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Mental Health News

Following are the latest news and information resources for the various mental health 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.

Eating Disorders Becoming A Reality For Women In Midlife

Eating disorders have long been considered a disease that affects young women and adolescents, but experts say women in midlife are increasingly vulnerable to the tangled and potentially fatal scourge.

"Women with midlife eating disorders have been invisible sufferers, but it's a problem we're seeing more than ever," says Adrienne Ressler, a specialist at The Renfrew Center, a residential facility with 16 national locations designed to treat anorexia nervosa, bulimia nervosa, binge eating disorder and related mental health problems. "Eating disorders were categorized early on as a problem affecting affluent, Caucasian adolescents, and it's been difficult to break through that myth. But the numbers are definitely changing."

"In 2001, 10 percent of our residential population was made up of women age 35 and above," Ressler said. "By 2003, 26 percent were midlife and older."

The National Eating Disorders Association says one-third of inpatient admissions to specialized eating disorder centers are for those 30 or older.

The jump is due, in part, to women's increased willingness to seek help, Ressler says. But it also speaks to unrealistic beauty standards that are intensifying, rather than diminishing, as women reach midlife.

"The pressure to be thin and have a perfect body becomes stronger than ever," Ressler says. "Meanwhile, the older you get, the farther and farther removed you become from whatever the current standard of beauty is."

Combine that with common midlife stressors — teenagers, college costs, career transitions, marital dissatisfaction, aging parents — and you've got an environment ripe for a disease that is largely triggered by anxiety, Ressler says.

"Midlife eating disorders can be part of a chronic illness they've had their entire lives," she says. "Maybe they've been dealing with chronic anxiety or depression and an eating disorder gets revived or triggered by specific midlife events."

Close to 50 percent of people with eating disorders meet the criteria for depression, according to the National Association of Anorexia Nervosa and Associated Disorders.

Ressler emphasizes the importance of seeking help for a midlife eating disorder, given the mental and physical health complications triggered by depleting your body of nutrients.

"The biggest thing we can do is to normalize this population and let them know there are lot of women just like (them)," she says. "Women have often spent their lives putting themselves last, but they need to know they are important enough to get help and take care of themselves."

One of her favorite quotes, Ressler says, comes from the author Mary Ann Evans, who wrote under the pen name George Eliot in the mid-1800s.

"It's never too late to be what you might have been," Ressler says. "I think a lot of midlife women think it's too late to take care of themselves or start to feel good. But it's never too late."

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How Practicing Mindfulness Helps Adults Overcome Childhood Adversity

With significant implications for early childhood education, new research reveals that a mindful disposition is associated with alleviating lasting physical and emotional effects of childhood adversity. A team of scientists from Temple University, UNC’s Frank Porter Graham Child Development Institute (FPG), Child Trends, and the Rockefeller University conducted the groundbreaking study—the first to examine relationships between childhood adversity, mindfulness, and adult health.

Robert Whitaker, professor of public health and pediatrics at Temple University, said the findings are especially important because adults who were abused or neglected as children typically experience poorer health.

“Previous research has shown that childhood traumas worsen adult health through changes in how the body responds to stress,” said Whitaker, who led the new study. He added that some people might adopt poor health behaviors, like smoking, to cope with stress.

As a visiting scholar at FPG, Whitaker collaborated with FPG scientist Kathleen Gallagher on the study, which surveyed 2,160 adults working for Head Start, the nation’s largest federally-funded early childhood education program. According to Gallagher, one of the study’s most striking features is its focus on Head Start teachers and staff, who are responsible for teaching and caring for some of America’s most vulnerable children.

“It’s essential for adults working with young children to be well--physically and emotionally,” said Gallagher. “Better health enables better relationships with children, and research has long demonstrated that good relationships are crucial for children’s learning and social-emotional development.”

Whitaker explained that when adults provide services to children who are experiencing trauma, it can reactivate in adults an unhealthy stress response to their own childhood adversity. “This can potentially worsen the health and functioning of these adult caregivers,” he said.

According to Whitaker, studies have shown the health benefits of learning to be more mindful—--focusing on and accepting your reactions to the present moment. Nobody, however, had explored whether mindfulness in adulthood could offset the effects of adverse childhood experiences.

Whitaker’s team surveyed 66 Head Start programs across Pennsylvania, asking staff if they experienced emotional, physical, or sexual abuse as children or if they were exposed to other adversities such as household violence, substance abuse, or mental illness. He also asked about their current health, as well their mindfulness—their tendency in daily life to notice what happens as it happens and to be aware and accepting of their thoughts and feelings.

“Nearly one-fourth of our Head Start respondents reported three or more types of adverse childhood experiences,” said Whitaker, adding that almost 30 percent reported having three or more stress-related health conditions, such as depression, headache, or back pain.

However, the risk of having multiple health conditions was nearly 50 percent lower among respondents with the highest level of mindfulness compared to those with the lowest levels, even for those with multiple types of childhood adversity. In addition, regardless of the amount of childhood adversity, Head Start workers who were more mindful also reported significantly better health behaviors, like getting enough sleep, and better functioning, including fewer days when they felt unwell mentally or physically.

“Our results suggest that mindfulness may provide some resilience against the poor adult health outcomes that often result from childhood trauma,” Whitaker said. “Mindfulness training may help adults, including those with a history of childhood trauma, to improve their own well-being—and to be more effective with children.”

The findings compelled Whitaker and Gallagher to begin developing Be Well to Teach Well, an online professional development program designed to help Head Start teachers improve their well-being and classroom interactions.

“In-person training on mindfulness practices is difficult to implement on a large scale and very costly,” Gallagher said. “But by providing online training and ongoing coaching, we plan to help many more teachers to be well—and to develop the healthy relationships that are so important for positive child outcomes.”

“We need more research on delivering mindfulness training to teachers,” said Whitaker. “But there’s reason to believe a program for teachers like Be Well to Teach Well will help teachers and children in their classrooms flourish.

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Schizophrenia Subtypes Identified

Schizophrenia encompasses several distinct subtypes, each characterized by different symptoms and genetic variant clusters, according to a new study.

As they reported in the American Journal of Psychiatry, members of a Washington University-led team that included representatives from the Molecular Genetics of Schizophrenia Consortium brought together genome-wide SNP profiles for thousands of individuals with or without schizophrenia to start defining sets of risk variants that co-occur.

After verifying dozens of these SNP clusters in still other study cohorts, the team folded in clinical information to find eight sets of risk variants that consistently coincided with the presence or lack of certain schizophrenia symptoms and seemed to represent new schizophrenia classes or subtypes.

"Schizophrenia is a group of heritable disorders caused by a moderate number of separate genotypic networks associated with several distinct clinical syndromes," the study's authors wrote, noting that these findings hint at the possibility of refining the way schizophrenia is diagnosed and treated in the future.

Past studies suggest that many risk variants contribute to schizophrenia, though it has been difficult to define the complete suite of genetic interactions that can produce the highly heritable condition. For their part, the study's authors speculated that "schizophrenia heritability is not missing but is distributed into different networks of interacting genes that influence different people."

"[Genes] function in concert much like an orchestra, and to understand how they're working, you have to know not just who the members of the orchestra are but how they interact," Washington University psychiatry and genetics researcher Robert Cloninger, a senior author on the study, said in a statement.

In an effort to define risk gene networks for schizophrenia — and potentially link them to phenotypic features found in those with the disease — he and his colleagues started by scrutinizing genotype profiles for 4,196 schizophrenic individuals with known phenotypic features enrolled through the Molecular Genetics of Schizophrenia project.

When they compared those SNP patterns to the genotypes present in 3,827 unaffected controls, the researchers narrowed in on hundreds of variants that appeared to be over-represented in individuals with schizophrenia.

A closer look at those variants revealed 42 SNPs clusters that were present in one or more individuals. Generally speaking, the team found that larger groups of variants tended to turn up in fewer and fewer schizophrenia cases and vice versa.

One trio of shared risk SNPs turned up in more than 250 individuals with schizophrenia, for instance, while a larger set of two-dozen schizophrenia-associated variants fell in 70 cases.

For their follow-up analyses, the researchers not only considered the level of schizophrenia risk associated with each SNP cluster but also the shared clinical features found in individuals carrying similar variant sets.

In the process, the team defined eight schizophrenia subtypes that were subsequently replicated in more than 1,000 additional cases enrolled through the Clinical Antipsychotic Trial of Intervention Effectiveness and the Psychiatric Genomics Consortium projects.

These sub-groups included individuals with varying types of symptoms and severity — from auditory or other hallucinations to disorganized speech and behavior — which were linked to SNP sets associated with schizophrenia risk to varying degrees.

"[W]e were able to find that different sets of genetic variations were leading to distinct clinical syndromes," Cloninger said. "So I think this really could change the way people approach understanding the causes of complex diseases."

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Depression In Parents Can Be Difficult To Spot

Parenting can be wonderful and it can be challenging. As the child grows, the challenges will change but probably not lessen. Pressures can range from homework, organizing play-dates, music lessons and sports to parents worrying about the threat of their relationship breaking up, their children's response to a new partner who also has children and/or juggling childcare with work.

Some parents may also worry about their children's constant demands for the latest phone and whether they will be a victim of cyber-bullying. As the child grows into adolescence, additional stressors may include worries to do with college fees, future employment and risks associated with alcohol, drugs and/or sex.

Being a parent was never easy and for many, the challenges are getting harder while the supports may seem less. It makes sense f or parents, at some stage, to feel depressed, anxious or overwhelmed, to feel useless, angry and/or guilty. Practically every parent will at some time have thought that he or she is not doing a good enough job. They may compare their parenting abilities unfavourably to others. Can we be surprised that some parents will also experience depression? It can be difficult to spot, though, as they might be the people who always seem in great form. You may never realize the effort it has taken for them to get out of bed and get dressed.

Depression is a real difficulty and parents of all ages and at any stage of their child's development can experience it.

The World Health Organization predicts that depression will be the number one global burden of disease by 2030, surpassing heart disease and cancer. It defines depression as a common mental disorder characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.

Depression is different from the usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and can affect how they are at work and in the family. People with depression may have a sense of hopelessness about themselves, the world and the future.

At its worst, depression can lead to suicide. However, it is so important to remember that a diagnosis of depression does not mean that suicide is the inevitable outcome. Hundreds of thousands of people in Ireland survive the bleakness of depression and go on to live fulfilling lives.

Parents who have depression can have the added stress of worrying about the impact their depression may have on their children. We know that children can be affected by parents' constant low moods and can learn to cope in different ways. Some young children may cry, act out or become extremely 'good' so as not to cause any trouble. Adolescents may become protective of the parent and in some instances, even become his or her carer for a while. Sometimes depression really is the 'elephant in the room'.

Parents may put themselves under extreme pressure to appear 'happy' rather than admit to their teenager that they are experiencing depression. This may seem understandable but it does not work, as young people usually have a very good sense of what is really going on. We often underestimate how resilient they can be. It can be a massive load off their shoulders if a parent who has depression is honest with them. While we would all hope that young people never have to face difficult challenges in their lives, it is only fair to equip them to cope with the unexpected as best they can. Seeing a parent courageously take support and manage depression can be one of the most unexpected gifts a young person may ever receive.

Four tips to help you if you are a parent who has symptoms of depression:

1. Pay more attention to what you are doing than on how you are feeling

It can be very easy to become very upset by feelings of sadness, depression, exhaustion, upset, guilt and anger. While gently acknowledging that you may feel any or all of these, pay particular attention to what you are doing. For instance, you may not be sleeping well or frequently snap, drink, eat and/or smoke too much. Are you telling people how you really are, or are you pretending that you are fine and quietly withdrawing from people who love you? Do you blame yourself for being a 'bad' parent and possibly even convince yourself that everyone would be better off if you were not here? Unless you pay attention, it can be very easy to do actions such as these automatically. Paying attention can highlight what you can do to start turning things around for yourself.

2. Get and take real support

It can be very difficult for any of us to raise a hand and say, 'please help me'. These words can seem weak, selfish or childish. Yet, few parents hesitate to say loudly enough so that they are heard, 'please help my child'! If you recognize that you do have symptoms of depression that are constant over a two-week period, visit your GP and take support. Also please confide in at least one adult who you know does really care about you. Doing so, might be the most difficult thing you will ever do - it might also be the most important.

3. Recognize and appreciate what is going well

It is too easy for all of us to focus on what is going wrong. If you are a parent who has a tendency towards depression, you may be an expert at doing this. You might easily list to yourself all of the things you did 'wrong' and spend time beating yourself up. It can take courage to stop and actually catch something that is going well and to appreciate these. Please take time to remind yourself of the joys of being a parent! Children and teenagers can be very resilient and forgiving. The 'I love you anyway' hug of a young child or embarrassed shrug of a teenager can be wonderful. Some children really do need to know that life can be difficult, that parents can struggle to cope and that there are always ways of getting and taking support.

4. Learn more about depression and how to cope with it

Aware offers two Life Skills courses free of charge to help people understand depression and to know what to do to manage it pro-actively. These are both based on cognitive behavioral principles. Independent external evaluation has shown that they are effective in reducing depression. One of these is a six-session course that takes place free of charge throughout Ireland. The second is an eight-module course that is online. It is also free of charge and is supported by trained Aware volunteers. The Aware website (www.aware.ie) contains a library of lectures on depression that have been given by professionals over the past three years.

A tip to help you if you are someone who is concerned about a parent who has symptoms of depression.

If you recognize that someone you care about has symptoms of depression, please do something more than offering support. Practical help might be to organize an enjoyable activity for the parent such as a walk, a trip to the cinema or going out for a coffee while the children are at school, in crèche, or in childcare. If the person you are concerned about works in the home full-time, it might be very useful to offer to fill in for a morning or afternoon and allow him or her time off. Spend time paying attention to what the person you are worried about is doing well. If you don't, you might focus on the unwashed hair and dirty dishes and not see the huge achievement of a child or adolescent at school, fed and dressed.

Remember, even though people who have depression might feel hopeless, there is always hope.

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Resilience: How To Train A Tougher Mind

Can you learn to be mentally tougher? Emma Young investigates the science of mindfulness and other techniques promising to foster resilience in the face of extreme stress.

“It was one of those perfect days. I think that’s what everyone remembers. And now whenever the day’s too perfect and the sky’s too blue, I think: what might happen?”

Tuesday, 11 September 2001. Lisa Siegman was in her first year as principal of Public School 3 (PS 3) in downtown Manhattan. Up on the fourth floor, the fifth-graders’ classroom looked directly towards the World Trade Center. “They had a perfect view of the towers,” Lisa says. “The kids saw people jumping. People were running into the halls of the school, just doubled over.”

PS 3 was far enough away to escape evacuation. But children from two other schools, PS 150 and PS 89, which were closer to the devastation, were sent there for safety. By the afternoon, the school had been identified as a potential site for a temporary mortuary. Refrigerated trucks were lining up outside, along Hudson Street.

Children all across the city were affected. By the end of that day the September 11th Fund had been established by two major local charities. Donations poured in. Money first went on immediate aid – hot meals for rescue workers, emergency checks for victims and their families – and then funds were made available for programs to help New Yorkers to recover. The damage wasn’t only physical, but psychological. Counsellors set up services in local churches, and psychiatrists came from around the country to offer their expertise and their insights. Thoughts turned to the city’s children – how would they deal with the stress and trauma?

Into the debate stepped Linda Lantieri. A former school principal in East Harlem and administrator with the city’s Department of Education, she had helped to develop social and emotional learning programs for US schools, and was head of the National Center for Resolving Conflict Creatively, an organization she’d co-founded to tackle school violence. Helping kids handle trauma and manage their emotions was Lantieri’s forte. She approached the Fund with her own take on resolving the problem: enhancing ‘resilience’ – a person’s ability to get through difficult circumstances without lasting psychological damage.

Since then similar programs to encourage resilience have been introduced in schools all over the world, both to help children recover from trauma, but also cope better with their day-to-day stresses. Many use techniques such as ‘mindfulness’, which some claim can foster a stronger state of mind. Meanwhile, researchers have been studying adults who have thrived under severe stress to try and identify what it takes to be truly resilient. Can you really teach people to be mentally tougher?

For scientists the concept of psychological resilience began in the 1970s with studies of children who did fine – or even well in life – despite significant early adversity, such as poverty or family violence. For a long time a person’s level of resilience was thought to be inherited or acquired in early life. This idea was supported by the often-replicated statistics on what happens after a trauma: while most people bounce back to normal relatively quickly, and some even report feeling psychologically stronger afterwards than they did before, about 8% develop post-traumatic stress disorder, according to US figures.

Dennis Charney at the Icahn School of Medicine at Mount Sinai, New York City and Steven Southwick at the Yale School of Medicine have avidly studied people to find out why some are more resilient than others.

Extreme stress

People whose bodies respond rapidly to a threat – with a surge of the stress hormones adrenaline, noradrenaline and cortisol – but who then recover quickly seem to cope better with stressful situations and jobs, such as working in the military.

More resilient people also seem to be better at using the hormone dopamine – which has a role in the brain’s reward system – to help keep them positive during stress. Charney’s team, along with colleagues from the National Institutes of Health, studied a group of US Special Forces soldiers. They found that the amount of activity in the reward systems of the soldiers’ brains remained high when they lost money in an experimental game, unlike in the brains of regular civilian volunteers. This suggests the system in resilient people’s brains may be less affected by stress or adversity. Each of the soldiers’ brains also featured a healthily large hippocampus (which as well as enabling the formation of new memories also helps regulate the release of the fight-or-flight hormone adrenalin) and a strongly active prefrontal cortex, the brain region dubbed ‘the seat of rational thinking’. This in turn helps inhibit the amygdala, the part of the brain that processes negative emotions such as fear and anger, allowing the prefrontal cortex to come up with a sensible plan to cope with a threat.

Charney and Southwick have also investigated the psychological attitudes and mental strategies linked to resilience. Their interviewees include former US prisoners of war in Vietnam, victims of sexual abuse in Washington DC, survivors of an earthquake in Pakistan, and later people who were hit hard by 9/11. “We started out with a blank slate,” Charney says. To the people who recovered well, they asked: “Tell us how you made it? What were the factors?”

Through their research, Charney and Southwick have identified 10 psychological and social factors that they think make for stronger resilience, either alone or ideally in combination:

- facing fear

- having a moral compass

- drawing on faith

- using social support

- having good role models

- being physically fit

- making sure your brain is challenged

- having ‘cognitive and emotional flexibility’

- having ‘meaning, purpose and growth’ in life

- ‘realistic’ optimism.

Charney and Southwick are convinced that it is possible to develop these 10 factors, and that this can lead to a positive change for generally healthy people in their ability to cope not just with a major trauma, but also with the day-to-day stresses of life. One technique, in particular, might help people with this development. Until recently this technique was relatively obscure. Now it’s everywhere: mindfulness.

Mindfulness has its origins in the Zen Buddhist tradition, but its central ideas – involving attention and awareness – are secular. A modern explanation is that it means paying attention, on purpose, in the present moment and non-judgmentally, to the unfolding of experience, moment to moment.

Mindful practice

Lantieri believes that mindfulness and other fundamental stress-reducing strategies are vital foundations for the kinds of changes Charney talks about. “Many of the factors he mentions are internal strengths that can be cultivated through mindfulness – such as cognitive and emotional flexibility or facing fear. We can’t just tell people that it’s better to face their fear without helping them figure out how,” she says.

In September 2001, as New Yorkers began to clear away the physical debris of the terrorist attacks, Lantieri developed her Inner Resilience Program for teachers. Working with them, she developed a suite of tools to promote mindfulness in the classroom, to help children cope not only with serious traumas, like the terrorist attacks, but also with more everyday stressors, from exams to poverty to conflict in the home. The tools include deep breathing exercises designed to improve conscious awareness of the body and how to calm it down, in part to tackle stress and anxiety, and in theory to boost long-term psychological resilience.

Lantieri’s is one of the longest-running ‘resilience-building’ programs for schools, but it isn’t the only one out there. The concept of resilience – both in schools and beyond the classroom – is a hot one. In February 2014 a UK cross-party government group produced a report calling for schools to promote “character and resilience”. May 2014 saw the launch of an all-party group to explore the potential for mindfulness in education, as well as in health and criminal justice.

Mark Williams, director of the Oxford Mindfulness Centre at the University of Oxford, is the joint-developer of a technique for treating depression called mindfulness-based cognitive therapy. It involves encouraging patients to be aware of their thoughts and to accept them, without judgment. Research shows that it may be as effective as drugs at cutting the chances of a person who’s experienced one episode of major depression from suffering another.

Meanwhile, in 2010 a pair of former teachers in the UK got together to develop the Mindfulness in Schools Project. They developed a nine-lesson curriculum to teach kids mindful meditations, such as ‘body scanning’, to encourage them to keep their attention focused in the present, and to help them deal with stress.

And Martin Seligman (sometimes dubbed the ‘father of positive psychology’) and a team at the University of Pennsylvania have developed the Penn Resiliency Program for late elementary and middle school students. Here the focus is on the content of thoughts. Over 12 sessions lasting 90 minutes, students are taught to detect ‘inaccurate’ thoughts, evaluate the accuracy of them and challenge negative beliefs by considering alternative explanations (that popular girl just ignored me in the corridor because she didn’t see me, not because she hates my guts). Students are also taught techniques for assertiveness, negotiation, decision-making and problem solving, as well as relaxation.

On what evidence?

But do these programs work? The effects of Mindfulness in Schools curriculum – rolled out in six participating schools – have been scrutinized in a pilot study conducted by Willem Kuyken at the University of Exeter along with other researchers who have worked with Williams. The results, published in the British Journal of Psychiatry in 2013, found that the curriculum had promising – but small – effects on stress levels and wellbeing. The researchers would like to investigate this further in a large-scale randomized controlled trial of the curriculum in British secondary schools.

The Penn Resiliency Program has been evaluated in the US and the UK, and again the effects are small, although statistically significant. There was a “small average impact on pupils’ depression scores, school attendance and English and math grades”, according to the UK report, but this only lasted until the one-year follow-up study. By the two-year follow-up its impact had vanished.

This doesn’t mean the programs aren’t useful, says Kuyken. Studies that involve giving an intervention to everybody, whether or not they have a problem, generally only get small overall results. “What these interventions have the potential to do is move the bell curve – that is, to help those most at risk of depression at one end of the curve, but also those who are flourishing and those in the middle who represent most people,” he says.

Still, there’s no silver bullet when it comes to resiliency in kids, says Ron Palomares, a school psychologist at Texas Woman’s University. Between 2000 and 2013 he worked on the American Psychological Association’s Road to Resilience campaign, which it set up after 9/11 to provide public information on how to become more resilient. For adolescents with depressive symptoms, perhaps the Penn Resiliency Program approach may work best, he says. The mindfulness programs being developed in schools in the US and the UK are focused more on emotional regulation, which some kids may need help with but others won’t.

The multifaceted approach of the Lantieri’s Inner Resilience Program (IRP), meanwhile, may be best for a group, like an entire school, because it’s more likely to cover the various needs of most of the pupils. Yet, compared to the formal programs, Lantieri’s IRP is more of a ‘bag of tricks’ – or “a bag of practical strategies” – as she describes it. She says she wants to give adults and kids options, as many as possible, to help children cope with whatever life throws at them. “As much as we like to think we can protect our children from what may come their way, we live in a very complex and uncertain world,” she says. “We have to give them all the skills of inner resilience, so they’re ready for just everyday life.”

The IRP has been adopted by schools in Ohio and Vermont as well as Manhattan, and a pilot project has been launched in Madrid, Spain. Lantieri estimates that more than 6,000 teachers and 40,000 students have been exposed to it. There have been various evaluations, but Lantieri is not aware of any formal assessment. Given the “pick-and-mix” adoption of the program – some using IRP strategies often and others not at all – formal evaluation would be tricky in any case. “It is very organic,” Lantieri says. “It has to be, because every school is such a mix of people and attitudes and experiences. You can’t make everybody do the same.”

Principal Eileen Reiter of New York City’s PS 112 has been teaching for 50 years. Interventions have come and gone, but for her the IRP’s focus on teachers as well as children sets it apart. She shares Lantieri’s view that if teachers are calm and nurtured, they’ll be in a better place to help their children. “It’s about taking care of the teachers so they can take care of the kids,” she says. And these particular children need all the help they can get.

“We have a lot of kids being raised by grandparents, or in foster care,” says Reiter. Some live in shelters, some have one parent, or both, in prison. Many of the kids also have special educational needs.

When the Twin Towers came down, Reiter had just recently become principal. “Everybody [had] felt safe before that,” she says. “It was an eye-opener for everybody. That was when we really had to think more deeply about how we support kids who are living in a lot of stress, just in general.”

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Do We Have An Internal Calorie Counter?

Many explanations have been offered for the country’s obesity epidemic, and one is nutritional ignorance. People simply don’t know what a calorie is, so how can they be expected to know a calorie-rich food when they see one? Most of us don’t even know what a gram of apple or an ounce of milk looks like, so how can we possibly calculate a sensible portion?

Well, perhaps arithmetic is not required, and it may even be misleading. Psychological scientists in Canada have been studying how people make food choices, and it appears that our deliberate estimates and calculations may not be much use to us. Instead, we may implicitly know how fattening foods are, even when our estimates are way off. Indeed, our brains may respond to the true caloric density of foods, and guide our food choices.

Neuroscientist Alain Dagher of the Montreal Neurological Institute, working with colleagues there and at McGill University, wanted to see how awareness of caloric content influences the brain’s response to familiar foods. Specifically, the scientists wanted to compare explicit and implicit awareness of caloric content by measuring the brain’s response to both estimated and true caloric content of various foods.

They recruited healthy, normal-weight subjects, and showed them pictures of familiar foods, some low-calorie and others high-calorie. They asked them to rate how much they liked each food, and to estimate each food’s calories. The subjects then took part in an “auction,” in which they stated their willingness to pay for each food—a measure of its implicit value. During the auction, the subjects underwent fMRI brain scanning, to see what kind of brain activity was associated with the valuing of various foods.

The idea is that food choices and consumption are governed by the anticipated effects of foods—effects that we have learned over time through experience. The sensory properties of foods tell the brain that this or that food will be rewarding, or not. Based on the brain’s response, we are more or less willing to pay for whatever food is available at the moment. The scientists expected that the true caloric value of foods—and not the conscious estimates of calories—would determine the neural response.

And that’s just what they found. As reported in a forthcoming issue of the journal Psychological Science, the true caloric density of foods was linked to activity in the brain’s ventromedial prefrontal cortex, a neural region that encodes the value of sensory stimuli and triggers immediate consumption. The subjects were quite poor at judging foods’ caloric content, yet their willingness to pay and their brain activity both reflected the actual caloric density of food choices.

Our world offers an increasing array of poor and fattening food choices, and this no doubt contributes to our national obesity problem. These findings, taken together, suggest that the reward value of food depends on its nutritional value, most notably its caloric content. We appear to have this reliable internal calorie counter, fine-tuned by years of experience as eaters, yet we are still making unwise eating decisions. Better understanding how this calorie counter works—and how we can use it—may  illuminate how we can make better choices even in a fattening world.

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EEG Study Findings Reveal How Fear Is Processed In The Brain

An estimated 8% of Americans will suffer from post traumatic stress disorder (PTSD) at some point during their lifetime. Brought on by an overwhelming or stressful event or events, PTSD is the result of altered chemistry and physiology of the brain. Understanding how threat is processed in a normal brain versus one altered by PTSD is essential to developing effective interventions.

New research from the Center for BrainHealth at The University of Texas at Dallas published online today in Brain and Cognition illustrates how fear arises in the brain when individuals are exposed to threatening images. This novel study is the first to separate emotion from threat by controlling for the dimension of arousal, the emotional reaction provoked, whether positive or negative, in response to stimuli. Building on previous animal and human research, the study identifies an electrophysiological marker for threat in the brain.

“We are trying to find where thought exists in the mind,” explained John Hart, Jr., M.D., Medical Science Director at the Center for BrainHealth. “We know that groups of neurons firing on and off create a frequency and pattern that tell other areas of the brain what to do. By identifying these rhythms, we can correlate them with a cognitive unit such as fear.”

Utilizing electroencephalography (EEG), Dr. Hart’s research team identified theta and beta wave activity that signifies the brain’s reaction to visually threatening images.

“We have known for a long time that the brain prioritizes threatening information over other cognitive processes,” explained Bambi DeLaRosa, study lead author. “These findings show us how this happens. Theta wave activity starts in the back of the brain, in it’s fear center – the amygdala – and then interacts with brain’s memory center - the hippocampus – before traveling to the frontal lobe where thought processing areas are engaged. At the same time, beta wave activity indicates that the motor cortex is revving up in case the feet need to move to avoid the perceived threat.”

For the study, 26 adults (19 female, 7 male), ages 19-30 were shown 224 randomized images that were either unidentifiably scrambled or real pictures. Real pictures were separated into two categories: threatening (weapons, combat, nature or animals) and non-threatening (pleasant situations, food, nature or animals).

While wearing an EEG cap, participants were asked to push a button with their right index finger for real items and another button with their right middle finger for nonreal/scrambled items. Shorter response times were recorded for scrambled images than the real images. There was no difference in reaction time for threatening versus non-threatening images.

EEG results revealed that threatening images evoked an early increase in theta activity in the occipital lobe (the area in the brain where visual information is processed), followed by a later increase in theta power in the frontal lobe (where higher mental functions such as thinking, decision-making, and planning occur). A left lateralized desynchronization of the beta band, the wave pattern associated with motor behavior (like the impulse to run), also consistently appeared in the threatening condition.

This study will serve as a foundation for future work that will explore normal versus abnormal fear associated with an object in other atypical populations including individuals with PTSD.

This work was supported by the Berman Laboratory of Learning and Memory at The University of Texas at Dallas and the Jane and Bud Smith Distinguished Chair.

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Researchers Identify Final Pieces To The Circadian Clock Puzzle

Researchers at the UNC School of Medicine have discovered how two genes – Period and Cryptochrome – keep the circadian clocks in all human cells in time and in proper rhythm with the 24-hour day, as well as the seasons. The finding, published today in the journal Genes and Development, has implications for the development of drugs for various diseases such as cancers and diabetes, as well as conditions such as metabolic syndrome, insomnia, seasonal affective disorder, obesity, and even jetlag.

“Discovering how these circadian clock genes interact has been a long-time coming,” said Aziz Sancar, MD, PhD, Sarah Graham Kenan Professor of Biochemistry and Biophysics and senior author of the Genes and Development paper. “We’ve known for a while that four proteins were involved in generating daily rhythmicity but not exactly what they did. Now we know how the clock is reset in all cells. So we have a better idea of what to expect if we target these proteins with therapeutics.”

In all human cells, there are four genes – Cryptochrome, Period, CLOCK, and BMAL1 – that work in unison to control the cyclical changes in human physiology, such as blood pressure, body temperature, and rest-sleep cycles. The way in which these genes control physiology helps prepare us for the day. This is called the circadian clock. It keeps us in proper physiological rhythm. When we try to fast-forward or rewind the natural 24-hour day, such as when we fly seven time zones away, our circadian clocks don’t let us off easy; the genes and proteins need time to adjust. Jetlag is the feeling of our cells “realigning” to their new environment and the new starting point of a solar day.

Previously, scientists found that CLOCK and BMAL1 work in tandem to kick start the circadian clock. These genes bind to many other genes and turn them on to express proteins. This allows cells, such as brain cells, to behave the way we need them to at the start of a day.

Specifically, CLOCK and BMAL1 bind to a pair of genes called Period and Cryptochrome and turn them on to express proteins, which – after several modifications – wind up suppressing CLOCK and BMAL1 activity. Then, the Period and Cryptochrome proteins are degraded, allowing for the circadian clock to begin again.

“It’s a feedback loop,” said Sancar, who discovered Cryptochrome in 1998. “The inhibition takes 24 hours. This is why we can see gene activity go up and then down throughout the day.”

But scientists didn’t know exactly how that gene suppression and protein degradation happened at the back end. In fact, during experiments using one compound to stifle Cryptochrome and another drug to hinder Period, other researchers found inconsistent effects on the circadian clock, suggesting that Cryptochrome and Period did not have the same role. Sancar, a member of the UNC Lineberger Comprehensive Cancer Center who studies DNA repair in addition to the circadian clock, thought the two genes might have complementary roles. His team conducted experiments to find out.

Chris Selby, PhD, a research instructor in Sancar’s lab, used two different kinds of genetics techniques to create the first-ever cell line that lacked both Cryptochrome and Period. (Each cell has two versions of each gene. Selby knocked out all four copies.)

Then Rui Ye, PhD, a postdoctoral fellow in Sancar’s lab and first author of the Genes and Development paper, put Period back into the new mutant cells. But Period by itself did not inhibit CLOCK-BMAL1; it actually had no active function inside the cells.

Next, Ye put Cryptochrome alone back into the cell line. He found that Cryptochrome not only suppressed CLOCK and BMAL1, but it squashed them indefinitely.

“The Cryptochrome just sat there,” Sancar said. “It wasn’t degraded. The circadian clock couldn’t restart.”

For the final experiment, Sancar’s team added Period to the cells with Cryptochrome. As Period’s protein accumulated inside cells, the scientists could see that it began to remove the Cryptochrome, as well as CLOCK and BMAL1. This led to the eventual degradation of Cryptochrome, and then the CLOCK-BMAL1 genes were free to restart the circadian clock anew to complete the 24-hour cycle.

“What we’ve done is show how the entire clock really works,” Sancar said. “Now, when we screen for drugs that target these proteins, we know to expect different outcomes and why we get those outcomes. Whether it’s for treatment of jetlag or seasonal affective disorder or for controlling and optimizing cancer treatments, we had to know exactly how this clock worked.”

Previous to this research, in 2010, Sancar’s lab found that the level of an enzyme called XPA increased and decreased in synchrony with the circadian clock’s natural oscillations throughout the day. Sancar’s team proposed that chemotherapy would be most effective when XPA is at its lowest level. For humans, that’s late in the afternoon.

“This means that DNA repair is controlled by the circadian clock,” Sancar said. “It also means that the circadian clocks in cancer cells could become targets for cancer drugs in order to make other therapeutics more effective.”

This research was funded by the National Institutes of Health and the Science Research Council and Academia Sinica in Taiwan.

Other authors of the Genes and Development paper are UNC postdoctoral fellows Yi-Ying Chiou, PhD, and Shobban Gaddameedhi, PhD, and UNC graduate student Irem Ozkan-Dagliyan.

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Unipolar And Bipolar Depression Manifest Different Brain Abnormalities

MRI imaging and associated techniques indicate that unipolar depression (UD) and bipolar depression (BD) show different manifestations in neural regions supporting emotion processing, according to German and US researchers.

In a September 3rd online paper in JAMA Psychiatry, Dr. Udo Dannlowski of the University of Munster and colleagues note that difficulty in distinguishing UD and BD often leads to misdiagnosis.

But, they say, a growing number of neuroimaging studies have reported functional and structural neural abnormalities in both disorders relative to healthy controls.

To investigate further, the researchers studied 58 currently depressed patients with bipolar I disorder, 58 age- and sex-matched unipolar depressed patients, and 58 matched healthy controls. They were equally divided between a site in the U.S. and one in Germany.

As Dr. Dannlowski told Reuters Health by email, this "is one of the first studies to directly compare UD and BD regarding neurostructural correlates using MRI and the first study at all to provide a replication sample from another site."

Subjects were examined by 3-T MRI. Voxel-based morphometry was used to compare local gray and white matter volumes. This statistical approach, developed in the 1990s, involving both pixels and volume, allows common brain morphological characteristics to be excluded and differences to be highlighted. The researchers also employed multivariate pattern classification to differentiate between UD and BD patient groups, even across different sites and scanners.

Patients with BD showed reduced gray matter volumes in the hippocampal formation and the amygdala relative to those with UD. Patients with UD showed reduced gray matter volumes in the anterior cingulate gyrus compared to those with BD.

The BD patients also exhibited reductions in white matter volume within the cerebellum and hippocampus.

Pattern classification by trained classifiers allowed up to 79.3% accuracy when differentiating between UD and BD in patients at the classifiers' training and testing site. However, this proportion, although still significant, fell to as low as 63.8% when the studied samples were not from their home site.

"Our machine learning approach," continued Dr. Dannlowski, "has never been used to differentiate between two (clinically similar) patient groups and it is the first time that a classifier successfully trained at one site has been applied to a second dataset from another imaging site."

"This implies that such neuroimaging measures might indeed be useful for improving diagnostic accuracy and that these methods are not tied to one specific scanner platform but can be easily shared with clinicians world-wide," he added.

Commenting by email, Dr. Helen S. Mayberg of Emory University School of Medicine in Atlanta told Reuters Health, "discriminating UP from BP is an important diagnostic goal with significant implications for choosing first-line treatment when patients present with depression. Using the classification defined in one cohort to the other is a significant accomplishment and the study sets the bar for the field going forward."

Dr. Mayberg, who has long used functional imaging to study neuropsychiatric disorders, added, "Hopefully others with such data can also apply this classification schema to their existing data. Replication is the key . . . We need findings that are robust and clinically relevant, and this is an important first step."

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Schizophrenia Cure Possible, Suggests UCSD-Salk Study

What could be a chemical basis for the development of schizophrenia was uncovered in a study published Thursday by researchers at UC San Diego and the Salk Institute for Biological Studies.

“The study provides new insights into neurotransmitter mechanisms in schizophrenia that can lead to new drug targets and therapeutics,” said senior author Vivian Hook, a professor with the Skaggs School of Pharmacy and UCSD School of Medicine.

Neurons derived from stem cells secreted significantly greater amounts of dopamine, epinephrine and norepinephrine, which are called catecholamine neurotransmitters, than other people, according to the study, which was published online by the journal Stem Cell Reports.

The scientists also found that patients with schizophrenia — a disabling disorder that affects how a patient thinks, feels and acts — dedicate more neurons to the production of an enzyme that leads to the production of dopamine, compared to the average person.

The regulation of dopamine, epinephrine and norepinephrine are known to be affected by psychiatric illnesses, and they are selectively targeted by some psychotropic drugs, according to the researchers.

Discovering that more neurons are dedicated to producing dopamine, which is required to make epinephrine and norepinephrine, provides another target for potential medication.

“All behavior has a neurochemical basis in the brain,” Hook said. “This study shows that it is possible to look at precise chemical changes in neurons of people with schizophrenia.”

She said the findings could help with evaluating the severity of an individual’s disease, identifying sub-types of the disease and pre-screening patients for drugs that would be most likely to help them. It also offers a way to test new drugs, she said.

“It is very powerful to be able to see differences in neurons derived from individual patients and a big accomplishment in the field to develop a method that allows this,” Hook said.

The study, which included the Icahn School of Medicine at Mount Sinai, N.Y., was funded by the UCSD Academic Senate, Brain and Behavior Research Foundation, National Institutes of Health, The JPB Foundation, The Leona M. and Harry B. Helmsley Charitable Trust and The New York Stem Cell Foundation.

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115m people globally will get Alzheimer's by 2050.

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