Following are the latest news and information resources for the various anxiety topics that we cover. We hope you will find the news educational and the links in the resources section useful in helping you to get even more in-depth data.
When trouble approaches, what do you do? Run for the hills? Hide? Pretend it isn’t there? Or do you focus on the promise of rain in those looming dark clouds?
New research suggests that the way you regulate your emotions, in bad times and in good, can influence whether – or how much – you suffer from anxiety.
In a series of questionnaires, researchers asked 179 healthy men and women how they managed their emotions and how anxious they felt in various situations. The team analyzed the results to see if different emotional strategies were associated with more or less anxiety.
The study revealed that those who engage in an emotional regulation strategy called reappraisal tended to also have less social anxiety and less anxiety in general than those who avoid expressing their feelings. Reappraisal involves looking at a problem in a new way, said University of Illinois graduate student Nicole Llewellyn, who led the research with psychology professor Florin Dolcos, an affiliate of the Beckman Institute at Illinois.
“When something happens, you think about it in a more positive light, a glass half full instead of half empty,” Llewellyn said. “You sort of reframe and reappraise what’s happened and think what are the positives about this? What are the ways I can look at this and think of it as a stimulating challenge rather than a problem?”
Study participants who regularly used this approach reported less severe anxiety than those who tended to suppress their emotions.
Anxiety disorders are a major public health problem in the U.S. According to the National Institute of Mental Health, roughly 18 percent of the U.S. adult population is afflicted with general or social anxiety that is so intense that it warrants a diagnosis.
“The World Health Organization predicts that by 2020, anxiety and depression – which tend to co-occur – will be among the most prevalent causes of disability worldwide, secondary only to cardiovascular disease,” Dolcos said. “So it’s associated with big costs.”
Not all anxiety is bad, however, he said. Low-level anxiety may help you maintain the kind of focus that gets things done. Suppressing or putting a lid on your emotions also can be a good strategy in a short-term situation, such as when your boss yells at you, Dolcos said. Similarly, an always-positive attitude can be dangerous, causing a person to ignore health problems, for example, or to engage in risky behavior.
Previous studies had found that people who were temperamentally inclined to focus on making good things happen were less likely to suffer from anxiety than those who focused on preventing bad things from happening, Llewellyn said. But she could find no earlier research that explained how this difference in focus translated to behaviors that people could change. The new study appears to explain the strategies that contribute to a person having more or less anxiety, she said.
“This is something you can change,” she said. “You can’t do much to affect the genetic or environmental factors that contribute to anxiety. But you can change your emotion regulation strategies.”
The research team also included postdoctoral researcher Sanda Dolcos, graduate student Alexandru Iordan and psychology professor Karen Rudolph.Read article >>
A world-first completed clinical study by an Australian team has found Kava, a medicinal South Pacific plant, significantly reduced the symptoms of people suffering anxiety.
The study, led by the University of Melbourne and published in the Journal of Clinical Psychopharmacology, revealed Kava could be an alternative treatment to pharmaceutical products for the hundreds of thousands of Australians who suffer from Generalised Anxiety Disorders (GAD)
Lead researcher, Dr Jerome Sarris from Department of Psychiatry at the University of Melbourne, said GAD is a complex condition that significantly affected people’s day-today lives. Existing medications have a modest clinical effect and new effective options were needed for patients with anxiety.
“Based on previous work we have recognised that plant based medicines may be a viable treatment for patients with chronic anxiety. In this study we've been able to show that Kava offers a potential natural alternative for the treatment of chronic clinical anxiety. Unlike some other options it has less risk of dependency and less potential for side effects,” he said.
The study also found that people’s genetic differences (polymorphisms) of certain neurobiological mechanisms called GABA transporters, may modify their response to Kava.
“If this finding is replicated, it may pave the way for simple genetic tests to determine which people may be likely to have a beneficial anxiety-reducing effect from taking Kava,” Dr Sarris said.
During the eight-week study, 75 patients with clinically diagnosed Generalised Anxiety Disorder were given Kava or placebo, and anxiety levels were regularly assessed.
Results showed a significant reduction in anxiety for the Kava group compared to the placebo group at the end of the study.
In participants diagnosed with moderate to severe GAD, Kava had an even greater effect in reducing anxiety. Following the completion of the controlled phase, 26 per cent of the Kava group were classified as in remission from their symptoms compared to six per cent of the placebo group.
Participants in the Kava group were given tablets twice per day consisting of water-soluble extracted Kava (peeled rootstock) for a total dose of 120mg of kavalactones for the first three-week controlled phase. In cases of non-response this was increased to a double-dose twice per day for the second three-week controlled phase. Participants in the placebo group took matching dummy tablets in the same manner.
Kava was also well tolerated. Results showed no significant differences across the two groups for liver function which had previously been a concern for Kava’s medicinal use. In addition there were no considerable adverse reactions that could be attributed to Kava and no difference in withdrawal or addiction between the groups.
An additional novel finding of the study, recently published in Phytotherapy Research was that Kava increased women’s sex drive compared to those in the placebo group, believed to be due to the reduction of anxiety, rather than any aphrodisiac effect.
Future studies confirming the genetic relationship to therapeutic response, and any libido-improving effects from Kava is now required. Dr Sarris said these significant findings are of importance to sufferers of anxiety and to the South Pacific region which relies on Kava as a major export.
The study was funded by the NHMRC and Integria Healthcare who manufacture MediHerb and Thompson’s Kava products.Read article >>
People provided with a real-time readout of activity in specific regions of their brains can learn to control that activity and lessen their anxiety, according to new findings published online in the journal Translational Psychiatry.
Using functional magnetic resonance imaging (fMRI), Yale researchers displayed the activity of the orbitofrontal cortex, a brain region just above the eyes, to subjects while they lay in a brain scanner.
Through a process of trial and error, these subjects were gradually able to learn to control their brain activity. This led both to changes in brain connectivity and to increased control over anxiety. These changes were still present several days after the training.
Extreme anxiety associated with worries about dirt and germs is characteristic of many patients with obsessive-compulsive disorder (OCD). Hyperactivity in the orbitofrontal cortex is seen in many of these individuals.
fMRI-driven neurofeedback has been used before in a few contexts, but it has never been applied to the treatment of anxiety. The findings raise the possibility that real-time fMRI feedback may provide a novel and effective form of treatment for OCD.
Michelle Hampson, assistant professor of diagnostic radiology, is senior author. Dustin Scheinost, a graduate student in the Yale School of Engineering & Applied Science, is lead author. Other Yale authors include Teodora Stoica, John Saksa, Xenophon Papademetris, R. Todd Constable, and Christopher Pittenger.Read article >>
It's no secret that stress increases your susceptibility to health problems, and it also impacts your ability to solve problems and be creative. But methods to prevent associated risks and effects have been less clear — until now.
Published in PLOS ONE, new research from Carnegie Mellon University provides the first evidence that self-affirmation can protect against the damaging effects of stress on problem-solving performance. Understanding that self-affirmation — the process of identifying and focusing on one's most important values - boosts stressed individuals' problem-solving abilities will help guide future research and the development of educational interventions.
"An emerging set of published studies suggest that a brief self-affirmation activity at the beginning of a school term can boost academic grade-point averages in underperforming kids at the end of the semester. This new work suggests a mechanism for these studies, showing self-affirmation effects on actual problem-solving performance under pressure," said J. David Creswell, assistant professor of psychology in CMU's Dietrich College of Humanities and Social Sciences.
Because previous research indicated that self-affirmation may be an effective stress management approach, Creswell and his research team had college students rank-order a set of values (e.g., art, business, family and friends) in terms of their personal importance, and indicate their levels of chronic stress. Participants randomly assigned to a self-affirmation condition were asked to write a couple of sentences about why their number one ranked value was important (a standard self-affirmation exercise). All participants then had to complete a challenging problem-solving task under time pressure, which required creativity in order to generate correct solutions.
The results showed that participants who were under high levels of chronic stress during the past month had impaired problem-solving performance. In fact, they solved about 50 percent fewer problems in the task. But notably, this effect was qualified by whether participants had an opportunity to first complete the self-affirmation activity. Specifically, a brief self-affirmation was effective in eliminating the deleterious effects of chronic stress on problem-solving performance, such that chronically stressed self-affirmed participants performed under pressure at the same level as participants with low chronic stress levels.
"People under high stress can foster better problem-solving simply by taking a moment beforehand to think about something that is important to them," Creswell said. "It's an easy-to-use and portable strategy you can roll out before you enter that high pressure performance situation."
In addition to Creswell, the research team consisted of Janine M. Dutcher, who participated as a Carnegie Mellon undergraduate student and is now at UCLA; William M. P. Klein of the National Cancer Institute; Peter R. Harris of the University of Sheffield; and John M. Levine of the University of Pittsburgh. National Science Foundation and the Pittsburgh Life Sciences Greenhouse Opportunity Fund supported this research.Read article >>
Dr. Shawn Talbott presented a new study on Relora(R) at the Experimental Biology 2013 Meeting. The study, conducted by Supplement Watch/GLH Nutrition, found that a proprietary blend of Magnolia officinalis and Phellodendron amurense significantly improved mood and other psychological states in moderately stressed subjects.
The study randomly assigned 60 subjects (56 of whom successfully completed the study) experiencing moderate levels of perceived psychological stress to take Relora or a placebo twice a day for four weeks, a time period selected to minimize the influence of short-term mood changes that result from daily stressors. All subjects submitted three saliva samples (morning, mid-day and evening) for cortisol testing and completed a baseline Profile of Mood States questionnaire (POMS) on the first and last day of the study.
The results indicated that daily use of Relora reduced cortisol exposure and perceived stress while improving a variety of mood parameters -- most significantly, anger (reduced by 42%) and fatigue (reduced by 31%).
"These are exciting results that suggest Relora may be an effective natural approach to managing the detrimental effects of chronic stress without the tranquilizing side effects of pharmaceutical agents", said Research Director, Shawn Talbott, PhD.
Other indicators measured in the study include overall stress (reduced by 11%), tension (reduced by 13%), depression (reduced by 20%) and confusion (reduced by 27%). Salivary cortisol exposure decreased by 18%. No adverse side effects were reported.
Relora (US Patent No. 6,582,735) is a blend of Magnolia officinalis and Phellodendron amurense. These botanicals have been used in Traditional Chinese Medicine for thousands of years. In the West, they have been recognized for treating stress. When compared to prescription drugs, Honokiol and Berberine, two of the active constituents in Relora, appear effective at calming stress without sedative side effects.
Experimental Biology 2013 is a multidisciplinary, scientific annual meeting of approximately 14,000 scientists and exhibitors along with six sponsoring societies and 30 guest societies. General fields of study that attend Experimental Biology include anatomy, physiology, pathology, biochemistry, nutrition, and pharmacology.
Relora is a product of Next Pharmaceuticals and is widely used as an ingredient in stress and weight management categories throughout the dietary supplement industry.Read article >>
You're on a stage, lights hot and glaring, watching the large audience you’ll soon be addressing file in. How is your body reacting?
You’re most likely jittery, your heart pounding through your rib cage and your breath quickening. Your legs may very well be able to run a marathon at this moment. And—oh great—your mouth just became super dry.
These reactions are not exactly conducive to standing in place and addressing a crowd, right? You’re not alone. Fear of public speaking, or glossophobia, is estimated to affect 75 percent of adults.
But such reactions, as it turns out, are the body’s natural way of helping us cope with stressful situations. According to a new study published in Clinical Psychological Science, rethinking the way we perceive stress may actually improve our physical and mental performance.
In the study, 73 adults, half of whom met the diagnostic criteria for social anxiety disorder, underwent the Trier Social Stress Test. Designed to induce stress in a socially-evaluative situation; the test gives participants three minutes to prepare a five-minute speech about their strengths and weaknesses to two judges. Immediately following the speech, subjects must count backwards by sevens beginning with the number 996.
Before beginning the test, half of the participants were randomly assigned to read information regarding the evolutionary advantages of the body’s stress response. Specifically, they were informed that “the increase in arousal [they] may feel during stress is not harmful,” and that they should “reinterpret [their] bodily signals during the upcoming public speaking task as beneficial.” They also read summaries of three psychological studies that evaluated the benefits of stress.
The other half of the participants did not undergo this “anxiety preparation” task.
Purposely, the judges provided negative, non-verbal feedback throughout the speeches by head-shaking, stone-faced expressions, and tapping annoyingly on their clipboards. If the participant made a mistake, the judge instructed them to start over.
Before, during, and after the stress test, cardiovascular measures of heart rate and blood pressure were assessed in all participants.
Participants who did not undergo anxiety preparation showed a much greater cardiovascular stress response. The group that went into the stress test informed about the benefits of stress, on the other hand, reported feeling that they had more resources to cope with public speaking.
Jeremy Jamieson, lead author of the study and assistant professor of psychology at University of Rochester, says that his work “shares the underlying concept that if you can alter cognitive factors, you can alter downstream outcomes.”
“Feelings of arousal, like sweaty palms or a racing heart that are typically construed negatively can instead be viewed as tools to help cope with acute stress,” he says.
Interestingly, despite greater fear of public speaking, individuals with social anxiety disorder did not show more physiological arousal than their non-anxious peers.
The authors conclude that our experiences of short-term stress are shaped by how we interpret our body. “Viewing one’s biological responses as beneficial will increased the ratio of perceived resources versus task demands,” says Jamieson. “Our reappraisal instructions focus on educating individuals that stress is an adaptive response.”
So the next time you feel the jitters of public speaking overtaking you, remind yourself that the human body is designed to help us cope with this stress, despite our trembling legs and dry mouths.
Above all, be grateful—this ability likely evolved when our ancestors had to outrun predators, not give speeches!Read article >>
Research to be published in the May issue of the Journal of Psychopharmacology has found cocoa polyphenols have a positive impact on mood in healthy individuals.
“To our knowledge, this is the first randomized, controlled trial to substantiate the effects of cocoa polyphenols on positive mood states in a non-clinical sample,” Matthew P. Pase of Swinburne University in Australia and his colleagues wrote in their study.
“Future research is needed to investigate whether cocoa polyphenols can ameliorate the symptoms associated with clinical anxiety or depression.”
The group of compounds are found naturally in the cocoa bean, the main constituent of dark chocolate. Many people believe consuming dark chocolate reduces anxiety and some research has even found that dark chocolate could improve mental functioning.
In the study of 72 healthy men and women aged 40–65 years, those who consumed a large amount of cocoa polyphenols in the form of a dark chocolate drink mix reported greater calmness and contentedness than those who consumed a chocolate drink mix that lacked polyphenols. The participants in the study maintained a relatively strict diet for 30 days to avoid consuming additional polyphenols.
The researchers failed to find any evidence that cocoa polyphenols significantly improved cognitive performance. Additionally, only those who consumed the highest amount of polyphenols (500 mg per day) reported any significant positive effects. Participants who consumed a moderate amount (250 mg per day) reported no significant effects.
Previous research suggests that cocoa polyphenols produce anti-anxiety effects by interacting with GABA receptors in the brain, Pase and his colleagues explained.
“Given the known actions of polyphenols on GABAa receptors, further human clinical trials are needed to substantiate the effects of cocoa polyphenols on anxiety and calmness.”Read article >>
“You always think about stress as a really bad thing, but it’s not,” said Daniela Kaufer, associate professor of integrative biology at the University of California, Berkeley. “Some amounts of stress are good to push you just to the level of optimal alertness, behavioral and cognitive performance.”
New research by Kaufer and UC Berkeley post-doctoral fellow Elizabeth Kirby has uncovered exactly how acute stress – short-lived, not chronic – primes the brain for improved performance.
In studies on rats, they found that significant, but brief stressful events caused stem cells in their brains to proliferate into new nerve cells that, when mature two weeks later, improved the rats’ mental performance.
“I think intermittent stressful events are probably what keeps the brain more alert, and you perform better when you are alert,” she said.
Kaufer, Kirby and their colleagues in UC Berkeley’s Helen Wills Neuroscience Institute describe their results in a paper published April 16 in the new open access online journal eLife.
The UC Berkeley researchers’ findings, “in general, reinforce the notion that stress hormones help an animal adapt – after all, remembering the place where something stressful happened is beneficial to deal with future situations in the same place,” said Bruce McEwen, head of the Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology at The Rockefeller University, who was not involved in the study.
Kaufer is especially interested in how both acute and chronic stress affect memory, and since the brain’s hippocampus is critical to memory, she and her colleagues focused on the effects of stress on neural stem cells in the hippocampus of the adult rat brain. Neural stem cells are a sort of generic or progenitor brain cell that, depending on chemical triggers, can mature into neurons, astrocytes or other cells in the brain. The dentate gyrus of the hippocampus is one of only two areas in the brain that generate new brain cells in adults, and is highly sensitive to glucocorticoid stress hormones, Kaufer said.
Much research has demonstrated that chronic stress elevates levels of glucocorticoid stress hormones, which suppresses the production of new neurons in the hippocampus, impairing memory. This is in addition to the effect that chronically elevated levels of stress hormones have on the entire body, such as increasing the risk of chronic obesity, heart disease and depression.
Less is known about the effects of acute stress, Kaufer said, and studies have been conflicting.
To clear up the confusion, Kirby subjected rats to what, to them, is acute but short-lived stress – immobilization in their cages for a few hours. This led to stress hormone (corticosterone) levels as high as those from chronic stress, though for only a few hours. The stress doubled the proliferation of new brain cells in the hippocampus, specifically in the dorsal dentate gyrus.
Kirby discovered that the stressed rats performed better on a memory test two weeks after the stressful event, but not two days after the event. Using special cell labeling techniques, the researchers established that the new nerve cells triggered by the acute stress were the same ones involved in learning new tasks two weeks later.
“In terms of survival, the nerve cell proliferation doesn’t help you immediately after the stress, because it takes time for the cells to become mature, functioning neurons,” Kaufer said. “But in the natural environment, where acute stress happens on a regular basis, it will keep the animal more alert, more attuned to the environment and to what actually is a threat or not a threat.”
They also found that nerve cell proliferation after acute stress was triggered by the release of a protein, fibroblast growth factor 2 (FGF2), by astrocytes — brain cells formerly thought of as support cells, but that now appear to play a more critical role in regulating neurons.
“The FGF2 involvement is interesting, because FGF2 deficiency is associated with depressive-like behaviors in animals and is linked to depression in humans,” McEwen said.
Kaufer noted that exposure to acute, intense stress can sometimes be harmful, leading, for example, to post-traumatic stress disorder. Further research could help to identify the factors that determine whether a response to stress is good or bad.
“I think the ultimate message is an optimistic one,” she concluded. “Stress can be something that makes you better, but it is a question of how much, how long and how you interpret or perceive it.”Read article >>
University of British Columbia researchers have found a new potential use for the over-the-counter pain drug Tylenol. Typically known to relieve physical pain, the study suggests the drug may also reduce the psychological effects of fear and anxiety over the human condition, or existential dread.
Published in the Association for Psychological Science journal Psychological Science, the study advances our understanding of how the human brain processes different kinds of pain.
“Pain exists in many forms, including the distress that people feel when exposed to thoughts of existential uncertainty and death,” says lead author Daniel Randles, UBC Dept. of Psychology. “Our study suggests these anxieties may be processed as ‘pain’ by the brain – but Tylenol seems to inhibit the signal telling the brain that something is wrong.”
The study builds on recent American research that found acetaminophen – the generic form of Tylenol – can successfully reduce the non-physical pain of being ostracized from friends. The UBC team sought to determine whether the drug had similar effects on other unpleasant experiences – in this case, existential dread.
In the study, participants took acetaminophen or a placebo while performing tasks designed to evoke this kind of anxiety – including writing about death or watching a surreal David Lynch video – and then assign fines to different types of crimes, including public rioting and prostitution.
Compared to a placebo group, the researchers found the people taking acetaminophen were significantly more lenient in judging the acts of the criminals and rioters – and better able to cope with troubling ideas. The results suggest that participants’ existential suffering was “treated” by the headache drug.
“That a drug used primarily to alleviate headaches may also numb people to the worry of thoughts of their deaths, or to the uneasiness of watching a surrealist film – is a surprising and very interesting finding,” says Randles, a PhD candidate who authored the study with Prof. Steve Heine and Nathan Santos.
While the findings suggest that acetaminophen can help to reduce anxiety, the researchers caution that further research – and clinical trials – must occur before acetaminophen should be considered a safe or effective treatment for anxiety.Read article >>
Key Findings: Getting stressed by everyday irritations can cause mental health problems a decade later. Researchers also warn that the cumulative effect of getting annoyed at small things every day is damaging.
As most of us know only too well, even at the best of times traffic jams are just plain infuriating. But being stuck in one queue or traffic jam too many could spark more than simply a foul mood – it can lead to severe mental disorder, a study claims.
Everyday irritations such as waiting in traffic can build up over time and cause mental problems later in life, psychologists found. And learning to keep a cool head in the face of modern life’s daily stresses is as essential as a healthy diet and an exercise routine, they said.
Susan Charles, a professor of psychology and social behavior, led the study to find out whether everyday irritations add up to make the straw that breaks the camel’s back, or whether they make us stronger. Using data from two national surveys, researchers found negative responses to daily stresses such as arguments with a partner, conflicts at work, standing in long queues or sitting in traffic led to psychological distress or anxiety and mood disorders ten years later.
The results, based on data from the Midlife Development in the United States project and the National Study of Daily Experiences, from men and women aged 25 and 74, show mental health problems are not affected by just major life events, but also by seemingly minor emotional experiences.
The findings echo the premise of the 1993 Michael Douglas film Falling Down, in which his character ‘snaps’ while waiting in LA traffic.
Speaking of the findings, published in the journal Psychological Science, Professor Charles said: ‘How we manage daily emotions matters to our overall mental health.
‘We’re so focused on long-term goals that we don’t see the importance of regulating our emotions. Changing how you respond to stress and how you think about stressful situations is as important as maintaining a healthy diet and exercise routine.'
‘It’s important not to let everyday problems ruin your moments. After all, moments add up to days, and days add up to years.’
Professor Charles, of the University of California, Irvine, added: ‘Unfortunately, people don’t see mental health problems as such until they become so severe that they require professional attention.”Read article >>
University of Edinburgh researchers may have uncovered how maternal stress during pregnancy contributes to a baby's future risk of mood disorders.
The stress hormone cortisol seems to play a key role, affecting gene expression and tissue development of other stress hormones, or glucocorticoids, which can harm the baby.
Using genetically modified mice, researchers, found that absence of an enzyme called 11ß-HSD2 (11beta-hydroxysteroid dehydrogenase type 2), which is present in the placenta and the fetal brain, caused reduced fetal growth and mood disorders later.
On the other hand, she found that 11ß-HSD2 can make cortisol inactive and help protect the baby.
The researchers say no firm conclusions can be drawn and more studies are needed. However, they hope this study will make healthcare workers more aware that children in adverse environments need closer monitoring and treatment to prevent future health problems like mood disorders.Read article >>
Minocycline, an older, broad-spectrum antibiotic in the tetracycline family, provides meaningful improvements as a therapeutic for children with fragile X syndrome, a study by researchers at the UC Davis MIND Institute has found. The finding is important, the researchers said, because minocycline is readily available by prescription.
After three months of treatment with minocycline, children with fragile X syndrome had greater improvements in general behavior, anxiety and mood-related behaviors, when compared with children with fragile X syndrome who received placebo rather than the medication. The study was led by Mary Jacena Leigh, associate clinical professor of behavioral and developmental pediatrics with the Fragile X Research and Treatment Center at the MIND Institute.
“This study provides evidence of the efficacy of this medication as a targeted treatment for fragile X syndrome with a long history of use and that can currently be prescribed,” Leigh said. “Further studies examining the long-term benefits and side effects are needed, perhaps in combination with other educational and medication treatments being developed for individuals with the condition.”
The research is published online today in the Journal of Developmental and Behavioral Pediatrics, the journal of the Society for Developmental and Behavioral Pediatrics.
Fragile X syndrome is the most common inherited cause of intellectual impairment, formerly termed mental retardation, and is the leading known single-gene cause of autism spectrum disorder. The United States Centers for Disease Control and Prevention estimates that about 1 in 4,000 males and females have the disorder. The condition is caused by a mutation in a single gene, FMR1, found on the X chromosome.
For the current study, 66 children with fragile X syndrome were randomly assigned to three months of treatment with minocycline or an inactive placebo. After three months, the study participants were switched to the other treatment. Parents and doctors did not know which treatment the child received until completion of the study.
Fifty-five patients completed the study. The children had small but significant improvements in certain areas during treatment with minocycline, compared to placebo. In particular, they scored better on the Clinical Global Impression Scale, on which doctors and parents rated their overall impression of the patients' status.
Children taking minocycline also had greater improvement in anxiety and mood-related behaviors, as rated by parents. Other outcomes were not significantly better with minocycline, including behavior problems and verbal functioning.
Side effects were generally similar between groups, with no serious adverse effects. Minocycline may cause some discoloration of the teeth — a known side effect of minocycline and related antibiotics — which was seen in both treatment arms.
“Some children responded very well to minocycline; others did not, so we now are studying biomarkers that can help us determine who will be a responder," said Randi Hagerman, MIND Institute medical director and the study's senior author.
Minocycline is an older antibiotic and most commonly is used for treatment of severe acne. Studies in animal models and initial studies in humans have suggested that it might have beneficial effects in the treatment of fragile X. It also has been studied as a potential neuroprotective treatment for other conditions, such as multiple sclerosis.
Other treatments for the condition now under investigation include a class of drugs called mGluR5 agonists and GABA agonists, such as ganaxolone or arbaclofen, which also are studied at the MIND Institute. However, minocycline is the only targeted fragile X treatment currently available by prescription. Because of its long history of use, the side effects and safety characteristics of minocycline are well known.
The study was funded by the National Fragile X Foundation, grant UL1 TR000002 from the National Center for Advancing Translational Sciences (Nguyen), Interdisciplinary Training for Autism Researchers 5T32MH073124 (Leigh), A Toolbox of Outcome Measures for Targeted Treatment Trials in Children 3UL1 RR024146-04S4, and the Fragile X Research Center Grant HD02274.Read article >>
Fear of public speaking tops death and spiders as the nation's number one phobia. But new research shows that learning to rethink the way we view our shaky hands, pounding heart, and sweaty palms can help people perform better both mentally and physically.
Before a stressful speaking task, simply encouraging people to reframe the meaning of these signs of stress as natural and helpful was a surprisingly effective way of handling stage fright, found the study to be published online April 8 in Clinical Psychological Science.
"The problem is that we think all stress is bad," explains Jeremy Jamieson, the lead author on the study and an assistant professor of psychology at the University of Rochester. "We see headlines about 'Killer Stress' and talk about being 'stressed out.'" Before speaking in public, people often interpret stress sensations, like butterflies in the stomach, as a warning that something bad is about to happen, he says.
"But those feelings just mean that our body is preparing to address a demanding situation," explains Jamieson. "The body is marshaling resources, pumping more blood to our major muscle groups and delivering more oxygen to our brains." Our body's reaction to social stress is the same flight or fight response we produce when confronting physical danger. These physiological responses help us perform, whether we're facing a bear in the forest or a critical audience.
For many people, especially those suffering from social anxiety disorder, the natural uneasiness experienced before giving a speech can quickly tip over into panic. "If we think we can't cope with stress, we will experience threat. When threatened, the body enacts changes to concentrate blood in the core and restricts flow to the arms, legs, and brain," he explains. So, "cold feet" is a real physiological response to threat, not just a colorful expression.
"Lots of current advice for anxious people focuses on learning to 'relax,'—you know, deep, even breathing and similar tips," says Jamieson. Such calming techniques, write the authors, may be helpful in situations that do not require peak performance. But when gearing up for a high-stakes exam, a job interview, or, yes, a speaking engagement, reframing how we think about stress may be a better strategy.
Then how can people reap the benefits of being stressed without being overwhelmed by dread? To answer that question, Jamieson and co-authors Matthew Nock, of Harvard University and Wendy Berry Mendes of the University of California in San Francisco, turned to the Trier Social Stress Test. Developed in 1993 by Clemens Kirschbaum and colleagues, this experiment relies on fear of public speaking and has become one of the most reliable laboratory methods for eliciting threat responses.
In the study, 69 adults were asked to give a five-minute talk about their strengths and weaknesses with only three minutes to prepare. Roughly half of the participants had a history of social anxiety and all participants were randomly assigned to two groups. The first group was presented information about the advantages of the body's stress response and encouraged to "reinterpret your bodily signals during the upcoming public speaking task as beneficial." That group also was asked to read summaries of three psychology studies that showed the benefits of stress. The second group received no information about reframing stress.
Participants delivered their speech to two judges. On purpose, the judges provided negative nonverbal feedback throughout the entire five-minute presentations, shaking their heads in disapproval, tapping on their clipboards, and staring stone-faced ahead. If study subjects ran out of things to say, the judges insisted that they continue speaking for the full five minutes. Following the speech, participants were asked to count backwards for five minutes in steps of seven beginning with the number 996. The evaluators again provided negative feedback throughout and insisted that participants start over if they made any mistakes.
Confronted with scowling judges, participants who received no stress preparation experienced a threat response, as captured by cardiovascular measures. But the group that was prepped about the benefits of stress weathered the trial better. That group reported feeling that they had more resources to cope with the public speaking task and, perhaps more tellingly, their physiological responses confirmed those perceptions. The prepped group pumped more blood through the body per minute compared to the group that did not receive instruction.
Surprisingly, this study also found that individuals who suffer from social anxiety disorder actually experienced no greater increase in physiological arousal while under scrutiny than their non-anxious counterparts, despite reporting more intense feelings of apprehension. This disconnect, argue the authors, supports the theory that our experience of acute or short-term stress is shaped by how we interpret physical cues. "We construct our own emotions," says Jamieson.Read article >>
Stage fright is the bane of the performer's existence. Severe anxiety has interfered with the work of classical musicians, including guitarist Andres Segovia, cellist Pablo Casals and pianists Glenn Gould and Van Cliburn. Pop performers — from Barbra Streisand and Andrea Bocelli to Carly Simon and Rod Stewart — have suffered intensely from it.
The traditional treatment is a quick swig of beverage alcohol, taken as needed, but that has obvious risks. Today, the possibilities include Valium, hypnotherapy, cognitive behavioral therapy, meditation, and, especially, the class of drugs known as beta blockers, widely known as "the musician's underground drug," or "better living through chemistry."
Beta blockers such as propranolol (often referred to by a brand name, Inderal) are used to treat everything from hypertension to heart attacks to tension headaches. They slow the heart rate, fight off stress hormones and restrain the amygdala, the part of the brain that controls emotion.
That, in turn, calms the fight-or-flight reaction that can make heartbeats race, palms go sweaty, and minds go blank. It can make a nervous musician calm in an audition, or make a difficult solo go more smoothly. A 10 milligram dose (a typical prescription for high blood pressure is 40 milligrams) will keep its taker calm for four to five hours.
A 1987 study by the International Conference of Orchestra Musicians indicated that 27 percent of its polled members said they used beta blockers. In more recent surveys, more than half of professional musicians and music teachers have reported using them. The figures are thought to be higher among conservatory students.
Their use is not without a degree of controversy — they're illegal for Olympians, although use for stage fright is medically approved — and many people who use blockers decline to go on the record about them. A spokeswoman for the Juilliard School responded to a request for comments with a curt, "We're going to pass on that story."
There is disagreement among musicians concerning their use. To St. Louis Symphony Orchestra principal horn Roger Kaza, taking beta blockers for performance anxiety is the equivalent of taking aspirin for a headache. To retired SLSO violinist Darwyn Apple, they give the performer who takes them an unfair advantage over others. To some observers, they can make a performance dull.
A recent Facebook discussion about their use between present and former members of the SLSO grew heated; only two participants responded to requests for interviews on the subject. Although anecdotal evidence suggests that their use is commonplace, some who had been previously open about them clammed up when asked directly.
Kaza plays an instrument known for humbling performers; he takes beta blockers as needed, for auditions, recitals and some orchestral performances "if it's certain repertoire that I know will be a little more anxiety-producing," he said.
Kaza, like others, stressed that the use of beta blockers should not be equated with performance-enhancing drugs, many of them dangerous to the user, such as the steroids, hormones and blood doping used by some athletes to make them stronger or faster.
Those "have nothing to do with the drugs performers take," he said. "Beta blockers are more in the vein of medical impairment/treatment. Think headache/aspirin, sniffles/antihistamine, performance anxiety/beta blockers. It's funny that some people are ashamed of it. If you were against all medicine — if you were a Christian Scientist — that would be one thing, but if you take medications for other things, I don't see the problem."
Fight-or-flight is, he noted, "hardwired" into mammals through eons of evolution. "It clearly has a survival advantage and thus is passed on in the gene pool," Kaza said. Musicians at all levels have a lot on the line when they perform, from earning a living to the satisfaction of doing their best. Fear and anxiety can get in the way of that.
"We're nervous because we're comparing ourselves with a CD that's perfect," he said. "It's an impossible situation."
Apple strongly disagrees. "The playing field is not level," he said of when some performers have what he calls a chemical advantage. "I practiced. I prepared. You have to be balanced and grounded to withstand the unfair competition."
He thinks the use of beta blockers changes more than stage fright. "I can pretty much tell who's used them. There's a whole different sense of energy that comes from them when they're ready to perform that seems really artificial. There's a distance. It's a whole different zone that I don't want to be in."
Instead, said Apple, "I use the adrenaline. There's no holding back. The music is a powerful force, and I don't think it should be corrupted by the use of drugs. Nobody seems to care in the performance industry; the only thing that seems to matter is cranking out the right notes in the right place. But a slip of the fingers does not destroy the artistry and full impact of a piece if you're a performer who's been properly trained."
Kenneth Rybicki, an internist and clinical instructor at Washington University School of Medicine, has prescribed beta blockers for musicians, usually at their specific request.
"My experience is that, for most of them, it's just for once in a while, if they really need something to calm things down," Rybicki said. "But if somebody said to me, Every time we rehearse I get nervous,' I would see if there are any other underlying causes."
Like most of those interviewed for this story, Rybicki stressed the importance of using beta blockers under a doctor's supervision. They can have side effects from sleepiness to diabetes, nightmares and bronchial constriction, and can be fatal for asthmatics.
Dr. Randi Mozenter, a clinical psychologist at Barnes-Jewish HealthCare, deals regularly with musicians and performance anxiety. She doesn't think using blockers is an issue. "It's an individual decision between the person and their physician," she said.
"When people are in situations which are anxiety-provoking, they get the same physiological reaction that they would if they were facing a bear in the woods. It is a very striking response, with sweating, rapid heartbeat, coldness in the extremities. The brain shifts to reacting instead of problem-solving; there can be feelings of impending doom. People end up in emergency rooms every day for (anxiety), thinking they're having a life-ending event."Read article >>