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.
“May Light always surround you;
Hope kindle and rebound you.
May your Hurts turn to Healing;
Your Heart embrace Feeling.
May Wounds become Wisdom;
Every Kindness a Prism.
May Laughter infect you;
Your Passion resurrect you.
May Goodness inspire
your Deepest Desires.
Through all that you Reach For,
May your arms Never Tire.”
― D. Nina Simone
Pregnant women who live in smog-filled areas may be twice as likely to have children with autism, a new study suggests.
“The study does not prove that pollution increases risk for autism. It found an association,” cautioned lead author Andrea Roberts, a research associate at the Harvard School of Public Health in Boston. “It adds to the weight of the evidence that there may be something in air pollution that increases risk for autism.” Researchers compared exposure to air pollution among 325 women who had a child with autism and 22,000 women who did not.
The women were participants in the Nurses’ Health Study II. Pollutants measured included diesel particulate matter, lead, manganese, mercury, methylene chloride, and a combined measure of metal exposure.
Twenty percent to 60 percent of the women lived in areas considered highly polluted. And the study showed that: those women who lived in the 20 percent of locations that had the highest levels of diesel particulates or mercury in the air were twice as likely to have a child with autism, compared to those who lived in the 20 percent of areas with the lowest levels of these pollutants. In addition, those who lived in the 20 percent of locations with the highest levels of lead, manganese, methylene chloride, and combined metal exposure were about 50 percent more likely to have a child with autism than those who lived in the 20 percent of areas with the lowest concentrations.
The findings held even after the researchers took into account other factors known to affect autism risk, such as income, education and smoking during pregnancy. Overall, the association was stronger for boys than it was for girls, but the number of girls included in the new study was too low to draw any firm conclusions. The findings, which were published June 18 online in Environmental Health Perspectives, do add to a growing body of research that suggests the air women breathe while pregnant is one of many factors linked to autism risk.
Previous studies have shown that pregnant women who live in polluted areas or close to freeways are more likely to have a child with autism, but the studies were done regionally. The new data is nationwide. Exactly how, or even if, air pollution affects the developing brain is murky. “By definition, pollution is stuff that is not good for us,” Roberts said.
Still, the overall increase in autism risk that may be attributed to pollution is low. “Let’s say a woman’s risk for having a child with autism is one in 100, women who live in the most polluted cities have a risk that is about one in 50, which means that 49 children would not have autism,” Roberts said. “Even if the risk is doubled, it’s still low,” she explained.
The U.S. Centers for Disease Control and Prevention now estimates that about one in 50 children aged 6 to 17 in the United States has an autism spectrum disorder, the name for a larger group of disorders that can range from the mild to the severe, and affect social and communication skills. Other experts also urged caution in interpreting the new findings.
“There many genes, probably hundreds, and many environmental factors, probably hundreds, that increase risk of autism,” said Alycia Halladay, senior director for environmental and clinical sciences at the advocacy group Autism Speaks.
“The real message is that a lot of things cause autism, namely genetics and the environment and their interaction.”
Laura Anthony, the associate director of the Center for Autism Spectrum Disorders at Children’s National Medical Center in Washington, D.C., said that these risks accrue during pregnancy, delivery and within the first month of a newborn’s life.
“Everything points to that as the critical period. This is the time when the brain is most sensitive because it is still developing,” she said. The new findings don’t mean that pregnant women should head for the hills to avoid smog, Anthony added.
“Even if you live someplace rural, you may be exposed to pollution while driving or you could live in a rural place right next to a plant [or factory],” she said. “We all need to campaign for cleaner air for a lot of reasons.”
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children’s Medical Center in Lake Success, N.Y., said that the new findings do add weight to previous studies that looked at the connection between prenatal exposure to airborn pollutants and later autism.
“While they do validate and affirm what other studies have found, there are many risk factors and genetic causes identified with autism,” Adesman said.
“Even with the strength of this study, parents can’t presume that most cases of autism are due to airborne contaminants. It’s easier said than done to suggest that she move or not breathe the air.”Read article >>
When the weather turns cold and daylight hours dwindle, it's easy to blame seasonal affective disorder (SAD) for a blue mood.
But chances are, there's a whole lot more to your SAD story. Before you flip on a light box, make sure these other seasonal mood-busters aren't dragging you down.
You're not moving enough
Cold temps make it all too easy to curl up on the couch and let your gym habit slide, but its common knowledge that regular exercise holds the power to lift your spirits.
"Moving around is helpful to everyone's mood," says Harvard psychologist Dr. John Sharp, author of "The Emotional Calendar."
You don't even have to commit to a full-on routine. In a study published in Perception and Motor Skills, researchers found that even a single exercise session at any intensity can increase positive mood feelings and decrease the negative ones. If you live in a wintery clime, take advantage of the snowshoeing and ice skating to shake up your exercise routine.
You're worried about money
Holiday expenses take a bite out of your bank account, and fretting about credit card bills can rob anyone of good cheer.
Before you start racking up the bills, decide if expensive gifts are even necessary. A homemade present can mean much more than a pricey package.
"Don't be afraid of the B word: a budget," says Sharp. "It can be a big or a small number. Spread it around in a way that can make you happy, but don't put yourself in the hole."
You're overwhelmed with family obligations
'Tis the season for familial gatherings -- and all of the holiday stress and drama they can bring.
But guess what? It's entirely within your power to decline any stress-inducing invites. If you'd rather not trek to Aunt Linda's house three hours away for a holiday dinner, politely say no by saying you're eager to start making new holiday traditions at home. And if you just can't avoid sitting next to a relative that drives you crazy, take a deep breath before engaging in conversation with her: Research from Harvard Medical School shows it decreases tension and anxiety.
You're not eating right
Chowing down fattening holiday foods you don't normally eat and skipping your usual nutritious fare can leave with no energy, says Jane Ehrman, a behavioral health specialist at the Cleveland Clinic. Make this a rule: If you're hitting a party in the evening, eat only fruits, vegetables, and lean protein during the day. The antioxidants, fiber, and protein will fuel your body -- and help keep a well-balanced mind.
You feel left out
While some people are running ragged at the holidays -- dashing from recital to party to neighborhood caroling -- others have a lot of unwanted time on their hands, particularly those who don't live near extended family.
"Holidays are oftentimes easier for couples and families, and if you're by yourself, you may feel alienated this time of year," says Ehrman.
If you're feeling blue about sitting on the sidelines, make a difference by volunteering at a nursing home, homeless shelter, or hospital -- you'll be helping yourself as much as others.
You're drinking too much
If seasonal revelry has upped your alcohol consumption, then you may notice you're feeling draggier than usual when the alarm clock chimes in the morning.
It's not just about hangovers: a study published online in the journal Alcoholism: Clinical and Experimental Research found that although booze may help put you to sleep, it prevents you from getting high quality rest.
"If you go to a holiday party with wine being poured, it's hard to keep track of what you're drinking," says Sharp. Be clear with yourself: Nurse one glass of Pinot Noir as long as possible, then switch to water.
The holidays are a magical time for kids, but the adult realities of bills, shopping, wrapping presents, and meal prep don't instill the same sense of wonder.
"As a child, it's about the parties and cookies and presents," says Ehrman. "As the grownup, you're responsible for all the background mechanics a kid is never aware of."
If you feel the holidays have lost some of their spark, try to reconnect with your childhood memories. Chat with a sibling about shared experiences or pop in an old home movie to stir up happy memories.
People are usually pretty busy all year, but the end-of-year wrap-up can be particularly hectic, leaving you frazzled, stressed, or just plain worn out.
"People don't always realize the amount of stress they experience this time of year," says Ehrman.
Not sure if you've got too much on your plate? Here's a way to tell: "If you get excited when something gets canceled, you've got too much going on," says Ehrman. When your plate is too full, take something off.
You're turning into a hermit
Cold weather and treacherous roads provide the perfect excuse to cancel your evening plans and veg out in your jammies.
But if you're the type of person who thrives on social stimulation, being a homebody could be bumming you out. A study of more than 33,000 people published in the Journal of Clinical Psychiatry found that social isolation puts you at greater risk for mental health problems.
Resist the urge to bail on dinner with a friend or skip a favorite group exercise class. Pull on your snow boots and forge ahead with activities that put you in contact with other people.
Your expectations are unrealistic
"Happiness in life really is about expectation management," says Sharp. If you think every meal, present and decoration is going to be absolutely perfect, you will always be disappointed.
Figure out what works for you, and make the right adjustment. "You can't change the fact that you're going down a river, but you can paddle to the left or the right to avoid the big boulder," says Sharp. "That makes a world of difference."Read article >>
In rare cases, Ritalin and some other drugs used to treat attention-deficit/hyperactivity disorder (ADHD) can cause long-lasting and sometimes painful erections, the U.S. Food and Drug Administration said Tuesday.
If this condition -- called priapism -- is not treated immediately, it can cause permanent damage to the penis.
The class of ADHD medications that have been linked to priapism include methylphenidates, which are central nervous system stimulants. They go by the brand names Ritalin, Concerta, Daytrana, Focalin, Metadate, Methylin and Quillivant.
A non-stimulant ADHD drug called Strattera (atomoxetine) has also been linked with priapism in children, teens and adults.
Based on a recent review of these products, the FDA has told manufacturers to update the drugs' labels and patient medication guides.
"There have been very few case reports on this adverse effect in association with drugs to treat ADHD," said one expert, Victoria Richards, an associate professor of medical sciences at Quinnipiac University in North Haven, Conn.
"Although the effect is rare, the warning will at least draw attention to the potentially dangerous connection, not only in light of improved recognition and diagnosing of ADHD, but also in the misuse/abuse of those stimulant drugs," Richards said.
Priapism appears to be more common in patients taking Strattera than in those taking methylphenidate products, but a lack of data means that the FDA does not know how often priapism occurs in patients taking either type of drug.
Priapism can occur in males of any age. It happens when blood in the penis becomes trapped, resulting in an abnormally long-lasting and sometimes painful erection.
Doctors should make sure that male patients and their parents know the signs and symptoms of priapism and the importance of immediate medical treatment, the FDA said.
The agency noted that younger males, especially those who haven't reached puberty, may not recognize the problem or may be too embarrassed to tell anyone about it. Patients should be encouraged to read the medication guide that comes with these products.
It's also important for doctors to use caution when switching patients from methylphenidate to Strattera, and patients should not stop taking a methylphenidate product without first discussing it with a doctor, the FDA said.
ADHD, a neurological behavior disorder, is usually diagnosed in childhood and often lasts into adulthood. Kids with ADHD may have trouble paying attention and controlling impulsive behaviors. These medications are intended to help them focus and control their actions.Read article >>
A study which monitored the health habits of 2,235 men over a 35-year period has found that exercise significantly reduces the risk of dementia.
The study identifies five healthy behaviors as being integral to having the best chance of leading a disease-free lifestyle: taking regular exercise, non-smoking, a healthy bodyweight, a healthy diet and a low alcohol intake.
The people who consistently followed four or five of these behaviors experienced a 60 per cent decline in dementia and cognitive decline - with exercise being the strongest mitigating factor – as well as 70 per cent fewer instances of diabetes, heart disease and stroke, compared with people who followed none.
"The size of reduction in the instance of disease owing to these simple healthy steps has really amazed us and is of enormous importance in an aging population," said Principle Investigator Professor Peter Elwood from Cardiff University’s School of Medicine. "What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health – healthy behaviors have a far more beneficial effect than any medical treatment or preventative procedure.
"Taking up and following a healthy lifestyle is however the responsibility of the individual him or herself. Sadly, the evidence from this study shows that very few people follow a fully healthy lifestyle. Furthermore, our findings reveal that while the number of people who smoke has gone down since the study started, the number of people leading a fully healthy lifestyle has not changed," he added.
Recent surveys indicate that less than one per cent of people in Wales follow a completely healthy lifestyle, based on the five recommended behaviors’, and that five per cent of the population follow none of the healthy behaviors; roughly equating to a city with a population the size of Swansea (240,000).
Professor Elwood continued: "If the men had been urged to adopt just one additional healthy behavior at the start of the study 35 years ago, and if only half of them complied, then during the ensuing 35 years there would have been a 13 per cent reduction in dementia, a 12 per cent drop in diabetes, six per cent less vascular disease and a five per cent reduction in deaths."
The Caerphilly Cohort Study recorded the healthy behaviors of 2,235 men aged 45-59 in Caerphilly, South Wales. The study had multiple aims and has been the basis for over 400 research papers in the medical press. One of the most important aims was to examine the relationship between healthy lifestyles, chronic disease and cognitive decline over a 35-year period; and to monitor changes in the take-up of healthy behaviors.
Dr. Doug Brown, Director of Research and Development at the Alzheimer’s Society said: "We have known for some time that what is good for your heart is also good for your head, and this study provides more evidence to show that healthy living could significantly reduce the chances of developing dementia.
"These large, longitudinal studies are expensive and complicated to run, but are essential to understand how dementia can be prevented. We are calling on the G8 Summit next week to commit to greater funding of important studies such as this one which give us hope for reducing the impact of dementia in the future."
Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, which part-funded the study, said: "The results of this study overwhelmingly support the notion that adopting a healthy lifestyle reduces your risk of cardiovascular disease and dementia.
"These findings will hopefully go a long way in encouraging people to carefully consider their lifestyle and how it will impact on their health in later years."
Rebecca Wood, Chief Executive of Alzheimer’s Research UK said: "This large study further underlines the importance of a healthy lifestyle, and provides yet more evidence to indicate that healthy living could lower the risk of dementia. We still need more research to understand how to prevent dementia – which is why Alzheimer’s Research UK is investing in this area – but it’s encouraging for people to know there are simple steps they can take now to reduce their risk of this devastating condition. We are facing potentially large increases in the numbers of people living with dementia as the population ages, and if we are to deal with this crisis head on we must invest in research."
Health Minister Mark Drakeford said: "The Caerphilly Cohort Study has thrown into sharp relief the extent to which prevention of illness and preservation of health lies in our own hands. It gives us the clearest insight yet into the effect decisions we make about the lifestyles we adopt will have on our future health."
Unhealthy living has accounted for around 10 per cent of the costs of the NHS in Wales since the study first started, while the annual expenditure on prevention and public health services in Wales is estimated to have been £280M.
The study was funded by the Medical Research Council, Alzheimer’s Society and the British Heart Foundation.Read article >>
Most people – including scientists – assumed we can’t just sniff out danger. It was thought that we become afraid of an odor – such as leaking gas – only after information about a scary scent is processed by our brain.
But neuroscientists at Rutgers University studying the olfactory – sense of smell – system in mice have discovered that this fear reaction can occur at the sensory level, even before the brain has the opportunity to interpret that the odor could mean trouble.
In a new study published today in Science, John McGann, associate professor of behavioral and systems neuroscience in the Department of Psychology, and his colleagues, report that neurons in the noses of laboratory animals reacted more strongly to threatening odors before the odor message was sent to the brain.
“What is surprising is that we tend to think of learning as something that only happens deep in the brain after conscious awareness,” says McGann whose laboratory studies the sense of smell. “But now we see how the nervous system can become especially sensitive to threatening stimuli and that fear-learning can affect the signals passing from sensory organs to the brain.”
McGann and students Marley Kass and Michelle Rosenthal made this discovery by using light to observe activity in the brains of genetically engineered mice through a window in the mouse’s skull. They found that those mice that received an electric shock simultaneously with a specific odor showed an enhanced response to the smell in the cells in the nose, before the message was delivered to the neurons in the brain.
John McGann, associate professor of behavioral and systems neuroscience in the Department of Psychology, School of Arts and Sciences.
This new research – which indicates that fearful memories can influence the senses – could help to better understand conditions like Post Traumatic Stress Disorder, in which feelings of anxiety and fear exist even though an individual is no longer in danger.
“We know that anxiety disorders like PTSD can sometimes be triggered by smell, like the smell of diesel exhaust for a soldier,” says McGann who received funding from the National Institute of Mental Health and the National Institute on Deafness and Other Communication Disorders for this research. “What this study does is gives us a new way of thinking about how this might happen.”
In their study, the scientists also discovered a heightened sensitivity to odors in the mice traumatized by shock. When these mice smelled the odor associated with the electrical shocks, the amount of neurotransmitter – chemicals that carry communications between nerve cells – released from the olfactory nerve into the brain was as big as if the odor were four times stronger than it actually was.
This created mice whose brains were hypersensitive to the fear-associated odors. Before now, scientists did not think that reward or punishment could influence how the sensory organs process information.
The next step in the continuing research, McGann says, is to determine whether the hypersensitivity to threatening odors can be reversed by using exposure therapy to teach the mice that the electrical shock is no longer associated with a specific odor. This could help develop a better understanding of fear learning that might someday lead to new therapeutic treatments for anxiety disorders in humans, he says.Read article >>
People with autism will often enjoy doing puzzles. Their love of puzzles may take many different forms. In fact, the autistic love of puzzles may offer a clue to understanding autism. Many parents of children with autism believe that until and unless medical research finds a cure for autism it is important for us to continue trying to understand autism. The more paths we have to understanding autism, or at least appreciating it, the more parents and teachers will be able to help students and children with autism to feel comfortable.
Today is the 100th anniversary of the crossword puzzle. On this day, journalist, Arthur Wynne, introduced the world to crossword puzzles on the puzzles page of the New York World. So on this day, the birthday of the crossword puzzle, it is appropriate to stop and contemplate the puzzle of autistic perception.
The use of the puzzle piece as a logo for the cause of autism has British origins. It was introduced by the National Autistic Society of the UK in 1963. One interpretation of this logo suggests that autism is a puzzle that needs to be solved. Another interpretation might simply be that people with autism love doing puzzles. Like all phenomena associated with autism, the penchant for working puzzles cannot be strictly defined. It will manifest in different ways among different people. In other words, just because a person has been diagnosed with autism does not mean they will automatically love doing crossword puzzles.
However, if you know someone with autism, then there is a good chance that you might be able to strengthen your bond with them by finding out what kinds of puzzles they might enjoy doing. In some larger sense, the act of playing video games may be considered as a form of puzzle solving. There is certainly a predilection for playing video games among children with autism.
Everything about video gaming requires one to find the best path of action, solve relevant clues, and pursue the challenge with focus. People with autism may often have the ability to go into hyper-focus. If a child with autism goes into hyper-focus to ‘solve’ a video game, a fire truck could ride right by them and they would not notice. Thus, hyper-focus is a common trait among people with autism that lends a great advantage to being able to solve even the most difficult puzzles. Parents and teachers of children with autism would do well to consider that solving puzzles comes naturally to many people with autism. In this way, the act of solving puzzles may actually offer us a clue to understanding autism. At the very least, providing puzzles to, or working puzzles with, people with autism may provide a pleasurable avenue for bonding.
In fact, the more difficult the puzzle is, the more a person with autism might enjoy doing it. There is an amazing characteristic found among people with autism from time to time. While many of us may have enjoyed working a jigsaw puzzle at some time in our lives, there are people with autism who love to do jigsaw puzzles, too. However, they like to turn the puzzle over and solve the blank cardboard side. With no social pictures or themes to get in their way, the blank backside of a jigsaw puzzle provides the kind of thrill a real autistic puzzle master cannot resist.
So, parents and teachers of people with autism might try turning over the jigsaw puzzle pieces to see if that sparks the autistic imagination. If the child likes it, and if they go into hyper-focus to solve it, then it might even be difficult to get them to stop. At the same time, if they like it, the parent or teacher now supplying endless blank jigsaw puzzles in the child’s life may come to be perceived as more of an ally and a genuine part of their support system.
Another version of autistic puzzle mastery can be found in the phenomenon of the autistic savant. The term appeared in print for the first time in a 1978 article in Psychology Today written by Bernard Rimland, Ph.D. Rimland was one of the expert consultants for the movie Rain Man, and he is largely considered to be the grandfather of the modern scientific approach to understanding autism.
Rimland talked about the high fidelity perception of people with autism, and how they had much more difficulty generalizing their perception to navigate social life. This appears at its height in the autistic savants. These people often display uncanny abilities to solve puzzles that no social person could even attempt. For example, there are autistic savants who can instantly tell the day of the week for any date given – even a century ago.
What is difficult for social people to understand is that the more social the puzzle becomes, the more difficult it may become for the person with autism to solve. If autism is a puzzle for social people, it may also be said that social life is a puzzle for people with autism. Recall that in Rain Man, Dustin Hoffman played Kim Peek, an autistic savant who was able to multiply numbers as fast as a computer and give the correct answer, no matter how large the numbers were. However, he was unable to make change on a dollar. Why could he do one and not the other?
Making change on a dollar is a more complex social transaction that requires more than mathematical computation. It also requires the ability to perform on command, and that kind of social expectation may elude the person with autism. In fact, the stronger the autistic perception, the more difficulty will be encountered in social, transactional, performance-on-command activities.
Research indicates that people with autism tend to excel at, or favor, tasks requiring deductive reasoning. Indeed, their talent for deductive reasoning might be what underlies the phenomenal ability among people with autism to work puzzles. This penchant for deductive thinking may make people with autism seem more like computers than people sometimes. Indeed, an autistic person with super-computer thinking might just be the biggest puzzle master in a parent or teacher’s life. And that’s why puzzles may offer a clue to understanding autism.Read article >>
Social anxiety disorder may be the most common phobia you've never heard of. Franklin Schneier, a Columbia University psychiatrist who specializes in research on social anxiety, said it represents the extreme end of shyness, and is so debilitating that people who suffer from it often can't stay in school, hold down a job or form a meaningful relationship.
Social anxiety disorder affects about 6 percent of the U.S. population at some point in their lives, he said, or more than 17 million people, and because its main feature is severe worry over dealing with other people, that in itself can make it hard for sufferers to seek help.
But there is help available, he said, particularly in the form of cognitive behavioral therapy, or CBT, which can help people change their negative thoughts about themselves and what will happen to them in social situations.
In the case of social anxiety, the "B" in CBT is crucial -- reshaping people's behavior by getting them to undertake social homework assignments, whether it's attending a party or giving a public speech.
"People have got to put themselves in these situations," Dr. Schneier said. "Otherwise, you see people who have been in talk therapy for years and they haven't made any progress."
As with other phobias, the optimal therapy is "exposure" -- gradually putting yourself in the very situations that make you anxious. But for social anxiety, the challenge is greater than for many other simpler phobias.
"There is a more cognitive part of [the therapy] than say, treating a fear of dogs, where simply exposing yourself to dogs and realizing they won't bite you can help. In a social situation, you need to understand how your thinking feeds into your fears. Otherwise, you can walk away from it thinking 'What an idiot I was!' or 'That person hated me.' "
If a person is deathly afraid of public speaking, for instance, "he'll think 'I'll make a fool of myself and people will think I'm stupid and my voice will tremble.' "
In cognitive behavioral therapy, "we would try to question this a bit. Often there is a lot of evidence to show their fears are not so realistic. We can also help them develop substitute thoughts, such as the idea that they've got something useful to present to people, or even if they're anxious, they can still get their point across."
Besides cognitive behavior therapy, there is evidence that antidepressants, particularly the type known as SSRIs, also can help with social anxiety, Dr. Schneier said.
It often starts young
Another key feature of social anxiety phobia is that it often starts in late childhood or during the teen years.
Wendy Silverman, a child psychiatry professor at Yale University, has been working with children with anxiety disorders for years.
The dread these children face goes beyond the normal fears and social pangs that most children experience, she said, and starts to interfere with the normal activities of the children and their families.
"If families are not able to get their children to go to school, or the parents have not been able to sleep alone in their bed for a long, long time, that's when anxiety is starting to interfere. We're also concerned when children are not enjoying the things that most children experience joy from, such as playing with friends or being involved in activities outside of school."
She gives children tools to combat their fears that are similar to what Dr. Schneier uses with adults, but are geared to their developmental level.
A favorite intervention is giving them a STOP pen, a red ballpoint whose end is twisted into the familiar octagonal stop-sign shape. It reminds them to "stop" when they begin to experience anxiety and follow the reminders that go with each letter. The "S" stands for recognizing the things in their lives that scare them; the "T" teaches them they have thoughts that go with those feelings; the "O" reminds them they can have other thoughts that are not as frightening; and the "P" lets them remember they can praise themselves when they conquer their fears.
She uses incremental exposure therapy both with parents and children.
If a child has extreme fears at bedtime and he doesn't want to sleep alone, for instance, she will teach a parent to first sit on the edge of the bed, then in a chair in the room, then stand by the door, and then stand outside of the doorway, until gradually he can go to sleep when the parent is out of sight.
When children are too anxious to even go to the playground at recess, she said, the homework sequence for a frightened girl might be to play with a child who is younger, then play with kids her own age, then ask a younger child a question, and then ask an older child a question.
After children have carried out these experiments, she likes to "get them to deconstruct the experience, and usually they learn that what they were worried would happen didn't happen. You can't just tell a child some bad thing won't happen -- you have to go out and get the evidence yourself as a kid and be able to process that."
And tackling these issues early on is vital, she said, because these kinds of intense fears don't go away on their own.
How parents influence
Michael Crowley, a psychologist at Yale who works with her, said parents can sometimes inadvertently contribute to children's fears, especially if they are anxious themselves.
One of the worst things parents can do, he said, is to protect their children from all the situations that scare them.
"To the extent you allow avoidance, which parents often do, the chances of the child recovering from anxiety are going to be less," he said. In fact, children can almost become addicted to avoidance, he said.
"It's rewarding to escape or avoid the things that are distressing; it's called negative reinforcement. If I have a headache, I take an aspirin; if I have an itch, I scratch it. And if I'm an anxious person, I might make an excuse for why I can't give a speech or do some other activity."
If children don't learn how to master their anxiety, it can have serious consequences later in life.
"People then build their lives around avoiding things that make them uncomfortable," Columbia's Dr. Schneier said. "They may choose a career that puts them in a back room and not in the forefront. They may be the helper or confidante rather than the leader, even though they might be more competent than that.
"There is data to show some people with the phobia marry later or don't marry at all, and in a few cases, people are so fearful of having to seek out a new relationship that they cling to a bad one."
Whether the anxiety is afflicting children or adults, the basic approach of facing their fears in successful small steps remains the same.
"What these exposure treatments are doing is showing that you can tolerate this stress," said Wendy Silverman, the Yale psychologist. "If an anxious person goes through treatment, instead of saying, 'Oh no, I'm going to embarrass myself' or 'I'm going to faint,' they say 'This is what always happens and it's uncomfortable but I know nothing bad is going to happen' -- so it encourages a cue to cope rather than to escape."Read article >>
Someday, a smart phone app that asks what you’re feeling 10 times a day may be able to tell you if you’re edging closer to depression—and recommend that you seek preventive therapy or drugs. Scientists have discovered that how quickly someone bounces back from negative feelings, over hours or days, can predict whether that person is at risk of an episode of major depressive disorder.
“The holy grail of depression epidemiology is that we want to intervene early to prevent people from having depressive episodes,” says social scientist Stephen Gilman of Harvard University, who was not involved in the study. “Where this work is headed is making an advance in that direction, toward early detection and therefore early intervention.”
Researchers asked more than 600 people—some healthy and some with a diagnosis of depression—to track their emotions for 5 or 6 days. Ten times a day, at random intervals, a watch would beep and the subjects would record how strongly they identified with each of four emotions: cheerful, content, sad, and anxious. Six to 8 weeks later, participants filled out a more detailed questionnaire that rated their levels of clinical depression.
By the end of the follow-up period, about 13% of the subjects had experienced a shift toward being more depressed, a number consistent with what would be expected in the general population. Trends in the daily mood records, the team discovered, could predict whether a previously healthy person would make that shift toward depression.
Mathematically, it turns out, the shift from a healthy state to a depressed state resembles other so-called tipping points—moments of critical mass where a system, such as changes to Earth’s climate or a social trend—shift rapidly from one state to another. Theories on tipping points suggest that as a system nears a tipping point, it becomes less resilient.
“In any system, if you push the system a little bit out of equilibrium, then the closer it is to the tipping point, the longer it takes to return to equilibrium after that perturbation,” explains Ingrid van de Leemput, an ecologist at Wageningen University and Research Centre in the Netherlands who led the new work. Indeed, the longer a patient took to recover from feelings of sadness and anxiety, the more likely they were to be more depressed by the end of the study, suggesting that they were closer to a tipping point between health and depression, her team reports online today in the Proceedings of the National Academy of Sciences. The results matched with a mathematical model that the researchers had previously created to represent how emotional swings could signal an impending tipping point.
“If a healthy person has an unpleasant call with their employer, they will be unhappy about it and dwell on it for 10 or 20 minutes but be done with it fairly quickly,” says psychiatry researcher Angelique Cramer of the University of Amsterdam, who collaborated with Van de Leemput. “What you see in people who are about to become depressed is that the next day, they are still sad about a phone call the day before.” Over time, she says, various symptoms of depression—negative mood, fatigue, and concentration problems, for example—can create a negative feedback loop that causes full-blown psychiatric disease. Cramer says the new research could lead to new ways for psychiatrists to track their patients’ well-being.
“I think this could open up new avenues of research in many ways,” Gilman says. He’d like to see the work expanded to include more variables that are already known to increase depression risk—such as family history, previous episodes of major depression, and social factors. “Really what we want to know is where on the distribution of sadness and mood is the dividing line between a serious depressive episode and nondepression. And are there factors that can push people further from or towards that dividing line?”Read article >>
In bustling primary care pediatric settings, where time and resources are limited, clinicians can use brief screening tools to reliably identify postpartum depression among adolescents, according to a research team that validated the diagnostic tools in 106 young mothers.
Kartik K. Venkatesh, MD, PhD, from the Department of Obstetrics and Gynecology, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, and colleagues report the findings of their validation study published online December 16 in Pediatrics.
Some 28% to 59% of pregnant mothers younger than 20 years self-report depressive symptoms, which are significantly higher rates than seen with older pregnant women, according to the authors. The mental ailment derails the young mothers' engagement in health-promoting behaviors for their infants as well as for themselves. What is more, children born to mothers with untreated depression are at higher risk for developmental delay and register lower levels of social engagement.
The researchers screened 106 women from February 2007 to August 2008. Women were eligible if they were younger than 17 years when they conceived and at less than 25 weeks' gestation. Their median age was 16 years; 53% were Latina, 17% were black, and 16% were white. At 6 weeks, 3 months, and 6 months postpartum, women completed formal psychiatric diagnostic interviews, "the gold standard for diagnosis," and the 10-item Edinburgh Postnatal Depression Scale (EPDS). Three EPDS subscales were assessed as brief screening tools.
Nineteen women, or 18%, met the diagnostic criteria for postpartum depression.
Of the trio of abbreviated diagnostic tools, the 7-item depressive symptoms subscale and the 2-item subscale, along with the EPDS, were found to be "highly accurate" in identifying postpartum depression among adolescent mothers. The lengthy EPDS had an overall area under the curve of 0.94. The abbreviated EPDS-7 and ultra-brief EPDS-2 scored overall areas under the curve of 0.96 (95% confidence interval, 0.92 - 0.99) and 0.90 (95% confidence interval, 0.83 - 0.97), respectively.
Although screening mothers for depression has become standard, pediatricians are an underused resource in the prevention battle, the authors note. Because the same clinician would treat young mothers and their offspring, pediatricians are "uniquely situated" to address postpartum depression among teenage mothers, the authors write. Reliance on clinical indicators only uncovers half of the women, however.
"With a wider recognition of the high frequency of postpartum depression among teenage mothers and increasing evidence of the deleterious effects of postpartum depression on maternal and child health, routine screening as part of postpartum care is essential whether in the obstetric provider's office or the pediatrician's office," the authors conclude.
Financial support for the study was provided by the National Institute of Mental Health and the National Institutes of Health. The authors have disclosed no relevant financial relationships.Read article >>