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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.

Study: Odor Identification May Be Able To Detect Risk For Cognitive Decline

Olfactory senses may be used for more than determining pleasant or undesirable aromas that may someday be a tool to assist in predicting risk for memory loss in late life.

From 2004 to 2010, Davangere Devanand, M.B.B.S., M.D., director of geriatric psychiatry at the New York State Psychiatric Institute and a professor of psychiatry at Columbia University, led a series of tests in a multiethnic population of 1,037 senior citizens without a diagnosis of cognitive dysfunction to determine whether a relationship exists between the inability to identify smells and a diagnosis of mild cognitive decline. Odor identification was measured by the University of Pennsylvania Smell Identification Test (UPSIT).

The results, presented recently at the 2014 Alzheimer’s Association International Conference in Copenhagen, showed that 210 participants transitioned to either dementia or Alzheimer’s disease (AD) during follow-up two to four years after initial UPSIT was administered. Transition to dementia and AD was correlated with lower odor-identification scores on the UPSIT, even after adjusting for demographics, cognitive and functional measures, and apolipoprotein E genotype. Each one-point deduction on the UPSIT was associated with an approximately 10 percent increase in AD risk.

Dolores Malaspina, M.D., a professor of psychiatry at New York University who has studied the link between olfactory senses and psychiatric illness, told Psychiatric News that, "while sensory and other processes can decline with aging, even in persons without dementia, olfactory process entails important connections in the areas that are most sensitive to the [amyloid-beta] accumulation that is associated with Alzheimer’s pathology. These results show that there may be a great potential in using olfactory-processing tests, along with other measures, to provide an early identification of those at risk for Alzheimer's disease."

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Study: Mothers Of Children With Autism Benefit From Peer-Led Intervention

Peer-led interventions that target parental well-being can significantly reduce stress, depression and anxiety in mothers of children with disabilities, according to new findings released today in the journal Pediatrics.

In a first-of-its-kind study, researchers from Vanderbilt University examined two treatment programs in a large number of primary caregivers of a child with a disability. Participants in both groups experienced improvements in mental health, sleep and overall life satisfaction and showed less dysfunctional parent-child interactions.

“The well-being of this population is critically important because, compared to parents of typically developing children, parents of children with developmental disabilities experience substantially higher levels of stress, anxiety and depression, and as they age, physical and medical problems,” said lead author Elisabeth Dykens, Ph.D., Annette Schaffer Eskind Professor and director of the Vanderbilt Kennedy Center for Research on Human Developmentand professor of Psychology and Human Development, Pediatrics and Psychiatry. “Add to this the high prevalence of developmental disabilities – about one in five children – and the fact that most adult children with intellectual disabilities remain at home with aging parents, we have a looming public health problem on our hands.”

Nearly 250 mothers of children with autism or other disabilities were randomized into one of two programs: Mindfulness-Based Stress Reduction (MBSR) and Positive Adult Development (PAD). The MBSR approach is more physical, emphasizing breathing exercises, deep belly breathing, meditation and gentle movement. The PAD approach is more cognitive and uses exercises such as practicing gratitude.

Supervised peer mentors, all mothers of children with disabilities, received four months of training on the intervention curriculum, the role of a mentor and research ethics. The peer mentors led six weeks of group treatments in 1.5-hour weekly sessions with the research participants.

At baseline, 85 percent of participants had significantly elevated stress, 48 percent were clinically depressed and 41 percent had anxiety disorders.

Both the MBSR and PAD treatments led to significant reductions in stress, depression and anxiety and improved sleep and life satisfaction among participants, and mothers in both treatments also showed fewer dysfunctional parent-child interactions. While mothers in the MBSR treatment saw the greatest improvements, participants in both treatments continued to improve during follow-up, and improvements in other areas were sustained up to six months after treatment.

“Our research and findings from other labs indicate that many mothers of children with disabilities have a blunted cortisol response, indicative of chronic stress,” Dykens said. “Compared to mothers in control groups, this population mounts a poorer antibody response to influenza vaccinations, suggesting a reduced ability to fight both bacterial and viral infections. They also have shorter telomeres, associated with an advanced cellular aging process, and have poorer sleep quality, which can have deleterious health effects. All of this results in parents who are less available to manage their child’s special needs or challenging behaviors.”

Dykens conducted this research with Vanderbilt’s Julie Lounds Taylor, Ph.D., assistant professor of Pediatrics and Special Education and Vanderbilt Kennedy Center investigator, and former Vanderbilt Kennedy Center post-doctoral fellows Marisa Fisher, Ph.D. and Nancy Miodrag, Ph.D.

Forthcoming research will examine how fathers fared in the interventions and the health status and medical conditions in mothers. Dykens and colleagues will also look at the differences in civilian versus military parents of children with developmental disabilities.

This research was funded by the National Institutes of Health’s National Center for Complementary and Alternative Medicine (Grant No. 5RC1AT005612), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant No. P30HDO15052), the National Center for Advancing Translational Sciences (Grant No. UL1TR000445) and the National Institute of Mental Health (Grant No. K01MH92598).

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U-M Study: Learning The Smell Of Fear

Babies can learn what to fear in the first days of life just by smelling the odor of their distressed mothers, new research suggests. And not just “natural” fears: If a mother experienced something before pregnancy that made her fear something specific, her baby will quickly learn to fear it too -- through the odor she gives off when she feels fear.

In the first direct observation of this kind of fear transmission, a team of University of Michigan Medical School and New York University studied mother rats who had learned to fear the smell of peppermint – and showed how they “taught” this fear to their babies in their first days of life through their alarm odor released during distress.

In a new paper in the Proceedings of the National Academy of Sciences, the team reports how they pinpointed the specific area of the brain where this fear transmission takes root in the earliest days of life.

Their findings in animals may help explain a phenomenon that has puzzled mental health experts for generations: how a mother’s traumatic experience can affect her children in profound ways, even when it happened long before they were born.

The researchers also hope their work will lead to better understanding of why not all children of traumatized mothers, or of mothers with major phobias, other anxiety disorders or major depression, experience the same effects.

“During the early days of an infant rat’s life, they are immune to learning information about environmental dangers. But if their mother is the source of threat information, we have shown they can learn from her and produce lasting memories,” says Jacek Debiec, M.D., Ph.D., the U-M psychiatrist and neuroscientist who led the research. 

“Our research demonstrates that infants can learn from maternal expression of fear, very early in life,” he adds. “Before they can even make their own experiences, they basically acquire their mothers’ experiences. Most importantly, these maternally-transmitted memories are long-lived, whereas other types of infant learning, if not repeated, rapidly perish.”

Peering inside the fearful brain

Debiec, who treats children and mothers with anxiety and other conditions in the U-M Department of Psychiatry, notes that the research on rats allows scientists to see what’s going on inside the brain during fear transmission, in ways they could never do in humans.

He began the research during his fellowship at NYU with Regina Marie Sullivan, Ph.D., senior author of the new paper, and continues it in his new lab at U-M’s Molecular and Behavioral Neuroscience Institute.

The researchers taught female rats to fear the smell of peppermint by exposing them to mild, unpleasant electric shocks while they smelled the scent, before they were pregnant. Then after they gave birth, the team exposed the mothers to just the minty smell, without the shocks, to provoke the fear response. They also used a comparison group of female rats that didn’t fear peppermint.

They exposed the pups of both groups of mothers to the peppermint smell, under many different conditions with and without their mothers present.

Using special brain imaging, and studies of genetic activity in individual brain cells and cortisol in the blood, they zeroed in on a brain structure called the lateral amygdala as the key location for learning fears. During later life, this area is key to detecting and planning response to threats – so it makes sense that it would also be the hub for learning new fears.

But the fact that these fears could be learned in a way that lasted, during a time when the baby rat’s ability to learn any fears directly was naturally suppressed, is what makes the new findings so interesting, says Debiec.

The team even showed that the newborns could learn their mothers’ fears even when the mothers weren’t present. Just the piped-in scent of their mother reacting to the peppermint odor she feared was enough to make them fear the same thing.

And when the researchers gave the baby rats a substance that blocked activity in the amygdala, they failed to learn the fear of peppermint smell from their mothers. This suggests, Debiec says, that there may be ways to intervene to prevent children from learning irrational or harmful fear responses from their mothers, or reduce their impact.

From animals to humans: next steps

The new research builds on what scientists have learned over time about the fear circuitry in the brain, and what can go wrong with it. That work has helped psychiatrists develop new treatments for human patients with phobias and other anxiety disorders – for instance, exposure therapy that helps them overcome fears by gradually confronting the thing or experience that causes their fear.

In much the same way, Debiec hopes that exploring the roots of fear in infancy, and how maternal trauma can affect subsequent generations, could help human patients. While it’s too soon to know if the same odor-based effect happens between human mothers and babies, the role of a mother’s scent in calming human babies has been shown.

Debiec, who hails from Poland, recalls working with the grown children of Holocaust survivors, who experienced nightmares, avoidance instincts and even flashbacks related to traumatic experiences they never had themselves. While they would have learned about the Holocaust from their parents, this deeply ingrained fear suggests something more at work, he says.

The research was supported by the National Institutes of Health (DC009910, MH091451), and by a NARSAD Young Investigator Award from the Brain and Behavior Research Foundation, and University of Michigan funds. 

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How You Choose Between 2 Positive Outcomes

People choosing between two or more equally positive outcomes experience paradoxical feelings of pleasure and anxiety, feelings associated with activity in different regions of the brain, according to research led by Amitai Shenhav, an associate research scholar at the Princeton Neuroscience Institute at Princeton University.

In one experiment, 42 people rated the desirability of more than 300 products using an auction-like procedure. Then they looked at images of paired products with different or similar values and were asked to choose between them. Their brain activity was scanned using functional magnetic resonance imaging (fMRI). After the scan, participants reported their feelings before and during each choice. They received one of their choices at the end of the study.

Choices between two highly valued items (high-high), such as a digital camera and a camcorder, were associated with the most positive feelings and the greatest anxiety, compared with choices between items of low value (low-low), like a desk lamp and a water bottle, or between items of different values (low-high). Functional MRI scans showed activity in two regions of the brain, the striatum and the prefrontal cortex, both known to be involved in decision-making. Interestingly, lower parts of both regions were more active when subjects felt excited about being offered the choice, while activity in upper parts was strongly tied to feelings of anxiety.

This evidence that parallel brain circuits are associated with opposing emotional reactions helps to answer a puzzling question, according to Shenhav: "Why isn't our positivity quelled by our anxiety, or our anxiety quelled by the fact that we're getting this really good thing at the end? This suggests that it's because these circuits evolved for two different reasons," he said. "One of them is about evaluating the thing we're going to get, and the other is about guiding our actions and working out how difficult the choice will be."

The study, "Neural correlates of dueling affective reactions to win-win choices," was published July 14 in the Proceedings of the National Academy of Sciences. Shenhav conducted the research as a graduate student at Harvard University, along with Professor of Psychology and Neuroscience Randy Buckner, the study's senior author.

A second fMRI experiment showed that the same patterns of emotional reactions and brain activity persisted even when the participants were told before each choice how similarly they had valued the items. Their anxiety didn't abate, despite knowing how little they stood to lose by making a "wrong" choice. In a third experiment, Shenhav and Buckner tested whether giving people more than two choices increased their levels of anxiety. Indeed, they found that providing six options led to higher levels of anxiety than two options, particularly when all six of the options were highly valued items. But positive feelings about being presented with the choice were similar for two or six options.

This suggests that the anxiety stems from the conflict of making the decision, rather than the opportunity cost of the choice — an economic concept that refers to the lost value of the second-best option. The opportunity cost should be the same, regardless of the number of choices. In addition, subjects in this final study were given an unlimited amount of time to make a decision, compared with 1.5 seconds in the first two studies. The results showed that time pressure was not the main source of anxiety during the choices.

At the end of each study, participants had a surprise opportunity to reverse their earlier choices. Higher activity in a part of the brain called the anterior cingulate cortex around the time of an initial choice predicted whether that decision would later be reversed. Previous work has shown that this brain region is involved in assessing how conflicted an individual feels over a particular choice; this result suggests that some choices may have continued to elicit conflict after the participant made a decision, Shenhav said. The researchers also found that people who reported more anxiety in their daily lives were more likely to change their minds. 

This work could explain why ostensibly positive options can evoke a mixture of positive and negative responses, which are not explained by purely economic analyses of choice. "Rationally, there's no reason why when you put one good thing with another good thing, you should feel worse about the situation," said Brian Knutson, an associate professor of psychology and neuroscience at Stanford University, who is familiar with the work but was not involved in it. "The neuroimaging tells us that these different mechanisms are fighting with each other," he said. "Understanding that dynamic can help us understand why decisions that we think should make us feel better can actually make us feel worse."

According to Shenhav, this research could shed light on the neural processes that can make more momentous choices so paralyzing for some people — for instance, deciding where to go to college or which job offer to take. But he admits that even more trivial decisions can be tough for him. "I probably experience more win-win choice anxiety than the average person," he said. "I'm even terrible at choosing where to eat dinner."

Shenhav's research was supported by Harvard University and a fellowship from the Mortimer and Theresa Sackler Foundation. Shenhav is a C.V. Starr Fellow at the Princeton Neuroscience Institute.

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Improving Depression Care In OB-GYN Settings

Major depression affects women twice as often as it does men over the course of a lifetime, with the highest rate occurring during reproductive and menopausal transition years. Many women seek care during these peak years of depression incidence in obstetrics and gynecology (OB-GYN) settings for birth control, pregnancy, and gynecological problems. In fact, one-third of visits for women aged 18 to 45 and the majority of non-illness-related visits for women younger than age 65 are to OB-GYN physicians.

Furthermore, it is estimated that over one-third of gynecology patients rely on OB-GYN physicians for primary care. This is especially true for socially disadvantaged and minority female populations who are often likely to seek care in university and county hospital women’s clinic settings.

Despite the fact that depression is one of the most common problems women face and that many women seek care in women’s clinic settings, OB-GYN physicians often have less training in diagnosis and management of depression than do other primary care physicians. Researchers have shown lower rates of diagnosis and quality of treatment in OB-GYN settings compared with other primary care specialties. OB-GYN physicians also perceive significant barriers to screening and treating depression, including inadequate training and lack of resources for follow-up mental health care.

Collaborative depression care has been found to significantly improve quality of depression care and depression outcomes in family medicine and internal medicine settings, but has not been tested in OB-GYN or women’s health care clinic settings.

The Depression Attention for Women Now (DAWN) collaborative model of care was recently tested in a randomized trial in two large OB-GYN clinics—a county-hospital-based clinic treating a largely minority and socially disadvantaged population with either no insurance or public insurance and a university-based OB-GYN clinic treating a mixed socioeconomic population, with about half having commercial insurance.

A total of 205 women with major depression and/or dysthymia was randomized to the DAWN intervention versus usual OB-GYN care. We adapted our collaborative care intervention to help engage women from socially disadvantaged backgrounds by hiring one social worker as a care manager in each clinic to assist with overcoming barriers to care, such as transportation, obtaining charity care for medications for uninsured patients, and housing issues.

The social workers were also trained to provide an initial engagement session that has been shown to improve rates of mental health follow-up care for socially disadvantaged women. The engagement session includes a unique combination of ethnographical and motivational interviewing to help understand the patient’s explanatory model of illness and potential barriers to care and to educate patients regarding depression and understanding which treatments might be especially acceptable and effective.

Care managers initially worked with the patients on behavioral activation goals, building in activities they enjoyed previously but had stopped doing due to depression. In addition, care managers provided a choice of starting with Problem-Solving Treatment in Primary Care (PST-PC) or antidepressant medication, as well as a choice of whether their contacts with patients would be in person, by phone, or a combination of these. Care managers completed a Patient Health Questionnaire (PHQ-9) depression scale at every contact and entered the dates of contacts and PHQ-9 results in an Excel registry that was reviewed to assess patient progress during weekly case-review meetings with a psychiatrist and a senior OB-GYN physician.

Recommendations about medication changes were then brought to the patient’s OB-GYN physician who wrote all prescriptions.

Women in the usual-care arm had their OB-GYN physicians notified about their depression, had access to a clinic social worker, and could be referred to psychiatry by their OB-GYN physician.

The DAWN program was a one-year intervention, and objective research follow-ups were completed at six, 12, and 18 months.

Intervention patients, compared with usual-care controls, were shown to have significant improvements in quality of depression treatment (number of mental health contacts and antidepressant adherence), as well as significant improvements in depressive symptoms and functioning over the 18-month follow-up period. Intervention patients were also more satisfied with the quality of depression care. A postintervention survey of OB-GYN providers showed a high level of satisfaction with the quality of care provided in the DAWN intervention.

Another important finding was that the results were similar in the two OB-GYN clinics despite differences in the socioeconomic strata of patients. The county hospital clinic population, which is predominantly a socially disadvantaged population, had almost two-fold higher rates of depression than the university-based clinic, and due to either lack of insurance or Medicaid insurance, clinic staff had limited ability to refer patients to mental health specialists for psychotherapy.

Women living in poverty have the highest incidence and persistence of depression. Because of the excellent outcomes associated with the DAWN intervention and the limited ability to find mental health referrals for this vulnerable population, the county-hospital clinic has continued to fund the DAWN intervention model (that is, the care manager and psychiatrist) after the grant funding ended. Our DAWN team hopes to be involved over the next five years in disseminating this model of care to other OB-GYN and women’s clinics. 

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The Rise Of Cranial Electrotherapy

Last week, the FDA announced that it plans to approve cranial electrotherapy stimulation, the simple handheld medical device currently cleared to treat depression, anxiety, and insomnia. The FDA “has determined that there is sufficient information to establish special controls, and that these special controls, together with general controls, will provide a reasonable assurance of safety and effectiveness for CES devices.” In short, cranial electrotherapy will soon become the only medical device in the United States that is FDA-approved to treat insomnia and anxiety, and the only home-use device approved to treat depression. As such, it becomes part of the psychiatric armamentarium.

To some, this is jaw-dropping news. But this device has been used in psychiatry practice for years and can be an essential adjunctive treatment to standard modalities of care for soldiers and veterans.

Cranial electrotherapy devices are essentially handheld pulse generators that deliver very low electric outputs. The device generates 1/1000 the output of electroconvulsive therapy (ECT) and connects with sponge electrodes to the side of the head. Patients use the device for 20 minutes twice a day for the first 6 weeks, then less frequently as needed. The device is easy to use and comfortable; it allows patients to go about their morning routine comfortably. The electrical current is gentle (no greater than 4 mA). This is why these devices are often referred to as electroceuticals—not quite as handy as popping a pill, but a lot more convenient than transcranial magnetic stimulation or ECT treatments in doctors’ offices. And cranial electrotherapy causes no serious adverse effects—only a headache or dizziness in fewer than 1 of 250 patients.

Used as an adjunct to drug therapy and other treatments, cranial electrotherapy is affordable without insurance and easy for patients to use without supervision. The cost ranges from $600 to $800, depending on the manufacturer and features. When used as an adjunct to antidepressants, medication dosages can be adjusted as clinically indicated according to symptoms and adverse effects. Cranial electrotherapy has been shown to attenuate methadone withdrawal and to improve cognitive function in chemically dependent patients.

The current indication language from the FDA does not specify a diagnosis, but the device is used for the symptomatic treatment of depression, anxiety, and insomnia. This fits with a patient-centered, empirical approach to treatment. This may fly counter to the prevailing DSM-5 culture, but aligns nicely with the realities of many psychiatric practices.

Many of my patients are veterans of the Iraq and Afghanistan conflicts, soldiers who have experienced multiple concussions and suffer from the cumulative symptoms of posttraumatic stress, depression, anxiety, insomnia, and chronic pain. I recommend using the device at home twice a day for 20 minutes at 2 mA. If after 2 weeks there are no changes in symptoms, the current is raised to 4 mA. It is common for sleep to improve after 5 days of twice-daily use. I often see alcohol and drug withdrawal symptoms profoundly diminish after several more days. About 70% of my patients report improvement in their sleep disturbance, anxiety, and depression.

There is published research spanning over 40 years, with at least 20 double-blind placebo-controlled studies that prove benefit outweighs risk. Several studies suggest that cranial electrotherapy triggers changes in neurotransmitters and endorphin release.

Too many patients do not improve with standard of care. Our nation is facing a mental health crisis in our returning soldiers and veterans. At a time when the VA system is struggling to meet the needs of these patients, I am encouraged that the FDA has recognized that this low-risk technology should be added to our armamentarium.

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IU Study Links Poor Early Language Skills To Later Behavior And Attention Problems

A new Indiana University study has tracked the links between early language skills and subsequent behavior problems in young children. Poor language skills, the study suggests, limit the ability to control one’s behavior, which in turn can lead to behavior problems such as ADHD and other disorders of inattention and hyperactivity.

“Young children use language in the form of private or self-directed speech as a tool that helps them control their behavior and guide their actions, especially in difficult situations,” said Isaac Petersen of the clinical science program in the IU Department of Psychological and Brain Sciences. "Children who lack strong language skills, by contrast, are less able to regulate their behavior and ultimately more likely to develop behavior problems."

Early childhood development has increasingly become a focus for public policy -- in debates over universal preschool, recognition of a “word gap” between rich and poor children, and new pediatric recommendations on reading to infants.

“Children’s brains are most malleable earlier on, especially for language,” said John Bates, professor in the Department of Psychological and Brain Sciences and co-author of the study. “Children are most likely to acquire skills in language and self-regulation early on. Many of the states are starting to focus on preschool, edging toward universal preschool. But early development specialists are not necessarily available. I would have programs more readily available to families -- and focused on children most at risk as early as possible.”

The paper, "The Role of Language Ability and Self-Regulation in the Development of Inattentive-Hyperactive Behavior Problems," appears online this week in the journal Development and Psychopathology. It is also co-authored by Angela Staples, research assistant professor at the University of Virginia.

Many previous studies have shown a correlation between behavior problems and language skill. Children with behavior problems, particularly those with attention deficits and hyperactivity, such as in ADHD, often have poor language skills. Whether one of these problems precedes the other and directly causes it was until recently an open question.

In a longitudinal study published last year, Petersen, Bates and several others concluded that the arrow points decisively from poor language ability to later behavioral problems, rather than the reverse. The current study shows that it does this by way of self-regulation, a varied concept that includes physical, emotional, cognitive and behavioral control. Self-regulation is integral to children’s capacity to adapt to social situations and to direct their actions toward future goals. The absence of self-regulation abilities is a key predictor and component of future behavior problems.

A number of studies have sought to explain the role of language in the development of self-regulation in terms of the cognitive and neurological mechanisms by which they are linked. This study traces the way they unfold over time and the role of self-regulation in this process.

To do this, Petersen, Bates, and Staples followed a group of 120 toddlers for a year, beginning when they were age 2 ½ and following up when they were 36 months and 42 months old. At each of these points they tested the children’s language skills and behavioral self-regulation, using tests for verbal comprehension and spoken vocabulary, as well as three tasks measuring self-regulating abilities. They also used parent and secondary caregiver assessments of behavioral problems. Their findings suggested that language skill predicted growth in self-regulation, and self-regulation, in turn, predicted behavioral adjustment.

The study lends renewed force to the argument that early childhood may offer a pathway for reducing social inequality. For what makes the "developmental cascade" from language to behavior particularly troubling, the researchers point out, is that children most at risk for a deficit in language ability, those from lower-income households, are often the least likely to get the services needed to remedy the problem.

Studies, for example, have shown a "word gap" between children of low income and those in affluent families, who hear 20 million more words by age 3 than their low-income counterparts. This gap results in less developed verbal and reading skills. If, as this study suggests, poor language skills lead to problems with self-regulation and behavior, this can in turn contribute to the less easily reversible and more costly social or academic problems in adolescence and later, adulthood.

Petersen said the study indicates that we could look more closely at language skill earlier on. But, he advises, “Don’t expect all children to be at the same level early on. If their language is slow to develop and self-regulation is lacking, they are likely to catch up with proper supports.

“Among those who are slow, some could develop problems. If, by the age of 3½, a child is still lagging, it may be worth pursuing treatment for language and self-regulation skills -- the earlier the better,” Petersen said.

The research was supported by Indiana University and grants from the National Institute of Mental Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Petersen was supported by Clinical and Translational Sciences Award from the National Center for Advancing Translational Sciences, part of the National Institutes of Health, and a National Research Service Award from the National Institute of Mental Health.

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What Is Whisper Therapy?

Consider the stress of modern life, with its cacophonous soundtrack of traffic, electronics and construction. It's no wonder so much of our leisure time is spent in a quest to let go of the workday and unwind. But sometimes our lifestyles conspire against us, and it's almost impossible to unplug, relax and fall asleep.

Studies have estimated that one-third of all adults in the U.S. cope with insomnia. The resulting fatigue-related injuries and loss of work productivity take a heavy toll on people's lives and costs employers billions of dollars annually.

Despite these serious consequences, according to Penn State Professor of Psychology Rich Carlson, insomnia goes largely undertreated by health care providers, with many people seeking relief through alcohol, over-the-counter medicines, and -- increasingly -- advice found online.

One of the most popular recent self-help trends for insomnia and anxiety is also among the more unusual ones. Autonomous Sensory Meridian Response, or ASMR, is a term coined in 2010 to describe "sounds that feel good." The sound of whispering is considered the most common trigger for the ASMR feelings. Other triggers can be things such as the scratching sound of a pen on paper, rhythmic monotone speech or tapping fingernails.

Not all triggers are sounds. Having someone focus intently on you -- such as during a haircut or an eye exam -- can bring on the pleasurable fizzle of ASMR, some people say. People experience ASMR episodes in different ways, but usually report feeling a relaxing tingling sensation in the back of the head, between the shoulder blades or down the spine.

There may be two things taking place, says Carlson. "One is the feeling of relaxation or stress relief, which is probably similar to what people experience listening to soothing music or natural sounds like running water or waves at the seashore. That might work by providing something to pay attention to other than stressful thoughts, or perhaps by providing an external stimulus to which breathing might be synchronized. They might also work by giving people a focus for achieving a meditative state. Research has provided evidence that this can help with anxiety."

The other explanation for ASMR's popularity, notes Carlson, may be "the physical sensation that some people report, such as a tingling scalp. It would be interesting to understand the mechanism of this phenomenon, but I haven't seen anything that resembles it in the scientific literature."

While the scientific evidence may be lacking, proof of ASMR's popularity is easy to find. YouTube boasts over a million ASMR videos created by hundreds of devotees for the purpose of helping people relax and sleep. Oddly enough, episodes of "The Joy of Painting" television show -- known for the soothing voice of its late host, painter Bob Ross, and the sound of brush strokes on canvas -- are an ASMR favorite on YouTube as well.

Some say there's a connection between ASMR and binaural beats, an auditory relaxation technique based on the way the brain interrupts sounds of different frequencies. Very preliminary research suggests there may be some reported anti-anxiety effect for people listening to binaural beat recordings.

"I don't see an obvious connection between ASMR and the binaural beat phenomenon," says Carlson, "but we do know that external events like sounds can result in entrainment of physical events like breathing. That is, breathing can become synchronized with sound, and we know that slowing one's breathing can have a calming effect. There's also evidence that neurofeedback (information about your own brainwaves) can help people control their anxiety, so perhaps ASMR or binaural beats have a similar effect."

Whether there turns out to be some validity to ASMR or not, its popularity might signal something about the country's frustration with existing methods for treating insomnia and anxiety. Yet, as Carlson notes, "often the public's enthusiasm for a phenomenon far exceeds the eventual scientific evidence for it. One could point to the 19th-century fascination with séances or phrenology (assessing personality by measuring the skull) or the more recent excitement about subliminal advertising or subliminal messages in music recordings. The popularity of ASMR may well be a response to the desire for methods to reduce stress and anxiety, or in part fascination with a surprising, counterintuitive kind of experience reported by others."

If there's a danger in this, it's probably that some people with severe anxiety or sleep disorders might put off seeking help because they believe a self-help approach will work, cautions Carlson. "People should always seek professional medical guidance for their physical or mental health concerns, including insomnia and anxiety," he explains. "I don't see much risk of personal harm. I frequently listen to music to help me relax, and if listening to something else works for others, that seems fine to me."

At the moment, the phenomenon is purely anecdotal, he says, and some people don't feel anything in response to so-called ASMR triggers. "To my surprise," Carlson says, "I experienced the tingling myself when listening to the whispering videos, although to me the sensation was not especially pleasant. It was more like the reaction I have when something tickles the hair on the back of my head."

People should understand, he adds, that "our individual expectations play a major role in the psychological effects we experience around many things, likely including the ASMR videos." And they should be aware too, he notes, that YouTube is an unlikely source for a miracle cure for serious problems. "There are at least dozens, probably hundreds, of self-help websites for managing anxiety, and they often include a mix of common-sense approaches, ideas modeled on cognitive-behavioral and other psychological techniques, as well as approaches that seem likely to be based on superstition or wishful thinking."

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People With Bipolar Disorder Take More Risks

People who have bipolar disorder are more likely to engage in risky behavior, a new study has revealed.

Research carried out by the Universities of Manchester and Liverpool, published in the journal BRAIN, found that circuits in the brain connected with "pursuing and relishing" rewarding experiences are activated more strongly in those who have the condition.

Scientists said this means they are more likely to shun safer gambles and make riskier decisions instead.

Professor Wael El-Deredy of the University of Manchester said the findings show that the "buzz" people with bipolar disorder get from reward is a "double-edged sword".

"On the one hand, it helps people strive towards their goals and ambitions, which may contribute to the success enjoyed by many people with this diagnosis," he commented.

However, Dr El-Deredy said it comes at a cost, as these individuals are driven more by immediate rewards when they are making decisions, rather than considering the long-term consequences of their actions.

Professor Peter Kinderman from the University of Liverpool, a Chartered Psychologist, comments:

"This excellent study is yet another example of how psychologists are piecing together the picture of why people experience mental health problems.

"Researchers here found that some people are more strongly motivated to take risks to pursue their goals, feel somewhat more of an emotional 'high', but are also somewhat more likely to experience the distressing mood swings that lead to a diagnosis of 'bipolar disorder'.

"That makes a lot of sense, could point the way to effective therapies, but also helps to make sense of mental health problems; too often seen as inexplicable 'illnesses'."

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Missing Sleep May Hurt Your Memory

Lack of sleep, already considered a public health epidemic, can also lead to errors in memory, finds a new study by researchers at Michigan State University and the University of California, Irvine.

The study, published online in the journal Psychological Science, found participants deprived of a night’s sleep were more likely to flub the details of a simulated burglary they were shown in a series of images.

Distorted memory can have serious consequences in areas such as criminal justice, where eyewitness misidentifications are thought to be the leading cause of wrongful convictions in the United States.

“We found memory distortion is greater after sleep deprivation,” said Kimberly Fenn, MSU associate professor of psychology and co-investigator on the study. “And people are getting less sleep each night than they ever have.”

The Centers for Disease Control and Prevention calls insufficient sleep an epidemic and said it’s linked to vehicle crashes, industrial disasters and chronic diseases such as hypertension and diabetes.

The researchers conducted experiments at MSU and UC-Irvine to gauge the effect of insufficient sleep on memory. The results: Participants who were kept awake for 24 hours – and even those who got five or fewer hours of sleep – were more likely to mix up event details than participants who were well rested.

“People who repeatedly get low amounts of sleep every night could be more prone in the long run to develop these forms of memory distortion,” Fenn said. “It’s not just a full night of sleep deprivation that puts them at risk.”

Fenn’s co-investigators include Steven Frenda and Elizabeth Loftus from UC-Irvine.

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Did You Know?

30 Minutes of exercise a day can help you be more mentally balanced and sharp by reducing stress hormones and increasing oxygen flow.

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