Studies by Kross and a colleague suggested that the distance technique alleviated depressed feelings.

Group to explore autism therapy

2009-02-24T13:49:00.000-08:00

Detroit Free Press -

Feb. 21--Heidi Scheer was told there was nothing she could do for her son, Gannon, after he was diagnosed with autism at age 4.
But the boy, now 8, recently had his first friend sleep over and is happy and playful, said Scheer, 42, of Commerce Township. So what made the difference?
Scheer said biomedical treatments, like a gluten-free diet and cod liver oil, helped Gannon shed heavy metals like mercury in his body.
"It's not my opinion that these treatments work," said Scheer, who is also Mrs. Michigan 2008. "It's what we've lived."
Scheer is one of about 250 parents, educators and health care professionals attending the International Conference on Autism Spectrum Disorders at the Crowne Plaza hotel in Novi this weekend.
One in 150 children in the United States has autism, according to the Web site for the Autism Society of America. That figure is substantially higher from about one in every 2,500 children in the 1980s, according to several published studies.
While many doctors and researchers say the increase is due to better diagnostic methods, others -- including many of the conference's speakers and attendees -- blame the increase on vaccines.
The conference, in its first year, is the idea of Dr. Phillip DeMio, an Ohio physician who created the American Medical Autism Board to certify health care professionals and provide resources for parents seeking biomedical treatments for their children.
DeMio's son, Daniel, was diagnosed when he was about 2 years old. At one point, Daniel was losing weight, suffered one infection after another and would stare into space for hours. He also stopped speaking.
"We felt like we lost him," DeMio said.
So DeMio, who had been a faculty member at the Cleveland Clinic and had a private pain management practice, started doing research on autism. With diet changes and nutritional supplements, DeMio said Daniel-- now 8 1/2 -- is doing well. DeMio now runs a practice treating children with autism.
"Some mainstream doctors will tell you there are no treatments for autism," said DeMio. "We use what we have to make sure the body is better. And that helps the brain."

Eating disorders are a silent epidemic

2009-02-24T13:48:00.000-08:00

Boston Herald -

Eating disorders are a silent epidemic - and the epidemic is spreading.
At one extreme, nearly a third of America is considered to be obese, according to the Centers for Disease Control. As recently as 1990, in no state was more than 15 percent of the population obese. By 2006, at least 20 percent of the population was considered obese in all but four states.
While millions of Americans are eating themselves to death, millions more are starving themselves to death. Anorexia is not just for models and celebrities. The National Institute of Mental Health estimates that 1 percent of women and adolescent girls have this debilitating, potentially deadly disease. Males account for just 10 percent of all cases, but their numbers are growing.
Bulimia is even more common. Those with bulimia purge their food, abuse laxatives or exercise obsessively to control their weight. Although research suggests that up to 4 percent of college-aged women have bulimia, it is increasingly common among women and men of all ages.
Eating disorders are serious illnesses. If left untreated, an estimated 20 percent of those with anorexia will die from malnutrition and other factors. Obesity, conversely, can double a person's susceptibility to heart disease, diabetes and cancer.
In spite of these startling statistics, surprisingly little has been done to address this epidemic. National Eating Disorder Awareness Week, which begins tomorrow, is a start, but eating disorders are a serious problem 52 weeks a year.
It would be hard to argue that eating disorders have not received their fair share of media attention. The problem is that media portrayals have left the impression that eating disorders mostly affect the rich and famous, and are the result of character deficiency and poor upbringing.
The number of afflicted individuals strongly suggests that these popular beliefs fall far short of explaining eating disorders. More critically, these stereotypes obscure reality and leave us all spectacularly vulnerable to the severe human suffering and excessive societal cost these conditions create.
So how can we do better?
The first step is to increase awareness of the seriousness of eating disorders and to accept, as we do with other major diseases, that there are many types of eating disorders and likely many causes.
We need to be wary of the quick fix. The science of eating turns out to be a complex subject involving the interplay of genetics, biochemistry, nutrition and psychology. There will be no "one size fits all" solution.
Lack of research funding is a major problem. According to the National Eating Disorder Association, research funding works out to $1.20 a year for each person with an eating disorder, compared with $159 for each person with schizophrenia.
As adults, we need to model healthy attitudes and habits, ignore fad diets and educate our children better. Most people can maintain a healthy weight through nutrition and exercise. It's not just about willpower, though. Some need professional assistance.
Insurers are uncertain about how best to cover eating disorders. They cover some eating disorders as mental health problems, others as medical problems and still others as both. Regardless of how eating disorders are covered, they pose a challenge, because the medical impact is so costly.
The good news is that with proper treatment, many people fully recover. If we begin to recognize eating disorders as the national epidemic that they are, a far greater percentage of patients can recover fully and enjoy happy and healthier lives.
Stuart Koman is president and CEO of Walden Behavioral Care Inc. of Waltham and Northampton.

As You Were Saying Facing a Silent Epidemic

2009-02-24T13:46:00.001-08:00

Eating disorders are a silent epidemic - and the epidemic is spreading.
At one extreme, nearly a third of America is considered to be obese, according to the Centers for Disease Control. As recently as 1990, in no state was more than 15 percent of the population obese. By 2006, at least 20 percent of the population was considered obese in all but four states.
While millions of Americans are eating themselves to death, millions more are starving themselves to death. Anorexia is not just for models and celebrities. The National Institute of Mental Health estimates that 1 percent of women and adolescent girls have this debilitating, potentially deadly disease. Males account for just 10 percent of all cases, but their numbers are growing.
Bulimia is even more common. Those with bulimia purge their food, abuse laxatives or exercise obsessively to control their weight. Although research suggests that up to 4 percent of college-aged women have bulimia, it is increasingly common among women and men of all ages.
Eating disorders are serious illnesses. If left untreated, an estimated 20 percent of those with anorexia will die from malnutrition and other factors. Obesity, conversely, can double a person's susceptibility to heart disease, diabetes and cancer.
In spite of these startling statistics, surprisingly little has been done to address this epidemic. National Eating Disorder Awareness Week, which begins tomorrow, is a start, but eating disorders are a serious problem 52 weeks a year.
It would be hard to argue that eating disorders have not received their fair share of media attention. The problem is that media portrayals have left the impression that eating disorders mostly affect the rich and famous, and are the result of character deficiency and poor upbringing.
The number of afflicted individuals strongly suggests that these popular beliefs fall far short of explaining eating disorders. More critically, these stereotypes obscure reality and leave us all spectacularly vulnerable to the severe human suffering and excessive societal cost these conditions create.
So how can we do better?
The first step is to increase awareness of the seriousness of eating disorders and to accept, as we do with other major diseases, that there are many types of eating disorders and likely many causes.
We need to be wary of the quick fix. The science of eating turns out to be a complex subject involving the interplay of genetics, biochemistry, nutrition and psychology. There will be no "one size fits all" solution.
Lack of research funding is a major problem. According to the National Eating Disorder Association, research funding works out to $1.20 a year for each person with an eating disorder, compared with $159 for each person with schizophrenia.
As adults, we need to model healthy attitudes and habits, ignore fad diets and educate our children better. Most people can maintain a healthy weight through nutrition and exercise. It's not just about willpower, though. Some need professional assistance.
Insurers are uncertain about how best to cover eating disorders. They cover some eating disorders as mental health problems, others as medical problems and still others as both. Regardless of how eating disorders are covered, they pose a challenge, because the medical impact is so costly.
The good news is that with proper treatment, many people fully recover. If we begin to recognize eating disorders as the national epidemic that they are, a far greater percentage of patients can recover fully and enjoy happy and healthier lives.
Stuart Koman is president and CEO of Walden Behavioral Care Inc. of Waltham and Northampton.

The Pursuit of Happiness

2009-02-24T13:44:00.001-08:00

Welcome to the happiness frenzy, now peaking at a Barnes & Noble near you: Last year 4,000 books were published on happiness, while a mere 50 books on the topic were released in 2000. The most popular class at Harvard University is about positive psychology, and at least 100 other universities offer similar courses. Happiness workshops for the post-collegiate set abound, and each day "life coaches" promising bliss to potential clients hang out their shingles.
In the late 1990s, psychologist Martin Seligman of the University of Pennsylvania exhorted colleagues to scrutinize optimal moods with the same intensity with which they had for so long studied pathologies: We'd never learn about full human functioning unless we knew as much about mental wellness as we do about mental illness. A new generation of psychologists built up a respectable body of research on positive character traits and happiness-boosting practices. At the same time, developments in neuroscience provided new clues to what makes us happy and what that looks like in the brain. Not to be outdone, behavioral economists piled on research subverting the classical premise that people always make rational choices that increase their well-being. We're lousy at predicting what makes us happy, they found.
It wasn't enough that an array of academic strands came together, sparking a slew of insights into the sunny side of life. Self-appointed experts jumped on the happiness bandwagon. A shallow sea of yellow smiley faces, self-help gurus, and purveyors of kitchen-table wisdom have strip-mined the science, extracted a lot of fool's gold, and stormed the marketplace with guarantees to annihilate your worry, stress, anguish, dejection, and even ennui. Once and for all! All it takes is a little gratitude. Or maybe a lot.
But all is not necessarily well. According to some measures, as a nation we've grown sadder and more anxious during the same years that the happiness movement has flourished; perhaps that's why we've eagerly bought up its offerings. It may be that college students sign up for positive psychology lessons in droves because a full 15 percent of them report being clinically depressed.
There are those who see in the happiness brigade a glib and even dispiriting Pollyanna gloss. So it's not surprising that the happiness movement has unleashed a counterforce, led by a troika of academics. Jerome Wakefield of New York University and Allan Horwitz of Rutgers have penned The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder, and Wake Forest University's Eric Wilson has written a defense of melancholy in Against Happiness. They observe that our preoccupation with happiness has come at the cost of sadness, an important feeling that we've tried to banish from our emotional repertoire.
Horwitz laments that young people who are naturally weepy after breakups are often urged to medicate themselves instead of working through their sadness. Wilson fumes that our obsession with happiness amounts to a "craven disregard" for the melancholic perspective that has given rise to our greatest works of art. "The happy man," he writes, "is a hollow man."
Both the happiness and anti-happiness forces actually agree on something important—that we Americans tend to grab superficial quick fixes such as extravagant purchases and fatty foods to subdue any negative feelings that overcome us. Such measures seem to hinge on a belief that constant happiness is somehow our birthright. Indeed, a body of research shows instant indulgences do calm us down—for a few moments. But they leave us poorer, physically unhealthy, and generally more miserable in the long run—and lacking in the real skills to get us out of our rut.
Psychology Today Magazine, Jan/Feb 2009

Death and Dying

2009-02-24T13:42:00.000-08:00

Definition
Death is the one great certainty in life. Some of us will die in ways out of our control, and most of us will be unaware of the moment of death itself. Still, death and dying well can be approached in a healthy way. Understanding that people differ in how they think about death and dying, and respecting those differences, can promote a peaceful death and a healthy manner of dying.
The primary course of action when death is near is to fulfill the dying person's wishes. If the person is dying from an illness, ideally, they will have participated in decisions about how to live and die. If the requests made do not seem practical to the caregiver, options should be raised with the dying individual to try to accommodate his request and still provide adequate care. If the dying individual has not been able to participate in formulating final plans, you should strive to do what this person would want.
If the individual is in a hospice, he may most likely desire a natural death. In this situation, the aim will be for the final days and moments of life to be guided toward maintaining comfort and reaching a natural death.
Symptoms
Cardiopulmonary criteria have traditionally been used to declare death. When breathing ceased and the heart no longer beats, the person is said to have died.
Brain death
Brain death is another standard for declaring death that was adopted by most countries during the 1980s. The brain death standard was originally recommended in 1968 by a Harvard panel of experts that studied patients in irreversible coma. They concluded that once a patient's whole brain no longer functions and cannot function again, the brain is dead. Cardiorespiratory death invariably follows.
Dying
If an individual is dying from a chronic illness as he is nearing death, each day the person may grow weaker and sleep more, especially if his pain has been eased.
Near the very end of life, the person's breathing becomes slower—sometimes with very long pauses in between breaths. Some pauses may last longer than a minute or two. The final stage of dying is death itself. You will know death has happened because the individual's chest will not rise and you will feel no breath. You may observe that the eyes are glassy. When you feel for pulse, you will not feel it.
The individual dying and facing eventual death may go through two main phases prior to actual death. The first stage is called the pre-active phase of dying and the second phase is called the active phase of dying. The pre-active phase of dying may last weeks or months, while the active phase of dying is much shorter and lasts only a few days, or in some cases a couple of weeks.
Pre-active Phase
Person withdraws from social activities and spends more time alone
Person speaks of "tying up loose ends" such as finances, wills, trusts
Person desires to speak to family and friends and make amends or catch up
Increased anxiety, discomfort, confusion, agitation, nervousness
Increased inactivity, lethargy or sleep
Loss of interest in daily activities
Increased inability to heal from bruises, infections or wounds
Less interest in eating or drinking
Person talks about dying, says that they are going to die or asks questions about death
Person requests to speak with a religious leader or shows increased interest in praying or repentance
Active Phase
Person states that he is going to die soon
Has difficulty swallowing liquids or resists food and drink
Change in personality
Increasingly unresponsive or cannot speak
Does not move for longs periods of time
The extremities—hands, feet, arms and legs—feel very cold to touch.
Not all people show these signs. These signs of death are merely a guide to what may or often happens; some may go through few signs and die within minutes of a change being noticed
Causes
Treatment
As a family member or friend of a dying individual, you may aim to do the following:
Help with comfort and rest (back rubs, holdings hands, reading and background music can be very comforting and help decrease a person's sense of being alone)
Prepare for physical problems (lip balm or salve prevent chapped lips, for example)
Welcome visitors and children, or ask the person whom he would like to see and invite those people
Prepare a list of people to call near the time of death
Talk with a friend about your feelings
Feel free to say good-bye at the place of death
Avoid calling 911 or an emergency team
Guidelines are also suggested for the person who is dying. Foremost is taking care of himself. Other suggestions are to think ahead about what could happen—and about how you will deal with problems if they do occur—and to create a better quality of life for yourself and for the people who love and care about you. Ideally, death and dying should be peaceful and healthy for you, the dying person and for the people who love and care about the dying individual. Helping friends and family deal with your death may help you find peace and comfort. If you are not at peace with death, you should seek advice from your health care provider.
More specific guidelines for the dying individuals include:
Be grateful and accept help
Don't be afraid to ask to be alone, time to be by yourself is necessary
Be your own counsel—no one, including your physician, religious counselor, spouse or friends can understand 100 percent what you want and need
Some people may treat you differently after learning that you are dying. Be patient; they may be more bearable after a brief adjustment period
Slow down, and ask your family and friends to slow down: There may not be a lot of time, but there is sufficient time, except in the most extreme cases, to think, plan and prepare
Search for, and then trust in, a single individual. This does not mean you should not listen to and follow reasonable directions and advice. But focus on one individual as the final helper. When you do, make certain that your family doctor knows whom you've appointed to serve in that role.
Ask your health care provider to explain what is being done to you so that you can understand why things are being done and what benefits you can expect. Call the health professional if you are concerned or uncertain and need more explanation.
You should be aware that nurses and other hospital staff may not know that you are dying. This fact may not be written in your chart—and can lead to conflicts between families and hospital staff. It's OK for your family to tell the hospital staff that you are dying.
Pre-planning will give your loved ones both assurance that your wishes are being followed and peace of mind from the knowledge that decisions have already been made.
Consider getting a durable power of attorney in which you name one or two people to make decisions or choices on your behalf if you should become incompetent or incapable of making decisions. Read the Do Not Resuscitate policies of your hospital. Under the U.S. Patient Self-Determination Act, every U.S. state must have a mechanism for allowing people to express their wishes for their death and dying, and healthcare providers are obligated to follow their patient's instructions.
Use resources that are available from the health care community. These include social services and psychological, financial and religious counseling, as well as hospital financial counseling.
Sources
The Significance of Dying Well. Illness, Crisis & Loss
British Medical Journal
You Cannot Die Alone, Elisabeth Kubler-Ross
Death and Dying: Mount Sinai School of Medicine, New York. Encyclopedia of Life Sciences
A Dying Person's Guide to Dying, Roger C. Bone, M.D. The American College of Physicians
American College of Physicians; What to Do Before and After the Moment of Death.
Hospice Patients Alliance
Harvard Adhoc Committee on Brain Death

Why I Hate Beauty

2009-02-24T13:41:00.000-08:00

Why I Hate Beauty

Men are barraged with images of extraordinarily beautiful and unobtainable women in the media, making it difficult for them to desire the ordinarily beautiful.

Poets rave about beauty. Brave men have started wars over beauty. Women the world over strive for it. Scholars devote their lives to deconstructing our impulse to obtain it. Ordinary mortals erect temples to beauty. In just about every way imaginable, the world honors physical beauty. But I hate beauty.
I live in what is likely the beauty capital of the world and have the enviable fortune to work with some of the most beautiful women in it. With their smooth bodies and supple waists, these women are the very picture of youth and attractiveness. Not only are they exemplars of nature's design for detonating desire in men, but they stir yearnings for companionship that date back to ancestral mating dances. Still, beauty is driving me nuts, and although I'm a successful red-blooded American male, divorced and available, it is beauty alone that is keeping me single and lonely.
It is scant solace that science is on my side. I seem to have a confirmed case of the contrast effect. It doesn't make me any happier knowing it's afflicting lots of others too.
As an author of books on marketing, I have long known about the contrast effect. It is a principle of perception whereby the differences between two things are exaggerated depending on the order in which those things are presented. If you lift a light object and then a heavy object, you will judge the second object heavier than if you had lifted it first or solo.
Psychologists Sara Gutierres, Ph.D., and Douglas Kenrick, Ph.D., both of Arizona State University, demonstrated that the contrast effect operates powerfully in the sphere of person-to-person attraction as well. In a series of studies over the past two decades, they have shown that, more than any of us might suspect, judgments of attractiveness (of ourselves and of others) depend on the situation in which we find ourselves. For example, a woman of average attractiveness seems a lot less attractive than she actually is if a viewer has first seen a highly attractive woman. If a man is talking to a beautiful female at a cocktail party and is then joined by a less attractive one, the second woman will seem relatively unattractive.
The contrast principle also works in reverse. A woman of average attractiveness will seem more attractive than she is if she enters a room of unattractive women. In other words, context counts.
In their very first set of studies, which have been expanded and refined over the years to determine the exact circumstances under which the findings apply and their effects on both men and women, Gutierres and Kenrick asked male college dormitory residents to rate the photo of a potential blind date. (The photos had been previously rated by other males to be of average attractiveness.) If the men were watching an episode of Charlie's Angels when shown the photo, the blind date was rated less desirable than she was by males watching a different show. The initial impressions of romantic partners—women who were actually available to them and likely to be interested in them—were so adversely affected that the men didn't even want to bother.
Since these studies, the researchers have found that the contrast effect influences not only our evaluations of strangers but also our views of our own mates. And it sways self-assessments of attractiveness too.

Actor Hector Elizondo knows how difficult it can be to care for a loved one who has Alzheimer's disease.

2009-02-10T10:26:00.000-08:00

When Bernard Madoff's huge Ponzi scheme burst, the New York Post reported, in its typical cut-to-the-jugular style, that suicide hotlines were lighting up in Greenwich, Connecticut, home to many of the financial high-rollers snared by the alleged $50 billion scam. But the deadly fallout from it was no joking matter. Only a couple of weeks after Madoff's mischief was revealed, French financier Rene-Thierry Magon de la Villehuchet killed himself in his New York City office, apparently distraught by his having lost more than a billion of his clients' (and his own family's) money to the unprecedented fraud.

The Madoff case is just one example of the terrible news gripping the economy and financial markets of late, news that in extreme cases can drive people to take their own lives. Two prominent businessmen, one in Germany and another in England, recently threw themselves in front of speeding trains after grappling with the wreckage of their beaten-down companies. And late last month, a Los Angeles area man despondent over his faltering finances murdered his wife and five children before killing himself.
Suicide experts say there is a strong correlation between acute financial strains and depression, often a prelude to substance abuse and suicides. While people jumping out of buildings during the Great Depression was not nearly as common as Hollywood and cartoonists had everyone believe, suicide definitely spiked during that dark period in the nation's history. Suicides in the U.S. reached a peak in 1933 (increasing to 17 per 100,000, from 14 per 100,000 in 1929), around the same time unemployment had swollen to 25%. By contrast, more recent recessions have not had a marked effect on suicide rates, which in the U.S have been running at about 11 per 100,000 (and shown a slight overall decline during the last two decades of relative prosperity). (See pictures of the stock market crash of 1929.)
"If indeed this recession mirrors in some respects more the Great Depression than the other intervening much briefer recessions, then obviously we have reason for greater concern," says Dr. Alan L. Berman, executive director of the American Association of Suicidology.
There are some clear differences between today's conditions and those in the 1930s, which fomented key reforms, including the introduction of welfare and social security. Today people are more willing to acknowledge and are better prepared to address mental illness, though many states' current budget woes will undoubtedly mean some cuts in social services and counseling. And at the Depression's nadir, 34 million Americans had no income at all, which is not likely to happen today. Still, if poverty levels approached anywhere near those levels, the psychological toll could be greater because of the intervening erosion in family and community cohesion.
"What you find is that suicides happen because of the total burden the person is feeling, how much they feel things can't get better and they can't tolerate the psychological pain they are experiencing," says Dr. John L. McIntosh, a psychologist and suicide expert at Indiana University. "Sometimes it takes years for the effect of economic downturn or instability to trickle down to the level of the psyche or penetrate the psyche, to get under the skin to produce some of the negative outcomes such as suicides."
There are roughly 32,000 suicides every year in the U.S., almost twice the 18,000 homicides recorded each year. Even these figures are just a hint of the nation's psychic pain. There are an estimated 800,000 attempted suicides every year, with the elderly and teenagers or college-age kids the most vulnerable. And survivors — currently numbering somewhere between 10 and 20 million — are at a higher risk for subsequent attempts.
What's more, only about a third of people in need of treatment are getting any. "If we were in the professional world in advertising and marketing we'd all be fired because we are not reaching the majority of our audience," says Alan Ross, executive director of the New York chapter of the Samaritans, an international counseling organization. Last year his center fielded 58,000 calls, which in the last couple of years have been increasing at double previous annual growth rates. He attributes this to a tremendous increase in stress levels due to things like economic insecurities exacerbated by globalization.
The particular nature of the current crisis is also a cause for concern. "For most Americans, our homes are our primary investment and the locus of our identities and social support systems," notes the American Association of Suicidology. "When combined with the loss of job, home loss has been found to be one of the most common economic strains associated with suicides."
Warning signs are already erupting in parts of the U.S. hard hit by the housing crisis. In Los Angeles, calls into the suicide prevention call center run by the Didi Hirsch Community Mental Health Center spiked 65% in the second half of 2008 over the previous year. There has also been a surge of training requests from fire and police departments from throughout Los Angeles County — even from a mortgage counseling company — to help deal with an upsurge in suicide risk. "The reality is we are already overwhelmed," says Dr. Kita S. Curry, the center's executive director. With any publicity about her center, calls spike, suggesting unmet need.
For all the advances the mental health community has made in recent decades, including pharmacological treatment, the biggest factors influencing suicides rates seems far beyond its reach. "Suicide rates appear to be quite strongly associated with broad sweeping cultural trends rather than more minor things such as a treatment," notes retired Colonel David Litts, who played a key role in reducing suicide within the Air Force by 60% in five years. (The overstretched Army, by contrast, is still experiencing historically high rates.) "So in the face of this economic turmoil perhaps the most important thing we can do is relieve the financial strains on individuals because research has shown that financial strain is the link between unemployment and depression and suicide."

5 Ways to Fight Alzheimer's Disease

2009-02-10T10:22:00.001-08:00

The Dallas Morning News - February 09, 2009
Actor Hector Elizondo knows how difficult it can be to care for a loved one who has Alzheimer's disease. When the stage and screen star's mother was diagnosed with the progressive form of dementia, his father insisted on becoming her sole caretaker. But her care proved so stressful that his father died a month before she did in 1974.
"It was a time when we were in the dark about what was occurring," says Mr. Elizondo, who lives in Los Angeles and began traveling across the country in June, teaming with local experts as part of an Alzheimer's disease awareness campaign.
An estimated 5.2 million Americans suffered from it in 2008, according to the 2008 Alzheimer's Disease Facts and Figures published by the Alzheimer's Association.
Here are Dr. David W. Crumpacker's, assistant chief of psychiatry at Baylor University Medical Center at Dallas suggestions for helping to prevent Alzheimer's disease, along with tips from the Alzheimer's Association.
1. Exercise: Walk or do something physical most days of the week.
2. Eat right: Choose a diet rich in fruits and vegetables, particularly deep green and orange vegetables; low in saturated and trans fats and sugars; and high in whole grains and legumes; include fish.
3. Reduce weight, blood pressure and high cholesterol: Following the first two tips (above) should help.
4. Stay mentally engaged and optimistic: Do puzzles, play music, learn a new language, volunteer, start a hobby, create a strong circle of friends.
5. Don't be in denial: Starting at age 60, ask for a memory test at your annual checkup. Because early treatment can be most effective, seek help at the first signs: forgetting recently learned material, forgetting simple words, putting things in odd places, paying bills twice or not at all, losing track of steps in making a call or playing a game.
SOURCES: Alzheimer's Association: www.alz.org

Diet could cut risk of dementia

2009-02-10T10:21:00.000-08:00

USA TODAY - A new study suggests a diet laden with fish, olive oil, vegetables and other foods common in Mediterranean-style cuisine may help ward off mild cognitive impairment, sometimes called borderline dementia. The study also suggests that such a diet reduces the chance of the transition from mild cognitive decline to Alzheimer's disease.
"We know from previous research that a healthy diet like this is protective for cardiovascular risk factors like cholesterol, hypertension and diabetes. Now this current study shows it may help brain function, too," says Nikolaos Scarmeas, assistant professor of clinical neurology at the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center.
Scarmeas and other researchers at Columbia examined, interviewed and screened 1,393 people with healthy brains and 482 patients with mild cognitive impairment. Study participants were questioned about their eating habits.
The study, which is published in this month's Archives of Neurology, reports that over an average of 4 1/2 years of follow-up, 275 of the 1,393 study participants who did not have mild cognitive impairment developed the condition. Those who had the highest adherence to a Mediterranean diet -- a menu rich in vegetables, legumes and fish, low in fat, meat and dairy, and high in monounsaturated fats like those in olive oil -- had a 28% lower risk of developing mild cognitive impairment than the one-third of participants who had the lowest scores for Mediterranean diet adherence. The middle one-third group had a 17% lower risk of developing mild cognitive impairment than those who ate the fewest Mediterranean foods.
Of the 482 study participants who had mild cognitive impairment at the beginning of the study, 106 developed Alzheimer's disease roughly four years later. The one-third of participants with the highest scores for Mediterranean diet adherence had a 48% less risk of developing Alzheimer's than the one-third with the lowest diet scores.
Previous research has found a similar association for subjects with Alzheimer's disease, but the new report is the first to connect a Mediterranean diet with decreased risk of mild cognitive impairment, says Scott Turner, program director of the Memory Disorders Program at Georgetown University. "The findings are important and intriguing."
Scarmeas says clinical studies that randomly assign people to a Mediterranean diet or another diet are needed to prove that a Mediterranean diet protects against cognitive decline.
But beginning more healthful eating habits earlier than the golden years may be the key, says Duke University Medical Center aging expert Murali Doraiswamy: "Since Alzheimer's changes may start in the brain decades before memory loss occurs, what you eat starting in your midlife may be crucial."

Childhood anxiety disorders can and should be treated, says expert

2009-01-10T17:23:00.001-08:00

There is an urgent need to recognise and treat anxiety disorders in children that otherwise might lead to educational underachievement, substance abuse and mental disorders in adulthood, according to a leading child psychiatrist from UT Southwestern Medical Centre.
While writing in New England Journal of Medicine, Dr. Graham Emslie said that anxiety disorders in children are frequently unrecognised because they may only report physical aches and may be unable to verbalize “worry” or “fear.”
“Anxiety disorders may cause children to avoid social situations and age-appropriate developmental milestones,” said Emslie.
“Further, the avoidance cycle can lead to less opportunity to develop social skills necessary for success later in life. Treatment would help children learn healthy coping skills,” the expert added.
Previous research has shown that failure to identify these disorders early leads to educational underachievement and increased rates of anxiety disorders, depression and substance abuse later in life.
The editorial accompanied a study led by John Walkup of Johns Hopkins Medical Institute compared medication treatment, cognitive behavioural therapy that examines thinking patterns in order to modify behaviour, and the combination of both treatments in children and teens with anxiety disorders.
The results showed that antidepressant medications and cognitive behavioural therapy were equally effective treatments for anxiety and that the combination of both treatments was most effective.
Emslie said he hopes future studies will help determine what type to treatment is best for individual patients. (ANI)

Causes of Anxiety Disorders

2009-01-10T17:22:00.000-08:00

Many prominent psychiatrists and therapists have different theories regarding the causes of this disorder. Many state that genetics may be the key to understanding such disorders. Others state it arises from circumstances people experience, thus making it a learned behavior. Many more have no real idea as to why extreme anxiety is caused in the first place.
We may identify some of the common causes of anxiety as being brought about by some mental condition, or perhaps a physical condition. The misuse of drugs, also the effects of certain types of prescribed medications can sometimes become press backgrounder of the causes. Also there is the possibility that a combination of the above causes can lead to an anxiety disorder.
Causes of anxiety illnesses are due to certain mental conditions which may also include other types of anxiety disorders such as panic disorders. There online press release also the physical conditions that can give rise to anxiety. Conditions such as Palpitations, dizziness and shortness of breath can all be considered to be causes.
Other reasons may include coffee and caffeine based beverages, amphetamines such as speed, an overactive thyroid muscle, abnormal heart rhythms and many types of heart problems. An example of such heart problems is mitral valve prolapse.
While these may be some of the causes of anxiety there are many others which play their part in causing anxiety disorders. Many other types of anxiety disorders may themselves contribute towards the disorder. This can be Generalized Anxiety Disorder or GAD, Phobic disorders and, or Stress Disorder.
General stress caused from a number of different situations can also cause anxiety. Instances like stress experienced at work, stress involving website press release problem, stress resulting from personal relationships like marriage and stress due to trauma, such as the death of a loved one. Stress due to a serious illness and financial stress may also be contributory causes of anxiety.
Apart from these causes you may experience anxiety because of the type of medication that you may be taking. These medications can be prescription drugs prescribed by your doctor, to treat other web site press release or in some cases they may even be illegal drugs like cocaine. Another thing to consider is that the side effects from certain drugs can also be part of the causes of anxiety.
We may never really know the reasons why extreme anxiety develops, because the exact causes of anxiety are still a mystery. Hopefully one day we will understand the causes of anxiety disorder and be able to treat it long before it becomes a serious problem.

Dealing with the anxiety of not smoking

2009-01-10T17:21:00.001-08:00

Was your New Year’s resolution to quit smoking cigarettes? Whether it was out of concern for your health, or because of a loved one’s concern for you, the decision to stop smoking itself causes anxiety.
To add to the problem, almost all newbie non-smokers gain weight, adding to the anxiety of withdrawal. This is because nicotine is an appetite suppressant – when it’s absent, appetite returns with a vengeance. To add to the problem, food meets the natural desire for comfort during times of anxiety.
One way to address these dual anxieties and help you carry through your New Year’s resolution is to use the Bach Flower Essence Rescue ® Remedy. British homeopath and physician Dr. Edward Bach developed this combination of essences from five different flowers in the 1930’s and it is now used by millions of people when they find the stress of life to be overwhelming.
The Rescue ® product comes in the form of a dropper bottle, a spray bottle, or even lozenges which provide the gratification of food. Instead of reaching for a cigarette next time, perhaps try Rescue Remedy. Soothing jangled nerves naturally will save your lungs and maybe a few pounds too.

Social anxiety disorder puts welfare recipients at risk for economic hardship

2009-01-10T17:20:00.001-08:00

Welfare recipients with social anxiety disorder worked only six of 12 months, compared with about nine months for those who did not suffer from this disorder or from major depression. By comparison, women with depression only worked about eight of 12 months.

ANN ARBOR, Mich.—Women on welfare who suffer from social anxiety find it harder to work—and leave welfare—than women without the disorder, according to a new University of Michigan study.Welfare recipients with social anxiety disorder worked only six of 12 months, compared with about nine months for those who did not suffer from this disorder or from major depression. By comparison, women with depression only worked about eight of 12 months.Social anxiety disorder is a persistent fear of social or performance situations that might involve exposure to unfamiliar people or possible scrutiny by others. This condition, which often remains undetected and untreated, undermines a woman's ability to become self-sufficient and impedes efforts to reduce welfare costs through return-to-work programs, the U-M researchers said."Women with social anxiety disorder are at risk of extreme economic hardship," said Richard Tolman, a professor in the School of Social Work and the study's lead author. "These welfare recipients may lose benefits if they fail to enter the work force rapidly and if they exceed time limits for support."Tolman and colleagues examined whether social anxiety disorder was an obstacle to successful employment among women receiving welfare. They analyzed data on 609 respondents who completed four annual interviews from the Women's Employment Study.More than a third of the women cared for a child younger than age 2 and more than 60 percent lived in poverty in the month before the interview.Interview questions included measures of social anxiety disorder, other mental health diagnoses, welfare and work status, and other variables."Very few of the women in this study received any help for a treatable problem that made it nearly impossible for them to get a job and get off of welfare," said Joseph Himle, an assistant professor in the Department of Psychiatry and School of Social Work.The findings also highlight that other barriers—such as poor physical health of the women and their children, low educational attainment and inadequate transportation—remain a concern and are significant obstacles to work for women in this disadvantaged economic group. An accumulation of multiple barriers increases interference with work efforts, the researchers said."With unemployment growing rapidly in these tough economic times, people suffering from social anxiety disorder may be at even greater risk," said James Abelson, a professor of psychiatry. "Social fears may increase their risk of being laid off, and discomfort making phone calls or interviewing will greatly undermine efforts to find new employment."In a follow-up study led by Himle, the research team is developing and testing a treatment program specifically designed for this disadvantaged population. The researchers hope to increase job success for those whose social anxiety has contributed to their lack of employment.Since the study focused on women, the researchers do not know if the findings are relevant to low-income men, who are generally denied public welfare benefits in the United States.The study's other authors are Deborah Bybee, research scientist, School of Social Work; Jody Hoffman of Ann Arbor Consultation Services; and Michelle Van Etten-Lee, adjunct assistant professor, Department of Psychology.The findings appear in the current issue of Psychiatric Services.

Ecstasy for treatment of traumatic anxiety

2009-01-10T17:19:00.001-08:00

TREATMENT with a pharmacological version of the drug ecstasy makes PTSD patients more receptive to psychotherapy, and contributes to lasting improvement. Norwegian researchers explain why.People who have survived severe trauma - such as war, torture, disasters, or sexual assault - will often experience after-effects, in a condition called posttraumatic stress disorder (PTSD). The symptoms can include anxiety, uncontrolled emotional reactions, nightmares, intrusive memories, sleep and concentration difficulties, evasion of situations that resemble the trauma, and feelings of shame or amnesia. For many, the condition gradually goes away by itself. Other individuals experience PTSD as a chronic condition that needs treatment, which typically involves drugs that help with anxiety and depression, and/or psychotherapy.More than just happy pillsPsychotherapy usually involves a combination of talk sessions and tasks. In exposure therapy, the focus is to help the patient digest the traumatic event in a safe context. So the patient realizes that the memories of the traumatic event and the situation surrounding it are not dangerous. The patient learns to deal with the traumatic incident as a painful memory, and not as if it will happen again.“Studies show that exposure therapy can be a very effective treatment of post traumatic disorders. Yet far too many patients receive treatment only with drugs. But anxiety reducing drugs and anti-depressants may work against our efforts and reduce the patient’s emotional learning”, says Psl-+rjan Johansen, a psychologist at the Norwegian University of Science and Technology. Along with Teri Krebs, a neurobiologist at the university, he is now exploring what happens when chronic trauma patients are treated with a combination of psychotherapy and pharmacological versions of ecstasy, MDMA (3,4 methylenedioxy-N-methyl-amphetamine). A U.S. study,* recently conducted by psychiatrist Michael Mithoefer, has shown remarkable success with this combination

Depression and pregnancy

2009-01-10T17:15:00.000-08:00

Pregnancy is a joyous occasion. Pregnancy, though, does not protect women from experiencing mild to severe depression. Medication and/or therapy may be recommended.
Treating depression is always important and it can be successfully treated during and after pregnancy. Some antidepressant/antianxiety medications can be used safely throughout pregnancy and breast feeding.

Paxil (generic name Paroxetine) has been shown to cause cardiac malformations in the fetus and absolutely should not be used during the first trimester of pregnancy. There is no evidence that children have harmful long-term effects as a result of their mother taking antidepressant medication during pregnancy.

No medication is 100 percent safe during pregnancy, but some are safer than others. Mood stabilizers generally are not safe during pregnancy. If you have been diagnosed with bipolar affective disorder, discuss this with your health care provider.
Untreated depression during pregnancy has been proven to lead to higher rates of:

Lower birth weights
Pre-term labor (depression doubles the risk)
Increased use of alcohol and drugs to self-medicate

Please have a candid discussion with both your psychiatrist and OB-GYN regarding the benefits, risks and side effects of all medications. If you have been diagnosed with depression and are considering pregnancy, meet with your health providers before you get pregnant. This will provide peace of mind and help to make sure that you and your baby are both as healthy as possible.
Please share your experiences.

Dysthymia treatment can help reduce depression symptoms

2009-01-10T17:13:00.002-08:00

Dysthymia is a chronic form of depression that lasts at least two years. Dysthymia symptoms can include depressed mood, appetite changes, sleep problems, concentration difficulties, poor energy, and feelings of worthlessness, pessimism or irritability. The symptoms are not as intense as severe depression symptoms. Still, dysthymia can cause significant problems in one's life.
People struggling with dysthymia are at risk for developing major depression, substance abuse problems and heart disease. Dysthymia tends to develop prior to the age of 20. Women having double the risk men do. Because it starts early on, you may have gotten used to your symptoms and just assumed you had to put up with them.

But don't get discouraged. We are fortunate to have good treatments, including medication, for many forms of depression, including dysthymia. A recent Dartmouth College study that looked at problem solving therapy and the use of a selective serotonin reuptake inhibitor (SSRI) such a Prozac, Zoloft, Paxil, Celexa or Lexapro showed good results.

When you get depressed, your thoughts can be distorted. The longer you've suffered from depression, the more ingrained your thought patterns are. Talk therapy can help to reverse these negative thinking patterns. As always, see your health care provider for accurate diagnosis and, if necessary, medical work up. And, if you've had any experience with dysthymia, please share your story.

Depression recovery program explained

2009-01-10T17:13:00.001-08:00

More than two million people in Canada suffer from depression annually and during stressful times, this disease can intensify, says Dr. Neil Nedley, presenter for his eight-week Depression Recovery Program that will be offered in the lakecity during February.
He says many factors can lead to depression including unrealistic goals, added financial stress, family expectations, and change of schedule or eating patterns. “But the cure may not be as difficult as you might think. Actually, just a few basic lifestyle changes can help you break free of the trap of depression.”
Nedley, has put together his eight-week Depression Recovery Program from his 15 plus years of research and clinical experience helping his patients.
The program he offers is being hosted in the lakecity by Valley Outreach, the Williams Lake SDA Church, and Lakeside Colour Productions, says Rita Corbett, one of the SDA directors.
“This seminar is not only excellent for people who are depressed, but also for those who have family members or friends who are depressed,” Corbett says.
“It will focus on brain health and what a person can do to treat depression as well as the healthy lifestyle habits they can adopt to keep depression from ever happening — even for those with a genetic predisposition to mental illness.
This course can help anyone!”
The program begins Monday, Feb. 2 at 7 p.m.
It will help people to identify the underlying causes, or “hits,” which bring on depression. “Every case is as different as each individual, but the 10 Hit Categories summarize all the possible causes for depression. And determining your causes can be as simple as taking the depression questionnaire in this program,” says Nedley.
Nedley is also the author of the books Proof Positive and Depression: the Way Out, and works to teach participants how to improve brain function, maximize IQ in children, increase energy, boost concentration, engage in healthy sleep habits, improve physical performance, and gain renewed hope.
In addition to the essential information on lifestyle and diet, Nedley will also cover by DVD the benefits and risks of psychiatric counseling and medication.
Stone said that those attending the sessions will learn how to understand depression, eliminate negative habits of body and mind, develop healthy patterns, and get more out of the day by enhancing brain function.
Participants will spend less time frustrated by stress, decrease the risk for many diseases, say goodbye to negative thinking, and understand the true power of positive thinking.
Nedley will show better ways to combat depression — how to know what you can change and what you can’t, the importance of minimizing drug use, and how to make use of effective natural therapies.
Dr. Neil Nedley has served thousands of families for more than 15 years through his medical practice and extensive, worldwide lecturing.
He educates students of all ages in nutrition and healthy lifestyle principles through his radio shows, satellite and cable television, and live appearances.
Nedley also helped develop the Omega-3 Uplift bar, a tasty way to get more than 3,000 mg of Omega-3 in each bar which is specially designed for optimal brain health.
Those interested should call Rita Corbett at 250-392-6598 or come to 782 Ninth Ave. North for the class beginning Feb. 2, 7-9 p.m.

Learning lessons from the Great Depression

2009-01-10T17:12:00.001-08:00

Mickey HepnerThe Edmond Sun
With a steady drumbeat of bad economic news and a recession that looks to be the most severe since World War II, it is inevitable that there would be many concerns about a repeat of the Great Depression. Such concerns, however, are unwarranted.There is clearly reason to be concerned about the economy, and a need for a stimulus package of some sort. The Congressional Budget Office released its latest economic outlook last week in which they predicted the current recession will turn out to be the longest downturn since World War II. On Friday, the U.S. Bureau of Labor Statistics reported that the U.S. economy shed another 524,000 jobs in December bringing the total job loss for 2008 to 2.6 million. Most disturbingly though, is that the job losses accelerated at the end of 2008 with the economy shedding 1.9 million jobs in just the last four months alone. With the automakers, financial institutions and retailers still struggling, more job losses are likely to come in the next few months.The magnitude of the job losses and the depth of this recession have led some economists to invoke the dreaded “depression” word. Princeton economist and recent Nobel Laureate Paul Krugman’s latest book is even titled “The Return of Depression Economics and the Crisis of 2008.” Also, a new report by the Center for American Progress shows on its front cover a picture of a Depression-era food line. Before we get too carried away with the Depression references though, let’s look at some facts.Below are the annual changes in U.S. Gross Domestic Product from 1930-33:• 1930: GDP fell by 8.6 percent.• 1931: GDP fell by 6.4 percent.• 1932: GDP fell by 13.0 percent.• 1933: GDP fell by 1.3 percent.How does this compare to today? While the final numbers for 2008 GDP will not be known until March (the advance estimates are due at the end of January), it appears that in 2008 GDP will fall by at most 1 percent. As for next year, the Congressional Budget Office estimates that GDP will fall by 2.2 percent before rebounding in 2010. In other words, the economy of today is nowhere near as bad as the economy of the Great Depression. Although it almost was.Perhaps the definitive book on the causes of the Great Depression was “A Monetary History of the United States,” written by Milton Friedman and Anna Schwartz in 1963. Friedman — who was arguably the greatest economist of the 20th century — and Schwartz found that a series of banking crises and bank runs in the early 1930s, coupled with an inattentive Federal Reserve, generated a significant contraction in the supply of money in the economy. It’s what Friedman and Schwartz called “The Great Contraction.” Since money is the fuel that powers commerce, with less fuel there is less commerce. In the 1930s this “Great Contraction” of money turned an ordinary recession into the Great Depression. According to Friedman and Schwartz, if the Federal Reserve had more aggressively sought to offset this contraction and pump more money into the financial system the Great Depression would have been avoided.Interestingly, earlier this year we saw this same scenario begin to play out, but with a much different ending. Just as we saw at the beginning of the Depression a banking crisis began to contract the money supply. In this case, banks holding assets that were plummeting in value began hoarding cash instead of lending it out into the economy. As a result, interbank lending interest rates nearly doubled in just the few weeks from late September to early October as banks demanded that borrowers pay higher interest rates in order to receive a loan.It was at this time that the Federal Reserve and the U.S. Treasury began pumping about $2 trillion of money into the economy. These efforts have ensured that we do not see another “Great Contraction” today. In fact, with more money available in the economy, interest rates have fallen, thereby facilitating more commerce. In other words, by not repeating the mistakes of the Great Depression, the efforts of the Federal Reserve and the U.S. Treasury are keeping us from repeating the experience of the Great Depression.The economy is not yet out of the woods. We are not yet on the verge of a recovery. The financial crisis of the past few months generated ripple effects throughout the economy that will take months to sort out. But the good news is that the Federal Reserve, and the U.S. Treasury, appear willing to do whatever needs to be done in order keep the money flowing. In short, it looks as if they have learned the lessons from the Great Depression.MICKEY HEPNER is an associate professor of economics at the University of Central Oklahoma.

Recession vs. Depression

2009-01-10T17:11:00.001-08:00

Do you think it is very likely that we'll head into a depression because of all this financial mess?

It might be helpful to define some terms.
One wag has said that a recession is when you lose your job. But a depression is when I lose my job.
There are some common (if serious) definitions of economic recessions and depressions. A recession is said to occur when an economy goes backward for at least two quarters (six months) in a row. A depression is less often identified by a specific number, but is said to occur when an economy shrinks "significantly" and lasts several years.
No one doubts that we are presently in the midst of some sort of economic recession. How deep and long it will last is usually only discernible after the fact, but it's a pretty good bet that this one is going to be on the big side.
Because we are linear creatures that tend to extrapolate our current trajectory to the extreme, it's natural that many folks are asking today, "Are we headed toward another Great Depression?" No one can guarantee that will not happen. But there are significant reasons to believe we are not headed to that extreme.
More production. We call all the stuff we make each year Gross Domestic Product (GDP). This is what we watch to see whether or not our economy is in recession. It seems inevitable that once all the chips are counted for 2008 that we'll see economic shrinkage. Suppose the number comes in at 2 percent to 3 percent economic shrinkage. That's a recession for sure.
Contrast that to the shrinkage of GDP during the Great Depression — it was 27 percent. Our nation's industrial production shrunk by 50 percent. We're nowhere near those kinds of cataclysmal numbers, nor are there any credible voices that anticipate that.
More jobs. This column is being written before the Friday jobs numbers come out. But suppose they show the unemployment rate at around 7 percent. It's likely to head higher before things level off. But during the Great Depression unemployment reached 25 percent — imagine one out of every four people in this nation unemployed. Not pretty, but we're not anywhere close to that.
More sales to others. During the Depression, governments around the world pursued a campaign of mutually assured destruction by putting up barriers to trade. This withered economic activity worldwide, destroyed jobs and caused incalculable misery in this country and around the world. U.S. exports shrank by 66 percent during the Depression era. Thankfully, our understanding of trade is very different today. While U.S. exports may shrink during a recession, the shrinkage will pale in comparison to the Depression.
More money. During the Depression the Fed foolishly pulled money out of the economy, thinking it could punish speculators without harming the overall economy. These days that approach has about as much economic credibility as the use of leaches for medical purposes. What the economy needs during a recession is a reasonable amount of money injected into it to stimulate economic growth without sowing the seeds of inflation. While this is a difficult balance to strike, attempts to strike that balance are far better than the economic leaching done during the Depression.
Recessions are best seen as a season of pruning. Pruning is painful and seems to head in the opposite direction of anyone wanting fruit off the tree. But the experienced gardener knows this cutting back is actually the secret to more and healthier fruit later.
Be wise. Be careful. Make the changes you need to make it. But whatever you do, don't give up or give in to despair.
Because of today's pruning there will be harvest days again.
Byron R. Moore, managing director for the planning group of Argent Advisors, Inc. Write to him at 500 East Reynolds Drive, Ruston, LA 71270 or call him at 251-5858.The views expressed in the preceding commentary do not necessarily reflect the views of Argent Advisors Inc.

The Vicious Cycle Of Depression And Insomnia

2009-01-10T17:10:00.001-08:00

Perhaps the lack of studies dedicated to treating depression stems from the fact that there are already anti-depressants on the market that are effective. At least, they're effective according to the statistics. As for the common side effects, there are sleeping pills that can help with insomnia. There are also drugs that can be used to treat most of the physical side effects associated with depression. However, these drugs tend to be difficult to obtain over-the-counter, which puts things into an interesting situation. Most people tend not to recognize by themselves that they are experiencing depression, which means that while they might treat the side effects, they're ignoring the heart of the matter. In addition, not all of the side effects of depression are treatable by medications, such as the changes in body temperature.Another problem is that the side effects have a tendency to form a vicious cycle that makes prolonged depression worsen. For example, one of the common causes of depression comes in the form of anxiety disorders, typically social anxiety. It has been documented that social anxiety can worsen with the onset of depression, about online courses resulting in total social withdrawal for short intervals. In another tangent, insomnia – another common side effects – can also worsen a person's depressed state. As the lack of sleep starts to interfere with the patient's already shaky ability to perform socially and professionally, the already-fragile self-confidence starts to fracture even more. This can cause the person's already shaky state of mental health to be damaged to the breaking point, possibly resulting in a total nervous breakdown.However, some people have also made the mistake of connecting insomnia directly to depression. While being depressed can have physical effects on the body that can trigger insomnia, it is by no means the absolute cause. According to about online courses studies on the matter, insomnia is a physical condition, one that is more likely to be affected by factors such as a person's diet than an anxiety disorder. However, the popular perception that insomnia is linked to depression can sometimes cause a person to develop the latter. There are several factors that have to be considered, such as whether or not the insomnia has caused a dip in the person's social standing, but the connection is a possibility.

Breaking recession psychology

2009-01-10T17:09:00.000-08:00

Here's something that everybody knew: we are worried about our jobs and household finances and the country's economy.
The Conference Board of Canada says its December consumer confidence index sank to levels just above the historic lows hit during the recession of 1981- 82.
The board had some other bad stuff to say. But we're going to choose to highlight some of the bright spots the board found in its telephone survey of 2,000 Canadians.
For one thing, the survey discovered that, for the second straight month, an increasing number of consumers said it was a good time to buy large items such as TV sets, fridges, stoves, washing machines and cars.
Glen Hodgson, the board's chief economist, noted that optimistic consumers are taking advantage of steep price cuts.
He also pointed out that the economy is in better shape than in the country's two previous recessions. Some predict Canada's unemployment rate could reach eight per cent next year, but that would be down from 13 per cent during the early 1980s and 10 per cent in the early 1990s.
In Canadians' favour is a decline in energy costs, which is taking out some of the sting of filling up cars and heating homes.
Unfortunately, any bright spots are, as Mr. Hodgson noted, being "crowded out by a fear of the future ...and that fear is not totally rational."
The economist is pinning his hopes for an increase in consumer confidence next year on an effective federal stimulus package expected to be announced as part of next month's budget.
If the package works, it could go a long way to breaking the "psychology of recession," which causes consumers to
Hodgson also points out that confidence will return once most Canadians realize they are keeping their jobs and, perhaps, getting a small wage increase.
"When that starts to happen, you'll see a change in attitude," Mr. Hodgson said.
So, much depends on breaking the "psychology of recession," which takes hold when worried consumers stop spending, which in turn causes retailers and manufacturers to cut back on goods and jobs.
We're counting on our political leaders to give us reason to be hopeful.

Anxiety and Depression Affect Left-Handed People More

2009-01-10T17:08:00.003-08:00

A new scientific study shows that the handedness of a patient is crucial in understanding at least a part of his or her behavior. Apparently, all left-handed people share in common traits such as anxiety, depression and fear of making important decisions, unlike right-handers. The researchers behind this survey say that the difference in the way people act occurs because different brain hemispheres are stimulated for the use of each hand.
The paths that the brain uses for the control of the dominant hand are located in the opposite hemisphere – meaning that right-handed patients will have a more active left hemisphere, whereas left-handed ones will use their right one more. Psychologists say that the right side of the brain is responsible for the control of negative emotions, so it stands to reason that, if it's more active than the left side, it also generates more such emotions.
These beliefs were confirmed by the new study, conducted by a team of scientists at the University of Abertay Dundee, in the UK, led by behavioral psychologist Lynn Wright. They tested on 46 left-handed participants, both men and women, as well as on 66 right-handed individuals. All participants were given questionnaires, meant to measure their levels of security, alertness, impulsiveness and restraint as well.
The results showed that left-handed people are generally more reticent than right-handers. This was also the case for women, regardless of their dominant hand, who answered positively to statements such as "Criticism or scolding hurts me quite a bit" and "I worry about making mistakes."
The team says that the fact that some people use their right side of the brain more, rather than the left side, is not an indicator of their personality in any way. It merely offers insight into how emotions are processed by those people. In fact, it's the way we process information and emotions that differentiates us from each other. Otherwise, all participants to an event, for example, will have the same opinion about it, and the same applies to every event involving many people.

The Psychology of Crying

2009-01-10T17:08:00.001-08:00

There are numerous scientific studies that argue the benefits of crying for most people, in terms of letting go of their inner emotions and of whatever bothers them. But a new research, conducted by researchers at the University of South Florida and the Tilburg University, in The Netherlands, shows that these benefits depend entirely on when, where and why crying occurs. The study was based on the accounts of volunteers who experienced recent crying episodes.
window.google_render_ad();
Out of the 3,000 participants to the new study, most indeed reported improvements in their moods after crying, but there were those who said that they actually felt worse afterwards. The psychologists in charge determined that an important factor that triggered these emotions was social support. And while two thirds of those who received it felt better, one third reported no change in their state of mind.An additional 10 percent said that they actually felt worse after crying, on account of the humiliation they experienced by crying in public, instead of when they are alone. This was especially true in the case of people suffering from anxiety and mood disorders. They reported none of the benefits of crying, and experienced only its negative effects.The main positive aspect of crying is the fact that it calms the body, which enters a state of arousal when a person is upset or in distress. Heart rates go up, and excessive sweating sets in. While crying, breath normalizes and the heart rate slowly reverts to normal, causing the calming effect crying is renowned for.Psychologists have been puzzled by crying for many years, as its effects, which vary considerably from individual to individual, are hard to catalog. The new finds, published in the December issue of the journal Current Directions in Psychological Science, show that the ability that the human mind has, of turning upsetting moments into positive thoughts via crying, is necessary, if crying is to be a calming experience. For those lacking this ability, crying will keep making things worse.

LEWISHAM AND GREENWICH: Psychology lecturer receives New Year Honour

2009-01-10T17:06:00.002-08:00

A PSYCHOLOGY lecturer researching stammering in children has been recognised in the New Year Honours list.
Dr Stephen Davis, of Baring Road, Grove Park, has been awarded an OBE for his research at University College London.
The 60-year-old is campaigning to raise awareness of children who suffer from the condition.
He said: “I was surprised and obviously absolutely delighted to receive this honour.
“Stammering absolutely destroys people’s lives and I’m pleased there is this opportunity to raise the profile of stammering and the need for more funding from the Government.”
Others awarded an OBE include Brockley resident Lucy Sayce, chief executive of disabled charity RADAR, and the Rev Adam Scott, of Blackheath, for his work in public and voluntary services.
Eltham resident Evelyn Green was awarded an MBE for voluntary work in south London, as well as Tracy Johnson from Lee for her services to the cosmetics industry.

Turner touts reverse psychology

2009-01-10T17:06:00.001-08:00

Originally published 06:47 p.m., December 31, 2008, updated 06:48 p.m., December 31, 2008
It's one of those fun plays, a gadget that gets crowds to their feet, gives offenses some razzle-dazzle and gives defenses something else to worry about. It's a play that always seems to go a long way or go nowhere at at all.
When it goes well, it's Norv Turner's kind of play.
“I'm a big reverse guy,” the Chargers coach said. “People used to complain in a couple places I've coached that I ran too many reverses.”
He's running more of them now. Last Sunday, the Chargers so enjoyed the sight of Vincent Jackson taking the ball around the corner for 17 yards against the Denver Broncos, they later called for a second reverse and got 13 more yards from the wide receiver.
In both cases, the blocker directly ahead of Jackson was Philip Rivers, though that wasn't why the NFL's top-rated quarterback Wednesday was named the league's Offensive Player of the Month for December.
“He's a football player,” Turner said of his quarterback. “He knows how to take care of himself. He did a good job of faking the block and getting out of the way.”
By making the call, Turner not only made more work for the Indianapolis Colts as they prepare for Saturday's playoff game, but he also was making a statement about his faith in Rivers' physicality. The coach said he restrained himself from calling such a play earlier this season because he knew Rivers was rebounding from postseason knee surgery.
“The quarterback has to be the lead block,” Turner said. “One thing that's kinda gotten lost in what's happened because Philip's played so well is that last March, we're sitting here wondering if he can be ready for training camp, ready for the season. What he's done has been remarkable.”
OK, so he's not Lorenzo Neal on the lead block. Rivers did prove an impediment to defenders trying to get at Jackson.
“All (last) week we're doing that play (in practice),” LaDainian Tomlinson said, smiling. “We joked with Philip about it, that (his) may be the block that springs Vincent. (Rivers) came back (Sunday) and said, 'Dang, I missed it.' I was thinking to myself, 'Were you surprised?'”
Starting to hear his name mentioned more in league MVP conversations, Rivers was almost off the charts in December. He completed 80-of-121 passes for 1,054 yards, with just one interception, in leading the Chargers to four consecutive victories and their highly improbable rise to another AFC West championship.
Rivers is the second Charger to win the monthly award this season. Darren Sproles was named the top special-teams player in September.
LT, GATES SKIP PRACTICE
Tomlinson (strained groin) and Antonio Gates (sprained ankle) were withheld from practice Wednesday, but could be back on the field Thursday, according to Turner.
As insurance against Tomlinson's unavailability for Saturday, though, the Chargers are likely to activate running back Michael Bennett for the first time since they acquired him off waivers Nov. 12.
“That's one of the things we have to consider,” said Turner, who also said he hopes Tomlinson and Gates “can get out and run around” in Thursday's practice. Tomlinson said he didn't expect to do much in drills.
“Part of (the problem) for me last year was trying to push it in practice, so it got sore the next day,” said Tomlinson, hobbled and sidelined by injury during the last postseason. “I'd rather push it in the game, then let it be sore the next day.”
Tomlinson said the fact the Chargers have played the Colts so many times – five games since 2004, including last season's playoffs and this year's regular season – minimized the effect of missed practice time.
“You can do it when you've played guys quite a bit,” Tomlinson said. “The only thing that might be a little different in the beginning is timing, but as the game goes on, that's something you can get. It shouldn't be too much of a factor when you don't practice too much during the week, knowing you're going against a team you've gone against a bunch of times.”
Tomlinson played little more than two quarters before leaving Sunday's game with the injury, but he still did enough damage – 96 yards on just 14 carries – to the Broncos to warrant the FedEx Ground Player of the Week award for last weekend.
CONCERNS ABOUT THE FIELD
Turner expressed concerns over the fact that by Saturday night, Qualcomm Stadium will have hosted four games in less than two weeks, including the Chargers' regular-season finale, the Poinsettia Bowl and Holiday Bowl.
“I was disappointed they didn't re-sod the whole field,” Turner said. “They did it between the numbers, inside the numbers. It was in great shape the other night when we played on it. It's obviously gotten torn up. I know some of our players have asked about it, but there's not a whole lot we can do right now.”
LUCKY 13
The Colts and Chargers will set a league record this weekend – longest combined winning streak for opposing teams in the wild-card round. The Colts have won nine straight, the Chargers four.

Practical Psychology: Affirmations for new year could improve relationships

2009-01-10T17:04:00.002-08:00

Today is the 6th day of the new year. I wish for each of you a very meaningful and happy new year. Today, instead of New Year’s resolutions, I offer you some affirmations that might help my wish for you to be realized.
How we think, feel and behave is highly influenced by our own individualistic perceptual world. If we view the world as threatening, we will behave defensively. If we perceive it to be friendly and supportive, we will be open and curious. How we interpret our perceptual world determines how we choose to function within it.
Our perceptual reality is like a colored glass bottle in which we live. Everything we experience as outside ourselves is distorted or clarified by the shape and color of the bottle. Likewise, everything we express from within ourselves is colored by our view of “how things are.” Six people viewing the same event will experience the event in six individual ways. All six will be correct — from their point of view.
When we are unhappy with our partner in a relationship, we need to change the nature of the “bottle” in which we live. One of the most powerful methods for changing our images of life is through changing the nature of the language in which we habitually think. Positive affirmations can have a transformational effect on our relationships and on us.
Healing affirmations
Irv Niece, a marriage and family counselor in Redlands, Calif., shares the following set of affirmations with couples. Can you imagine the healing transformation of a marital relationship if both partners agreed to, regularly stated to one another, and habitually behaved according to these affirmations?
-- I want to know and give attention to your needs.
-- Your emotional needs are more important than my desires.
-- I want you to be right instead of me having to be right.
-- I want to quit blaming.
-- I want you to feel loved, valued, understood and listened to in our relationship.
-- I want you to feel confident that you are my best friend, the top person in my life.
-- I want to generate positive energy in our relationship.
-- I want to quit feeding the negative when we disagree.
-- I want you to help me to not offend your spirit.
-- I want to listen to your feelings and honor them.
-- I want to help you raise your self-esteem all the time.
-- I want to be a forgiving, trusting partner to you always.
-- I want my daily behavior to be loving behavior toward you.
-- If I give you unloving behavior, please alert me so that we can talk about it.
-- I want to make our relationship and home joyous, loving and enthusiastic.
-- I accept responsibility for creating the climate of positive values in our home and relationship. Please help me.
-- I want to learn how to process anger creatively. I give you permission to be angry. I promise not to attack you when I’m angry.
-- I need your help with my anger. Help me to express my anger in a way that does not hurt you.
-- I want to do more learning and less protecting of myself.
-- My intent is to learn and truly understand, rather than to defend and protect my ego.
-- I want to explore our thoughts behind our negative emotions so that we can correct them, understand each other better, and live together without threat.
-- I want to build comfortableness and harmony into our relationship more and more.
-- I want to explore how you are affected by my behavior, so we can both gain more freedom and more intimacy.
-- I want you to be able to share your pain and receive my warmth and caring in return.
-- I want to learn to say, “I’m sorry” when I have offended your spirit.
-- And I want you to know that I’m grateful for you, and want us together to enjoy an increasingly fulfilling and loving relationship.
Can you imagine the healing change that would occur in 2009, if the grown-ups viewed themselves and their relationships from a bottle colored and shaped by those affirmations?

The psychology of Territorians’ New Year resolutions

2009-01-10T17:04:00.001-08:00

After weeks of binge eating and enthusiastic drinking, many Territorians are now wrestling with the sober activity of New Year resolutions, according to a Darwin psychologist.
Senior Lecturer in Psychology at Charles Darwin University, Dr Mary Morris said New Year resolutions were a puzzling ritual from a psychological perspective.
Dr Morris said of greatest interest was what determined the goals that were set, how many goals people set themselves at one time and how successful they were at achieving these goals.
“Why do we pick a single point in time each year to try and change certain things in our life — behaviours, attitudes, whatever — make resolutions about them, and then proceed to fail at them within a month’s time?” she said.
Some of the more popular New Year goals Territorians set include starting an exercise regime, eating better, reducing their consumption of alcohol and caffeine, and the most popular of all, quitting smoking.
“Research suggests that people who believe that self-control is something dynamic, changing and unlimited, and would therefore make claims such as - ‘I can stop smoking, all I have to do is put my mind to it’ - tend to set more resolutions and are generally more successful at achieving their goals,” Dr Morris said.
“In contrast, people who believe that we all are born with a limited, set amount of self-control, that we cannot change and who also have little belief in their own capabilities to carry out their own goals naturally do worse in achieving their New Year’s resolution goals.
“Yet these people still make resolutions knowing they have absolutely no chance of achieving them.”
Dr Morris said another major contributing factor determining success or failure was the actual skills a person possesses to make the changes proposed for the New Year.
“While it’s all well and good to say you want to quit smoking or eat healthy foods, one of the determining factors in achieving success is whether you really know how to actually do it,” she said.
“Researching the most effective methods for achieving change ahead of time predicts better success in actually achieving goals. And, of course, being ready to change also helps.
“If you don’t want to change and so only make a half-hearted resolution to do so, don’t be surprised by your amazing lack of success.”
Dr Morris’ tips for New Year resolution success:
• Have a strong initial commitment to make a change • Identify what method will work for you• Engage the support of family and friends• Have coping strategies to deal with problems that will come up • Keep track of your progress. The more monitoring you do and feedback you get, the better you will do.

PU Psychology dept holds first sports day

2009-01-10T17:01:00.000-08:00

LAHORE: Punjab University Centre for Clinical Psychology (CCP) celebrated its first sports day and charity carnival, according to a press release issued by the university on Saturday.The funds generated from the carnival were donated to the Rose Garden-Half Way House, a CCP project launched in collaboration with the Punjab Institute of Mental Health. The centre will rehabilite under-privileged women with chronic schizophrenia. Both the visitors and the participants of the sports days participated with enthusiasm. The visitors also showed great interest in the stalls set up by the Rose Garden, Living Institute for Special Learners and students of the centre. Badminton and cricket matches were played. Four quarter finals and two semi finals were conducted for Badminton. The final match was played between the Pansy (BSV) and the Pink Rose (BS III) teams in which Pink Rose bagged the trophy. The final match of cricket was played between the Hawks (BS III) and the Stallions (BS I,V,VII). The Hawks (BS III) won the match by 21 runs.Prof Dr Shahida Hasnain, dean of PU Life Sciences Department, was the chief guest at the prize distribution ceremony. Addressing the ceremony, she said that the significance of physical education could not be undermined as it developed discipline, leadership, cooperation, endurance and a desire to excel among the students. She also appreciated the efforts of the centre for its commitment in running the Rose Garden-Half Way House, saying that it was the foremost duty of psychologists to help people with mental problems. She also met the members of the Rose Garden. CCP Director Dr Aisha Sitwat was also present on the occasion.

Birth Order, Age Raise Autism Risk, Study Says UW Researcher Finds More Frequency in Kids of Older Parents

2009-01-07T10:08:00.000-08:00

In the largest study of its kind, researchers have shown that the risk of autism increases for firstborn children and children of older parents.
The risk of a firstborn with an autism spectrum disorder triples after a mother turns 35 and a father reaches 40.
Although the study was not designed to uncover the cause of the disorder, the findings suggest avenues of research to explore, including the role of environmental toxins.
"Is this pure genetics? Or a toxic phenomenon?" said Darold Treffert, former president of the Wisconsin Medical Society, a psychiatrist at St. Agnes Hospital in Fond du Lac and an expert in savant syndrome. Treffert was not involved in the study.
"I think we're bombarded with all sorts of stuff. And we know from experiences such as thalidomide that there are specific times during development of specific risks with specific chemicals. The problem is there is just so much out there."
Thalidomide was a drug taken by pregnant women in the 1950s and 1960s that caused severe birth defects in their children.
The autism study, led by University of Wisconsin-Madison epidemiologist Maureen Durkin, looked at more than 1,200 cases of autism, or 50% more than any previous study. The research team looked at more than 300,000 U.S. births.
The team found a 20% increase in the risk of autism with each 10- year increase in the parents' ages. Also, they found a couple's fourth child has half the risk of the first, regardless of the parents' ages.
Although debate exists about the prevalence of autism in the U.S. population and whether it is on the rise, the Centers for Disease Control and Prevention says the disorder appears in one in 150 births and is increasing.
Regardless of its prevalence, Durkin and Treffert say, the link between age and the risk of autism is not surprising. They pointed to several developmental disorders, including Down syndrome, for which risk rises as the parents' age increases.
Treffert said, "This a trend that I'm concerned about: The increase in developmental disorders in general and the rise in premature births," which are related to autism.
Durkin said the study shows there probably is an ideal window in which to have children -- when parents are not too young or too old. But regardless of age, she said, the chances are still very low.
"For the individual family, this study is not going to have a big impact," because the chances are so low for any one individual, said James Crow, a retired professor of genetics at UW. But the study will shape public health statistics, he said.
Possible causes
Durkin said her research will hopefully lead to other studies designed to uncover the causes of the disorder. She said the observations that parental age and birth order are involved bring to mind several likely causes.
For instance, she said, factors that might influence the disorder in the children of older parents include age-related genetic and chromosomal damage, environmental toxins and the effects of infertility treatment.
Crow thinks the genetic hypotheses can be ruled out because the kinds of genetic problems that occur with age are not the same for men and women. So, if autism were caused by an age-related genetic mutation, then the study would show that it is only the age of the father that causes the disorder. That's because men produce sperm throughout their lives, while a woman's eggs are developed before she is born.
And if the disease were caused by chromosomal damage, as occurs in older women's eggs, then the risk would be dependent on only the mother's age.
Crow said the other two possibilities are more likely.
As for what is occurring in firstborn children, he said the most likely explanation is just a statistical artifact caused by "stoppage." Parents whose first child is autistic generally do not continue to have other children. The correlation seen with firstborn children is simply a result of parents not having more children, Crow said.
Although Durkin didn't test for this, she believes it's unlikely because most parents do not know their child is autistic until the child is 2 or 3 years old. She said many couples have had, or already are pregnant with, their second child when they realize that their first is autistic.
Other theories include the firstborn's exposure to toxins. The chemicals a woman has acquired over her lifetime are either released directly into the fetus or passed through her breast milk as she nurses. The firstborn soaks up more of those stored chemicals.
Another theory is the hygiene hypothesis, which suggests that firstborn children are exposed to fewer infections from other children early in childhood. Because of this delay, they may be more likely to develop autoimmune responses that affect brain development.
Although some parents consider vaccines a possible cause of autism, they were not mentioned in the paper. Numerous other studies have shown no link between vaccines and autism.
Before any cause can be discovered, Treffert said, doctors must refine their definition of autism. Some types of autism are apparent at birth, while other cases don't appear until a child is 3 or 4. There may be different causes for these kinds of autism, he said.
"While I'm all for community acceptance and education, if we keep expanding the definition, we're never going to find the cause," he said.

A New Council of Psychological Advisors for President Obama?

2009-01-07T10:07:00.001-08:00

After President Barack Obama figures out how to bring the economy out of recession, stabilize financial institutions, end two wars, and get every citizen health insurance, there is something else that he should consider: The United States needs a Council of Psychological Advisors.
This new body would parallel and complement the Council of Economic Advisors. When economists have the president's ear, all their whispers concern incentives and self-interest. We need psychologists whispering in his other ear, about the economy, education, healthcare, and more.
On the Economy—Understand the "Irrational" Where did our financial institutions go wrong? Many accounts focus on greed, fear, and lack of trust. And why did things get so out of hand? Why was there a housing "bubble"? Somehow, "irrational exuberance" (Robert Schiller) or "animal spirits" (John Maynard Keynes) overwhelmed rational calculations of risk and reward. And it isn't just that irrational optimism, or even blindness to market fundamentals, gets the better of our rational faculties. Rather, as George Soros has pointed out, these psychological phenomena can become part of a feedback loop that actually changes market fundamentals. "Reflexivity," he calls it. The housing bubble was not the first such phenomenon, nor will it be the last.
Economists offer little that helps us understand why such bubbles occur or how they might be prevented. They also have little to tell us about how to prevent a "downward spiral of negative expectations" that makes fear of an economic downturn self-fulfilling. Economists largely make assumptions about the rationality of human decision-making and proceed from there. Witness Alan Greenspan's recent admission that he was mistaken in assuming that markets operate rationally and efficiently. The current crisis makes it clear that ignoring the real psychology of greed, fear, trust, and irrational enthusiasm (0r pessimism) can be perilous. Economists offer little that helps us understand why such bubbles occur or how they might be prevented. A Council of Psychological Advisors could help.
On Education—More than Just Carrots and Sticks: One of President Obama's top priorities is to improve the quality of American education. This will require recruiting and retaining excellent teachers and finding ways to motivate students. How can this worthy goal be achieved? At the moment, we're pointing in the direction of school choice and competition to produce better schools, higher pay to produce better teachers, big tests to monitor their performance, and financial incentives to motivate students. A bunch of carrots and sticks. Will these kinds of measures be enough? Research in psychology suggests not. More important than pay (as long as it is adequate) are working conditions that allow teachers to be flexible, autonomous, and creative in their work with students, and that provide teachers with a sense that they are working in a community that has a common purpose. From this perspective, the regimentation of instruction ushered in by big-test accountability is actually counter-productive. And so is the move, now being tried in pilot projects around the country, to pay students for showing up to class and for getting good grades. A Council of Psychological Advisors could help design environments that encourage students to pursue mastery rather than money and teachers to view their work as a calling.
On Health Care—Understanding Efficacy and Managing Chronic Conditions: Everyone should have health insurance. This is necessary, but not sufficient. The cost of health care must come down. Computerized medical records that produce coordination of care will help bring down costs, but it also isn't sufficient. We need to help patients (and their doctors) understand how to think about the efficacy and the risks involved in various medical procedures, so that fewer unnecessary, but costly procedures are undertaken. There is plentiful evidence that patients make serious mistakes in thinking about risks and efficacy, and that their doctors make the very same mistakes! Moreover, most medical care in a developed country like the U.S. involves management of chronic diseases (hypertension, heart disease, diabetes, asthma). Managing these conditions effectively demands that patients be partners; they need to make lifestyle changes (eg., diet, smoking, and exercise) that are often difficult to adhere to. A Council of Psychological Advisors can help in designing formats for presenting evidence about the efficacy and risks of various treatments that will reduce misunderstanding and thus reduce unnecessary procedures. And it can help develop interventions that will make patients healthcare partners more effectively.
On the Environment—Do It Because It's Right: Traditional economic incentives like investment tax credits, energy taxes, and pollution credits might help us reduce our environmental footprint, but focusing exclusively on these neglects the extraordinary opportunity to call on citizens to do the right thing because it's the right thing. Indeed, there is even evidence that incentives can undermine people's desire to do the right thing. In a Swiss study of citizen-willingness to have a nuclear waste dump located in their communities, researchers found that whereas 50% of citizens agreed (reluctantly) when no incentives were involved, only 25% agreed when substantial incentives were involved. Each of us can take responsibility as citizens to contribute in small ways to solving the big environmental problems we face. A Council of Psychological Advisors can help in crafting appeals to citizens to do their duty.
Moving Beyond GDP: Finally, let us ask the most fundamental question: what is public policy for? We aim to increase collective welfare, but just what does welfare consist in? For the most part, under the sway of economic thinking, our aim has been to make the country more prosperous-to increase per capita GDP. The appeal of this goal is two-fold. First, we assume that if people are richer, they will be freer to choose as individuals the objects and activities that serve their welfare. We (the state and its technocrats) don't have to choose for them. So wealth serves as a proxy for everything else. And second, GDP can be measured. But like a drunk looking under a lamp post for his car keys, even though he dropped them someplace else (because "that's where the light is"), it doesn't help much to pursue what you can measure if what you're measuring is the wrong thing. It doesn't help to get better at achieving goals if you're achieving the wrong goals. Much research in the psychology of well being suggests that some wealth-enhancing policies improve welfare, but others do not. Indeed, some of what it takes to get more prosperous may be counterproductive when it comes to well being. A Council of Psychological Advisors can help here too, in the design of a system of national "psychological accounts" that does a better job of measuring well being than per capita GDP ever could.Many of us hold out the hope that the coming Obama administration will mark a return to respect for knowledge and expertise. Agencies will be run and staffed not by political cronies, or by people who "just know in their gut" what needs to be done, or by ideologues, but by people who actually have respect for evidence. It would be a shame to bring experts on board in existing agencies, only to have them have to rely on personal intuition rather than knowledge in formulating policies and making decisions that could benefit from psychological expertise. A Council of Psychological Advisors is long overdue. This would be an excellent time to create one

Good sex is good for relationships: Oxytocin and relationships

2009-01-07T10:06:00.001-08:00

My evolutionary psychology colleagues have a fascination with what they affectionately call "human mating." Obviously, sex and sexuality is an important part of human experience, and it is important to have a theoretical framework for trying to understand sex differences in sexual strategies. Plus, if the headlines splashed on supermarket magazine covers are to be believed, we all like to read about sex, so it makes for good reading.

Unfortunately, many evolutionary approaches take a fairly narrow view of sexuality, by starting with the role of sex in reproduction. This discussion needs to be broadened.

To caricature the evolutionary psychology approach to human mating, these views assume that animals with internal conception (like humans) require a larger parental investment by the female than by the male. Thus, males should be prone to mate with many females to try to maximize the probability of conception. Because conception is internal, there is paternity uncertainty, so females should try to get the best genes possible for their future offspring, but should also try to gain resources from males to support the unborn children.
Unfortunately, a lot of human behavior gets missed by this approach. Lots of people stay married for a long time. Couples that are the happiest tend to be those with the best sex lives. People continue to have sex long after they are able to conceive children.

An interesting study in the November, 2008 issue of Psychological Science by Christian Unkelbach, Adam Guastella, and Joseph Forgas helps shine a light on an aspect of sexuality that is under-appreciated in many discussions of sex that come out of evolutionary psychology.
They did a study on a group of men who were given either a dose of oxytocin or a placebo. Oxytocin is a chemical that is released in men and women during orgasm. It plays other roles as well, but we'll focus on that one for now.

The men in this study were then given a recognition test for positive and negative words related to sex, relationships, other positive emotions, and words unrelated to positive emotion at all. This recognition test was set up to determine the degree of accessibility of the words. As frequent readers of this blog will remember, concepts that are more accessible tend to have a stronger influence on behavior than concepts that are less accessible.

This study observed that oxytocin made positive words related to sex and relationships more accessible relative to the placebo condition. Other words (including words for positive emotions) were not influenced. This finding suggests that oxytocin release will make it easier for men to act in a positive and loving way toward their sexual partners. This study was done only with men, but similar kinds of results have been obtained with women as well.

So, it is important to recognize that sex plays an important role in strengthening relationships in a way that goes above and beyond mere procreation. To be clear, I am not saying that the principles that evolutionary psychologists use are all wrong, only that the discussion needs to be broadened.

The Ideological Animal

2009-01-07T10:03:00.000-08:00

We're easily manipulated by politics. We think our political stance is the product of reason, but we're surprisingly malleable. Our essential political self is more a stew of childhood temperament, education, and fear of death.

By: Jay Dixit

Cinnamon Stillwell never thought she'd be the founder of a political organization. She certainly never expected to start a group for conservatives, most of whom became conservatives on the same day—September 11, 2001. She organized the group, the 911 Neocons, as a haven for people like her—"former lefties" who did political 180s after 9/11.
Stillwell, now a conservative columnist for the San Francisco Chronicle, had been a liberal her whole life, writing off all Republicans as "ignorant, intolerant yahoos." Yet on 9/11, everything changed for her, as it did for so many. In the days after the attacks, the world seemed "topsy-turvy." On the political left, she wrote, "There was little sympathy for the victims," and it seemed to her that progressives were "consumed with hatred for this country" and had "extended their misguided sympathies to tyrants and terrorists."
Disgusted, she looked elsewhere. She found solace among conservative talk-show hosts and columnists. At first, she felt resonance with the right about the war on terror. But soon she found herself concurring about "smaller government, traditional societal structures, respect and reverence for life, the importance of family, personal responsibility, national unity over identity politics." She embraced gun rights for the first time, drawn to "the idea of self-preservation in perilous times." Her marriage broke up due in part to political differences. In the lead-up to the invasion of Iraq, she began going to pro-war rallies.
In 2005, she wrote a column called "The Making of a 9/11 Republican." Over the year that followed, she received thousands of e-mails from people who'd had similar experiences. There were so many of them that she decided to form a group. And so the 911 Neocons were born.
We tend to believe our political views have evolved by a process of rational thought, as we consider arguments, weigh evidence, and draw conclusions. But the truth is more complicated. Our political preferences are equally the result of factors we're not aware of—such as how educated we are, how scary the world seems at a given moment, and personality traits that are first apparent in early childhood. Among the most potent motivators, it turns out, is fear. How the United States should confront the threat of terrorism remains a subject of endless political debate. But Americans' response to threats of attack is now more clear-cut than ever. The fear of death alone is surprisingly effective in shaping our political decisions—more powerful, often, than thought itself.
Abstract Art vs. Talk Radio: The Political Personality Standoff
Most people are surprised to learn that there are real, stable differences in personality between conservatives and liberals—not just different views or values, but underlying differences in temperament. Psychologists John Jost of New York University, Dana Carney of Harvard, and Sam Gosling of the University of Texas have demonstrated that conservatives and liberals boast markedly different home and office decor. Liberals are messier than conservatives, their rooms have more clutter and more color, and they tend to have more travel documents, maps of other countries, and flags from around the world. Conservatives are neater, and their rooms are cleaner, better organized, more brightly lit, and more conventional. Liberals have more books, and their books cover a greater variety of topics. And that's just a start. Multiple studies find that liberals are more optimistic. Conservatives are more likely to be religious. Liberals are more likely to like classical music and jazz, conservatives, country music. Liberals are more likely to enjoy abstract art. Conservative men are more likely than liberal men to prefer conventional forms of entertainment like TV and talk radio. Liberal men like romantic comedies more than conservative men. Liberal women are more likely than conservative women to enjoy books, poetry, writing in a diary, acting, and playing musical instruments.

"All people are born alike—except Republicans and Democrats," quipped Groucho Marx, and in fact it turns out that personality differences between liberals and conservatives are evident in early childhood. In 1969, Berkeley professors Jack and Jeanne Block embarked on a study of childhood personality, asking nursery school teachers to rate children's temperaments. They weren't even thinking about political orientation.
Twenty years later, they decided to compare the subjects' childhood personalities with their political preferences as adults. They found arresting patterns. As kids, liberals had developed close relationships with peers and were rated by their teachers as self-reliant, energetic, impulsive, and resilient. People who were conservative at age 23 had been described by their teachers as easily victimized, easily offended, indecisive, fearful, rigid, inhibited, and vulnerable at age 3. The reason for the difference, the Blocks hypothesized, was that insecure kids most needed the reassurance of tradition and authority, and they found it in conservative politics.
The most comprehensive review of personality and political orientation to date is a 2003 meta-analysis of 88 prior studies involving 22,000 participants. The researchers—John Jost of NYU, Arie Kruglanski of the University of Maryland, and Jack Glaser and Frank Sulloway of Berkeley—found that conservatives have a greater desire to reach a decision quickly and stick to it, and are higher on conscientiousness, which includes neatness, orderliness, duty, and rule-following. Liberals are higher on openness, which includes intellectual curiosity, excitement-seeking, novelty, creativity for its own sake, and a craving for stimulation like travel, color, art, music, and literature.
The study's authors also concluded that conservatives have less tolerance for ambiguity, a trait they say is exemplified when George Bush says things like, "Look, my job isn't to try to nuance. My job is to tell people what I think," and "I'm the decider." Those who think the world is highly dangerous and those with the greatest fear of death are the most likely to be conservative.
Liberals, on the other hand, are "more likely to see gray areas and reconcile seemingly conflicting information," says Jost. As a result, liberals like John Kerry, who see many sides to every issue, are portrayed as flip-floppers. "Whatever the cause, Bush and Kerry exemplify the cognitive styles we see in the research," says Jack Glaser, one of the study's authors, "Bush in appearing more rigid in his thinking and intolerant of uncertainty and ambiguity, and Kerry in appearing more open to ambiguity and to considering alternative positions."
Jost's meta-analysis sparked furious controversy. The House Republican Study Committee complained that the study's authors had received federal funds. George Will satirized it in his Washington Post column, and The National Review called it the "Conservatives Are Crazy" study. Jost and his colleagues point to the study's rigorous methodology. The study used political orientation as a dependent variable, meaning that where subjects fall on the political scale is computed from their own answers about whether they're liberal or conservative. Psychologists then compare factors such as fear of death and openness to new experiences, and seek statistically significant correlations. The findings are quintessentially empirical and difficult to dismiss as false.
Yet critics retort that the research draws negative conclusions about conservatives while the researchers themselves are liberal. And it's true that over the decades, a disproportionate amount of the research has focused on figuring out what's behind conservative behavior. Right shift is likewise more studied than left shift, largely because most of that research has been since 9/11, and aimed at trying to explain the conservative conversions of people like Cinnamon Stillwell.

Even with impeccable methodology, bias may creep into the choice of which phenomena to study. "There is a bias among social scientists," admits Glaser. "They look for the variables that are unflattering. There probably are other nice personality traits associated with conservatism, but they haven't shown up in the research because it's not as well studied."
"There are differences between liberals and conservatives, and people can value them however they like," Jost points out. "There is nothing inherently good or bad about being high or low on the need for closure or structure. Some may see religiosity as a positive, whereas others may see it more neutrally, and so on."
Red Shift
By 2004, as the presidential election drew near, researchers saw a chance to study the Jost results against the backdrop of unfolding events. Psychologists Mark Landau of the University of Arizona and Sheldon Solomon of Skidmore sought to explain how President Bush's approval rating went from around 51 percent before 9/11 to 90 percent immediately afterward. In one study, they exposed some participants to the letters WTC or the numbers 9/11 in an image flashed too quickly to register at the conscious level. They exposed other participants to familiar but random combinations of letters and numbers, such as area codes. Then they gave them words like coff__, sk_ll, and gr_ve, and asked them to fill in the blanks. People who'd seen random combinations were more likely to fill in coffee, skill, and grove. But people exposed to subliminal terrorism primes more often filled in coffin, skull, and grave. "The mere mention of September 11 or WTC is the same as reminding Americans of death," explains Solomon.
As a follow-up, Solomon primed one group of subjects to think about death, a state of mind called "mortality salience." A second group was primed to think about 9/11. And a third was induced to think about pain—something unpleasant but non-deadly. When people were in a benign state of mind, they tended to oppose Bush and his policies in Iraq. But after thinking about either death or 9/11, they tended to favor him. Such findings were further corroborated by Cornell sociologist Robert Willer, who found that whenever the color-coded terror alert level was raised, support for Bush increased significantly, not only on domestic security but also in unrelated domains, such as the economy.
University of Arizona psychologist Jeff Greenberg argues that some ideological shifts can be explained by terror management theory (TMT), which holds that heightened fear of death motivates people to defend their world views. TMT predicts that images like the destruction of the World Trade Center should make liberals more liberal and conservatives more conservative. "In the United States, political conservatism does seem to be the preferred ideology when people are feeling insecure," concedes Greenberg. "But in China or another communist country, reminding people of their own mortality would lead them to cling more tightly to communism."
Jost believes it's more complex. After all, Cinnamon Stillwell and others in the 911 Neocons didn't become more liberal. Like so many other Democrats after 9/11, they made a hard right turn. The reason thoughts of death make people more conservative, Jost says, is that they awaken a deep desire to see the world as fair and just, to believe that people get what they deserve, and to accept the existing social order as valid, rather than in need of change. When these natural desires are primed by thoughts of death and a barrage of mortal fear, people gravitate toward conservatism because it's more certain about the answers it provides—right vs. wrong, good vs. evil, us vs. them—and because conservative leaders are more likely to advocate a return to traditional values, allowing people to stick with what's familiar and known. "Conservatism is a more black and white ideology than liberalism," explains Jost. "It emphasizes tradition and authority, which are reassuring during periods of threat."

To test the theory, Jost prompted people to think about either pain—by looking at things like an ambulance, a dentist's chair, and a bee sting—or death, by looking at things like a funeral hearse, the grim reaper, and a dead-end sign. Across the political spectrum, people who had been primed to think about death were more conservative on issues like immigration, affirmative action, and same-sex marriage than those who had merely thought about pain, although the effect size was relatively small. The implication is clear: For liberals, conservatives, and independents alike, thinking about death actually makes people more conservative—at least temporarily.
Fear and Voting In America
Campaign strategists in both parties have never hesitated to use scare tactics. In 1964, a Lyndon Johnson commercial called "Daisy" juxtaposed footage of a little girl plucking a flower with footage of an atomic blast. In 1984, Ronald Reagan ran a spot that played on Cold War panic, in which the Soviet threat was symbolized by a grizzly lumbering across a stark landscape as a human heart pounds faster and faster and an off-screen voice warns, "There is a bear in the woods!" In 2004, Bush sparked furor for running a fear-mongering ad that used wolves gathering in the woods as symbols for terrorists plotting against America. And last fall, Congressional Republicans drew fire with an ad that featured bin Laden and other terrorists threatening Americans; over the sound of a ticking clock, a voice warned, "These are the stakes."
"At least some of the President's support is the result of constant and relentless reminders of death, some of which is just what's happening in the world, but much of which is carefully cultivated and calculated as an electoral strategy," says Solomon. "In politics these days, there's a dose of reason, and there's a dose of irrationality driven by psychological terror that may very well be swinging elections."
Solomon demonstrated that thinking about 9/11 made people go from preferring Kerry to preferring Bush. "Very subtle manipulations of psychological conditions profoundly affect political preferences," Solomon concludes. "In difficult moments, people don't want complex, nuanced, John Kerry-like waffling or sophisticated cogitation. They want somebody charismatic to step up and say, 'I know where our problem is and God has given me the clout to kick those people's asses.'"
Into The Blue
Studies show that people who study abroad become more liberal than those who stay home.
People who venture from the strictures of their limited social class are less likely to stereotype and more likely to embrace other cultures. Education goes hand-in-hand with tolerance, and often, the more the better:
Professors at major universities are more liberal than their counterparts at less acclaimed institutions. What travel and education have in common is that they make the differences between people seem less threatening. "You become less bothered by the idea that there is uncertainty in the world," explains Jost.
That's why the more educated people are, the more liberal they become—but only to a point. Once people begin pursuing certain types of graduate degrees, the curve flattens. Business students, for instance, become more conservative in their views toward minorities. As they become more established, doctors and lawyers tend to protect their economic interests by moving to the right. The findings demonstrate that conservative conversions are fueled not only by fear, but by other factors as well. And if the November election was any indicator, the pendulum that swung so forcefully to the right after 9/11 may be swinging back.

Tipping The Balance
Political conversions that are emotionally induced can be very subtle: A shift in support for a given issue or politician is not the same as a radical conversion or deep philosophical change. While views may be manipulated, the impact may or may not translate in the voting booth. Following 9/11, most lifelong liberals did not go through outright conversion or shift their preferred candidate. Yet many liberals who didn't become all-out conservatives found themselves nonetheless sympathizing more with conservative positions, craving the comfort of a strong leader, or feeling the need to punish or avenge. Many in the political center moved to the right, too. In aggregate, over an electorate of millions—a large proportion of whom were swing voters waiting to be swayed one way or the other—even a subtle shift was enough to tip the balance of the Presidential election, and the direction the country took for years. "Without 9/11 we would have a different president," says Solomon. "I would even say that the Osama bin Laden tape that was released the Thursday before the election was sufficient to swing the election. It was basically a giant mortality salience induction."
If we are so suggestible that thoughts of death make us uncomfortable defaming the American flag and cause us to sit farther away from foreigners, is there any way we can overcome our easily manipulated fears and become the informed and rational thinkers democracy demands?
To test this, Solomon and his colleagues prompted two groups to think about death and then give opinions about a pro-American author and an anti-American one. As expected, the group that thought about death was more pro-American than the other. But the second time, one group was asked to make gut-level decisions about the two authors, while the other group was asked to consider carefully and be as rational as possible. The results were astonishing. In the rational group, the effects of mortality salience were entirely eliminated. Asking people to be rational was enough to neutralize the effects of reminders of death. Preliminary research shows that reminding people that as human beings, the things we have in common eclipse our differences—what psychologists call a "common humanity prime"—has the same effect.
"People have two modes of thought," concludes Solomon. "There's the intuitive gut-level mode, which is what most of us are in most of the time. And then there's a rational analytic mode, which takes effort and attention."
The solution, then, is remarkably simple. The effects of psychological terror on political decision making can be eliminated just by asking people to think rationally. Simply reminding us to use our heads, it turns out, can be enough to make us do it.

This Is So We

2009-01-07T10:01:00.000-08:00

Our preferences in art and music are often influenced by the masses.

Duncan Watts was annoyed to see a rapturous mob swarming around Leonardo da Vinci's Mona Lisa at the Louvre while many other magnificent works at the museum sat unviewed.
A sociologist at Columbia University, Watts traced the Mona Lisa's popularity to a series of events that brought attention to it, among which were its theft by an Italian patriot in 1911 and a refashioning by Andy Warhol in 1963.
"We have this myth of individual people making decisions, but our tastes are shaped by social forces," says Watts's colleague Matthew Salganik, a professor of sociology at Princeton University.
To explore why some works of art top the charts while others languish in the discount bin, the team created a Web site where thousands of subjects could listen to obscure songs. Half of the group simply downloaded the tunes they liked. The other half did the same, but could see how many times each song had already been downloaded.
The second group tended to choose the most popular songs, creating a snowball effect for tunes picked by the first listeners. Though bowing to the influence of others gets a bad rap, there are good reasons to go along with the crowd, Salganik says. "We're social creatures. If everyone at work is talking abut Harry Potter, it's nice to be able to join in." Besides, it's a natural shortcut out of the tremendous consumer-choice overload we face.
Groupthink tends to keep the dreck down, thankfully unappealing songs (as judged by the group who couldn't see which were popular) were not downloaded often. But not all good songs rose to the top. Salganik advises artists not to feel bad if the masses haven't latched on to their work. "Just because you haven't broken through doesn't mean people wouldn't like what you're doing if they were exposed to it."

By: Carlin Flora

Chronic Pain Might Contribute To Suicidal Thoughts

2008-11-12T10:22:00.001-08:00

New research suggests that patients with chronic pain are more prone than others are to consider suicide. The increased risk remained even when study authors took the possible influence of mental illness into account. "This is further evidence that we need to be aware of the heightened risk for suicide in those with chronic pain," said Mark Ilgen, lead study author. "More work is needed to figure out who's going to be at the greatest risk and how can we intervene and decrease this risk." Ilgen and colleagues conducted the study to gain perspective on the link between pain and suicide in the public. Most prior research on this topic had looked only at patients already receiving treatment for their pain, said Ilgen, a psychologist at the Ann Arbor VA Hospital and assistant professor at the University of Michigan. The researchers examined information collected during a 2001 to 2003 epidemiological survey of 5,692 English-speaking adults in the United States who answered questions about chronic pain and suicidal thoughts in the last 12 months. The study findings appear in the November/December issue of the journal General Hospital Psychiatry.After adjusting the figures to account for the effect of mental illness and chronic physical conditions, the researchers found that those who suffered from head pain were almost twice as likely as others to report having suicidal thoughts. They were also more than two times as likely to report suicide attempts. Those with other types of pain not related to arthritis were four times as liable to have tried to commit suicide. The researchers also found that almost 14 percent of those with three or more pain conditions reported suicidal thoughts and almost 6 percent of these individuals reported a suicide attempt. "Pain is one of those factors that may make someone feel more hopeless and less optimistic about the future and increases the chances that they will think about suicide," Ilgen said. Still, "the vast majority of people with any of these forms of pain are not suicidal," he said. Thomas Joiner, a psychology professor at Florida State University who has written a book on suicide motivations, said people accustomed to pain might think they could tolerate suicide. "The natural and deep fear of pain, injury and death stops people from hurting themselves, and this includes people who have high desire for suicide," Joiner said. "It might not be as hard for someone who has already had to contend with a lot of physical pain." "This particular view has not gotten enough attention, probably because, in the public mind, a kind of fearlessness does not seem to fit with suicide. But here, the public mind is mistaken," Joiner said. General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. Ilgen MA, et al. "Pain and suicidal thoughts, plans and attempts in the United States." General Hosp Psychiatry, 30(6)), 2008. Health Behavior News Servicehttp://www.hbns.org

Autism remains lightening rod

2008-11-12T10:19:00.001-08:00

McClatchy-Tribune Information Services -- Unrestricted - November 09

Autism is a word that causes instant angst among parents, not just because the reality of it can be so harsh and there is no medical treatment, but also because myths about it continue to grow.
The brain development disorder is characterized by impaired social interaction and communication and restricted and repetitive behavior.
"It's just a lightening rod topic in the field, with information and misinformation flying around the Internet," Dr. Mark Bertin said during a presentation at Danbury Hospital's annual pediatric conference Thursday.
"The developmental path of a typical child requires them to intuitively read other people and learn to interact and communicate, but children with autism don't."
The number of children with the disease, along with the symptoms, treatment and prognosis for the future, all contribute to families' fears.
But, Bertin said, the statistic that one of every 150 children will be diagnosed on the autism spectrum compared to 1 in 300 just 20 years ago must be put in perspective.
For one thing, a better understanding of autism spectrum disorders means they are more often recognized and diagnosed now.
In addition, the diagnosis has expanded to include more disorders -- autism, Asperger's syndrome, pervasive developmental disorder, and regressive disorders -- all connected by a child's deficient social skills.
"We have a better understanding of autism spectrum disorders, and now that we know what to look for we define it with milder symptoms that were not diagnosed before," Bertin said.
In 1980, 20,000 children were diagnosed with autism spectrum disorder. In 2003, 125,000 were diagnosed. Bertin said during that time the number of children diagnosed with mental retardation dropped as the number of children with autism increased.
The total number of children with one or the other didn't change, which shows the increase in autism had to do with relabeling children's disorders.
"There is a huge amount of relabeling, and that is how you can explain the vast increase in the autism spectrum disorder," Bertin said, adding that some of the increase is not explained.
The cause of autism is still not fully understood. Bertin discounted the theory that childhood vaccines play a role, since research shows there is no difference in the statistics of children who receive vaccines or those who don't and the onset of autism does not correlate to the time the child receives the vaccination.
But some facts are becoming known.
There is a threefold increase in autism among children of older fathers. Some people may have genetic triggers. Two-thirds of children with autism had rapid head growth from 6 to 14 months, and greater brain growth may correlate with more severe symptoms.
Screening and early intervention is key, Bertin said, adding that there are red flags in a child's social, behavioral and language development that parents can watch, in addition to the screenings pediatricians should perform.
Once there are concerns, parents need a medical diagnosis of the disorder as well as an educational diagnosis to determine what services the child needs.
"After diagnosing, what you want is an intensive intervention," Bertin said.
That means more than lining up services. It means connecting parents to support groups and informing parents about the misinformation that could send them on the wrong track.
"The core intervention for a child with autism is behavior therapy," Bertin said.
Adults must ensure the focus is on building the social skills of a child diagnosed with autism spectrum disorder, no matter how well a child is doing in academics.
Some recommendations call for 25 hours of services a week, though many kids do well on less, he said.
"It's like with any other skill that the child wants to learn, it has to be practiced every day. There is a benefit to intense early intervention," Bertin said, though even kids who are diagnosed later will benefit.
Danbury's three school-based health clinics can help identify children who may not have been diagnosed before.
"When you see a child with poor social skills, with poor eye contact, who is not succeeding in school, it has to be looked at to make sure you are not missing something," said Nancy Munn, nurse practitioner at Danbury's Rogers Park Middle School. "There is still time to support them."
She encourages parents to take their young children to play groups, so they can see if they are developing like the other children, and, if not, get them help.
Danbury also has a new Special Education Parent Teacher Association, which will provide workshops and other resources so parents and teachers and other residents can understand the problems students face with learning disabilities, social issues or autism.
"We are a link in the chain to getting parents information -- especially once parents find out about their child's diagnosis -- to help them know where to go for support," said Michelle Keenan, president of Danbury SEPTA.
Jack Fong, clinical associate professor of pediatrics at New York Medical College and retired chief of pediatrics at Danbury Hospital, said autism is a difficult issue for parents.
"Most behavioral and psychiatric conditions are vague. It's not a hard science," he said. "It becomes challenging and confusing."
An knowledge about the future of children with autism spectrum disorders is limited, so doctors have little to offer families except that a child's progress will relate to the severity of the disorder, Bertin said. "Research is relatively new, so we don't know about long-term prognosis."
Contact Eileen FitzGerald
at eileenf@newstimes.com
or at (203) 731-3333.
Red flags for autism spectrum disorders Social development No big smiles by or after 6 months. No back and forth sharing of sounds or facial expression by 9 months. No back and forth gestures like pointing or reaching or waving by 12 months. Poor response to name. Language development Not responding to name by 12 months. No babbling by 12 months. No single words by 16 months. No two-word spontaneous phrases by 24 months. Behavior development No creative or imaginative play. Stuck on toys or topics. Unusual repetitive behaviors. Workshop Handling the maze of special education Nov. 18 7 to 9 p.m. C.H. Booth Library, Main Street, Newtown Presented by psychologist Charles Manos, coordinator of special services for Danbury public schools Free and open to the public. To see more of the News-Times or to subscribe to the newspaper, go to http://www.newstimes.com. Copyright (c) 2008, The News-Times, Danbury, Conn. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

You must remember: Forgetting has its benefits

2008-11-12T10:16:00.000-08:00

There's an old saying that inside every 70-year-old is a 35-year-old wondering, "What happened?"
What happened is that countless days, nights, meetings, commutes and other unremarkable events went by, well, unremarked. They didn't make a lasting impression on the brain or they were overwritten by so many similar experiences that they are hard to retrieve. In short, they've been forgotten.
That's not necessarily a bad thing. Neuroscientists say forgetting is crucial to the efficient functioning of the mind, to learning, adapting and recalling more significant things.
"We focus so much on memory that forgetting has been maligned," says Gayatri Devi, a neuro-psychiatrist and memory expert in New York City. "But if you didn't forget, you'd recall all kinds of extraneous information from your life that would drown you in a sea of inefficiency."
That was what prompted Jill Price to contact the memory experts at the University of California at Irvine in 2000. As she wrote in a book published this summer, "The Woman Who Can't Forget," Ms. Price could recall in detail virtually every day since she was 14, but she was mentally exhausted and tormented by her memories. UC Irvine scientists are interviewing more than 200 people who say they have similar "autobiographical" memories, but so far have found only three more.
Memories of singular, significant events - say, last week's historic election - are generally easy to recall; people typically store them in long-term memory with many associations attached.
Memories of mundane, recurring events compete to be recalled, and scientists say the brain appears to be programmed to forget those that aren't important. Neuroimaging studies show that it's the brain's prefrontal cortex, the area of complex thought and executive planning, that sorts and retrieves such "like-kind" memories. Researchers at Stanford University's Memory Laboratory demonstrated last year that the more subjects forgot competing memories, the less work their cortexes had to do to recall a specific one. In short, forgetting frees up brain power for other tasks, says psychologist Anthony Wagner, the lab's director.
A real-world example, he says, is having to learn a new computer password every few months: As your brain suppresses the memory of the old password, it gets easier to summon the new one.
In fact, forgetting is a very active process, albeit subconscious, neuroscientists say. The mind is constantly evaluating, editing and sorting information, all at lightning speed. "Your brain is only taking a small amount in, and it's already erasing vast amounts that won't be needed again," Dr. Devi says.
Much that happens during the day doesn't make an impression at all because our attention is focused elsewhere. Take your daily commute, says Dr. Wagner: "A heck of a lot of stuff is landing on our retinas as we're driving down the road. But if you were focusing on the presentation you have to give, you didn't perceive it and it didn't get stored."
He notes that people face such a constant cognitive barrage that they frequently fail to attend to information that isn't essential at the time. "I have two 4 1/2-year-olds and I'm already thinking, where did those first four years go?" Dr. Wagner says.
Are memories for events you didn't focus on stored in your brain nevertheless - like unwatched bank-surveillance tapes? That's an area of much debate. Some experts believe hypnosis can trigger long-buried associations. But so-called recovered memories are also susceptible to distortion.
"Memory consists of billions of puzzle pieces, and many of them look the same," Dr. Devi says. "Each time you retrieve a memory, you're reconstructing a puzzle very quickly and breaking it down again. Some of the pieces get put back in different places."
What if you want to remember more about each passing day? One simple method is to keep a journal. Writing down a few thoughts and events every day not only makes a tangible record, it also requires you to reflect. "You're elaborating on why they were meaningful, and you're laying down an additional memory trace," says neuroscientist James McGaugh at UC Irvine. Taking photographs and labeling them reinforce memories too.
But remember that forgetting can be very useful, says Dr. McGaugh: "If you used to go out with Bob and now you're married to Bill, you want to be able to say, 'I love you, Bill.' That's why forgetting is important."
---
Email: healthjournal@wsj.com.

Does Mozart make you smarter?

2008-11-12T10:15:00.001-08:00

By Henkjan Honing

Mozart's Sonata for Two Pianos in D Major (KV 448) is one of the most used compositions in music psychology research. Since the publication of the study Music and Spatial Task Performance in Nature in 1993, numerous researchers have tried to replicate the so-called "Mozart effect" using this composition. And often with little success. The idea is of course compelling: to become smarter by simply listening to Mozart's music. It could be a helpful fact in the much needed support for a more prominent place of music in the curricula. However, the effect has been shown to appear not only with the music of Mozart, but also that of Beethoven, Sibelius, and even a 'Blur effect' was shown (based on a study by Glenn Schellenberg from the University of Toronto using 8,000 teenagers).
Currently, the most likely interpretation of the effect is that music listening can have a positive effect on our cognitive abilities when the music is enjoyed by the listener. Apparently (and in a way unfortunately), it is not so much the structure of the music that causes the effect, but a change in the mood of the listener. While this indirectness might be disappointing for admirers of Mozart's music, it is important to note that, at the same time, it leaves uncovered an important aspect of music appreciation. What makes certain music so effective in changing or intensifying our mood? It seems that while we are all experienced and active users of music as a kind of mood regulator (widely ranging from energizer to consoler of grief), music research has only just begun to explore the how and why of the relation between music and emotion.

How Will Obama Lead?

2008-11-12T10:13:00.001-08:00

By John D. Gartner, Ph.D.

This historic election is over, and now the question becomes how will Barack Obama lead? To understand how an Obama White House might be similar to or different from that of his immediate predecessors, Bush and Clinton, it pays to compare and contrast the three men on two components of their basic temperaments: curiosity and hypomania. Clinton was both hypomanic and curious. Bush was neither. And Obama appears to be curious but not hypomanic. For a hundred years, academic personality psychologists have been trying to identify the basic axes on which to map the human personality. Intellectual curiosity, it turns out, is one of these fundamental dimensions, according to the widely accepted Five Factor theory, developed by Paul Costa and Robert McCrea at The National Institutes of Health. According to their data, you are either born curious, or not. Hypomania, too, as I argued in The Hypomanic Edge, and more recently in my book, In Search of Bill Clinton, is also best understood as an innate temperament, imbuing one with dynamic traits such as energy, creativity, confidence, and charisma, but also with problems in self-regulation and impulse control. When Bill Clinton was making the case for Barack Obama with the voters, the first qualification that he noted was that Obama was both intelligent and curious. While at first blush, curiosity might seem like a strange qualification to emphasize, Clinton was not offering feint praise, as some suspected. Clinton knew just how important curiosity really is to the day-to-day work of a president. If one had to point to one factor that distinguished Clinton from Bush, and explained why Bush was a failure and Clinton a relative success, this would be it. Simply put, Bush just wasn't that interested in the details of governing. He didn't like to consider alternate views or findings. He accepted neo-conservative dogma on faith, and that was that. Even when his policies appeared to be failing or unpopular, Bush was had no desire to hear dissenting ideas or inconvenient facts. Bush who is neither curious nor hypomanic kept his meetings short-no point in jaw-boning these things to death-and went to bed early, losing little sleep of America's problems. Clinton, who is both intensely curious and hypomanic couldn't be a stronger contrast. Well-known for being a policy junkie, Clinton was insatiably omnivorous in his consumption of everything ever said or written about every aspect of policy. Clinton reads everything related to public policy, and even more remarkable, remembers it all. Journalist Joe Klein wrote in The Natural that Clinton "seemed to know everything there was to know about domestic social policy....Oh, could he talk policy! He seemed to know more about the school choice experiment in East Harlem than the governor of New York did; he knew all about the competitive bidding for sanitation contracts in Phoenix, the public housing manager in Omaha who'd come up with a great after-school program for kids in the projects, the terrific for-profit welfare to work program in New York." In my interviews with people who know Clinton, I was told again and again by experts in a half a dozen fields "He knows more about my specialty than I do." And, because Clinton was hypomanic as well as curious, there was a driven quality to his quest for endless information and ideas. He often stayed up all night reading, usually half a dozen different books at a time, devouring them with an almost physically greedy intensity. What does a White House run by a curious hypomanic look like? Where Bush' meetings were short and structured, Clinton's were endless and open ended. Clinton wanted to hear every point of view, review every fact, and play with creative variations of every exiting idea. Cabinet officers confessed to me that they were physically passing out from fatigue and hunger during these marathon meeting, asking themselves, as Leon Panetta put it, "Where the hell all this going?" While Clinton was widely criticized for this chaotic creative style, it worked. Panetta argued that Clinton usually made very good decisions, "even if he had to go by way of Mars to get there." Obama, who is curious but not hypomanic, is likely to fall in between these two extreme contrasts in style. Because he is curious like Clinton, Obama is likely to also hear from a range of advisors, review findings and arguments from diverse sources, and consider creative policy approaches. However, because he is not hypomanic, the Obama White House should be less chaotic than that run by Clinton. No drama-Obama has proved to be but unusually steady, cool, and deliberative. Indeed, during the financial crisis, it was Obama's "preternatural calm" that seemed to reassure the country that he was presidential enough to lead. We have reason to be optimistic that Obama's temperament may be just right, not too hot and not too cold. And that should help us all sleep better at night.

Sexual Arousal Disorder

2008-11-12T10:11:00.000-08:00

Definition
Sexual arousal disorder is an aberration during any stage of the sexual response cycle (desire, arousal, orgasm, and resolution) that prevents the experience of satisfaction through sexual activity. A person with this disorder may be interested in sexual intercourse but has difficulty becoming stimulated enough to go through with it.
Sexual arousal disorders were previously known as frigidity in women and impotence in men, though these have now been replaced with less judgmental terms. Impotence is now known as erectile dysfunction, and frigidity is now described as any of several specific problems with desire, arousal, or anxiety.
For both men and women, these conditions may appear as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity. In women, there may be an inability to lubricate enough to complete the sex act.
Considerations
Occasional impotence occurs in approximately 50 percent of American adult men, and chronic impotence affects about 1 in 8 American men, with the chances increasing as a person ages. Between 2 and 30 million men in the United States are affected by impotence problems, according to recent estimates. About 52 percent of men between 40 and 70-years-old have some degree of erectile dysfunction (ED).
Impotence can be classified as primary or secondary. A man with primary impotence has never had an erection sufficient for intercourse. Secondary impotence involves loss of erectile function after a period of normal function. This tends to occur gradually, except in cases caused by injury or sudden illness.
Treatment of secondary impotence is usually more successful than that of primary impotence because the patient has some history of normal penile function in the past.
There are several components required for an erection:
A responsive emotional state of mind
A normally functioning pituitary
Adequate testosterone
Adequate penile blood supply
Premature ejaculation (when orgasm comes on too quickly) is different from impotence, and a couple should seek counseling for this problem.
Male infertility is quite different from impotence. A man who is unable to maintain an erection may be perfectly capable of siring a child. An infertile male may be able to have intercourse normally, but he may be unable to father a child.
Symptoms
In Men or Women:
Lack of interest or desire in sex
Inability to feel aroused
Pain with intercourse (much less common in men than women)
Infertility
In Men:
Inability to achieve an erection
Inability to maintain an adequate erection for intercourse
Delay or absence of ejaculation despite adequate stimulation
Inability to control timing of ejaculation
In Women:
Inability to relax vaginal muscles enough to allow intercourse
Inadequate vaginal lubrication before and during intercourse
Inability to attain female orgasm
Causes
Sexual dysfunction can exist throughout a person's life or may develop after an individual has previously experienced normal sexual responses. The difficulty may develop gradually over time, or may occur suddenly and present itself either as total or partial dysfunction in one or more stages of the sexual response cycle. The cause may be physical, psychological, or both.
Emotional factors include both interpersonal problems (marital/relationship troubles, lack of trust between partners) and an individual's psychological problems (depression, sexual fears or guilt, past sexual trauma, and so on).
Physical factors include drugs (alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, or most psychotherapeutic drugs); complications related to back, prostate, or vascular surgeries; failure of various organ systems (such as the circulatory and respiratory systems); endocrine disorders (thyroid, pituitary, or adrenal gland problems); neurological problems caused by trauma (such as spinal cord injuries) or disease (such as diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis); hormonal deficiencies (low testosterone or androgens); and some fetal development abnormalities.
Sexual dysfunction disorders are generally classified into four categories: sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders.
Sexual desire disorders (decreased libido) may result from a decrease in normal androgen or testosterone hormone production. Other causes may be aging, fatigue, medications, pregnancy, or psychiatric conditions such as depression and anxiety.
Common causes of impotence
Medication use (especially antihypertensives)
Smoking
High blood pressure
Hormonal deficiency caused by disease (diabetes) or injury
Liver disease, usually caused by alcoholism
Circulation problems (arteriosclerosis, anemia, or vascular surgery)
Neurological problems (injury, trauma, disease)
Urological procedures (prostatectomy, orchiectomy, radiation therapy)
Penile implants (or prostheses) that are not functioning properly
Depression, anxiety, fatigue, boredom, stress, fear of failure
Mood altering drugs, alcohol, medications
Deep-seated psychological problems
Orgasm disorders, which can affect both sexes, are a persistent delay or absence of orgasm following sexual excitement. Sexual pain disorders affect many more women than men and are known as dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the musculature of the vagina that interferes with intercourse). Dyspareunia may be caused by insufficient lubrication in the female, which may result from breastfeeding, irritation from contraceptive creams and foams, aging, or by fear and anxiety. Vaginismus may be caused by a sexual trauma such as rape or incest.
Sexual dysfunctions are more common in the early adult years, with the majority of patients seeking care for such conditions during their late twenties into their thirties. The issues increase again in the geriatric population, typically with a gradual onset of symptoms associated most commonly with organic causes of sexual dysfunction.
Increased risk is often linked to a history of diabetes, degenerative neurological disorders, chronic psychological problems, alcohol use, drug abuse, difficulty maintaining relationships, or chronic disharmony with the current sexual partner.
Prevention
Honest and accurate communication regarding sexual issues and body image between parents and their children may prevent children from developing anxiety or guilt about sex and carrying those emotional responses into their adulthood.
Review all medications (prescription and over-the-counter) for possible side effects regarding sexual dysfunction. Avoiding drug and alcohol abuse may help prevent sexual dysfunction.
Couples engaging in adequate communication may be able to avoid some problems within their relationship that could potentially create some forms of sexual dysfunction.
People who are victims of sexual trauma should receive comprehensive treatment, including individual counseling and group therapy. This may prove beneficial in allowing them to fully enjoy voluntary sexual experiences with a partner of their choice.
Treatment
Specific physical findings and testing procedures depend on the form of sexual dysfunction examined. A complete history and physical exam should be done to identify predisposing illness or conditions; highlight possible fears, or guilt specific to sexual performance; and bring out any history of prior sexual trauma. A physical examination of both the partners should not be limited to the reproductive system.
Treatment measures should be specific to the cause of the sexual dysfunction. Organic causes that are reversible or treatable are usually managed medically or surgically. Physical therapy and mechanical aides may help some people with physical illnesses, conditions, or disabilities. Viagra (sildenafil) often improves both organic and psychological sexual dysfunction in males by increasing blood flow to the penis. Men on nitrates for coronary heart disease should refrain from taking sildenafil, as it may cause dangerous drug interactions. Mechanical aids and penile implants are sometimes used. Men with androgen deficiency sometimes benefit from testosterone shots. Women with androgen deficiency can tolerate smaller doses of testosterone orally or topically with a cream.
Self-stimulation and the Masters and Johnson treatment strategies are just two of many behavioral therapies used to treat problems associated with orgasm and sexual arousal disorders.
Some couples may require joint counseling to address interpersonal issues and communication styles. Psychotherapy may be required to address anxieties, fears, inhibitions, or poor body image. In general, the prognosis is good for physical (organically caused) dysfunctions resulting from treatable or reversible conditions. However, many organic causes do not respond to medical or surgical treatments. In functional sexual problems resulting from either relationship issues or psychological factors, the prognosis may be good for temporary or mild dysfunction associated with situational stressors or lack of accurate information. However, those cases associated with chronically poor-functioning relationships or deep-seated psychiatric problems usually do not have positive outcomes. Some forms of sexual dysfunction may cause infertility.
For impotence caused by fear of infection, use safe sex practices and consider abstinence. Talk to your health care provider if impotence is related to fear of recurring heart problems—sexual intercourse is usually safe.
If the problem is persistent or if there are other associated and unexplained symptoms, call your health care provider.
Persistent sexual dysfunction may cause depression. Sexual dysfunction that is not addressed adequately may lead to conflicts or potential breakups for couples.
Sources:
Journal of Men's Health and Gender
Journal of the American College of Cardiology
National Institutes of Health - National Library of Medicine

Relationship Rules

2008-11-12T10:10:00.000-08:00

Relationship Rules
Tips on how to build a healthy love life with your spouse.
By: Hara Estroff Marano

Human beings crave intimacy, need to love and be loved. Yet people have much trouble doing so.
It's clear from the many letters I get that lots of folks have no idea what a healthy relationship even looks like. Because I care about these things, and care about the environments children grow in, I'm using this space as an attempt to remedy the problem—again.
From many sources and many experts, I have culled some basic rules of relationships. This is by no means an exhaustive list. But it's a start. Print them out and pin them up on your refrigerator door. I won't test you on them—but life will.
Choose a partner wisely and well. We are attracted to people for all kinds of reasons. They remind us of someone from our past. They shower us with gifts and make us feel important. Evaluate a potential partner as you would a friend; look at their character, personality, values, their generosity of spirit, the relationship between their words and actions, their relationships with others.
Know your partner's beliefs about relationships. Different people have different and often conflicting beliefs about relationships. You don't want to fall in love with someone who expects lots of dishonesty in relationships; they'll create it where it doesn't exist.
Don't confuse sex with love. Especially in the beginning of a relationship, attraction and pleasure in sex are often mistaken for love.
Know your needs and speak up for them clearly. A relationship is not a guessing game. Many people, men as well as women, fear stating their needs and, as a result, camouflage them. The result is disappointment at not getting what they want and anger at a partner for not having met their (unstated) needs. Closeness cannot occur without honesty. Your partner is not a mind reader.
Respect, respect, respect. Inside and outside the relationship, act in ways so that your partner always maintains respect for you. Mutual respect is essential to a good relationship.
View yourselves as a team, which means you are two unique individuals bringing different perspectives and strengths. That is the value of a team—your differences.
Know how to manage differences; it's the key to success in a relationship. Disagreements don't sink relationships. Name-calling does. Learn how to handle the negative feelings that are the unavoidable byproduct of the differences between two people. Stonewalling or avoiding conflicts is NOT managing them.
If you don't understand or like something your partner is doing, ask about it and why he or she is doing it. Talk and explore, don't assume.
Solve problems as they arise. Don't let resentments simmer. Most of what goes wrong in relationships can be traced to hurt feelings, leading partners to erect defenses against one another and to become strangers. Or enemies.
Learn to negotiate. Modern relationships no longer rely on roles cast by the culture. Couples create their own roles, so that virtually every act requires negotiation. It works best when good will prevails. Because people's needs are fluid and change over time, and life's demands change too, good relationships are negotiated and renegotiated all the time.
Listen, truly listen, to your partner's concerns and complaints without judgment. Much of the time, just having someone listen is all we need for solving problems. Plus it opens the door to confiding. And empathy is crucial. Look at things from your partner's perspective as well as your own.
Work hard at maintaining closeness. Closeness doesn't happen by itself. In its absence, people drift apart and are susceptible to affairs. A good relationship isn't an end goal; it's a lifelong process maintained through regular attention.
Take a long-range view. A marriage is an agreement to spend a future together. Check out your dreams with each other regularly to make sure you're both on the same path. Update your dreams regularly.
Never underestimate the power of good grooming.
Sex is good. Pillow talk is better. Sex is easy, intimacy is difficult. It requires honesty, openness, self-disclosure, confiding concerns, fears, sadnesses as well as hopes and dreams.
Never go to sleep angry. Try a little tenderness.
Apologize, apologize, apologize. Anyone can make a mistake. Repair attempts are crucial—highly predictive of marital happiness. They can be clumsy or funny, even sarcastic—but willingness to make up after an argument is central to every happy marriage.
Some dependency is good, but complete dependency on a partner for all one's needs is an invitation to unhappiness for both partners. We're all dependent to a degree—on friends, mentors, spouses. This is true of men as well as women.
Maintain self-respect and self-esteem. It's easier for someone to like you and to be around you when you like yourself. Research has shown that the more roles people fill, the more sources of self-esteem they have. Meaningful work—paid or volunteer—has long been one of the most important ways to exercise and fortify a sense of self.
Enrich your relationship by bringing into it new interests from outside the relationship. The more passions in life that you have and share, the richer your relationship will be. It is unrealistic to expect one person to meet all of your needs in life.
Cooperate, cooperate, cooperate. Share responsibilities. Relationships work ONLY when they are two-way streets, with much give and take.
Stay open to spontaneity.
Maintain your energy. Stay healthy.
Recognize that all relationships have their ups and downs and do not ride at a continuous high all the time. Working together through the hard times will make the relationship stronger.
Make good sense of a bad relationship by examining it as a reflection of your beliefs about yourself. Don't just run away from a bad relationship; you'll only repeat it with the next partner. Use it as a mirror to look at yourself, to understand what in you is creating this relationship. Change yourself before you change your relationship.
Understand that love is not an absolute, not a limited commodity that you're in of or out of. It's a feeling that ebbs and flows depending on how you treat each other. If you learn new ways to interact, the feelings can come flowing back, often stronger than before.

A surprising link to obesity

2008-10-15T15:22:00.001-07:00

Childhood ear infections may pave the way for weight gain in adulthood.
By Michael PriceMonitor staff Print version: page 18
They say the best way to a man's heart is through his stomach, but new evidence suggests the best way to his stomach may be through his ears. Research presented at APA's Annual Convention suggests that ear infections in early childhood have a profound effect on obesity later in life. Researchers presented findings that children who suffer from repeated middle-ear infections, or otitis media, are much more likely to be overweight as children and as adults.
The possible link first came to light when in 1993 University of Florida School of Dentistry researcher Linda Bartoshuk, PhD, and her colleagues administered general health questionnaires to 7,000 Americans, looking for correlations between taste perceptions and health.
"An unexpected finding emerged," Bartoshuk said. A history of otitis media was associated with a higher body mass index. Using statistical analysis, she determined that these ear infections weren't just a correlation; they made an independent contribution to being overweight, she said.
In her studies since, she's found that males may be particularly susceptible: Those with a history of otitis media are almost twice as likely to be overweight or obese as men who have no history of the condition.
"This is not a small effect," she said.
How could an ear infection influence someone's weight? Derek Snyder, a Yale University neuroscience graduate student, explained that a damaged nerve might be the culprit. An important taste nerve, the chorda tympani, runs from the tongue up through the middle ear and into the brain. If the middle ear is infected, the nerve can get damaged. The effect is that certain nontaste sensations, like the creaminess of fat, get intensified.
"When we perceive food in the mouth, several nerves are at work," Snyder said. "Each of these nerves carries a distinct array of sensory information."
The chorda tympani is responsible for the taste perception on the front of the tongue. If that nerve becomes damaged, tastes at the back of the tongue actually get enhanced to preserve overall "taste constancy." But other cues that go into our sensory experience of flavor, including texture, smells and chemical sensitivity, are also enhanced.
Snyder and the other presenters think that the tongue's texture detectors pull double duty when the chorda tympani is damaged. These texture detectors latch onto the intensified creamy, fat sensation. The result is that overall taste perception remains the same, but a person's food preferences shift toward fatty and creamy foods.
"Over time, a history of ear infection may contribute to a more energy-dense diet," Snyder said. After a number of years, this can lead to obesity.
Especially susceptible are a subgroup of people known as supertasters, who, Bartoshuk explained, have an abnormally high number of taste buds. These people make up about 25 percent of the world population.
"These people live in a neon taste world," Bartoshuk said. For them, damage to the chorda tympani might pose an even bigger danger, as their enhanced taste perceptions would amplify the effects.

Cocaine addicts' brains predisposed to abuse: study

2008-10-15T15:19:00.000-07:00

CHICAGO - Cocaine addicts may have brain deficits that predispose them to drug abuse, and abusing drugs appears to make matters worse, U.S. researchers said on Wednesday.
They said images of cocaine addicts' brains reveal abnormalities in the cerebral cortex -- the brain's outer surface -- and these changes relate to dysfunction in areas responsible for attention and decision-making.

"These data point to a mixture of both drug effects and predisposition underlying the structural alterations we observed," said Dr. Hans Breiter of Massachusetts General Hospital, whose research appears in the journal Neuron.

Breiter and colleagues compared magnetic resonance images, or MRIs, of 20 cocaine addicts with 20 carefully matched volunteers to map out cocaine-related differences in the brain.
Compared to their healthy counterparts, cocaine addicts had far less overall volume in the cortex, the outer layer that helps plan, execute and control behavior. These differences were especially pronounced in areas regulating reward, attention and decision-making.
They also noticed that while the healthy volunteers tended to have thicker areas in some frontal regions on the right side of the brain, this was reversed in the addicts. And overall, the addicts had less variation in the thickness of their cortex.
Differences in the right and left side of the brain are important because they typically suggest a genetic cause, Breiter said.
The researchers also found changes in the cingulate -- another reward center -- that appeared to correspond with the length of cocaine use but not nicotine or alcohol use, suggesting that these changes were the result of long-term cocaine exposure.
"Human studies have shown differences in how addicts make judgments and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts," Breiter said in a statement.
The researchers said the findings underscore the importance of keeping vulnerable people from using cocaine. And they said follow-up studies should be done to see if similar changes are present in people with other addictions.

2008 Reuters

Some depressed patients opt for assisted suicide

2008-10-15T15:18:00.000-07:00

By Anthony J. Brown, MD
NEW YORK (Reuters Health) - The results of a survey in Oregon suggest that the Death with Dignity Act enacted in the state in 1997 does not always prevent patients with depression, a treatable condition, from receiving a prescription for a lethal drug.
The findings indicate that "most people in Oregon who request physician aid in dying do not have clinical depression," but yet there are "small number of patients with clinical depression who are able to access lethal medications," lead investigator Dr. Linda Ganzini, from Portland Veterans Affairs Medical Center, told Reuters Health.

"The Oregon law," she explained, "requires that if the prescribing physician is concerned that the patient might have depression influencing their judgment, that they be evaluated by a psychiatrist or psychologist. The proportion of requesting patients who are evaluated by a mental health professional has been dropping over the last decade and last year no mental health assessments occurred among the 46 people who died by physician-assisted suicide in Oregon."
The survey, reported in the Online First issue of the British Medical Journal, looked at 58 state residents with a terminal illness, usually cancer or ALS, who had requested assistance in dying, either directly from a physician or through an advocacy organization.
Using standard measures, including the structured clinical interview of the Diagnostic and Statistical Manual of Mental Disorders, the investigators identified 15 people with depression and 13 with anxiety.
Forty-two people died by the end of the study, including 18 who had received a prescription for a lethal drug. Three of the 18 individuals met criteria for depression and all three died from lethal ingestion within 2 months of the study survey.
"Physicians need to do a better job in screening for depression among terminally ill patients who wish to die," Ganzini emphasized. She added that her group "is continuing to analyze data from this data set regarding these patients' views on their medical care."
In a related editorial, Dr. Marije L. van der Lee, from the Helen Dowling Institute in Utrecht, the Netherlands, comments that while the current study examined how well depressed patients are protected from assisted suicide, the focus should be on "trying to prevent patients from becoming depressed in the first place."
She added that "depression has a strong negative effect on the quality of life of terminally ill patients and their family, but depression could potentially be treated."
SOURCE: British Medical Journal, online October 8, 2008.

2008 Reuters.

A study that could improve our health and well-being at work is about to start at The University of Nottingham.

2008-10-15T15:17:00.000-07:00

Patients who were depressed had higher heart rate, study finds

NEW YORK - In people who have suffered a heart attack, depression and a high heart rate at night, while often coexistent, are independent predictors of death, according to research published in the journal Psychosomatic Medicine.
Dr. Robert M. Carney of Washington University School of Medicine in St. Louis, Mo., and colleagues conducted a series of tests in 333 depressed patients and 383 non-depressed patients who'd recently suffered a heart attack and were followed for up to 30 months.
After accounting for a number of potential factors that might influence the results, depressed patients had higher nighttime heart rate (70.7 versus 67.7 beats per minute) and daytime heart rate (76.4 versus 74.2 beats per minute) than non-depressed patients.

Overall, 33 depressed patients (9.9 percent) and 14 non-depressed patients (3.7 percent) died during follow-up. Twenty-four of the deaths among the depressed patients (73 percent) and 10 of the deaths among the non-depressed patients (71 percent) were classified as likely due to cardiovascular causes.
Carney and colleagues also report that "nondepressed patients with low heart rate had the best survival, and depressed patients with high heart rate had the worst."

After adjusting for other major predictors and for each other, depression and a high nighttime, but not daytime, heart rate independently increased the risk of death in these post-heart attack patients.
According to the investigators, disturbed sleep, which is frequently reported in patients with depression, may help explain the association of nighttime elevated heart rate with mortality.
There is evidence that arousals from sleep that are associated with increased heart rate may provoke events related to ischemia (restriction of the blood supply and thus oxygen to the tissues) and abnormal heart rhythms in patients with heart disease, they note.

2008 Reuters

Major Study Begins Into Work-Related Health And Well-Being

2008-10-15T15:16:00.001-07:00

A study that could improve our health and well-being at work is about to start at The University of Nottingham. In 2006 and 2007 more than half a million individuals in Britain reported experiencing work-related stress at a level that was making them ill. Dr Maria Karanika-Murray, a Research Fellow in Occupational Health Psychology, has received funding from the Economic and Social Research Council to spend the next two and a half years researching the impact of organisational level factors on employee health and well-being. Until now most investigations into the impact of work on health have been limited to the person in the context of their immediate job. This study will take a different perspective and could potentially have a major impact on theory and our knowledge, as well as on practice and how we manage work-related health. This research looks at the impact of the organisation itself: its structure and culture. Maria Karanika-Murray and her research staff, will examine the organisation and work systems of some 40 companies - large, small, and medium sized enterprises. Information on hundreds of employees, their work and their organisations will be sampled over a period of 20 months. Maria Karanika-Murray said: "A large body of academic research has been carried out on the subject. For example, we know that characteristics of the job such as the level of demands and job variety, relationships and support at work, the work-life balance, and so on, impact on job satisfaction, absence and productivity. But very few studies have considered what impact organisational factors such as culture, leadership, policies, strategies, change and development goals can have on such outcomes." Health and safety at work is one of the most concentrated and most important social policy sectors in Europe. Since the 1990's the increasingly recognised importance of health at work has given rise to policy and national guidance on its management in the UK and in Europe. Between 2006 and 2007 30 million working days were lost due to work-related ill health and six million working days were lost due to workplace injury. More than two million people suffer from an illness they believe was caused or made worse by work. Maria Karanika-Murray, who is based at the Institute of Work, Health and Organisations (I-WHO), says the problem has been identified in research which shows many organisational interventions are not as successful as they might have been expected and that the wider organisational environment may affect the success or failure of an intervention. She said: "Research into occupational health often neglects to look at the broader organisational system within which employees carry out their work. This may be due to shortcomings in research methodology and can have important implications for theory and what we know about the causes of work-related health. The importance of this study lies in its implications for the successful and sustainable management of work-related health." With a total cost of £320,000 the research will use a multilevel longitudinal approach, which is appropriate for estimating the cause and effect of relationships. Tom Cox, Professor of Organisational Psychology & Head of I-WHO said: "This is an important development in occupational health psychology and for the health and well-being of working people. It is clear that the nature of their employing organisations, and their cultures, determine many aspects of their behaviour at work, the quality of their working lives and ultimately their well-being. As a result of this research, we can learn much more about these important relationships."

Being Altruistic May Make You Attractive

2008-10-15T15:15:00.002-07:00

Displays of altruism or selflessness towards others can be sexually attractive in a mate. This is one of the findings of a study carried out by biologists and a psychologist at The University of Nottingham. In three studies of more than 1,000 people Dr Tim Phillips and his fellow researchers discovered that women place significantly greater importance on altruistic traits that anything else. Their findings have been published in the British Journal of Psychology. Dr Phillips said: "Evolutionary theory predicts competition between individuals and yet we see many examples in nature of individuals disadvantaging themselves to help others. In humans, particularly, we see individuals prepared to put themselves at considerable risk to help individuals they do not know for no obvious reward." Participants in the studies were questioned about a range of qualities they look for in a mate, including examples of altruistic behaviour such as 'donates blood regularly' and 'volunteered to help out in a local hospital'. Women placed significantly greater importance on altruistic traits in all three studies. Yet both sexes may consider altruistic traits when choosing a partner. One hundred and seventy couples were asked to rate how much they preferred altruistic traits in a mate and report their own level of altruistic behaviour. The strength of preference in one partner was found to correlate with the extent of altruistic behaviour typically displayed in the other, suggesting that altruistic traits may well be a factor both men and women take into account when choosing a partner. Dr Phillips said: "For many years the standard explanation for altruistic behaviour towards non-relatives has been based on reciprocity and reputation - a version of 'you scratch my back and I'll scratch yours'. I believe we need to look elsewhere to understand the roots of human altruism. The expansion of the human brain would have greatly increased the cost of raising children so it would have been important for our ancestors to choose mates both willing and able to be good, long-term parents. Displays of altruism could well have provided accurate clues to this and genes linked to altruism would have been favoured as a result." Dr Phillips concluded: "Sexual selection could well come to be seen as exerting a major influence on what made humans human." Dr Tom Reader in the School of Biology said: "Sexual preferences have enormous potential to shape the evolution of animal behaviour. Humans are clearly not an exception: sex may have a crucial role in explaining what are our most biologically interesting and unusual habits." ----------------------------Article adapted by Medical News Today from original press release.---------------------------- Source: Lindsay Brooke University of Nottingham

Chair Of Joint Chiefs Calls For Broader PTSD Screenings

2008-10-15T15:15:00.001-07:00

Michael Mullen, chair of the Joint Chiefs of Staff, recently proposed that all returning combat troops undergo screening for post-traumatic stress disorder with a mental health professional, according to USA Today. Troops currently fill out questionnaires after combat tours that aid in assessing their mental health and are examined by physicians for physical injuries, but they do not meet with a mental health professional. According to USA Today, a trained mental health professional can determine signs of PTSD within five minutes in an in-person meeting.Mullen said troops often are reluctant to acknowledge psychological problems because they are hesitant to show weakness. According to Terri Tanielian, co-director of RAND's Center for Military Health Policy Research, troops are concerned that seeking mental health treatment could negatively affect their military career. Mullen said the Pentagon has yet to address the negative connotation associated with mental health care. Mullen said, "I'm at a point where I believe we have to give a (mental health) screening to everybody to help remove the stigma of raising your hand." There currently are no estimates regarding the potential cost of Mullen's proposal or a start date. A shortage of available mental health professionals could hinder adoption of the proposal, although the military has increased signing and retention bonuses in recent years to address the issue. Another concern is that troops often know how to evade certain health questions to avoid treatment.According to a RAND study, one in five combat veterans from Iraq and Afghanistan suffer from PTSD or depression. RAND estimates that 300,000 veterans have been affected and that it may cost more than $6.2 billion to treat them. The study also showed rates of PTSD and depression were highest among soldiers and Marines (Vanden Brook, USA Today, 10/13). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Psychological Effects Of Abortion Deserve 'New Dialogue,' Editorial Says

2008-10-15T15:14:00.001-07:00

Although it is "well-known" that a woman has choices when she is pregnant, "what is not fully known ... is that each of these choices has long-term effects for both the parents," a Washington Times editorial says, adding, "An abortion, much like" carrying a pregnancy to term or choosing adoption, is "not consequence-free." According to the editorial, abortion-rights advocates are "still in denial that there is a mental health impact" associated with the procedure, and many members of the scientific community "insist there is no proof of a causal relationship between abortion and mental health problems." The editorial concludes that "the dialogue on abortion can benefit from a fresh perspective: The discussion should not be centered solely on whether girls and women should be permitted to have an abortion. Women must fully grasp that abortion actually causes mental health problems" (Washington Times, 10/14). Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

Adolescent Brain Function Adversely Affected By Marijuana Use

2008-10-15T15:13:00.002-07:00

Brain imaging shows that the brains of teens that use marijuana are working harder than the brains of their peers who abstain from the drug. At the 2008 annual meeting of the American Academy of Pediatrics in Boston, Mass., Krista Lisdahl Medina, a University of Cincinnati assistant professor of psychology, presented collaborative research with Susan Tapert, associate professor of psychiatry at the University of California, San Diego. Medina's Oct. 12 presentation, titled, "Neuroimaging Marijuana Use and its Effects on Cognitive Function," suggests that chronic, heavy marijuana use during adolescence - a critical period of ongoing brain development - is associated with poorer performance on thinking tasks, including slower psychomotor speed and poorer complex attention, verbal memory and planning ability. Medina says that's evident even after a month of stopping marijuana use. She says that while recent findings suggest partial recovery of verbal memory functioning within the first three weeks of adolescent abstinence from marijuana, complex attention skills continue to be affected. "Not only are their thinking abilities worse, their brain activation to cognitive tasks is abnormal. The tasks are fairly easy, such as remembering the location of objects, and they may be able to complete the tasks, but what we see is that adolescent marijuana users are using more of their parietal and frontal cortices to complete the tasks. Their brain is working harder than it should," Medina says. She adds that recent findings suggest females may be at increased risk for the neurocognitive consequences of marijuana use during adolescence, as studies found that teenage girls had marginally larger prefrontal cortex (PFC) volumes compared to girls who did not smoke marijuana. The larger PFC volumes were associated with poorer executive functions of the brain in these teens, such as planning, decision-making or staying focused on a task. Medina says adolescence is a critical time of brain development and that the findings are yet another warning for adolescents who experiment with drug use. She says more study is needed to see if the thinking abilities of adolescent marijuana users improve following longer periods of abstinence from the drug. "Longitudinal studies following youth over time are needed to rule out the influence of pre-existing differences before teens begin using marijuana, and to examine whether abstinence from marijuana results in recovery of cognitive and brain functioning," says Medina. ----------------------------Article adapted by Medical News Today from original press release.---------------------------- The research was supported by the National Institute on Drug Abuse (NIDA). Source: Dawn Fuller University of Cincinnati

No Friend to Turn to

2008-10-15T15:13:00.001-07:00

Chicago Tribune -

Maybe you and your friends have stopped talking politics.
Then again, maybe you've stopped talking altogether.
"Loneliness," a new book by University of Chicago psychology professor John T. Cacioppo and science writer William Patrick, sounds a wake-up call for those of us walking around in a state of isolation - and we are plenty. Roughly 60 million Americans, according to the book, feel lonely to the point of unhappiness at any given moment.
That's about 20 percent of us.
Part of our problem, according to Cacioppo's book, is an alarming trend in American communities: We've stopped confiding in each other.
In 1985, the General Social Survey talked to nearly 1,500 adults about their network of confidants. In 2004, sociologists repeated the same survey and found Americans had onethird fewer confidants - defined as people with whom you "discuss important matters." A quarter of the respondents in 2004 said they had no one with whom they talk openly and intimately.
What about you? Are you swimming in confidants, or treading water on your own? We came up with a little quiz to help you decide.
If your answers leave you feeling a little lonely, it may be time to take action. Cacioppo and Patrick report that "social isolation has an impact on health comparable to the effect of high blood pressure, lack of exercise, obesity or smoking."
"Loneliness is not only a sad event, it's a threatening event," Cacioppo said in a recent phone interview.
"Loneliness is a pain signal calling attention to an important need. It's the same as hunger, thirst and pain."
And although he stresses that the quality of your relationships is far more important than the quantity, ("A few close friends and confidants make a big difference"), it helps to branch out beyond your immediate family.
Answer these questions:
- Do you regularly discuss your health, job, current events or other "important matters" with someone outside your family?
- Who could you call on to pick up your child(ren) from school or day care?
- Do you belong to a community organization?
- How many of your neighbors do you know?
- Do you play on a sports team?
- Do you have a regular hangout (coffee shop, diner, bookstore)?
- How many of your online friends do you socialize with face-to-face?
- Who feeds your pet/collects your mail/waters your plants when you leave town?
- Who would you call if your car broke down?
- What are you doing next Saturday?
If you continually answered "my spouse" to the "who would you turn to"-type questions, consider this: "Ties outside the family are the most likely to connect respondents to people from different parts of society," according to the most recent issue of Contexts, a magazine published by the American Sociological Association.
"Family members tend to be similar in class, religion and race. Therefore, if the majority of a person's connections are through family, their social world is limited."
This may not seem like such a bad thing, but the Contexts report (which centered on the same confidant study mentioned in "Loneliness") makes this point: "The tangible, material help we get from others leads to longer, healthier lives."
"People stranded on rooftops after Hurricane Katrina perhaps didn't know anyone with a car and didn't have a close friend they could stay with for a few days," it says.
So it behooves us to make some time for relationships.
"We are fundamentally a social species," notes Cacioppo, who says he was surprised to learn how profoundly we are affected by our connectedness.
"It affects our ability to think, to self-regulate, our sense of self-worth. Exactly how central our social existence is to us as human beings, that was a surprise. That changed how I started to think about human nature."
---
GET THE BALL ROLLING
BetterTogether.org, an initiative by Harvard University to rebuild civic trust among Americans and their communities, offers "150 Things You Can Do to Build Social Capital." In other words, make some friends. From the list:
- Surprise a new neighbor by making a favorite dinner - and include the recipe.
- Organize or participate in a sports league.
- Audition for community theater or volunteer to usher.
- Volunteer in your child's classroom or chaperone a field trip.
- Participate in a political campaign.
- Help coach Little League or other youth sports - even if you don't have a kid playing.
- Start a lunch gathering or discussion group with co-workers.
- Start or join a carpool.
- Plant tree seedlings along your street with neighbors and rotate care for them.
- See if your neighbor needs anything when you run to the store.

Internet searching increases brain function: study

2008-10-15T15:12:00.001-07:00

WASHINGTON, Oct 14, 2008 (Xinhua via COMTEX) -- A new study by U.S. scientists shows that for computer-savvy middle-aged and older adults, searching the Internet triggers key centers in the brain that control decision-making and complex reasoning.
The findings, released on Tuesday, demonstrated that Web search activities may help stimulate and possibly improve brain function. The study, the first of its kind to assess the impact of Internet searching on brain performance, will appear in the American Journal of Geriatric Psychiatry.
"The study results are encouraging, that emerging computerized technologies may have physiological effects and potential benefits for middle-aged and older adults," said principal investigator Gary Small, a professor from University of California, Los Angeles. "Internet searching engages complicated brain activity, which may help exercise and improve brain function."
As the brain ages, a number of structural and functional changes occur, including atrophy, reductions in cell activity, and increases in deposits of amyloid plaques and tau tangles, which can impact cognitive function.
Small noted that pursuing activities that keep the mind engaged may help preserve brain health and cognitive ability. Traditionally, these include games such as crossword puzzles, but with the advent of technology, scientists are beginning to assess the influence of computer use -- including the Internet.
For the study, the UCLA team worked with 24 neurologically normal research volunteers aged between 55 and 76. Half of the participants had experience searching the Internet, while the other half had no such experience.
Internet searches revealed a major difference between the two groups. While all participants demonstrated the same brain activity that was seen during the book-reading task, the Web-savvy group also registered activity in the frontal, temporal and cingulate areas of the brain, which control decision-making and complex reasoning.
"Our most striking finding was that Internet searching appears to engage a greater extent of neural circuitry that is not activated during reading -- but only in those with prior Internet experience," said Small.
In fact, researchers found that during Web searching, volunteers with prior experience registered a twofold increase in brain activation when compared with those with little Internet experience. The tiniest measurable unit of brain activity is called a voxel. Scientists discovered that during Internet searching, those with prior experience sparked 21,782 voxels, compared with only 8,646 voxels for those with less experience.
Compared with simple reading, the Internet's wealth of choices requires that people make decisions about what to click on to pursue more information, an activity that engages important cognitive circuits in the brain.

Drinking alcohol associated with smaller brain volume: study

2008-10-15T15:10:00.000-07:00

WASHINGTON, Oct 13, 2008 (Xinhua via COMTEX) -- The more alcohol an individual drinks, the smaller his or her total brain volume, according to a report in the October issue of U.S. journal Archives of Neurology.
Brain volume decreases with age at an estimated rate of 1.9 percent per decade, accompanied by an increase in white matter lesions, according to background information in the article.
Lower brain volumes and larger white matter lesions also occur with the progression of dementia and problems with thinking, learning and memory. Moderate alcohol consumption has been associated with a lower risk of cardiovascular disease; because the brain receives blood from this system, researchers have hypothesized that small amounts of alcohol may also attenuate age- related declines in brain volume.
Researchers from Wellesley College, Mass., and colleagues studied 1,839 adults (average age 60). Between 1999 and 2001, participants underwent magnetic resonance imaging (MRI) and a health examination. They reported the number of alcoholic drinks they consumed per week, along with their age, education and other factors.
"Most participants reported low alcohol consumption, and men were more likely than women to be moderate or heavy drinkers," the authors write. "There was a significant negative linear relationship between alcohol consumption and total cerebral brain volume."
Although men were more likely to drink alcohol, the association between drinking and brain volume was stronger in women, they note. This could be due to biological factors, including women's smaller size and greater susceptibility to alcohol's effects.
"The public health effect of this study gives a clear message about the possible dangers of drinking alcohol," the authors write. "Prospective longitudinal studies are needed to confirm these results as well as to determine whether there are any functional consequences associated with increasing alcohol consumption."
This study suggests that, unlike the associations with cardiovascular disease, alcohol consumption does not have any protective effect on brain volume.

Handling a mental recession

2008-09-23T14:57:00.000-07:00

Chicago Tribune -

An onslaught of phone calls tells Richard Chaifetz all he needs to know about how Americans are handling the nation's economic plunge.
The head of ComPsych, a Chicago-based provider of mental health services, said inquiries are spiking as never before in the wake of Wall Street's tumble, the housing slide and other financial calamities. "It's led to anxiety levels I have not seen in 20 years," he said. Psychologists and other professionals across Chicago and beyond report similar worries in patients. The economic unrest has been building for months; this week's bankruptcies and bailouts simply deepened a sense of despair.
Although mental health assistance won't restore a vaporized retirement fund, experts say it can be crucial in lending perspective and hope to situations that can seem irredeemably dark. Some of the concerns follow, along with coping approaches suggested by experts.
I'VE TAKEN A HUGE HIT, AND IT FEELS LIKE THE END OF THE WORLD
"It's appropriate to be anxious," said Nancy Molitor, a Wilmette psychologist. "It's not helpful to panic. Panic disables people and renders them ineffective to cope."
Molitor said she has seen a steady stream of people who are reacting to their losses in unhelpful ways: abusing drugs and alcohol, terminating their gym memberships and gaining weight, or trying to make up their financial losses through gambling.
Equally troubling are those who try to ignore the bad news, she said. Taking action can help stave off even worse trouble down the road.
"Some people are afraid to call their broker and banker, and that's not healthy," she said. "If you're worried [about paying bills], it's very important to pick up the phone. . . . Most creditors would be very happy if they heard from you."
MY FINANCES ARE OK BUT I CAN SENSE RUIN APPROACHING
California psychologist Judith M. Bardwick wrote a book on "psychological recession," a feeling that can haunt even those who, by all impartial measures, are weathering the financial storm just fine.
"It reflects people's sense that they no longer have control over what happens to them," she said. "It's the feeling that the present is lousy and the future is worse: 'I am vulnerable, and there's no one out there to help me.' "
That can be a helpful response in moderation, if it leads to updating one's skills or seeking a more secure job. But it also may encourage paralysis, anxiety and a general dreariness that infects work and home life.
Avoiding that trap means objectively reviewing one's career and finances with the help of a respected adviser, Bardwick said. She added, though, that it will take more than a positive attitude to defeat this scourge--it will take a new commitment on the part of governments and employers to see that workers are valued and cared for.
I'M MARRIED, AND MY SPOUSE IS GOING TO BANKRUPT US
"When it comes to your relationship, you really have to [adopt] a viewpoint that there are many different ways, many different spending patterns," Geneva marriage counselor Brent Atkinson said. "The biggest mistake you're going to make is your way is right and your partner is wrong."
Atkinson said husbands or wives shouldn't back off if they believe spouses are making truly disastrous financial decisions, but they shouldn't make their concerns personal or vindictive.
"If you look at the actual data on how relationships work, what you find is widely differing ideas about ways to handle money don't impact the marriage," he said. "Two savers can have a terrible marriage."
I HAVE TO POSTPONE RETIREMENT, AND I FEEL BETRAYED
"When that desire to retire is frustrated, there's a sense of losing control over your destiny," said Dr. Sandra Swantek, a geriatric psychiatrist at Northwestern Memorial Hospital. "But the other issue for the 50-plus person is, 'Will I be able to hold onto my job long enough?' "
The dark thoughts stemming from those realities can be subdued by conversation with friends and family members, Swantek said, but more serious signs--diminished energy, weight loss, scant interest in normally pleasurable activities--should prompt a visit to the doctor.
Physicians can refer patients to psychiatrists and other professionals, and those who can't afford private treatment can go to community mental health centers, which charge on a sliding scale, she said.
jkeilman@tribune.com
-----
To see more of the Chicago Tribune, or to subscribe to the newspaper, go to http://www.chicagotribune.com.

Child development key to economic growth

2008-09-23T14:55:00.000-07:00

Maine -- The state's business leaders were advised that investing in early child care was one of the most important steps that can be taken to ensure strong economic growth and development.
Harvard professor Dr. Jack P. Shonkoff told the more than 150 men and women attending the Maine Development Foundation's 30th annual meeting at the Augusta Civic Center during his keynote speech Thursday that a child's brain begins absorbing knowledge in the first year of its life. He said it was critical to their growth and intellectual development to ensure that they have healthy interactions with others at that time. It was also crucial that their young lives be as stress-free as possible.
"The healthy development of all children really does benefit all of society. It provides a solid foundation for economic prosperity and makes responsible citizens and strong communities," Shonkoff said. "The way a child grows up now is going to affect their ability to participate in society."
Shonkoff is the Julius B. Richmond professor of Child Health and Development at the Harvard School of Public Health and Graduate School of Education. He also is chairman of the National Scientific Council on the Developing Child, a multi-university collaboration of leading scholars in neuroscience, psychology, pediatrics and economics.
Shonkoff said decades of scientific research has found that early life experiences get hard-wired into the brain. The studies have found that children who undergo high levels of stress at an early age generally have encountered problems later in life. Using charts and graphs, Shonkoff showed that children from less economically secure families learn at slower rates than those who are more fortunate and that it was difficult to reverse the pattern once it is established.
"There is something about early life stress that is absorbed in your body," he said. "The poorer you are, the more health problems you have and the shorter you live."
Because a "huge amount" of brain development occurs in early childhood, it was all but impossible to "go back and re-wire" the brain with good experiences and behaviors, he said.
The mission of the Maine Development Foundation is to foster sustainable, long-term economic growth for the state, and Shonkoff commended its members for their long history of strong support for education at all levels in Maine. He said the policymakers need to view the situation over the long term and not expect a quick fix to a problem that defines itself over time. He said that while there was no "magic bullet," behaviors can be changed if they are identified at an early level and are corrected by qualified people.
Advising that "we can't afford babysitting anymore," Shonkoff said that policymakers should work to create private-public partnerships to invest in early childhood education if the state and country want to compete in the global market. He pointed out that China and India were world leaders in focusing on early childhood development. The dangers confronting children have to be addressed early in life for them to fit in a competitive world, he said.
Shonkoff described children as born learners and that it was scientifically proven that they react favorably to supportive relationships and good learning experiences. Taking a balanced approach to their emotional, social, cognitive and language needs was important to all of society, he said.
"This is the kind of investment that really requires thinking of this in legacy terms, it's not short term," he said. "This is the kind of investment for leaders with a sense of legacy and the future." To see more of the Bangor Daily News, or to subscribe to the newspaper, go to http://www.bangordailynews.com. Copyright (c) 2008, Bangor Daily News, Maine Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

Sexism = Success

2008-09-23T14:54:00.001-07:00

According to US scientists, men who display the chauvinism of David Brent in the office are better paid than modern thinkers
So there is hope for chauvinist men after all. US scientists have discovered that sexist men who believe a woman's place is in the kitchen consistently earn more than "modern-thinking" men. This amounts to an extra $8,500 (4,722) in annual salaries.
Conversely, women who hold stronger feminist views earn more, on average, than those who have a more traditional outlook on what a woman's role should be, the experts found, with a difference in salaries of $1,500.
Researchers in Florida interviewed 12,686 men and women in 1979 and then three times over the following decades, the last time in 2005. When first interviewed, the respondents were aged between 14 and 22. The team asked the interviewees whether they believed a woman's place was in the home; whether the employment of women was likely to lead to higher rates of juvenile delinquency and whether a woman should take care of her family.
Far more men answered affirmatively to all three questions, although the gap between the answers of men and women drastically reduced over the period of the survey. But when the men were asked about their salaries in 2005, another gap emerged. Those holding more "traditional" - or, some would say, chauvinist - views earned significantly more.
The research, published in the latest edition of the US Journal of Applied Psychology, suggests there are reasons why men such as David Brent - the Slough paper merchant played by Ricky Gervais, who frequently belittles his female staff in the cult comedy series The Office - earn more.
Researchers say the extra money earned by sexist men came even after other factors such as education, the complexity of the job and the number of hours a person worked were considered. They also found that couples where both spouses tended to view the ideal place for a woman as the home had a significant earnings advantage over those who disagreed.
One of the study authors, Timothy Judge, of Florida University, said: "These results cannot be explained by the fact that, in traditional couples, women are less likely to work outside the home. Though this plays some role in our findings, our results suggest that even if you control for time worked and labour force participation, traditional women are paid less than traditional men for comparable work."
Dr Judge said the findings might be explained by the fact that sexist men have historically earned more, and now have a vested interest in keeping things that way. "More traditional people may be seeking to preserve the historical separation of work and domestic roles," he said. "Our results prove that is, in fact, the case. This is happening in today's workforce where men and women are supposedly equal as far as participation."
The study also found that people whose parents had both worked outside the home tended to have less traditional views on gender roles and that married couples and men and women who were religious tended to have more traditional views on the priorities of each gender.
Magdalena Zawisz, a psychologist at Winchester University, said the discrepancies in earnings could be explained by several factors. "It could be that more traditionally minded men are interested in power, both in terms of access to resources - money in this case - and also in terms of a woman who is submissive," she said. "Another theory suggests employers are likely to promote men who are the sole earner in preference to those who are not - they recognise they need more support for their families."
4,722
The difference between what sexist men earn and what their more enlightened counterparts are paid

The Downside of Downsizing

2008-09-23T14:53:00.000-07:00

In an effort to increase productivity while cutting down costs, more and more U.S. companies are shrinking their staffs. There's only one problem with downsizing. It's not working, insists a team of researchers at the University of Michigan.
Of 30 automakers studied over four years of downsizing, only five or six experienced gains in productivity, report Kim Cameron, Ph.D., and colleagues. In the others, corporate performance actually declined following staff reductions.
Possibly, downsizing was so poorly managed that the intended cost reductions have not occurred. But it also may be that downsizing creates resentment and resistance among remaining employees--and that hinders competitiveness.
Organizational shrinkage often leads to what Cameron's team calls "the dirty dozen"--12 negative effects including decreased morale, trust, communication, and innovation, as well as increased conflict, scapegoating, and conservatism.
Cameron and Co. interviewed the heads of each organization five times over the four years and compared their reports with perceptions of corporate culture and the outcomes of downsizing gathered from more than 2,500 employee questionnaires. The end result? The way downsizing was carried out proved more important to effectiveness than the actual size of the work-force reduction.
"The most successful firms implemented both short-term and long-term strategies as they downsized, and they used both across-the-board and targeted techniques," reports Cameron. The short-term, across-the-board shrinkage helps relate the seriousness of the company's problem, while the long-term organizational restructuring rebuilds employee security that changes are in motion to stop the bleeding.
Cameron's team also recommends that the downsizing strategy be designed by employees, not top managers, and that suppliers, customers, and distributors be included in the reductions. And, perhaps most important: "Pay special attention to those who lost their jobs. And those who didn't."

Antisocial Personality Disorder

2008-09-23T14:52:00.000-07:00

Definition
Antisocial personality disorder is best understood within the context of the broader category of personality disorders.
A personality disorder is an enduring pattern of personal experience and behavior that deviates noticeably from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to personal distress or impairment.
Antisocial personality disorder is characterized by a pattern of disregard for and violation of the rights of others. The diagnosis of antisocial personality disorder is not given to individuals under the age of 18 and is only given if there is a history of some symptoms of conduct disorder before age 15.
The severity of symptoms of antisocial personality disorder can vary in severity. The more egregious, harmful, or dangerous behavior patterns are referred to as sociopathic or psychopathic. There has been much debate as to the distinction between these descriptions. Sociopathy is chiefly characterized as a something severely wrong with one's conscience; psychopathy is characterized as a complete lack of conscience regarding others. Some professionals describe people with this constellation of symptoms as "stone cold" to the rights of others. Complications of this disorder include imprisonment, drug abuse, and alcoholism.
People with this illness may seem charming, but they are likely to be irritable and aggressive as well as irresponsible. They may have numerous somatic complaints and perhaps attempt suicide. Due to their manipulative tendencies, it is difficult to separate what they say about themselves that is true from what is not.
Symptoms
Disregard for society's laws
Violation of the physical or emotional rights of others
Lack of stability in job and home life
Lack of remorse
Superficial wit and charm
Recklessness, impulsivity
A childhood diagnosis (or symptoms consistent with) conduct disorder
Diagnosis is given to those over 18 years of age. Antisocial personality is confirmed by a psychological evaluation. Other disorders should be ruled out first, as this is a serious diagnosis.
People with antisocial personality disorder often use alcohol and other drugs, which can exacerbate symptoms of the disorder. The coexistence of substance abuse and antisocial personality disorder complicates treatment for both.
Causes
While the exact causes of this disorder are unknown, environmental and genetic factors have been implicated. Genetic factors are suspected since the incidence of antisocial behavior is higher in people with an antisocial biological parent. Environmental factors are believed to contribute to the development of antisocial personality disorder since a person whose role model had antisocial tendencies is more likely to develop the disorder. About 3 percent of men and about 1 percent of women have antisocial personality disorder, with much higher percentages among the prison population.
Treatment
Antisocial personality disorder is one of the most difficult personality disorders to treat. Individuals rarely seek treatment on their own and may only initiate therapy when mandated by a court. There is no known effective treatment for this disorder.
Sources:
American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders (4th ed.).
National Institutes of Health, National Library of Medicine, MedlinePlus, 2006. Antisocial Personality Disorder. www.nlm.nih.gov/medlineplus/ency/article/000921.htm
Stout, M. (2005). The Sociopath Next Door. NY: Broadway.
Westermeyer, J. and Thuras, P. (2005). Association of Antisocial Personality Disorder and substance disorder morbidity in a clinical sample. American Journal of Drug and Alcohol Abuse.

What is Bulimia?

2008-09-18T11:34:00.001-07:00

nativeremedies.com - Bulimia is an eating disorder characterized by the eating of a large amount of food in a short space of time (binging) followed by self-induced vomiting, or excessive use of laxatives, diuretics, fasting or exercise to ‘rid’ the body of the food (purging).
People with Bulimia nervosa struggle with their binge eating disorder. They often feel that they are out of control during their binging sessions and then feel tremendous shame and guilt afterwards. It is the self-induced purging that makes them feel a release of this tension and guilt.
Characteristics of Bulimics
Unlike Anorexia Nervosa, (where the individual usually feels a sense of accomplishment and often denies having a problem), Bulimics generally feel ashamed of their binge eating disorder and know that what they are doing ‘is not normal’.
They evaluate themselves primarily on their body weight and shape, and thus often have a very poor self-esteem. Ironically, most people with Bulimia tend to be either overweight or fall within 10% of their normal body weight, and rarely attain the skinny figures that they desire and aim for.
As with other eating disorders, most Bulimics are female and the disorder tends to develop in adolescents or young women. The binge eating disorder known as Bulimia is much more prevalent in Western Societies than elsewhere in the world. This is possibly due to the common society-ideal of a slim, trim figure that is emphasized and encouraged by the media. Bulimia nervosa is a serious condition that can cause extremely severe medical consequences if left untreated. Thankfully, there are binge eating disorder treatment plans that offer help for overcoming Bulimia.
Overcoming Bulimia nervosa can be very challenging so the earlier treatment starts, the better the chances are for a positive outcome. It is important to stick to treatment and resolve underlying emotional issues to reduce the chances of relapse.
Diagnosing Bulimia
Should you seek professional help for yourself or your child, a battery of tests will be done by a health care professional before a diagnosis is made. This should include a full physical examination, with possible blood tests and urine analysis. Your doctor will be checking for confirmation of an eating disorder, as well as checking for any damage or medical complications that may have been caused by the Bulimia. A person overcoming Bulimia will also be referred to a psychologist who will take a full personal and family history, discuss your feelings and attitudes towards food and body-image and also note the history of your condition - how often you binge and purge, the emotions associated with these events and how it is affecting your life.
Symptoms of Bulimia
Eating a large amount of food in a fixed period of time, followed by compensating techniques (exercise) or purging (vomiting or use of laxatives). This must occur at least twice a week for a period of three months. sense of loss of control during binges
Self-evaluation that is unreasonably influenced by body shape and weight
Distorted body perception that may be accompanied by poor self-esteem, anxiety and depression
A pre-occupation with dieting, but also a tendency to horde food or food-related items such as recipes and cookbooks
What Causes Bulimia?
Genetics – Research suggests that women with a Bulimic family member are more likely to develop Bulimia than the average women. While this may suggest that there is a genetic component to the disorder, it may be due to the shared experiences and learned behaviors within the family context. It is also likely that personality traits related to Bulimia such as perfectionism, emotional sensitivity and addictive personality tendencies are inherited rather than the disorder itself.
Family and learnt behavior – As mentioned learnt behavior may contribute to an increased risk of Bulimia. Parents who place great importance on physical appearances, criticize their child’s body shape, or who are dieting themselves, are more likely to have a child who will develop an eating disorder.
Culture and The Media – Western society places great emphasis on the ideal body and this is especially aimed at women. The pre-pubescent female figure is highly valued and many young women feel that they need to strive for this unrealistic and unhealthy ideal. Many TV programs and magazines encourage thinness, as hundreds of young women aspire to look like the models and actresses that society idealizes. Both young men and women have almost come to expect that these “air-brushed” and semi-starving models represent the normal population. Restrictive eating – Dieting may be a huge cause of Bulimia. Studies have shown that dieting and restrictive eating lead to obsessions about food which may ultimately lead to Bulimia. Once again, society, the media, peers, and sometimes parents, often promote dieting as apposed to a healthy life-style and balanced diet. Being overweight as a child or teenager is often a precipitator to developing Bulimia.
Help for Bulimia
There are a number of binge eating disorder treatment options available to help in the struggle against Bulimia. Some form of psychotherapy is usually necessary as Bulimia is essentially a psychological disorder wrapped in emotions and personal conflicts that need to be dealt with. Pharmaceutical medications are also commonly prescribed in order to help treat accompanying problems such as depression.
Psychotherapy
Individual, family or group therapy may be very beneficial in dealing with Bulimia. Cognitive Behavioral Therapy (CBT) helps the individual address the negative ideas surrounding food, body-image and self-esteem, while providing constructive ways of implementing new food habits. Family therapy may help the entire family deal with underlying conflicts and provide coping techniques for the family as a whole, while support groups provide a source of support and comfort. Individual therapy addresses underlying personal issues such as self-esteem and guilt associated with food. On the whole, psychotherapy is very successful in treating Bulimia and it is advised that you research which type or types of therapy would best suit you.
Drug Treatments
Medication may be prescribed to Bulimic patients to help improve related symptoms such as accompanying depression, anxiety or obsessive behavior. Commonly prescribed drugs include antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and the antipsychotic drug lithium. While these drugs may help initially, up to 80% of patients relapse after the medication is discontinued, and in many cases, the side-effects are distressing.
It is strongly advised that you research any prescription medication and their side-effects before agreeing to drug therapy.
Natural Herbal and Homeopathic Remedies for Bulimia
Of the binge eating disorder treatment options available, natural remedies can be of great benefit in alleviating symptoms of anxiety and depression associated with Bulimia without the negative side effects of prescription medications. Some herbal formulas that assist with the related symptoms of Bulimia include Passiflora Incarnata – to soothe the mind and calm the nerves. Hypericum perforatum (St John’s Wort) has been very successful in treating the depression which often accompanies an eating disorder.
Natural remedies such as MindSoothe may facilitate a reasonable attitude and lessen the burden on pressured minds. MindSoothe may also promote a well-adjusted outlook and positive temperament and support healthy sleep patterns and routine appetite.

Depressed College Students Benefit From Study

2008-09-13T14:02:00.001-07:00

A pilot program called the College Screening Project, a suicide prevention outreach program, was successful in identifying and treating college students with severe depression and feelings of desperation that may have led to suicide. The study, supported by the American Foundation for Suicide Prevention (AFSP), was conducted with Emory University students over six college semesters from 2002-2005. Depression is a significant risk factor for suicide, and according to the Centers for Disease Control and Prevention (CDC) suicide is the third leading cause of death for teenagers and young adults, behind accidents and homicides. "A profound percentage of the students who participated in AFSP's College Screening Project reported current (past four weeks) suicide ideation and were subsequently treated," says Charles B. Nemeroff, MD, PhD, Reunette W. Harris Professor and chair of the Department of Psychiatry and Behavioral Sciences at Emory University. "That represents a large number of lives that were improved, and possibly saved, because of this program." The study, which began as simply an outreach program, revealed some startling statistics about suicide risk and depression in college students:
11 percent of the participants in the screening project reported current suicidal ideation
16.5 percent of the participants in the screening project had made at least one lifetime suicide attempt
More than half had clinically significant depression
Suicide ideation was related not just to depression, but also to feelings of desperation and feeling overwhelmed or out of control. "These are important emotions to look for in at risk students," says Nemeroff. From 2002-2005, approximately 8,000 students were invited to participate in the AFSP program and asked to complete a brief questionnaire that covered depression and related problems. The invitations were distributed on a secure, project-developed website. During the three-year study interval, a total of 729 Emory students participated by completing the questionnaire. An experienced clinician reviewed the responses and a detailed personalized assessment was returned to each student's secured email address. Students whose questionnaire results suggested significant problems were urged to come in for a face-to-face evaluation. In addition, a dialogue feature on the website gave the students the option to exchange follow-up messages with the clinician while remaining anonymous. Study data showed that 91 percent of the students who filled out the questionnaire viewed the counselor's assessment; 34 percent engaged in dialogues and 20 percent came in for an evaluation. More than 80 students characterized as high-risk entered psychotherapy after the in-person evaluation. The study also found that among students designated to be at-risk, the rates of those coming for in-person evaluation and entering treatment were three times higher for those who engaged in online dialogues than for those who did not. In addition, for some students who dialogued with the counselor the online relationship appeared to have had a therapeutic effect. Steve Garlow, MD, PhD, a study co-author, believes that college students are particularly vulnerable when it comes to feelings of depression, but don't seek treatment because of concerns about the stigma attached to mental illness. "The students responded to this program because it was readily available and they were using technology that they could relate to and trusted to keep their identity anonymous." David Moore, MD, study investigator and psychiatrist at Emory University's Student Health Center says, "We have always tended to be proactive, but this project was so effective that we continued to use the AFSP program at Emory. We believe it is a very effective tool for supporting our students." ----------------------------Article adapted by Medical News Today from original press release.---------------------------- Dr. Charles Nemeroff was principal investigator for the study, and currently serves as President of the American Foundation for Suicide Prevention. Drs. Moore and Garlow are assistant professors in Emory's Department of Psychiatry and Behavioral Sciences. Jill Rosenberg, LCSW, project counselor, was with the department when the study was implemented. The University of North Carolina, Chapel Hill (UNC) was included in the project for the last three of the six semesters. In addition to Emory faculty, study authors included, Ann Haas, PhD, and J. John Mann, MD, with the AFSP; Bethany Koestner, BS, with the AFSP at the time the project was implemented; Jan Sedway, PhD, and Linda Nicholas, MD, with the Department of Psychiatry at the University of North Carolina School of Medicine, Chapel Hill and Herbert Hendin, MD, with New York Medical College in Valhalla. The research was supported by unrestricted grants to the American Foundation for Suicide Prevention from Eli Lilly and Company, Wyeth Pharmaceuticals, Janssen Pharmaceuticals and Solvay Pharmaceuticals, Inc. An article describing key findings of the initial implementation of the program recently appeared in the journal Depression and Anxiety (Vol 25: 482-488) 2008 and a second article summarizing the combined results of the pilot test that included both Emory University and UNC was published in the Journal of American College Health (Vol 57 (1): 15-22 (2008). Source: Kathi Baker Emory University

Psychological Therapies Ease Arthritis Pain

2008-09-13T14:01:00.001-07:00

Arthritis sufferers can alleviate their pain by using mental imagery and hypnotherapy.This is the finding of Bryan Bennett and colleagues from Bangor University who presented their findings on the11 September 2008, at The British Psychological Society's Division of Health Psychology Annual Conference held at the University of Bath.Rheumatoid arthritis (RA) is a chronic, progressive and disabling auto-immune disease affecting 0.8% of the UK adult population. It is an incredibly painful condition and can cause severe disability and ultimately affects a person's ability to carry out everyday tasks. Even with current medical treatment many people still report high levels of pain. A rising number of chronic sufferers now turn to complementary and alternative medicines to lessen the main symptoms of pain and fatigue. This study examined the effect of visualisation techniques and hypnotherapy to help reduce the pain and fatigue, which prevents many sufferers from living a full and active life. Forty two patients were asked to visualise their pain in different ways and try to manage it. For example participants were asked to visualise their pain in the form of a person and then thank that person for letting them know something was not right. They would then ask the person to leave, visualising their image going further away, until the image was hardly visible and eventually disappearing, leaving them free of pain. The results showed that these imagery techniques, and hypnotherapy, were effective at reducing the pain and fatigue caused by RA.Bryan Bennett commented: 'All the participants were asked to identify what areas of their life were important to them but were negatively affected due to the RA. By doing so they were taking an active part in their own therapy. By employing the techniques they were taught, they were able to self-treat when necessary - allowing them to control their pain and enabling them to get on with enjoying life.'More than 700 psychologists from the UK, Europe and further are gathering at the University of Bath from 9 - 12 September 2008 for the joint European Health Psychology Society and British Psychological Society's Division of Health Psychology Conference 2008. The conference, themed 'Behaviour, Health and Healthcare: From Physiology to Policy', will look at how psychology can be applied at individual and group level to promote health, and even prevent illness, at a national level.British Psychological Society

Exploring The Search Processes Used In Both Spatial And Abstract Settings

2008-09-13T14:00:00.002-07:00

Exploring The Search Processes Used In Both Spatial And Abstract Settings

New research from Indiana University has found evidence that how we look for things, such as our car keys or umbrella, could be related to how we search for more abstract needs, such as words in memory or solutions to problems. "Common underlying search mechanisms may exist that drive our behavior in many different domains," said IU cognitive scientist Peter Todd. "If how people search in space is similar to how they search in their minds, it's a very exciting prospect to try to find the deep, underlying roots of human behavior that may be common to varied domains." Lead author Thomas Hills worked with Todd and fellow IU cognitive scientist Robert Goldstone in designing experiments to explore the search processes their study participants used in both spatial and abstract settings. The studies revolved around two search modes -- exploitation, where seekers stay with a place or task until they have gotten appreciable benefit from it, and exploration, where seekers move quickly from one place or one task to another, looking for a new set of resources to exploit. They then examined whether an initial search, in this case for resources in space, primed the mode used in the subsequent, more abstract search. "We asked the question -- are the same mechanisms that let simpler organisms search in space for food related to how we search for things in our mind, for concepts or ideas?" Todd said. "Our conclusion is that they seem to be linked at some level, which is what our priming experiment suggests." Some people might be more inclined to one search mode or the other, having a lesser ability to focus on a given task or difficulty letting go of an idea. An extreme form of the exploratory cognitive style would be someone with attention deficit hyperactivity disorder. An extreme form of the exploitive cognitive style would be someone with obsessive compulsive disorder. These new findings, published in the latest issue of Psychological Science, have possible implications related to other recent work on brain chemistry and cognitive disorders. Exploratory foraging -- actual or abstract -- appears to be linked to decreases in the brain chemical dopamine. Many problems related to attention -- including ADHD, drug addiction, some forms of autism and schizophrenia -- have been linked to such a dopamine deficit. The authors suggest that computer foraging, such as that used for their experiments, could reveal individual differences in underlying cognitive search style, and could even be used to manipulate that style. If that were possible, it could perhaps lead to therapies for such cognitive disorders. Modern tools -- a computerized search game and board game -- used to examine ancient cognitive search processes The scientists had a group of volunteers use icons to "forage" in a computerized world, moving around until they stumbled upon a hidden supply of resources (akin to food or water), then deciding if and when to move on, and in which direction. The scientists tracked their movements. The volunteers explored two very different worlds. Some foraged in a "clumpy" world, which had fewer but richer supplies of resources. Others explored a "diffuse" environment, which had many more, but much smaller, supplies. The idea was to "prime" the optimal foraging strategy for each world. Those in a diffuse world would in theory do better giving up on any one spot quickly and moving on, and navigating to avoid any retracing. Those in a clumpy world would do better to stay put in one area for an extended period, exploiting the rich lodes of resources before returning to the exploratory mode. The volunteers then participated in a more abstract, intellectual search task -- a computerized game akin to Scrabble. They received a set of letters and had to search their memory for as many words as they could make with those letters. As with the board game, they could also choose to trade in all their letters for a new set whenever they wanted to. The researchers found that the human brain appears capable of using exploration or exploitation search modes depending on the demands of the task, but it also has a tendency through "priming" to continue searching in the same way even if in a different domain, such as when switching from a spatial to an abstract task. They also found that individuals were consistent in their cognitive style -- the most persevering foragers for resources in space were also the most persevering Scrabble players. Everybody should be able to switch back and forth, Todd said, but the people who have a tendency to use one mode more in one task have a similar tendency to use that mode more in other tasks. ----------------------------Article adapted by Medical News Today from original press release.---------------------------- The study was supported by the National Institutes of Health, U.S. Department of Education, National Science Foundation and Indiana University. Hills was a research scientist at IU when this study was conducted. He now is a research scientist at the University of Basel, Switzerland. "Search in External and Internal Spaces: Evidence for Generalized Cognitive Search Processes," Psychological Science. August, vol. 19 (8). Source: Peter Todd Indiana University

Women's Work: Never Too Nice

2008-09-13T14:00:00.001-07:00

Women's Work: Never Too Nice

Are you nice enough? Today's working woman may face discrimination for not being sociable enough.
By: Amy Wilson

Working women were once kept beneath the glass ceiling because they were considered "too nice." Now they're being held back because they aren't nice enough.
In an effort to erase gender discrimination, many companies have been abandoning their emphasis on stereotypical male qualities like assertiveness, and seeking workers with interpersonal sensitivity and people skills. Or "qualities usually associated with women," says Peter Glick, a professor of psychology at Lawrence University in Wisconsin. Ironically, what he calls the "feminization" of companies may work against women lacking the outgoing attributes that employers now expect from them—attributes that employers don't expect from men.
Proof of this double standard comes from Glick's study in which subjects were asked to rate job applicants vying for a managerial position. Women perceived as being more competitive were deemed competent for the job but also less sociable than other candidates, and thus less hirable. Competent men, however, were described as hirable even if they weren't socially adept.
Still, the big picture for women is getting brighter: Lawrence Pfaff, a human resource consultant in Michigan, reports that women are considered better managers than men, thanks to their collaborative skills on the job.
Psychology Today Magazine

Help save a life - give your brain to science

2008-09-13T13:59:00.001-07:00

Joe Daniell of Orlando made his final gift to his family and fellow man when he died eight years ago at age 86.
Daniell, like his mother and sister before him, succumbed to dementia. But because his brain was donated to science, he gave his wife and children a precise diagnosis for the illness that claimed his life.
He also gave researchers a peek at the mechanics of that insidious, poorly understood disease.
"The report came back that he had Alzheimer's," said his widow, Katy, 84. "It is so heartbreaking, but my daughters and I agreed that we wanted to know."
Joe Daniell's brain tissue was preserved through the Florida Brain Bank, a program that remains relatively unknown despite being more than 20 years old. Not only does the program ensure an autopsy -- the only definitive way to diagnose Alzheimer's disease -- but it also makes the tissue available to international researchers studying everything from the role of genetics to possible treatments to the accuracy of presumptive diagnoses made while people are still alive.
Experts estimate 500,000 Floridians suffer from Alzheimer's. And although it is commonly associated with the elderly, early-onset forms can strike people in their 30s. Roughly 15 percent to 20 percent of cases are thought to be caused by genetic factors.
But there have been only 1,159 donors since the Brain Bank began in 1987.
"Researchers continue to have a desperate need" for brain tissue to study, said Martha Purdy, the Brain Bank coordinator at the Alzheimer Resource Center in Orlando. The agency pushed for the program's creation.
Last year, Purdy enrolled 42 potential donors, all of whom have to undergo a complete neurological evaluation. And for the first time, she is recruiting healthy individuals or those with very mild impairment so that when they eventually die, their brain tissue can be used for comparison.
"We've been wanting to do that for years, but we are just now finding the money," she said.
While dementia patients routinely undergo tests so they can be diagnosed and treated -- a process typically covered by insurance -- a complete neurological work-up for people with healthy brains would run $3,000 to $5,000 out of pocket.
Dr. Ranjan Duara, medical director of the Wien Center for Alzheimer's Disease & Memory Disorders at Mount Sinai Medical Center in Miami Beach, said such comparative tissue samples are increasingly important as researchers study treatments designed to halt the disease.
"We're trying to develop tests to diagnose the disease very early," he said. "But if we want to know what the accuracy of these tests is, the best way is by looking at the brain itself at autopsy."
In 2007 alone, five research papers were generated from Florida Brain Bank tissue donations. And recently, UCF's NanoScience Technology Center formed a partnership with the Alzheimer Resource Center to study neurons taken from the donated brains. No donation goes to waste, Purdy said.
In spite of the importance, Purdy doesn't pressure people to enroll themselves or loved ones in the program. She tells them the diagnosis they'll get may be important for family medical history, and she assures them the donation will not interfere with memorial viewings or funerals. But she understands some people are still disturbed by the notion of organ donation.
On the other hand, some find out about the program too late.
Jo Emerson, 75, had never heard of the Brain Bank when her husband died of early-onset dementia in 1999, two days before their 46th wedding anniversary. She didn't even know there were other types of dementia besides Alzheimer's disease.
"Everyone just said it was Alzheimer's, and I believed them," said Emerson, who lives in Altamonte Springs and has two grown daughters from her marriage. "I missed my chance, and now we'll never know."

Is Your Hospital Safe? Disruptive Behavior And Workplace Bullying

2008-09-13T13:58:00.001-07:00

One of the most significant challenges in organizations today is dealing with disruptive behavior in the workplace. Hospitals face such challenges. The Center for American Nurses (2007) published a booklet entitled Bullying in the Workplace: Reversing a Culture. Even the landmark Institute of Medicine report, To Err is Human, stated that for years "the health system has not had effective ways of dealing with dangerous, reckless, or incompetent individuals and ensuring that they do not harm patients" (1999, 146). In hospitals, the challenge of workplace bullying extends beyond high performance and civility. Recent evidence suggests a link between performance failures, particularly among physicians, and declines in patient safety and welfare (Leape and Fromson 2006). Researchers in this field have also suggested an association between "intimidation (bullying) of and by nurses" (Leape and Fromson 2006, 189) and retention of nurses (Longo and Sherman 2007; Stevens 2002).
Physicians throwing charts, nurses berating less experienced nurses, and supervisors publicly belittling staff are all common examples of disruptive behavior. Such behavior represents one of those managerial challenges that affect not only the target but also the organization itself. This phenomenon is not new; neither are the organizational approaches to preventing and addressing it. Still, bullying remains problematic in most workplaces (see Appendix). Per a survey of 7,740 U.S. adults conducted by Zogby International and the Workplace Bullying Institute (2007), nearly two-thirds (62%) of the respondents reported that employers ignored the situation. The stakes are too high, and the risk is too great for healthcare leaders and managers to ignore them.
Although researchers have documented disruptive behavior for some time and have even devised theoretical models to address such behavior (Piper 2006), the challenge persists. Recent efforts to tackle the problem include the following: (a) On April 9, 2008, in Daniel H. Raess v. Joseph E. Doescher, the Indiana Supreme Court affirmed a jury award of $325,000 to a former St. Francis Hospital employee who had accused a prominent heart surgeon of bullying him. (b) In March 2008, New York state legislators passed a bill establishing a cause of action for employees who are subjected to an abusive work environment (New York State Assembly 2008). (c) In adopting the 2009 Leadership Chapter Standards, the Joint Commission on Accreditation of Hospitals (2008) included requirements that leaders create protocols for managing disruptive behaviors and that they maintain a hospital culture of safety and quality. (d ) In February 2008, the Center for American Nurses adopted its statement on Lateral Violence and Workplace Bullying. And (e) at the 75th Annual Congress of the American College of Health Care Executives, the speaker for the 2008 Bachmeyer Address delivered a call for coordinated, organizational action by healthcare leaders and managers entitled "The Human Aspects of Quality Improvement" (Martin 2008).
Today, healthcare leaders and managers must view workplace bullying not only from a legal point of view but also from the perspectives of organized labor and ethics. More unions are notifying members about workplace bullying. For example, the 2007 Service Employees' International Union (SEIU) contract bulletin at a California hospital warned, "A word on allegations of bullying and threats . . . we have zero tolerance for bullying and threats by anyone inside or outside the organization" (El Camino Hospital 2007).
Lavan and Martin (2007) proposed a model to address workplace bullying as an ethical issue. The popular media have called for a more organized response to workplace bullying, with articles such as "Is Your Boss a Bully: 5 Ways to Fight Back" in the March issue of Essence magazine (Hamilton-Wright 2008) and "Don't Tolerate Disruptive Physician Behavior" in the March online issue of American Nurse Today (Lazoriz and Carlson 2008).
Hospital leaders and managers must take action when faced with such behavior. They must (a) ensure that the environment is a safe place to work, (b) make certain that individuals focus on performance rather than protection or vengeance, and (c) instill respect and civility as pillars of the organizational culture.
Some researchers assert, "effective antibullying practices must include a statement of exactly what constitutes bullying, because often perpetrators do not define their behavior as problematic" (Stevens 2002, 191-92, citing Gorman 1997). The ability to distinguish among disruptive, impaired, and incompetent behavior is critical because the strategies used to prevent and resolve these issues are specific to each type. The distinctions are especially important when dealing with physicians because the Joint Commission on Accreditation of Hospitals (2008) in its 2009 leadership chapter, in the prepublication standards, requires that healthcare organizations have a specific process to address impaired physician behavior. Furthermore, The Joint Commission on Accreditation of Hospitals' 2009 leadership standards (2008) require that each hospital has a code of conduct that defines acceptable, disruptive, and inappropriate behaviors. This distinction among disruptive, impaired, and incompetent behaviors is not purely academic; it is critical for two reasons. First, to meet the leadership standards, hospital administrators must formulate definitions. Second, a treatment plan is limited by the accuracy of the diagnosis, and a managerial and organizational intervention is limited by the accuracy of the assessment and the root cause of the problem.
Disruptive behavior, sometimes called "dysfunctional behavior" (Griffin and Lopez 2005), is a vague and emotionally laden term. Disruptive behavior ". . . can have a significant impact on care delivery, which can adversely affect patient safety and quality outcomes of care" (Rosenstein and O'Daniel 2008, 1,564).
Similar to the definition of disruptive behavior, the definition of impaired behavior addresses personal issues. Leape and Fromson (2006) defined impairment as a "disability resulting from psychiatric illness, alcoholism, or drug dependence" (107). But it focuses on personal health, suggesting that there may be an underlying physiological or psychological illness related to the manifestation of such behavior. Baldisseri (2007) estimated that about 10-15% of healthcare professionals misused drugs at some time during their careers.
The interventions also differ. In the case of disruptive behavior, the initial response is often risk management preceding discipline. For impaired behavior, the initial response is often a referral to employee assistance or physician wellness programs, using the Maslach Burnout Inventory as a pre-post measure (Dunn et al. 2007). For example, the Pharmacy Recovery Network (PRN) covers all 50 states and uses a rehabilitative approach to pharmacists suffering from alcohol and drug abuse (Kenna, Erickson, and Tommasello 2006).
The definition of incompetent behavior focuses on professional behavior related to standards, guidelines, and professional norms. Competence can be defined as possessing the requisite abilities and qualities to effectively perform professional duties according to specific professional and ethical standards.
Disruptive, impaired, and incompetent behaviors are not mutually exclusive. Any given practitioner may display all three behaviors simultaneously. In this article, I focus on disruptive behavior.
Prevalence of Disruptive Behavior
Namie (2003) found that 71% of the targets of disruptive behavior were bullied by those who outranked them in the hierarchy. Tepper (2000) labeled this as abusive supervision, "subordinates' perception of the extent to which supervisors engage in the sustained display of hostile verbal and non-verbal behavior, excluding physical contact" (82).
No definitive source describes the incidence of disruptive behavior in hospital settings. But several recent studies have indicated that the problem is significant. Weber (2004) found that 54.6% of responding physician executives reported that problems with physician behavior occurred more than five times per year. In another study of 1,500 nurses and physicians in 12 states, researchers discovered that 68% of the nurses and nearly half (47%) of the physicians reported witnessing disruptive behavior in which fellow hospital workers targeted other hospital workers (Rosenstein 2002). In an additional study, 88% of the respondents reported encountering some form of disruptive behavior (Institute for Safe Medication Practices 2003).
Gender affects the prevalence of disruptive behavior. Bruder (2001) found verbally abusive behavior toward female nurses was pervasive. Namie (2003) discovered that 80% of all targets of disruptive behavior were women.
Even if the prevalence of such behavior were less frequent, hospital leaders and managers must take into account and would be prudent in heeding the impact of the behavior. As previously mentioned, the 2007 Workplace Bullying Survey found that more than one in three workers (37%) have been bullied, almost three of four bullies (72%) are bosses, and nearly six in ten of the targets (57%) are women.
Disruptive Behavior: Individual and Organizational Consequences
Disruptive behavior has a ripple effect (Keogh and Martin 2004). Negative consequences affect both the individual and the organization. Pfifferling (2003) described the consequences of disruptive behavior on one type of clinical team:
Disruptive behavior by any member of the oncology team can sabotage professionalism and has clinical, operational, and economic consequences. The interdisciplinary team becomes less productive and creative. At best, work is not as exhilarating as it could be. In the worst-case scenario, working becomes filled with anxiety. (16)
On the level of individual employees, researchers have shown that those who are the targets of disruptive behavior report less organizational citizenship behavior, more psychological distress, greater dissatisfaction with work and life, and an increasing intention to quit work (Duffy, Ganster, and Pagon 2002; Zellars, Tepper, and Duffy 2002). With the national nursing shortage already being a critical problem (Rosenstein 2002), hospitals can not afford to have another cause for turnover.
On the organizational level, disruptive behavior has a negative effect on patient satisfaction, staff performance, and-in more recent studies- quality of care (Longo and Sherman 2007). First, Rosenstein (2005) found a link between disruptive behavior and patient satisfaction. Second, other researchers have established a relation between disruptive behavior and staff health, retention, and even patient care (Firth-Cozens 2001; Hicks 2000). Field (2002) found that bullying was associated with staff turnover, absenteeism, impaired performance, decreased productivity, and poor teamwork. As hospitals struggle with staffing because of labor shortages and escalating hospital costs, hospital leaders and managers must remove all obstacles to staff performance and then develop a culture of high performance.
The most serious potential consequence of disruptive behavior concerns medical errors and patient safety. The 2004 Institute of Safe Medication Practices Survey on Workplace Intimidation found that "healthcare providers frequently employ intimidating behaviors when interacting with each other" (1). Of the 2,095 respondents in this survey, 7% reported that they were involved in a medication error during the past year in which intimidation played a role. Other behavior problems may have an even greater effect on medical errors. One analysis of adverse medical events attributed 60% of the cause to "out-of-control physicians" (Atlantic Information Services 2005, 1). Rosenstein and O'Daniel (2005) reported, "between 53% and 75% of respondents said they saw a strong link between disruptive behavior and negative clinical outcomes" (57).
Not only is disruptive behavior linked to a potential increase in errors and mistakes, but also reporting of these problems may be affected. Physicians may not report mistakes and errors because they are concerned about external bodies, such as state medical boards (Kingston et al. 2004). Nurses may not report the mistakes of physicians because they fear being threatened (Kingston et al.).
As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for eight preventable conditions: patient falls, pressure ulcers, urinary tract infections, vascular-catheter-associated infections, mediastinitis, air emboli, removal of objects left in the body during surgery, and injury caused by use of incompatible blood products. In short, CMS ends coverage for hospital errors.
Recommendations: Prevention to Treatment
The literature of best practices indicates a variety of strategies to decrease disruptive behavior in hospital settings. These organizational approaches may seem like common sense, but it is not uncommon for healthcare organizations to have "cultural blind spots" (Smith 2003, 313) in which even common sense is difficult to execute. In addition, many organizational change initiatives fail, and healthcare organizations often are slow to learn. Adopting one of the following recommendations is not enough. Leaders need to focus on executing all such changes and must hold themselves accountable for their success.
(a) Adopt a policy of zero tolerance for disruptive practitioner behavior and enforce the policy consistently throughout the organization.
(b) Create and sustain a high-performance work culture that focuses on attaining organizational goals by enabling individuals and groups at all levels to maximize their full potential.
(c) Recognize and reward behaviors that demonstrate collaboration, respect, and a high regard for interpersonal ethics.
The culture of the organization must make clear that disruptive behavior of any type is not acceptable under any circumstances. No exceptions should be made, even for those who are politically connected and those who produce high revenue.
Hospital leaders should consider three themes when constructing an organizational strategy to deal with disruptive behavior: laws and regulations, culture, and systems and processes.
Laws and Regulations: Begin with Compliance, but Move toward Commitment
In the United States, no specific federal legislation forbids disruptive behavior at work. New York is the only state that forbids abusive conduct in the workplace. To date, 13 states have introduced bills. Among them is Oregon State Legislature's (2007) Senate Bill 1035, which would outlaw workplace bullying. As used in this section, "harassment, intimidation or bullying" means any persistent verbal or physical act of an employer or employee that is unrelated to the employer's legitimate business interests and that a reasonable person would find threatening, intimidating, hostile, or offensive. "Harassment, intimidation, or bullying" includes, but is not limited to, derogatory remarks; insults or epithets; physician conduct that a reasonable person would find threatening, intimidating, or humiliating; and the gratuitous sabotage or undermining of an employee's work performance (2).
However, there are two federal statutes that spell out the affirmative duty of managers to provide a safe working environment for employees (Occupational Safety and Health Act of 1970) and ensure a nonhostile work environment (Title VII, Civil Rights Act). Lapenta (2004) asserted that a managerial duty exists "to provide an environment where care can be delivered to patients in a safe and effective manner" (24). Under the General Duty Clause, Section 5(a)(1), of the Occupational Safety and Health Act of 1970, employers must provide their employees with a place of employment that "is free from recognizable hazards that are causing or likely to cause death or serious harm to employees."
Even accreditation standards (e.g., The Joint Commission on Accreditation of Hospitals 2009 leadership standards; Joint Commission on Accreditation of Hospitals, 2008) address the issue. Both the American Medical Association (AMA; 2004) and the American Bar Association (ABA; 2005) have set forth recommendations for healthcare organizations. In 2000, the AMA adopted a disruptive behavior policy setting forth this recommendation:
Each medical staff should develop and adopt bylaw provisions or policies for intervening in situations where a physician's behavior is identified as disruptive. The medical staff bylaw provisions or policies should contain procedural safeguards that protect due process. Physicians exhibiting disruptive behavior should be referred to a medical staff wellness or equivalent committee. (2)
Although this recommendation addresses the medical staff, healthcare organizations should implement policies and procedures for all staff who display disruptive behavior. In nursing, for example, the Florida Nurses Association (Florida Nurses Association; 2007) Board of Directors formulated FNA Proposal for Action 2007 on the Eradication of Horizontal Violence and Bullying in Nursing.
The American Bar Association (ABA; 2005) also recommended a five-step disciplinary process for disruptive behavior. This process starts with a verbal warning and proceeds to governance action if the behavior continues.
For any policies and procedures to be perceived as just, it is essential that reporting a complaint has no repercussions. Because nurses are concerned about intimidation and fear retaliation (Rosenstein 2002), this condition is critical. Another way of assuring perceived fairness is to attend to due process in all procedures, but particularly in peer review and any grievance procedures (Pfifferling 2003). No direct competitors of the disruptive individual should be involved in any of the proceedings.
The Workplace Bullying Institute in collaboration with Zogby (2007) found that 3% of targets of workplace bullying filed lawsuits. One such example is Dunn v. Washington County Hospital and Thomas J. Coy, in which the court ruled as follows:
Employees are not puppets on strings; employers have an arsenal of incentives and sanctions (including discharge) that can be applied to affect conduct. It is the use of (or failure to use) these options that makes an employer responsible-and in this respect independent contractors are no different from employees. Indeed, it is no difference whether the actor is human. (3)
Culture: The Way We Act Around Here
Healthcare leaders and managers in hospital settings must take a proactive role in creating and sustaining a safe, high-performing hospital culture for all workers. Smetzer and Cohen (2005) strongly recommended that healthcare organizations develop a culture of openness, honesty, respect, and cooperation to address workplace intimidation.
The first step to a functional organizational culture is a psychologically and physically safe culture. To develop a safe culture, administrators should first write and publish behavioral expectations for all employees and manage adherence to those expectations with the same diligence as with a balance sheet, income statement, marketing plan, or the Joint Commission on Accreditation of Hospitals (2008) requirements. Second, administrators should address complaints of workplace bullying if they arise. One empirical investigation found that less than half of all nurses were satisfied with the response of their organization when they complained of workplace bullying (Aiken 2001). Third, administrators should approach bullying as an organizational-development intervention and should leverage existing resources, such as the Call for Action of the American Association of Critical- Care Nurses Zero Tolerance for Abuse position statement, which falls under their Healthy Work Environment initiative.
Thus, at one urban hospital on the Gulf Coast, voluntary turnover among nursing staff was higher than in comparable hospitals in that region. One of the factors identified through observations, focus groups, and data review was that the climate was "abusive." Staffers demonstrated "disruptive behaviors," ranging from verbal threats and unwarranted accusations to berating of other staff in front of patients, family members, and others. Some staffers reported that they had experienced physical and psychological harm. To change the culture, senior hospital leadership launched the American Association of Critical Care Nurses' Healthy Work Environment Initiative (2004).
Systems and Processes
Systems and processes enable hospital leaders and managers to weave policies, procedures, and behavioral expectations into the fabric of the organization. I address three systems and processes influential to disruptive behavior: selection and orientation, education and training, and performance management.
Selection and orientation. First, hospital administrators can use selection and orientation as a resource to prevent disruptive behavior. A well-designed selection and orientation system should be able to differentiate not only between potential high and low performers but also between those who are likely to demonstrate desired behaviors and those who are not, especially under stress. Suggestions for a functional selection and orientation system are to:
(a) Develop an orientation process for new employees and voluntary medical staff to clearly teach the expected behaviors and norms.
(b) Update job descriptions on the basis of a job analysis and competency development process that focuses on collaboration and teamwork.
(c) Adopt a behavior-based job interview process to not only select for skills but also for behavioral competencies and a behavioral fit with the culture.
Education and training. To modify the behavior of those who demonstrate disruptive behavior, it is critical to identify the root causes and to work on the source of such behavior, without condoning or excusing it in any way. For the potential victims of disruptive behavior, Gardner and Johnson (2001) advised that employers train workers about their rights and responsibilities on an ongoing basis. For the disruptive individual, administrators should use simulations, role-playing, and case studies or other experiential learning tools to maximize "transfer of learning" to the actual work situation (10). Outside the classroom, a powerful educational influence occurs when key executives model expected behaviors. According to LeTourneau (2004),
The lead physician executive and the lead nurse executive must forge, then become a model for, a collaborative and respectful relationship. . . . The physician and nursing executives must initiate the development of an organizational vision of how physicians and nurses should work together for the benefit of the patient. (13)
LeTourneau further advocated that at the highest levels of the organization, the "senior management team, the medical staff leadership, and the board must participate in the development of these activities" (13). Peskett, Empey, and Johnson (2006) argued that "culture and leadership are inextricably intertwined" and that "successful leadership must incorporate emotional intelligence and should encourage its development in others" (194).
Performance management. Although managers must be actively engaged throughout all of these interventions, hospital leaders and managers must take a unique role in preventing and swiftly resolving issues related to disruptive behavior in hospital settings. Keogh and Martin (2004) proposed a managerial framework that first invites the manager to determine the "ripple effects" of the disruptive behavior (19). If the consequences, or ripples, are too large to be ignored, then managerial action must be taken. Keogh and Martin outlined four different actions: coaching, mediating, referring, and disciplining. They recommended that these interventions be woven into part of a hospital management system:
In the end, preventing and managing disruptive behavior is directly proportional to your organization's underlying performance management system and associated policies and procedures. (22)
Conclusion
Hospital leaders and managers are agents of their respective organizations, but they are also fiduciaries. As fiduciaries, they are required by sound leadership principles and increasingly by legal and accreditation standards to ensure that healthcare organizations are not only safe for patients but also safe for employees. These organizations must be safe not only physically but also psychologically. Thus, hospital leaders and managers must proactively create high-performance work cultures that enable the talented members of the organization to realize their full potential. The realization of full potential is naturally limited if disruptive behavior harms its target, if such behavior distracts and distresses witnesses, and if the perpetrator of such behavior focuses on bullying rather than accomplishing work tasks that directly or indirectly benefit the patient and the organization. Dealing with disruptive behavior must share the stage with other organization-wide initiatives by which hospital administrators attempt to build an excellent organization.

Down With La Difference

2008-09-13T13:57:00.001-07:00

Down With La Difference

Men and women cope with stress on the job in the same ways.
By: PT Staff

Like most people these days, you're getting combat fatigue from the gender wars. You'll grasp at any shred of evidence that men and women have enough in common to someday be capable of inhabiting the same planet peacefully.
The news from the gender front offers a glimmer of hope in the office. A team of Louisiana psychologists found that, faced with stress in the workplace, men and women actually employ identical coping strategies.
Linda Brannon, Ph.D., of MacNeese State University, and Kathleen Fontenot, Ph.D., of CITGO Petroleum Corp., both in Lake Charles, Louisiana, surveyed 21 men and 21 women performing similar jobs at similar pay. All were asked to recall a stressful situation involving tasks and one involving other people at work.
There were no gender differences in the ways those surveyed handled stress, the researchers reported. The only differences were in the coping strategies by type of stress situation.
In the face of interpersonal stress, both men and women made more attempts to aggressively alter the situation—so-called confrontive coping—and to control their own emotions. When experiencing task-oriented job stress, both were equally likely to analyze and change the situation, so-called planful problem solving.
If there are gender differences in coping with job-related stress, conclude the researchers, it's due to the nature of the job, not to gender.

On the Job: Broad Attack

2008-09-13T13:55:00.000-07:00

On the Job: Broad Attack
Lethal Lana Stefanac finds peace in the fighting ring.
By: Kim Mickenberg
Name: Lana Stefanac
Profession: Mixed martial artist
Claim to fame: Undefeated in her professional fighting league
For "Lethal" Lana Stefanac, the four-time PanAm Gold Medalist in mixed martial arts (MMA), a woman's work is never done. After 200 fights, she's still going at a breakneck pace: managing a team of bruisers (the Ladies of Pain), training, fighting, and teaching. A former premed student and hot-tar roofer, Lana insists she's a nonviolent person; she's just in it to win it. When she's not training or competing, she's battling gender discrimination and misperceptions of her sport—or getting a pedicure.
Whom do you coach?
I have an HR person, a nurse, a couple of doctors, a porn star, a famous person's daughter—I've got people from every walk of life you can imagine. And I've got about a dozen amateur guys I co-manage and train.
What's a "win by submission"?
It's essentially saying, "I've got you in a position where I could break your arm, break your leg, and 'put you to sleep'—kill you." You give your opponent the option to tap—to submit. If she's harmed in any way, you as a fighter did your job wrong, or she as an opponent didn't submit quickly enough.
Are you a violent person?
Not at all! I've never been in a real fight. I don't like to argue with people; I don't like to impose my will. At least 95 percent of the people in MMA are not violent people.
What's hard about being a woman in a combat sport?
Dealing with the discrimination, particularly in pay. A man with my status might get $150,000 a show. If I'm really lucky, I'll get $5,000.
What's managing women like?
You've got this whole Barbie-doll thing, where a promoter will call me and be like, "Do you have a girl at 125 pounds I can use?" Yeah, I sure do. Then they say, "But what does she look like?" How does her appearance affect her fighting?
Do you get flak for not being more feminine?
I have these perfectly shaved legs and these pedicured feet, and my nail polish always matches the belt I'm wearing. When I was a blue belt, I did my nails in chrome blue. When I got my purple belt, I switched to purple.
How do promoters interfere with the sport?
The promoter says, "Let's make you wear black with flames and come out calling this guy a coward, threatening to sleep with his wife, steal his babies, and ruin his car." Fighters are pretty much fed what to say. When promoters are like, "Can you say, 'I'm gonna push her through the floor'?" I just wrinkle my face and say, "No."

Depression : Some tips to face it

2008-09-06T12:54:00.000-07:00

Easir AbedinDepression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850 000 thousand lives every year.Depression is the leading cause of disability as measured by YLDs (Years Lived with Disability) and the 4th leading contributor to the global burden of disease (DALYs) in 2000. By the year 2020, depression is projected to reach 2nd place of the ranking of DALYs (Disability Adjusted Life Years) calculated for all ages, both sexes. Today, depression is already the 2nd cause of DALYs in the age category 15-44 years for both sexes combined. Depression occurs in persons of all genders, ages, and backgrounds.FactsDepression is common, affecting about 121 million people worldwide. Depression is among the leading causes of disability worldwide. Depression can be reliably diagnosed and treated in primary care. Fewer than 25 % of those affected have access to effective treatments. Depression can be reliably diagnosed in primary care. Antidepressant medications and brief, structured forms of psychotherapy are effective for 60-80 % of those affected and can be delivered in primary care. However, fewer than 25 % of those affected (in some countries fewer than 10 %) receive such treatments. Barriers to effective care include the lack of resources, lack of trained providers, and the social stigma associated with mental disorders including depression.Primary care based quality improvement programs for depression have been shown to improve thequality of care, satisfaction with care health outcomes, functioning, economic productivity, and household wealth at a reasonable cost WHO has recently launched an initiative on Depression in Public Health. The objectives and planned activities of this project are explained below.Overall objective: To reduce the impact of depression by closing the substantial 'treatment gap' between available cost-effective treatments and the large number of people not receiving it, worldwide.Specific objectives:To educate patients, family members, providers, and policy makers about depression. To reduce the stigma associated with depression. To train primary care personnel in the diagnosis and management of depression. To improve the capacity of countries to create policies supportive of improving care for depression and to provide effective management of depression in primary care. Activities:Global, regional, and national events to increase awareness of depression. Production and dissemination of resources for improving depression care. Regional and national workshops to strengthen the capacity to care for depression. Multi-site intervention studies to improve the primary care for depression. Well, if you want to be happy and want to bid your depression goodbye, now is the time to straighten up and hold your head high so that you can start feeling better!Here are the best remedies on the block that'll make you feel as good as new.THE TOP 10 TIPS TO OVERCOME OF DEPRESSION:1. First and foremost, 'talk'. Talking to someone close to you can go a long way in keeping away the blues. Your spouse/partner, your parents, your siblings or your close friends can be your pillar of strength during this depressive phase. Always remember… those who love you, will not judge you based on your weaknesses and will definitely give you the support you need.2. Exercise.Take a walk or jog a while. If you're into sports like basketball or baseball, go sweat it out in the court or on the field. Exercising helps the release of endorphins, which in turn stimulate happiness.3. Cry.Experts believe that crying relieves a lot of stress. You'll feel better once you've wet those eyes a bit.4. Get some sunlight.One of the simplest ways to get rid of depression is to step outdoors. Sunlight will surely make you feel better, especially if you tend to stay holed up in your house or in poorly lit environment.5. Music to the rescue.Listening to peppy numbers does surely elevate the spirits. Put on your dancing shoes and shake a leg to some groovy numbers. Join some salsa classes or take ballroom lessons. The Fred Astaire feel will make you float on air!6. Don't stay idle.An idle mind is the devil's workshop… an oft used phrase. Well, it's true. The more occupied you are doing chores, the lesser the time, that you'll spend thinking about depressing things.7. Write.Making your journal your best buddy would help you pour out your feelings and frustrations. You could chart out how you want to go about planning your strategy to combat depression.8. Diet.A well balanced nutritious diet would help you stay focused and keep your mind and body in perfect order, helping you cope better with anxiety during depressive phases.9. Get a hug.So get one of your loved ones to give you a nice, tight hug and you'll be feeling much brighter and cheerful.10. Seek professional help.If the depression persists for more than two weeks, with periods of lack of sleep or change in appetite or a feeling of despair or worthlessness, consult a specialist. Remember, that the doctor is your best friend and the more you let him/her know how you're feeling, the better and quicker will your recovery be. Anti- depressants can help you shorten your recovery period.Follow these tips and you'll be fast tracking your way to recovery, holding your head really high!"This is my depressed stance. When you're depressed, it makes a lot of difference how you stand. The worst thing you can do is straighten up and hold your head high because then you'll start to feel better. If you're going to get any joy out of being depressed, you've got to stand like this." - Charlie Brown

Take time for yourself — and your mental health

2008-09-06T12:53:00.001-07:00

Were you aware there are things you can do to remain mentally fit in the same way that you can take action to be physically fit?
The National Office of the Canadian Mental Health Association offers these tips to stay mentally fit:
■ Daydream: Close your eyes and imagine yourself in a dream location.
Breathe slowly and deeply.
Whether it’s a beach, a mountaintop, or a hushed forest let the comforting environment wrap you in a sensation of peace and tranquility.
■ “Collect” positive emotional moments: Recall times when you have felt pleasure, comfort, tenderness, confidence or other positive emotions.
■ Learn ways to cope with negative thoughts: Negative thoughts can be insistent and loud.
Learn to interrupt them.
Don’t try to block them (that never works), but don’t let them take over.
Try distracting yourself or comforting yourself, if you can’t solve the problem right away.
■ Do one thing at a time: For example, when you are out for a walk or spending time with friends, turn off your cellphone and stop making that mental “to do” list.
Take in all the sights, sounds and smells you encounter.
■ Exercise: Regular physical activity improves psychological well-being and can reduce depression and anxiety.
Joining an exercise group or a gym can also reduce loneliness, connecting you with new people sharing a common goal.
■ Enjoy hobbies: Taking up a hobby brings balance to your life by allowing you to do something you enjoy because you want to do it, free of the pressure of everyday tasks.
It also keeps your brain active.
■ Set personal goals: Goals don’t have to be ambitious.
Finish that book you started three years ago; take a walk around the block every day; learn to knit or play bridge; call your friends instead of waiting for the phone to ring.
Whatever goal you set, reaching it will build confidence and a sense of satisfaction.
■ Keep a journal (or even talk to the wall): Expressing yourself after a stressful day helps you gain perspective, release tension and boost resistance to illness.
■ Share humour: Life often gets too serious, so when you hear or see something that makes you smile or laugh, share it with someone you know.
A little humour can go a long way to keeping us mentally fit.
■ Volunteer: Volunteering is called the “win-win” activity because helping others makes us feel good about ourselves, widens our social network, provides us with new learning experiences and can brings balance to our lives.
■ Treat yourself well: Cook yourself a good meal or have a bubble bath.
See a movie.
Call a friend or relative you haven’t talked to in ages.
Sit on a park bench and breathe in the fragrance of flowers and grass.
The key is, do it just for you.
Thank you for your
questions and comments and for reading Mental Health Matters. You can reach us at kamloops@cmha.bc.ca, and be sure to check out our website at kamloops.cmha.bc.ca because, after all, your mental health does matter.

Bringing back memories

2008-09-06T12:51:00.000-07:00

A new drug promises a breakthrough in Alzheimer’s treatment. Vicky Allan meets those living in hope, and those offering it

MARJORIE ALLAN often feels as though she has lost her mum. It happened slowly and gradually, starting with her mother's anxieties about the whereabouts of her keys on a Mallorca holiday, and has reached a stage where, sometimes, Jean Rankin does not seem to recognise her own daughter. These days, caring for her feels rather like looking after a difficult child. She can be awkward and irritable, prone to storming off. The frail woman sitting on the sofa of her Stenhousemuir home, dressed in the same mauve polyester suit she likes to wear every day, is not really Allan's mum. Here is her mother, captured in an old gilt-framed photograph: younger, fleshier, brighter, pink-lipped and groomed.
Conversation is difficult. Rankin seems distant and distracted. When she does engage, it is often to discuss events from long ago, as though she were constantly returning to her few clear remaining memories. She frequently talks about "the children". But these are not her own now grown-up son and daughter, nor her four grandchildren, nor anyone present in her life now. They are the family that lived in the big house where she worked as nanny before her marriage. It's as if that time and place were where she still exists.
When I arrive at her home with my own one-year-old, she lights up and begins to sing, clapping along as she trills out the tune, but not the words, of Coming Through The Rye. She used to sing this song for the children in the big house. In an instant, she is back there in her youth.

For her daughter, this is clearly heart-breaking. Tears dampen Marjorie Allan's eyes. There is something brutally random about which of Rankin's memories have been kept and which lost. Not only does Allan's childhood appear forgotten; Rankin barely ever mentions her late husband.
Alzheimer's is often described as a condition in which the sufferer is lost, little by little. Author Terry Pratchett, who was recently diagnosed with the disease, described how Alzheimer's "strips away your living self a bit at a time". This capacity for emotional as well as physical cruelty makes Alzheimer's one of the most disturbing diseases of Western society. And at the moment, Alzheimer's, along with other forms of dementia, is a disease that demands that we sit up and take notice. Given our ageing population, the number of dementia cases is predicted to increase from the current 700,000 to 1.7 million by 2051, with the associated NHS costs running into billions of pounds. Worldwide, cases of the disease are expected to quadruple to 106m by 2050. For this reason, a bill is currently going through the US congress pushing for the investment needed to fund a breakthrough in Alzheimer's treatment. The panic is on.
The memory loss associated with senility was once considered a normal part of ageing: Granny has gone "soft in the brain"; great-uncle has "lost his marbles". Only in the past half-century have we begun properly to treat it as a disease. In fact, back in the early 20th century when Alois Alzheimer originally defined the condition, it was pertinent only for those rare "pre-senile" dementias occurring before old age. By the 1970s, however, with the emergence of a growing older population, the senile form of the disease was also given the name.
Dementia has ceased to be a condition that is hidden away in the family closet. Former prime minister Margaret Thatcher's descent into forgetfulness has been publicly charted by her daughter, while Terry Pratchett has described his own as an "embuggerance" but carried on writing. We also live in an era when all aspects of ageing are considered worth fighting.
Does this mean we are any closer to real hope for sufferers? For Jean Rankin, now entering the severe stages of the disease, perhaps not. The carers at her day centre recently told her daughter she was losing more of her personal skills. Her independent life at her Falkirk home is "hanging by a thread". The future for her is only further deterioration.
But there is hope. Ongoing research at the University of Aberdeen by Professor Claude Wischik and his company TauRx suggests that within five years a drug that stems the development of the disease may be on the market. Currently undergoing trials, the drug - remberTM - has so far been found to reduce memory loss by 80%. Effectively, it is halting the progress of the condition. What is remarkable about remberTM is that it came from left-field. Most other scientists had been pursuing the theory that the culprit - and, therefore the target for drugs - was protein deposits in the brain called "amyloid plaques". Meanwhile, Wischik had been examining another set of protein formations known as "tau tangles". He believed that if those tangles could be broken down, the disease could be halted.
The announcement of Wischik's findings last July, at the International Con-ference for Alzheimer's Disease in Chicago, came at a time of despondency, following a series of failed trials for a drug that, it was hoped, would affect the progress, rather than merely the symptoms, of the disease. Meanwhile, the limitations of existing drugs used to treat symptoms were becoming apparent. A report earlier this year in the US Annals Of Internal Medicine declared that the five main drugs currently approved in the US (four of which are approved in the UK) produced only "marginal" improvements in cognitive levels.
Wischik insists that his motivation for telling the world about the optimistic findings of the remberTM trials was the need for $150 million (£84m) additional funding to take the drug through Phase III trials. "I had to make a big splash," he tells me. "My purpose really was not to get on the front pages of newspapers. The people I needed to get through to were 100 analysts in New York who will determine whether we can raise this money or not. I needed to do this with a big noise, so they would come knocking on my door."
The remberTM story is one of maverick promise. Its central character, Wischik, is eccentric by nature, bloody-minded yet self-deprecating, with a flair for colourful metaphor. He tells me he is not a brilliant scientist (and he's worked with a few, including Nobel prize winners Aaron Klug and Cesar Milstein), but that he has "the right combination of bullshit skills and technical skills".
His is also a tale of persistence coming good. For Wischik, remberTM has been just another stage on a quarter-century-long journey, which began when he left his Australian home for a research post at Cambridge University under the late Professor Martin Roth. Roth, then Britain's most eminent psychiatrist, had come to believe that the tau formation was "the most important lesion for explaining dementia". What was needed, he told Wischik, was "to seize the tangle by the throat".
Alzheimer's lies at the centre of a battle for the human mind that raged throughout the 20th century. Roth played a role in this fight. Wischik credits him with having "guided a generation of psychiatrists through a period of post-Freudian thought into the age of drugs, when psychiatry understands mental illness biologically".
But the battle began long before Roth - in 1910, just nine years after a woman in her 40s arrived at the Frankfurt Mental Institute exhibiting many of the symptoms associated with what was then called senile dementia. Auguste D, as she was called, had memory loss and delusions. She was in the habit of dragging sheets about her house and would scream for hours during the night. Her doctor, Alois Alzheimer, asked her to write her name, and she would start, then seemingly forget, and say: "I have lost myself."
When she died in 1906, Alzheimer studied her brain and published a paper outlining his findings of plaques and fibrules and their connection with the condition. He made no attempt to suggest this was his own discovery, or indeed anything new in the investigation of dementia. It was his co-worker, Emil Kraepelin - now widely considered the father of modern scientific psychiatry - who, in his 1910 book, Psychiatrie, identified Alzheimer's disease. He cited it as proof, in his battle against the Freudians, that mental illness could be caused by physical changes.
Few nowadays dispute that Alzheimer's is an organic disease. In the past 30 years the battle for a cure has switched from Freud versus Kraepelin to tau versus amyloid ß , the "tauists" versus the "ßaptists". In his dogged adherence to tau, Wischik was pushing against the scientific grain that amyloid was the key. But he was sure of his evidence. Working at Cambridge University in the 1980s, he measured not just the levels of the tau tangles and proteins, but also those of the amyloid in sufferers.
"We discovered that you can have high levels of amyloid in your brain and play bridge," he said, "but if you have high levels of aggregate of tau in your brain, you can't find your way to the toilet." The discovery encouraged Wischik to continue, even when he and his team were feeling that: "There's too much opposition. Let's just walk from this." Again and again, he would think it through and come to this conclusion: "Who else is going to be stupid enough to do this? Nobody. We're it."
As so often in scientific discoveries, accident played a role. In 1987, while conducting some analysis of tau tangles, Wischik came across a substance that made them disappear. This, he immediately thought, was significant. It signalled the possibility of finding a drug that could break down the filaments within the nerve cells. Yet he did not publish his findings until 1996. "I couldn't, after all, just present a chance discovery. I needed to understand what the mechanism was."
After further research, Wischik published his findings in 1996. Then - partly because he loved Scotland - he moved his research team to Aberdeen. Now, he was ready to go about developing a drug.
The Phase II trial of remberTM was the largest there has been in a disease-modifying Alzheimer's treatment so far. It involved 300 people, mostly from around Aberdeen and Birmingham, some with mild Alzheimer's, some with moderate. Following standard procedure, half the participants were put on the drug, half on a placebo.
One of those who received the drug itself was Helen Carle. Today, there are no obvious signs that she has Alzheimer's. Bright and chatty, she talks in an Aberdonian machine-gun rattle. Her sisters often tell her they think she has been misdiagnosed. But the symptoms of the disease are subtly present in her life, to the extent that her husband, George, is required to act as her carer. She leaves food cooking on the stove, then sits down to read a book and forgets about it. "One or two things have been burned. But it's still eatable," she says. She has left the bath running twice. On the day that we meet she is distressed because, although she recently took some plant cuttings, she can't now find them.
For Carle, the disease first arrived in the form of depression, which she had never experienced before. There were dizzy spells and forgetfulness, but mostly she just felt down. She went for long walks in an effort to lift her mood. And although the doctors prescribed anti-depressants, her sisters couldn't believe she was depressed. "No, Helen, not you," they said. In Ibiza she had her first big flash of memory loss. After coming out of a shop, she hadn't a clue where she was. Other episodes of forgetfulness followed. At the shop where she worked, she let someone leave without paying. Finally she went to the doctor again. When the diagnosis came, her response was: "But I'm only 62. That's an old person's disease."
Carle was immediately asked if she would like to go on the trial. For her that meant taking large blue pills three times a day. It meant having brain scans and doing regular monthly cognitive tests. The pills turned her urine blue. They also seemed to help. "I think I'm probably more alert," she says. "It's hard to tell. If you've got a busy day you're not going to remember everything. I don't think I've got any worse." In her latest test, she boasts, she got 30 out of 30, having used a new storytelling memory technique.
One of the surprises about remberTM is that it looks as though it may work at almost all stages of the disease. Given this, it could function, like statins, as a preventative. It could halt the development of the tau tangles long before there are any symptoms.
Does Wischik foresee a future in which everyone over 60 will begin popping these pills with their muesli? No. Rather, he hopes that, using diagnostic tests he is developing, those who need the drug will be identified and targeted. The potential market is huge. Wischik's research suggests that more people than were previously realised currently have undetected Alzheimer-type patterns in their brains. He recognises six stages of deterioration. By stage two there is a small amount of memory loss. A person gets demented "somewhere between stage two and stage four". Of the 10m over-65s in Britain, he notes, 6m are at stage two or beyond. "That," he says, "funnels down to about a million who have full-blown Alzheimer's, and even that, I think, is an underestimate."
Is remberTM the miracle pill? Sceptics remain. There are reasons, after all, why others dismissed tau. Professor Rudy Castellani of the University of Maryland, for instance, believes tau may be "an effect, rather than a cause, of the disease". This, he says, does not necessarily mean that remberTM will not work, but rather that its mechanism may be yet to be understood.
And what matters, surely, is whether the drug is effective. "Scientists can attempt to uncover the mechanism in retrospect," says Castellani, "but the empirical results are much more meaningful ... The hope is that effective therapy for Alzheimer's disease will be stumbled upon by accident. This may or may not be the case with remberTM. Time will tell."
Neither Helen nor George Carle chooses to think too much about their future with the disease. "We just get on with it. That's it," says George. They are managing fine just now. Nevertheless, if the drug fails, there is the possibility Helen will deteriorate to a state where she can no longer recognise her husband. How would they then cope? "As Helen says herself," says George, "if she ever got really bad, she would do away with herself."
That feeling is a common one. We fear this disease, not so much because of what the sufferer experiences, but because of its burden on carers and loved ones. Such is our hunger for a cure that Wischiks announcement was pounced upon by the world's media. As a result, the University of Aberdeen received 800 phone calls, mostly from sufferers' relatives, asking if there was any way they could be put on the Phase III trial. Does remberTM merit that frenzy of hope?
Wischik quotes a former colleague who said: "The difference between science and reading a detective novel is that in science when you turn the page, it's blank, whereas with a detective novel you can go to the back and see who did it." Are we close to the final page of this particular book? More likely than not we are merely half-way through. It is possible, however, that Wischik has struck on the big plot twist. If the drug works, it will be an important turning point.
Too late, perhaps, for some. Too late, probably, for Jean Rankin, who is unlikely to be hauled back from her diminishing pasts into the present. Too late for my partner's mother, an Alzheimer's sufferer who died before I even got to meet her.
But perhaps not too late for future generations of Rankin's family, or even my own. One of the features of Alzheimer's is that it has been shown to have a genetic element. Sometimes, when she is looking after her mother, Marjorie Allan is haunted by the possibility that she is confronting a vision of her own future. "I often say to my friends," she says, "don't let me get like this'."

Dialogues with daemons

2008-09-06T12:49:00.000-07:00

VASANTHA SURYA

This novel affirms that being authentically creative with one’s own emotions and thoughts is a healing play, a leela.

The Finger Puppet, Anu Jayanth, HarperCollins, 2008, Rs. 295.

Filthy rich and clean broke!” — that’s the situation of a dysfunctional family sitting on a gold mine of stolen antiques and prime real estate in Tiruchirapalli, and are reduced to eating rancid curd rice with mango pickle to disguise the taste. Thanks to a megalomaniac pater familias, who fancies himself to be a rationalist and a “modern”.
Set in the mid 1960s, with a speechless 12-year-old’s thumb as the protagonist, Anu Jayanth’s debut novel is about many things Indian. Put together in the eclectic fashion of a Navaratri Golu, she holds together the whole show with some startling insights into the nature and function of language.
Restoring faith
The book’s much- more-than-whimsical illuminations have proved wrong my distrust of a whole genre of Indian English writing, sparked long ago by Naipaul’s An Area of Darkness. My reasoning then went thus: Here I am, drenched and gasping in this torrent of ‘India’ — what can a diaspora writer have to tell me about it, from that abstracting distance? This story of a deceptively phlegmatic maami and her three daughters who subvert feminist stereotypes and intelligently resist patriarchy without detesting their yajamaan, has taken the sting out of my defeat. Now, after all these years, I shall accept that for many outside India, as much if not more than for those who are here, India is not a geographical expression but an area of consciousness which can accommodate and sometimes ingeniously reconcile opposites. Its darkest patches have a way of suddenly lighting up.
Tara has been silenced by the experience of domestic violence. Unwilling to burden her beloved co-sufferers with her own struggle to cope with a seething welter of contradictory messages and feelings, she takes to talking with her own thumb. A common enough childhood daydream, you think. We remember whispering to invisible companions, and not just long ago. But when it’s the coping technique of a victim of abuse, unsettling questions can surface: is this child “disturbed”, or “depressed”? Does she have behavioural problems?
Changing conceptions
Our guesses on what constitute sanity and insanity have been changing, as we strive constantly to align received wisdom and apparent commonsense with what is currently seen as politically correct. Discoveries in neuroscience tempt us to speculate on the role of will and consciousness in human systems ruled by self-propelled neural impulses. The sense of losing ground and authenticity in a world of fragmenting identities has driven us to look anew at old ideas about the mind.
Lest you should think Tara’s is a case of what goes by the name of schizophrenia, or the now-discredited diagnosis of “dissociative identity disorder” or multiple personality, hers is a instance which does not fit into that model of mutually exclusive or antagonistic selves. Tara’s is a personality which grapples with but also celebrates and embraces its own “split”, to use a phrase no longer fashionable in psychiatry. It divides itself not to escape from its daemons, but to have a dialogue with them from two standpoints. To remain integrated — and sane — without erasing the line of division, she plays … and how she plays! Her daemons, once confronted, turn into curiously endearing presences…
Serving a purpose
Like the many swamis and devis in the puja room, each of them a loving concatenation of human aspirations, Tara’s daemons are there for a purpose: to guide her to solutions not available through the usual avenues of logical analysis. Tara and her sisters discover that being authentically creative with one’s own emotions, observations, and thoughts is a healing play, a leela. What saves their flights of fantasy from turning into pathological delusions is the sense of fun that flutters around that house, under the indulgent eye of the “shock absorber” mother steeped in Vedas, ayurveda, ahimsa, and Carnatic music. The father who insists that it is just a figment of his silly womenfolk’s imagination slowly sickens, while his wife heals herself of all her deepest griefs with her customised version of occupational therapy. She assures her children that their crazy father loves them all “in his own way”. Positive reinforcement? Or just self-defense? The family breaks away at one point for sheer survival’s sake but returns to care for him till the end. For, he is one of them, a pitiable fragment who has “lost it”.
As Anu Jayanth weaves together the fabric of life in Tiruchi with the khadi values of Gandhigram, the motif of the finger puppet pops in and out. A strange kind of sutradhar, the finger puppet somehow manages to tassel together the many loose ends in this perceptive tale.

More daytime sleeping predicts less recovery during rehabilitation for older adults

2008-09-06T12:47:00.003-07:00

A study in the 1 September issue of the journal Sleep shows that daytime sleeping during a rehabilitation stay predicts less functional recovery for older adults, with effects lasting as long as three months.
Results show that a higher percentage of daytime sleep during rehabilitation was significantly associated with less functional recovery from admission to discharge even after adjusting for other predictors such as mental status, hours of therapy received and reason for admission. More daytime sleeping during rehab remained a significant predictor of less functional recovery at a three-month follow-up.
'We were surprised that the results suggested that it was the excessive daytime sleeping in the rehabilitation facility which was associated with less improvement in their physical functioning,' said principal investigator Cathy A. Alessi, MD, of the VA Greater Los Angeles Healthcare System and the UCLA David Geffen School of Medicine. 'We were also surprised by how long this effect lasted. For up to three months later, more sleeping during the daytime while they were in the rehabilitation facility was still related to their physical functioning after being discharged.'
The authors suggest that these findings are particularly significant because sleep disturbances may be a modifiable predictor of rehabilitation outcomes. In contrast, many other predictors of rehabilitation outcomes such as cognitive functioning or hospital readmission are difficult or impossible to change. Interventions to improve sleep patterns of older people during rehabilitation, and in particular to reduce daytime sleeping, may promote functional recovery.
The study involved 245 adults with an average age of 80.6 years. Each participant had been admitted at one of two study sites for in-patient 'post-acute' rehabilitation related to conditions such as an orthopaedic problem, a heart problem or a stroke. According to the study, older people who are admitted to the hospital due to an illness or injury sometimes are unable to return home immediately. Instead, elderly patients may require a period of therapy and recovery in a rehabilitation facility such as a nursing home.
Objective sleep measurements were recorded by actigraphy for seven days and nights. As another objective measure of daytime sleeping, trained research staff conducted two days of scheduled observations every 15 minutes between 9 a.m. and 5 p.m. Respiratory sleep monitoring data were collected for 115 participants by one night of attended multichannel sleep recording. An assortment of questionnaires also were completed, and a follow-up assessment was conducted three months from the date of admission to the rehab facility.
Results show that participants slept for an objectively measured daily average of 2.1 hours during the daytime, which represents 15.8 percent of the time between waking up and bedtime. Structured observations also found that participants were asleep on 16.3 percent of observations. Participants reported worse sleep during their rehabilitation admission compared to their sleep before the onset of their recent illness, and 50 percent of participants reported clinically significant sleep disturbances during their rehabilitation stay.
According to the authors, patients' sleep may be disrupted during a hospital stay by existing medical conditions, sleep disorders or environmental factors. Daytime sleeping may play a direct rule in attenuating functional gains due to decreased motivation and effort expended during therapy sessions.Source: American Academy of Sleep Medicine

Brain imaging links chronic insomnia to reversible cognitive deficits

2008-09-06T12:47:00.001-07:00

A neuroimaging study in the 1 September issue of the journal Sleep is the first to find that cognitive processes related to verbal fluency are compromised in people with insomnia despite the absence of a behavioural deficit. These specific brain function alterations can be reversed, however, through non-pharmacological treatment with sleep therapy.
Results of functional magnetic resonance imaging (fMRI) scanning during verbal fluency tasks show that people with insomnia have less activation than controls in the left medial prefrontal cortex and the left interior frontal gyrus, two fluency-specific brain regions. However, participants with insomnia generated more words than controls on both the category fluency task (46.4 words compared with 38.7 words) and the letter fluency task (40.1 words compared with 32.7 words).
'It was surprising to see that the patients performed at a higher level than the control group, but showed reduced brain activation in their fMRI results,' said principal investigator Ysbrand Der Werf, PhD, of the Netherlands Institute for Neuroscience in Amsterdam. 'The success during the task may reflect a conscious effort to counteract the effect of poor sleep.'
Results from post-treatment neuroimaging shows that cognitive abnormalities recovered for insomnia patients who received sleep therapy, but not for those assigned to a wait-list group. Participants in the sleep therapy group also generated more words on the verbal fluency tasks after treatment than members of the wait-list group, although the results did not achieve statistical significance.
According to the authors, these results should encourage the use of sleep therapy in clinical practice as a low-cost, non-pharmacological intervention for insomnia.
The study included 21 chronic insomnia patients with an average age of 61 years and 12 healthy controls with an average age of 60 years who were matched for age, sex and education. Insomnia was defined as 'chronic' if it had lasted for at least 2.5 years. Participants underwent fMRI scanning during the performance of verbabal fluency tasks between 5 p.m. and 8:30 p.m.
Insomnia patients then were randomly assigned to a six-week long sleep therapy group or a wait-list group. Therapy involved a combination of sleep restriction, multifaceted cognitive-behaviour therapy, morning and late afternoon bright-light exposure and body temperature manipulations. After six weeks, fMRI scanning was repeated on both treatment groups during the same verbal fluency tasks.Source: American Academy of Sleep Medicine

What a sleep study can reveal about fibromyalgia

2008-09-06T12:45:00.001-07:00

Research engineers and sleep medicine specialists from two Michigan universities have joined technical and clinical hands to put innovative quantitative analysis, signal-processing technology and computer algorithms to work in the sleep lab. One of their recent findings is that a new approach to analysing sleep fragmentation appears to distinguish fibromyalgia patients from healthy controls.
Joseph W. Burns, a research scientist and engineer at the Michigan Tech Research Institute (MTRI); Ronald D. Chervin, director of the University of Michigan's Michael S. Aldrich Sleep Disorders Laboratory; and Leslie Crofford, director of the Centre for the Advancement of Women's Health at the University of Kentucky, report the results of their study in the current issue of the journal Sleep Medicine.
MTRI, a freestanding research institute acquired by Michigan Technological University in 2006 and based in Ann Arbor, specialises in remote sensors that collect data, and in signal processing, using algorithms or computer programs to analyse and correlate the information the sensors gather. MTRI has developed an ongoing collaboration with the University of Michigan's sleep laboratory, one of the nation's leading clinical and research centres specialising in sleep medicine.
This several-year collaboration provided MTRI's first opportunities to apply quantitative analysis, remote sensing technology and computer algorithms to clinical challenges, said Burns. 'In this case, our analyses of sleep stage dynamics suggest potential clinical relevance,' he noted. Newly explored measures of sleep fragmentation seem to correlate - at least in this study - with levels of pain reported by fibromyalgia patients.
Burns, who has a PhD in electrical engineering, finds that more and more of his research is taking a biomedical turn. He and his team are working with Chervin to use signal-processing technology to record and analyse the brain waves and biophysical responses of children and adults with a variety of sleep disorders. They hope it will help them better understand conventional sleep patterns, as well as diagnose and treat sleep disorders.
They presented the results of research related to assessment of sleep-disordered breathing and sleep fragmentation at Sleep 2008, an international sleep research conference, in Baltimore in June.
Patients who may have sleep disorders often undergo complicated and expensive tests in sleep laboratories, Chervin explained. These studies collect an assortment of biophysical data that reflect brain, cardiovascular and muscle activity throughout the night. Up to now, these data had to be analysed manually by highly trained technicians.
'We are collaborating to find new ways to analyse routinely collected data in a way that will be meaningful to the patient's health and will help us understand how sleep disorders affect brain functions,' he said.
Automated analysis of data potentially can provide improved assessments and reduce the cost of sleep studies, Burns noted. For example, MTRI and UM have developed an automated technique for assessing the severity of sleep-disordered breathing, using just two signals - brain waves and respiration - instead of the dozen or more signals typically needed for standard visual scoring of a sleep study.
'It may even become possible for people to take sleep tests - simpler and more effective than some of those currently available - at home where they can sleep in their own familiar bedrooms,' he suggested.
Both partners are reaping the benefits of the collaboration, Burns said. Not only can automated technology improve clinical research; what the MTRI scientists have learned about biomedical techniques such as brain mapping is informing their more traditional work on radar and optical sensing technology.
Michigan Tech and UM have patented the new algorithm for assessing sleep-disordered breathing, which enables them to study what the extra work of breathing does to the brainwaves of patients with sleep apnea, a sleep disorder in which breathing stops briefly many times during sleep. Sleep apnea has been linked to excessive daytime sleepiness, cognitive changes and other health effects, and to hyperactive behaviour in children.
The universities have filed an application for another patent for an algorithm that helps automate the assessment of patients with REM Sleep Behaviour Disorder. People with this neurological condition act out their dreams during Rapid Eye Movement (REM) sleep, which can cause them to harm themselves or a bed partner while they are asleep.
Burns and Chervin published the results of that study in the December 2007 issue of the journal Sleep.
The team plans to investigate other sleep disorders and to continue to develop automated processing techniques to improve the performance and efficiency of sleep disorder diagnosis and assessment.Source: Michigan Technological University

Children of older fathers more likely to have bipolar disorder

2008-09-06T12:44:00.003-07:00

Older age among fathers may be associated with an increased risk for bipolar disorder in their offspring, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Bipolar disorder is a common, severe mood disorder involving episodes of mania and depression, according to background information in the article. Other than a family history of psychotic disorders, few risk factors for the condition have been identified. Older paternal age has previously been associated with a higher risk of complex neurodevelopmental disorders, including schizophrenia and autism.
Emma M. Frans of the Karolinska Institutet, Stockholm, Sweden, and colleagues identified 13,428 patients in Swedish registers with a diagnosis of bipolar disorder. For each one, they randomly selected from the registers five controls who were the same sex and born the same year but did not have bipolar disorder.
When comparing the two groups, the older an individual's father, the more likely he or she was to have bipolar disorder. After adjusting for the age of the mother, participants with fathers older than 29 years had an increased risk. 'After controlling for parity [number of children], maternal age, socioeconomic status and family history of psychotic disorders, the offspring of men 55 years and older were 1.37 times more likely to be diagnosed as having bipolar disorder than the offspring of men aged 20 to 24 years,' the authors write.
The offspring of older mothers also had an increased risk, but it was less pronounced than the paternal effect, the authors note. For early-onset bipolar disorder (diagnosed before age 20), the effect of the father's age was much stronger and there was no association with the mother's age.
'Personality of older fathers has been suggested to explain the association between mental disorders and advancing paternal age,' the authors write. 'However, the mental disorders associated with increasing paternal age are under considerable genetic influence.' Therefore, there may be a genetic link between advancing age of the father and bipolar and other disorders in offspring.
'As men age, successive germ cell replications occur, and de novo (new, not passed from parent to offspring) mutations accumulate monotonously as a result of DNA copy errors,' the authors continue. 'Women are born with their full supply of eggs that have gone through only 23 replications, a number that does not change as they age. Therefore, DNA copy errors should not increase in number with maternal age. Consistent with this notion, we found smaller effects of increased maternal age on the risk of bipolar disorder in the offspring.'Source: JAMA and Archives Journals

Family therapy helps relieve depression symptoms in bipolar teens

2008-09-06T12:44:00.001-07:00

Family-focused therapy, when combined with medication, appears effective in stabilising symptoms of depression among teens with bipolar disorder, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Between one-half and two-thirds of patients with bipolar disorder develop the condition before age 18, according to background information in the article. 'Early onset of illness is associated with an unremitting course of illness, frequent switches of polarity, mixed episodes, psychosis, a high risk of suicide and poor functioning or quality of life,' the authors write. 'The past decade has witnessed a remarkable increase in diagnoses of bipolar disorder in children and adolescents and, correspondingly, drug trials for patients with early-onset disorder. There has been comparatively little controlled examination of psychotherapy for paediatric patients.'
David J. Miklowitz, Ph.D., of the University of Colorado, Boulder, and colleagues conducted an outpatient randomised controlled trial among 58 adolescents (average age 14.5) with bipolar disorder who had experienced a mood episode in the prior three months. Between 2002 and 2005, 30 teens were randomly assigned to receive pharmacotherapy plus family-focused treatment for adolescents. Over nine months, they participated in 21 50-minute sessions. Therapy included the patient, parents and siblings and consisted of education about their disease, communication training and problem-solving skills training.
The other 28 teens were assigned to pharmacotherapy plus enhanced care, which involved three 50-minute family sessions that focused on preventing relapse. Independent evaluators, who did not know patient group assignments, assessed the teens every three to six months for two years.
A total of 60 percent of the family-focused therapy group and 64.3 percent of the enhanced care group completed the two-year follow-up; of those, 53 (91.4 percent) experienced a full recovery from their original mood episode. There were no differences between the two groups in rates of recovery or in the amount of time that elapsed before a subsequent mood episode. However, patients in the family-focused therapy group recovered from depressive symptoms more quickly, spent fewer weeks in depressive episodes over the two-year period and had an overall more favourable trajectory of depressive symptoms than those in the enhanced care group.
'To enhance full symptomatic and functional recovery among adolescents, family-focused treatment for adolescents may need to be supplemented with collaborative care interventions found effective in mania stabilisation,' the authors conclude. The program's emphasis on 'reducing conflict in family relationships, enhancing social supports and teaching interpersonal skills may underlie its stronger effects on bipolar depression.'Source: JAMA and Archives Journals

Chronic fatigue patients benefit from cognitive behaviour therapy

2008-09-06T12:43:00.001-07:00

Cognitive behaviour therapy is effective in treating the symptoms of chronic fatigue syndrome, according to a recent systematic review carried out by Cochrane Researchers.
Chronic fatigue syndrome (CFS) is a potentially long-lasting illness that can cause considerable distress and disability. Some estimates suggest it may affect as many as 1 in 100 of the population globally. There is no widely accepted explanation for the disease and patients are currently offered a variety of different treatments. Cognitive behaviour therapy (CBT) uses psychological techniques to balance negative thoughts that may impair recovery with more realistic alternatives. In treating CFS, these techniques are combined with a gradual increase in activity levels.
The researchers looked at data from 15 studies involving a total of 1,043 patients with CFS. The studies compared the effects of CBT with those of usual care and other psychological therapies and suggest that in both cases CBT is more effective at reducing the severity of symptoms, provided patients persist with treatment.
Further research is required to determine whether CBT is more beneficial than other forms of treatment, such as exercise and relaxation therapies. The researchers also suggest that CBT could be more effective if used as part of a combination treatment approach.
'CFS is a challenging illness for patients, and there is ongoing controversy about its causes. There remain unanswered questions, but the available evidence is clear - CBT can help many people with CFS,' says lead researcher Jonathan Price, who works at the University of Oxford in the UK.Source: Wiley-Blackwell

Spending time in the intensive care unit can traumatise kids

2008-09-06T12:42:00.002-07:00

Children who spend time in the intensive care unit of a hospital can be traumatised by the experience even months after returning home. Dr Janet Rennick from the Research Institute of The Montreal Children's Hospital of the McGill University Health Centre and her colleagues have developed the Children's Critical Illness Impact Scale to measure psychological distress in children following hospital discharge. This is the first self-report scale ever created to measure the psychological impact of intensive care unit hospitalisation on children. The Journal of Pediatric Critical Care Medicine recently published the study.
This 23-item questionnaire provides a tool that will allow health care professionals to pick up on and recognise those children who need psychological support as a result of their hospital stay. It is based on the results of 64 interviews conducted with children who had been hospitalised in an intensive care unit, their parents, and health care professionals. The study was conducted across three Canadian paediatric hospitals.
'We know some children suffer post traumatic stress symptoms after having spent time in the intensive care unit,' explains Dr Rennick, 'Parents and children have described delusional memories of their hospital experience which continue to bother the child after they go home. In addition, parents have described behavioural changes and ongoing fears in their children, and children have told us they don't feel the same as they did before they were critically ill. This tells us something negative is going on with these children, but there was no way to capture the whole story since questionnaires had not been developed specifically for use with this population of children. As a result, we found that some kids were falling through the cracks and not getting the help needed to cope with the stress of hospitalisation.'
Dr Rennick and her colleagues decided to develop a questionnaire specifically for children aged six to 12 years. It was a challenging exercise because they had to find a way of interviewing children that would encourage and allow them to share their feelings and fears.
The interviews were done in two ways, focus groups and individual interviews. For younger children, researchers used a storyboard with felt pieces and hospital play sets. The children were encouraged to use the felt pieces to tell a four part story about: being in the hospital, going home, going back to school, and returning to the hospital for a check up.
'This interviewing method worked well for younger children who created detailed stories of their experiences But we discovered that the storyboard method was less effective for children 10 years and older. While it helped them focus on their hospital experiences, they didn't interact with the storyboard in the same way the younger children did. They would handle the felt pieces, and simply tell their story as we changed the storyboards,' says Dr Rennick.
Dr Rennick believes this child friendly, self-report questionnaire will allow health care workers to more effectively determine if children are bouncing back after an intensive care unit stay. 'With this new scale we will be better able to pick-up and help the child whose life simply hasn't returned to normal.'Source: McGill University Health Centre, Research Institute

Former child soldiers of Nepal at increased risk for range of mental health problems

2008-09-06T12:42:00.001-07:00

In Nepal, former child soldiers display greater severity of mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression, compared with children who were not forced into military service, according to a study in the 13 August issue of JAMA, a theme issue on violence and human rights.
Armed groups throughout the world continue to exploit children to wage war, according to background information in the article. Former child soldiers are considered in need of special mental health interventions. However, there is a lack of studies investigating the mental health of child soldiers compared with civilian children in armed conflicts.
Brandon A. Kohrt, M.A., of Emory University, Atlanta, and colleagues conducted a study to determine if former child soldiers have more mental health problems than never-conscripted (compulsorily enrolled into military service) children. The study, conducted in March and April 2007 in Nepal, compared the mental health of 141 former child soldiers and 141 never conscripted children matched on age, sex, education, and ethnicity. Participants were an average of 15.75 years old at the time of the study, and former child soldiers ranged in age from 5 to 16 years at the time of conscription. All participants experienced at least 1 type of trauma.
The researchers found that the numbers of child soldiers meeting symptom cutoff scores on various measures and scales were 75 (53.2 percent) for depression, 65 (46.1 percent) for anxiety, 78 (55.3 percent) for PTSD, 55 (39.0 percent) for general psychological difficulties, and 88 (62.4 percent) for function impairment. After adjusting for traumatic exposures and other variables, soldier status was significantly associated with depression (2.4 times higher odds) and PTSD among girls (6.8 times higher odds), and PTSD among boys (3.8 times higher odds), but was not associated with general psychological difficulties, anxiety, or function impairment.
'The difference in mental health outcomes between child soldiers and never-conscripted children can be explained in part by greater exposure to traumatic events among child soldiers, especially for general psychological difficulties and function impairment,' the authors write.
'The study has several clinical and programmatic implications. First, the greater burden of mental health problems among former child soldiers supports the need for focused programming, which should include, but not consist solely of, interventions to reduce depression symptoms and the psychological sequelae of trauma, especially bombings and torture, as well as incorporate belongingness and income generation. Second, girl soldiers may require focused attention, possibly for factors not addressed in this study, such as problems of sexual violence and reintegration difficulties. Third, the variation in type and severity of mental health problems highlights the importance of screening, including locally developed measures of function impairment, as a base for intervention.'
'Without screening there is a risk of pathologising child soldiers as a group rather than providing support to those individuals most impaired. Finally, the presence of mental health problems among never-conscripted children illustrates the need for comprehensive postconflict community-based psychosocial care not restricted only to child soldiers,' the authors conclude.Source: JAMA and Archives Journals

Antidepressants may impair driving ability

2008-09-06T12:41:00.002-07:00

People taking prescription antidepressants appear to drive worse than people who aren't taking such drugs, and depressed people on antidepressants have even more trouble concentrating and reacting behind the wheel.
These were the conclusions of a study released Sunday at the Annual Convention of the American Psychological Association.
University of North Dakota psychologists Holly Dannewitz. PhD, and Tom Petros, PhD, recruited 60 people to participate in a driving simulation in which participants had to make a series of common driving decisions, such as reacting to brake lights, stop signs or traffic signals while being distracted by speed limit signs, pylons, animals, other cars, helicopters or bicyclists. The simulation tested steering, concentration and scanning. Thirty-one of the participants were taking at least one type of antidepressant while 29 control group members were taking no medications with the exception of oral contraceptives in some cases.
The group taking antidepressants was further divided into those who scored higher and lower on a test of depression. The group taking antidepressants who reported a high number of symptoms of depression performed significantly worse than the control group on several of the driving performance tasks. But participants who were taking antidepressants and scored in the normal range on a test to measure depression performed no differently than the non-medicated individuals.
'Individuals taking antidepressants should be aware of the possible cognitive effects as [they] may affect performance in social, academic and work settings, as well as driving abilities,' the researchers wrote. 'However, it appears that mood is correlated with cognitive performance, more so than medication use.'
This research is important in light of the rapid increase in the number of Americans taking antidepressants. Americans' use of antidepressant drugs such as Prozac, Paxil or Zoloft, nearly tripled in a decade, according to the 2004 Health United States report, issued by the National Centre for Health Statistics. Among women, one in 10 takes an antidepressant drug, according to the government.Source: American Psychological Association

Researchers create animal model of chronic stress

2008-09-06T12:41:00.001-07:00

In an effort to better understand how chronic stress affects the human body, researchers at the Yerkes National Primate Research Centre and the Department of Psychiatry and Behavioural Sciences, Emory University, have created an animal model that shows how chronic stress affects behaviour, physiology and reproduction.
Developing the animal model better positions the researchers to understand the neurohormonal causes of such stress and the body reaction in order to develop more effective treatment options for humans. The study is available in the current online edition of Molecular Psychiatry.
According to lead researcher Mark Wilson, PhD, chief of the Division of Psychobiology at Yerkes, 'Chronic stress can lead to a number of behavioural changes and physical health problems, including anxiety, depression and infertility.'
Via the animal model, the researchers found corticotropin releasing factor (CRF) is a key neurohormone involved in stress response. Wilson explains, 'CRF is located in several different brain regions, serving different functions. Its release is important for our ability to adapt to every day stressors and to maintain our physical and emotional health.'
In response to stress, CRF levels rise; CRF levels decrease when the stressor no longer is present. Chronic stress, however, increases the length and volume of expression of CRF in areas of the brain associated with fear and emotion, including the amygdala. Such chronic stress changes the body's response, and the resulting increased expression of CRF is thought to be the cause of such health-related stress problems including anxiety, depression and infertility.
To study the importance of CRF, the research team used a viral vector to increase the production of CRF in the amygdala of female rats.
'In our study, rats that continuously were exposed to CRF from this area of the brain experienced anxious and depressive behaviour, decreased libido and disrupted ovarian cycles suggesting that persistent release of CRF such as occurs in chronic stress clearly affects multiple body systems,' says Wilson. 'These behavioural changes are similar to what we see in human females who are exposed to stressors on a daily basis.'
Dr Wilson and his research team next will attempt to learn more about the negative effects of increased CRF by examining actual molecular and cellular changes in specific brain areas targeted by the neurohormone. Knowing how CRF affects the brain positions the researchers to develop better treatment options.Source: Emory University

Antidepressants need new nerve cells to be effective

2008-09-06T12:40:00.000-07:00

Researchers at UT Southwestern Medical Centre have discovered in mice that the brain must create new nerve cells for either exercise or antidepressants to reduce depression-like behaviour.
In addition, the researchers found that antidepressants and exercise use the same biochemical pathway to exert their effects.
These results might help explain some unknown mechanisms of antidepressants and provide a new direction for developing drugs to treat depression, said Dr Luis Parada, chairman of developmental biology and senior author of a study in the 14 August issue of the journal Neuron.
In animals, it was already known that long-term treatment with antidepressants causes new nerve cells to be generated in a part of the brain called the dentate gyrus. Exercise, which can also relieve the symptoms of depression, stimulates the generation of new nerve cells in the same area.
'We would never claim that what we study in mice directly relates to how antidepressants work in humans, but there are interesting features in parallel,' Dr Parada said. 'The study unifies different observations that point to the brain's dentate gyrus region and to creation of nerve cells as being important in depression.'
Antidepressants act very quickly to increase levels of natural compounds, called neurotransmitters, which nerve cells use to communicate. It takes several weeks to several months, however, for the patients who respond to such treatments to feel less depressed. Dr Parada said this implies that some other long-term mechanism is also at work.
The current study was designed to test several phenomena that have long been observed in animal studies but have not been studied together to see if they are linked, Dr Parada said.
The researchers focused on a molecule called TrkB, or Track-B, which is found on the surface of nerve cells and responds to several growth factors to cause new nerves to grow in the dentate gyrus.
They genetically engineered mice to lack TrkB specifically in the stem cells that give rise to new neurones, then gave them antidepressants for several weeks or allowed them to run on wheels. When the mice were tested for depressive behaviour, the tests revealed that neither the antidepressants nor the exercise had helped them, and the animals also had not grown new nerve cells in the dentate gyrus.
'At least in mice, this result directly links antidepressants and voluntary exercise with TrkB-mediated creation of nerve cells,' Dr Parada said.
The results also showed that antidepressants required TrkB to stimulate the growth of new nerve cells.
Matching the timeframe for medicated patients to feel less depressed, it takes several weeks for new nerve cells to grow, Dr Parada said. This parallel effect, he said, may mean that antidepressants need to stimulate growth of new cells in the dentate gyrus in order to achieve their full effect.
'We can get biochemical, physiological, behavioural and anatomical results in animal models,' Dr Parada said. 'These all resonate with the human condition, so perhaps you have a physiological relevancy.
'There could be a way to stimulate growth of nerve cells to fight depression, for example.'Source: UT Southwestern Medical Centre

Depression and anger can plague recent university graduates

2008-09-06T12:39:00.000-07:00

The post-university years can start out tough. The good news: it gets better.
A new University of Alberta study of almost 600 of its graduates (ages 20-29 years old) tracked mental health symptoms in participants for seven years post-graduation and looked at how key events like leaving home and becoming a parent were related to depression and anger. Graduates showed a significant decrease in depressive symptoms over the seven years. Expressed anger also declined over time after graduation, suggesting improved mental health.
The researchers also found that while home may be a haven for young people in the early years of adulthood, the longer they stay at home, or if they return home, the more likely they are to experience symptoms of depression. Previous research has found that more than half of students under 25 in four-year university programs lived with their parents.
In this study, it was shown that younger participants were more depressed at times when they lived on their own, while older participants were more depressed while they lived with their parents.
'Some key events, such as leaving home, may throw emerging adults a little off kilter, depending on the timing of the transition,' said Nancy Galambos, University of Alberta psychology professor. 'Leaving home too soon can be challenging in ways that have the potential to affect mental health.'
It was revealed that women were more depressed and angry at the start of the study than men. Also, anger increased when participants became parents.
'Although we generally welcome parenthood as a positive experience, we found that people who became parents became angrier, and this was especially pronounced for mothers,' said Harvey Krahn, University of Alberta chair of sociology. 'The transition to parenthood produces a new set of demands on the couple that may be difficult to cope with as parents have to negotiate a whole new set of family responsibilities.'
The study was conducted by Nancy Galambos, University of Alberta psychology professor, and Harvey Krahn, University of Alberta chair of sociology. It appears in the Journal of Marriage and Family.Source: University of Alberta

Memory trick shows brain organisation

2008-09-06T12:30:00.000-07:00

A simple memory trick has helped show UC Davis researchers how an area of the brain called the perirhinal cortex can contribute to forming memories. The finding expands our understanding of how those brain areas that form memories are organised.
The brain puts together different items - the what, who, where and when - to form a complete memory. It was previously thought that this association process occurred entirely in a brain structure called the hippocampus, but this appears not to be the case, said Charan Ranganath, a professor at the UC Davis Centre for Neuroscience and the Department of Psychology who led the research.
'We want to know how the brain areas that encode memory are organised,' Ranganath said. 'If your memory is affected by ageing or Alzheimer's disease, is there a way to learn that can capitalise on the brain structures that may still be working well?'
Ranganath, along with graduate student Andrew Logan Haskins, Andrew Yonelinas, a UC Davis psychology professor and associate director of the Centre for Mind and Brain, and Joel Quamme, a former UC Davis graduate student now at Princeton University, used functional magnetic resonance imaging (fMRI) to see which parts of the brain were active when volunteers memorised pairs of words such as 'motor/bear' or 'liver/tree.' In this experiment, the volunteers either learned the pairs as separate words that could be fitted into a sentence, or as a new compound word, for example 'motorbear,' defined as a motorised stuffed toy.
'It's a sort of memory trick,' Ranganath said.
When volunteers memorised word pairs as a compound word, the perirhinal cortex lit up, and this activity predicted whether the volunteers would be able to successfully remember the pairs in the future. The results suggest that the perirhinal cortex probably can form simple associations, such as between the parts of a complex object. This information is probably passed up to the hippocampus, which may create more complex memories, such as the place and time a specific object was seen.

A PIECE OF MY MIND: Laurence Llewelyn-Bowen

2008-09-06T12:28:00.000-07:00

GARDENING ON TELEVISION tends to be presented as a corduroy sort of thing: a baggy jumper with holes in the elbows, something that happens in a potting shed. My new show may be the first time gardens have been shown as the high-end, high-fashion design destinations they truly are.
TV CREPT UP ON ME SNEAKILY. Jackie, my wife, was one of the first wedding organisers in Britain and was doing an enormous amount of television 15 years ago. Her agent was approached by the BBC to see if he knew any interior designers and I was rather pushed forward for it. Even when they rang to say I'd got the job despite my ridiculous name, stupid way of dressing and terrible haughtiness, I still never saw it as a day job.
I'VE ALWAYS DRESSED TO SUIT myself. It's not about fashion or dressing to be noticed. I'm in my mid-40s and a country squire, so there's a lot of tweedage and a lot of suitage. I don't wear shellsuits, I don't wear shorts and I've got one pair of flip flops which only come out in irony.

THE LIST OF NAMES MY MOTHER wanted to call me included Sebastian and Lancelot. I think Laurence was a good compromise.
JACKIE AND I LIVE IN A VERY "us" way. We don't compromise, so our children have always been part of our slipstream. Both girls have always been delighted to float round the world with us or do a shoot for OK! at home.
AN ENORMOUS AMOUNT OF psychology is involved in interiors. All those years on Changing Rooms has really helped me in my career. I've had to do rooms for some really kooky people on TV and when you're faced with a real-life person that experience is invaluable.
I ONCE DID THROUGH THE KEYHOLE and David Frost, who I suspected of being not entirely sober, said "and all your friends call you Larry". I was slightly in awe of him and didn't feel his mind was currently quick enough to cope with the fact people didn't call me Larry, so I just nodded. But no-one has ever called me Larry.
JACKIE AND I GOT TO THE £1 million question in Celebrity Who Wants To Be A Millionaire in 2006, which was: "Translated from the Latin, what is the motto for the United States of America?" When "In God We Trust" came out there was a big ripple around the audience, but the answer they were looking for was "Out of Many, One." The US embassy got involved and said In God We Trust and E Pluribus Unum were both mottos, so we had to go back and re-record the ending.
IT SUITS ME NOT TO HAVE AMBITION or a list of life goals. Life is something which is best surfed rather than trying to be a complete Canute about it and suggesting that the tide will do what you want it to do.
SOMEONE TOLD ME ONCE YOU should never wear brown shoes with a blue suit. They were right.
WHEN I EXPECT A DAY OF national mourning. Television screens will go black, they'll muffle the hooves of the carriage horses, and there'll be women crying into black-bordered lace handkerchiefs wearing large, powdered wigs. To be honest, I've decided not to die this time - it's too inconvenient.
Laurence Llewelyn-Bowen presents the four-part series I Own Britain's Best Home And Garden, on Five
Interview by Paul Dalgarno