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Updated: 1 hour 43 min ago

Survey: Increase in Teen Reports of Anxiety, Depression, Suicidal Thoughts

Mon, 04/06/2020 - 8:00am

An extensive multi-year national survey suggests that anxiety, depression, suicidal thoughts, and other “internalizing” problems are increasing among teens. These conditions now represent a significant portion of the adolescent mental health burden.

Researchers from Johns Hopkins Bloomberg School of Public Health and Columbia University reviewed nationwide survey data on more than 230,000 U.S. adolescents over the period 2005 to 2018. They discovered that “internalizing” disorders were reported by larger percentage of adolescent girls. Moreover, the number of teens seeking mental health care rose significantly during the period, as did the use of outpatient mental health care services by adolescent girls.

“We aren’t sure why this is occurring, but it is clear from this evidence and other epidemiological studies that anxiety, depression, and other internalizing problems are becoming more prevalent among adolescents relative to other types of mental health problems,” said study lead author Ramin Mojtabai, M.D., Ph.D., M.P.H., a professor in the Department of Mental Health at the Bloomberg School.

The study appears online in JAMA Psychiatry.

Much of what is known about rates of depression and other mental health problems among U.S. adolescents comes from the U.S. Substance Abuse and Mental Health Services Administration’s National Survey of Drug Use and Health (NSDUH), an annual nationwide survey of tens of thousands of Americans age 12 and up.

NSDUH data have shown, for example, that at the time of the 2017 survey, 20 percent of adolescent girls ages 12 to 17 reported having had at least one major depressive episode in the prior year, compared to 8.7 percent of adult women.

In the study, Mojtabai and co-author Mark Olfson, M.D., Ph.D., of Columbia University’s Vagelos College of Physicians and Surgeons, examined long-term trends in NSDUH data on adolescents with an analysis of survey data from January 1, 2005 to December 31, 2018.

The researchers grouped the 14 annual surveys into seven sets of two consecutive surveys, to address short-term variability in the data and make longer-term trends more evident.

During the 2005 to 2018 period, 203,070 adolescents had been interviewed, and of these 47,090 (19.7 percent) reported prior-year treatment or counseling for mental health problems.

Mojtabai and Olfson found that the percentage of surveyed adolescents who reported treatment or counseling didn’t change significantly from 2005-06 to 2017-18. However, the proportion of adolescent girls reporting treatment or counseling did rise significantly.

Specifically, investigators discovered the number of teen girls seeking care increased from an average of 22.8 percent in the 2005-06 surveys to 25.4 percent in 2017-18, an 11.4 percent increase. In comparison, the proportion of boys reporting treatment or counseling declined from 17.8 percent to 16.4 percent, a decrease of 7.9 percent, over the same interval. Most of those changes occurred after 2011-12.

The mental health problems were categorized by researchers into several categories including internalizing problems (anxiety, depression, suicidal thinking, somatization disorders), externalizing problems (conduct and substance-use problems), relationship problems, and problems at school.

Mojtabai and Olfson found that internalizing problems accounted for an increasing proportion of the total during the study window — from 48.3 percent in 2005-06 to 57.8 percent in 2017-18, a 19.7 percent increase. Among internalizing problems, suicidal thoughts or attempts increased most sharply, by 63.3 percent, from 15.0 percent to 24.5 percent of the total.

“These trends in the types of reported problems were seen across different care settings, from school counseling to inpatient mental health services,” Mojtabai said.

There were also trends in the types of services reported by the survey respondents. In particular, the researchers found a 15.8 percent increase in reliance on outpatient mental health services such as psychiatric and psychotherapy clinics. Over 67 percent of respondents reported seeking care in these clinics 2017-18 vs. 58.1 percent in 2005-06.

Researchers also discovered a corresponding drop in the reported use of school counseling services, from 49.1 percent to 45.4 percent, a decrease of 7.5 percent during these same time periods. However, changes in the use of inpatient mental health care and general medical services were slight.

The authors did not attempt to address these trends in this study, although they did note that other research suggests a link between Internet social media use and texting, on the one hand, and increased rates of depression on the other.

Increased use of psychiatric drugs for children, and decreased exposure to environmental lead compounds — which are known to cause neurological problems associated with aggressive behavior— are two other factors noted that might explain declines in externalizing problems.

Psychiatrists have long observed that mental health problems are more likely to manifest in girls and women as internalizing problems, and in boys and men as externalizing problems. The increased proportion of girls reporting mental health problems during 2005-18 is thus a potential factor underlying the observed increase in internalizing problems.

However, Mojtabai and Olfson found that this trend remains in place even when adjusting for sex and other factors. “This trend cannot be completely explained by the larger proportion of girls seeking treatment in later years,” he said.

Olfson noted that policymakers, education system planners, and the medical profession should be aware of the observed trends in the uses of different mental health services, in particular the shift away from school counseling towards more use of outpatient mental health services.

Source: Johns Hopkins University

Overconfidence Seen in Kids as Young as Four

Mon, 04/06/2020 - 7:30am

Overconfidence is consistently observed among people in certain professions, including business executives, bankers and physicians across different countries and cultures, but a new U.K. study finds it persistent and widespread during early childhood as well.

“Much of our knowledge on judgment and decision-making is based on adult participants but there is no reason to believe that humans only develop such an omnipresent cognitive illusion once we reach adulthood,” said Dr. Dominik Piehlmaier, lecturer in marketing at the University of Sussex Business School and the study’s author.

“My findings indicate that effective interventions that increase an individual’s knowledge about their own knowledge and its boundaries might be needed to target much younger individuals if one wants to efficiently calibrate a person’s irrational confidence.”

For the study, children played a card game known as the Children’s Gambling Task where they choose cards from one of two packs. The card is then turned over to reveal how many stickers the participant has won and lost. One pack had cards with significantly higher wins and losses than the other.

At intervals, the young participants had to decide whether they thought they would win more, about the same, or fewer stickers than they did in a previous game.

After six practice trials, each child started off with four stickers. On average, each participant gained 0.3 stickers per turn and left the game with an average of 6.67 stickers, ranging from zero to 33.

The results show that more than 70% of four-year-olds and half of all five and six-year-olds were overconfident in their expectations after playing 10 turns and six practice trials.

“A vast number of repetitions, learning, and feedback in the study did not diminish the misplaced confidence in the success of the majority of participants,” said Piehlmaier. “The children played more than 60 turns and saw their payoff balance rose and fell, yet every third child still thought that they could do better than they had done in the previous 50 turns.”

“The Children’s Gambling Task closely resembles a very simplified version of the financial markets with relatively safe options providing low but steady average return rates and highly risky assets that promise much higher short-term gains with a catastrophic long-term yield,” he said.

“The finding that overconfidence is persistent even in the face of own shortcomings mirrors results from previous studies that looked at the performance of investors.”

Overconfidence is more commonly seen as a male trait, but the study revealed interesting results when it came to the general performance of boys and girls.

In general, girls outperformed boys by an average of 2.87 stickers thanks to a less high-risk strategy of choosing relatively more safe cards which offered smaller but more sustainable gains.

“Boys seem to follow a negative trend line that indicates slow but steady learning on what might be considered ‘reasonable expectations.’ Girls’ behavior is much more unpredictable. When the girls’ overconfidence plot is compared to their payoffs, it can be noticed that they closely align,” said Piehlmaier.

“This indicates that girls overestimate their abilities if they have a winning streak and underestimate themselves whenever they lose a few times in a row.

“By the end of the experiment, there were relatively more overconfident girls than boys — a finding that contradicts previous reports regarding more calibrated girls in metamemory tasks.”

Source: University of Sussex

 

 

Non-Western Men Seem Less Preoccupied With Muscularity

Mon, 04/06/2020 - 6:00am

A new study that looked at men’s attitudes toward muscularity in three countries found that non-Western men were generally less hung up on their body image and pursuing a muscular physique than Western men.

“However, we did still find evidence that men in these populations are influenced by both other men around them and by the media,” said lead author Dr. Tracey Thornborrow at the University of Lincoln in the United Kingdom.

The findings are published in the journal Frontiers in Psychology.

Most of the research on sociocultural influences, such as the media portrayals that shape male ideals and behaviors around muscularity and masculinity, have focused on so-called WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations.

Therefore, many of the conclusions around the drive for muscularity and its negative behaviors, such as steroid use and unhealthy dieting, are very Western-centric.

Thornborrow and the other U.K. researchers on the team wanted to find out if those attitudes translated to countries with different cultural norms, so they compared a cohort of British men against Ugandan and Nicaraguan males.

The team collected and assessed a number of parameters from each group, ranging from demographics and body mass index (BMI) to feelings about media influences and peer pressure on achieving an idealized appearance to personal body goals.

Participants also ranked the perceived level of muscularity of their current body and their ideal body on the Male Adiposity and Muscularity Scale (MAMS). Designed by the Person Perception Lab at the University of Lincoln, the new scale uses two-dimensional images created from 3D software, providing a more realistic range of body types and sizes based on measurements of real people.

The researchers also used a form of artificial intelligence to identify patterns in the data that might predict which ethnic groups would be driven toward behaviors to achieve more muscle regardless of country of origin.

“We used machine learning methods because they are good at determining if sociocultural factors, such as media and ethnicity, and a drive for muscularity, make it more likely that men will actively want to change their bodies,” said co-author Dr. Tochukwu Onwuegbusi, also of the University of Lincoln, who crunched the numbers on the study.

For example, the data from the current study suggest that being a Caucasian man in the UK or a Miskitu man in Nicaragua means that he would more likely believe that one should be muscular. Such men are more likely to engage in muscle-building activities, such as weight training or drinking protein shakes.

Motivations behind the drive toward a more muscle-bound frame can be complex, Thornborrow noted. For instance, men from certain ethnic groups in Nicaragua who reported being less concerned with physical appearance were still likely to try to increase muscle mass.

These non-media influenced motivations “could include local ideas about masculinity, and a muscular body being a visual indicator of a working man, not a lazy man,” Thornborrow explained. “In rural Nicaragua, many men will engage in physical work, such as farming, fishing, and construction, so a muscular body is associated with being a hard-working man.”

While there is growing evidence that men in Western countries are experiencing more pressure to conform to stereotypical body ideals, similarly to women, the picture emerging in non-WEIRD populations is less clear. More research is needed to better understand the consequences of these other cultural attitudes and behaviors around body image.

“This study, in particular, shows how there can be variation within groups — for example, nations or ethnic groups — and so it becomes more important to ensure any strategies or interventions are tailored to the specific cultural context,” Thornborrow said.

Source: Frontiers

Parental Training to Reduce Child’s Anxiety Can Be As Effective as Child Therapy

Mon, 04/06/2020 - 5:00am

A new randomized clinical trial suggests that parent training is as effective as child individual therapy for the treatment of childhood and adolescent anxiety disorders.

Anxiety disorders including social phobia, separation anxiety and generalized anxiety are the most common mental health problems in childhood. The disorders often cause significant distress to the child and family.

The conditions are common with up to one-third of youth experiencing a clinically impairing anxiety disorder by the time they reach adulthood. Saliently, such disorders can lead to impairment in personal, social and academic functioning. When not treated successfully, anxiety disorders in childhood can cause long term impairment and an increased risk of additional physical and mental health problems.

In the new study, researchers enrolled 124 children with existing clinical anxiety disorders and randomly assigned them to receive either the current front-line cognitive behavioral therapy (CBT) treatment, or SPACE (Supportive Parenting for Anxious Childhood Emotions.

SPACE is a program developed by researcher Dr. Eli Lebowitz and his team at the Yale Child Study Center, Yale School of Medicine, in New Haven, Connecticut.

The study appears in the Journal of the American Academy of Child and Adolescent Psychiatry(JAACAP).

SPACE teaches parents to reduce their accommodation and to respond to a child’s anxiety symptoms in a supportive manner that conveys acceptance of the child’s genuine distress along with confidence in the child’s ability to cope with anxiety.

The authors found that children whose parents participated in 12 sessions of SPACE were as likely to overcome their anxiety disorder as children who participated in 12 sessions of CBT, the best-established evidence-based treatment for child anxiety.

Anxious children look to their parents for help in coping with their anxiety and avoiding the things that make them feel afraid. Unfortunately, parents of anxious children typically become entangled in their child’s symptoms through a process known as family accommodation.

For example, a child who is chronically worried may rely on a parent for constant reassurance, or a child with separation anxiety may require a parent to stay at home with them or sleep next to them at night.

For children with social phobia, parents often speak in place of the child or avoid having guests over to the home. Research indicates that family accommodation can contribute to maintaining the child’s anxiety symptoms over time.

Following CBT and SPACE interventions, approximately 60 percent of children improved, no longer meeting diagnostic criteria for any anxiety disorder. The outcomes were based on assessments conducted by independent evaluators who were unaware of which treatment children received.

An even greater proportion (87.5 percent for SPACE and 75.5 percent for CBT) showed significant improvement in their symptoms. Anxiety symptom questionnaires completed by children and by their parents also showed equivalent improvement for SPACE and CBT. Parents and children rated both treatments as highly satisfactory.

Source: Elsevier

Postpartum Disorders May Dissuade Women From Having More Kids

Sun, 04/05/2020 - 6:18pm

A new study has found that women who suffer from psychiatric disorders such as depression, anxiety, mania, and schizophrenia, following the live birth of their first child are less likely to go on to have more children.

The study found that 69 percent of women who experienced postpartum psychiatric disorders within the first six months after the birth of their first baby went on to have further children compared to  82 percent of mothers who did not experience psychiatric problems.

Previous research has shown that, overall, around 3 percent of women develop psychiatric disorders in the first three months after childbirth. These disorders encompass a wide range of mental health problems and usually involve a combination of abnormal thoughts, behaviors, and relationships with other people, researchers explained. To date, there has been little research into whether this affects women’s subsequent reproduction, they add.

“We wanted to explore whether women with postpartum psychiatric disorders had a reduced possibility of having a second child. Furthermore, we considered whether a reduction in the live birth rate was due to personal choices or decreased fertility, as these are important issues to consider,” said Dr. Xiaoqin Liu, a postdoctoral researcher at the National Centre for Register-based Research at Aarhus University in Denmark, who led the study.

For the new study, the researchers analyzed data from Danish registries for 414,571 women who had their first live birth between 1997 and 2015 in Denmark. They followed the women for a maximum of 19.5 years until the next live birth, emigration, death, their 45th birthday, or June 2016, whichever occurred first.

They identified women with postpartum psychiatric disorders by seeing if they were given prescriptions for psychotropic medications or had hospital contact for psychiatric disorders during the first six months after the live birth of their first child.

According to the study’s findings, 4,327 — or 1% — of the women experienced psychiatric disorders following the birth of their first child.

These women were a third less likely to have a second live birth compared to women who did not experience psychiatric disorders, the study discovered.

If the first child died, the difference in subsequent live birth rates disappeared. However, if the psychiatric problem required hospitalization, the likelihood of a woman having a second child nearly halved and this remained the case whether the first child survived or not, the researchers reported.

“Although fewer women with postpartum psychiatric disorders had subsequent children, it is noteworthy that about 69 percent of these women still chose to have a second child,” Liu said. “For the remaining 31% of women, we need to differentiate the reasons why they did not have another child. If they avoided another pregnancy due to fear of relapse, an important clinical message to them is that prevention of relapse is possible.”

“We recommend that they seek help from their family doctors or psychiatrists if they want to have another child, so that plans for treatment that are specific for their individual needs can be made to reduce the risk of relapse, and so that their health, well-being and symptoms can be closely monitored and treated,” she continued.

The researchers noted that women whose first child died were nearly four times as likely to have a subsequent live birth as women whose first child survived.

“These findings suggest that the overall reduced rate of subsequent live births among women who experienced psychiatric disorders after the birth of their first child is, at least in part, voluntary,” Liu said.

The researchers add that other possible explanations for the reduction in the subsequent live birth rate may be that women with postpartum psychiatric disorders are less able to conceive or have more problematic relationships with partners.

“The reason why women with postpartum psychiatric disorders choose to have fewer children needs to be explored further,” said Liu.

A limitation of the study is that, although the researchers had an almost complete follow-up of the women through the Danish registries, they did not have accurate information on stillbirths or miscarriages. Only pregnancies that led to a live birth were included in the study. Another limitation is that not all women with psychiatric disorders might have received medications or hospital treatment. In addition, it might not be possible to generalize the findings of the study to populations in other countries, the researchers noted.

“Denmark offers free and easily available healthcare to all individuals, so we believe our results can inform other, similar populations, although we cannot rule out local differences,” concluded Liu.

The study was published in Human Reproduction. 

Source:  European Society of Human Reproduction and Embryology

Some Alluring Details Can Be Detrimental to Learning

Sun, 04/05/2020 - 6:08pm

When teachers use a funny joke, a cat video, or even background music in their lessons, it can keep students from understanding the main content, according to new research.

These so-called “seductive details,” information that is interesting but irrelevant, can be detrimental to learning, according to a meta-analysis by researchers at Washington State University.

The analysis of 58 studies involving more than 7,500 students found that those who learned with seductive details performed lower on learning outcome measures than those who learned without the extraneous information, according to the study’s findings.

“If you have an irrelevant piece of information, and it is something that is interesting, students tend to perform worse,” said Kripa Sundar, the lead author on the paper that is based on her dissertation from WSU’s College of Education.

“There are multiple hypotheses on why that happens, but the simplest is that students’ attention is now diverted toward that irrelevant information, and they’re spending too much time trying to understand what that seductive detail is instead of the content matter.”

Sundar and her co-author Dr. Olusola Adesope, a WSU professor of educational psychology, found that the effect was worse when the seductive detail was placed next to informative and relevant diagrams, or when it was constant, such as a static joke or image on a screen. Including seductive details was also more detrimental on paper than in digital formats, and more prominent in certain subjects, such as social studies and natural sciences, the researchers discovered.

The analysis supports the coherence principle in multimedia learning, which recommends that all relevant information needs to be placed together and unnecessary information should be excluded, the researchers claimed.

Good detail that helps engage students is still important, Sundar said. It’s just important that those details are pertinent to the topic, she added.

“This does not mean that learning shouldn’t be fun,” she said. “We just might need to exert a little more effort into thinking how we can make the learning activity itself a lot more engaging and interesting in a way that contributes toward the educational objective.”

Humans tend to connect details to big concepts, so good details that teachers include can be helpful in having students remember a certain idea. However, if detail is included that is not useful — but very alluring — it can potentially trigger a different line of thought, she noted.

For example, if, during a science lesson about how lightning forms, the teacher talks about how a freak lightning strike killed 16 people at a church in Rwanda in 2018, students can easily be derailed by that very specific, dramatic story, she explained.

The researchers also call for further research into this phenomenon. Even though the analysis was broad, Sundar noted that most studies used short learning sessions of only six to 12 minutes when a typical class is 55 minutes long.

She pointed to two other aspects for further investigation: The role of prior knowledge of a subject, which may allow a learner to better distinguish relevant from irrelevant information, and the potential positive effect seductive details may have on students’ emotions. For instance, something distracting like a joke or music might lessen the anxiety many people feel about learning math, she said.

“There may be some trade-offs between the potential emotional benefit and the detrimental effects of seductive details that we’re seeing on learning,” said Sundar. “Understanding that would enable us to make strong recommendations for practice because teachers are teaching children, and they’re human.”

The study was published in the journal Educational Psychology Review.

Source: Washington State University

Do Health Warning Labels on Alcohol and Snacks Limit Consumption?

Sun, 04/05/2020 - 5:50pm

Image-and-text health warning labels (HWLs), similar to those on cigarette boxes, show potential for reducing the consumption of alcoholic drinks and high-calorie snacks, according to a new study published in the open access journal BMC Public Health.

HWLs using gruesome images and text to show the negative health effects of smoking have been deemed effective and acceptable for changing smoking-related outcomes.

However, evidence is limited regarding the usefulness of HWLs for reducing the consumption of alcohol and energy-dense foods like chocolate bars or potato chips.

A team of researchers at the Universities of Cambridge and Bristol in the U.K. conducted two online studies with different participants, asking them to rate varying image-and-text HWLs on alcoholic drinks (5,528 participants) or energy-dense snacks (4,618 participants).

“To our knowledge, these are the first large-scale studies in general populations to examine the potential effectiveness and acceptability of image-and-text health warning labels on alcohol and on snack foods,” said Dr. Gareth Hollands, the corresponding author.

“Prior research in this area has typically either looked at these warning labels on sugary drinks, or used smaller or less representative samples.”

U.K. participants for the alcohol study were recruited if they self-reported consuming either beer or wine at least once a week. A total of 5,528 people were shown an image of a bottle of beer or wine labeled with one of 21 possible HWLs depicting the negative health consequences of alcohol consumption.

Participants were asked how afraid, worried, uncomfortable or disgusted the label made them feel, to rate their desire to consume the product, and how strongly they supported putting the label on alcoholic drinks.

For the food study, participants were recruited if they self-reported that they consumed biscuits, cake, chips or chocolate at least once a week, and liked chocolate. A total of 4,618 people were shown an image of a chocolate bar labeled with one of 18 possible HWLs illustrating the adverse health consequences of obesity and related conditions, caused by excess calorie consumption.

The authors found that HWLs on alcoholic drinks depicting bowel cancer, followed by those showing liver cancer were associated with the highest level of negative emotions — fear, disgust, discomfort and worry — and the lowest desire to consume the product.

In general, few of the alcohol HWLs were considered acceptable, with only three out of 21 rated at least somewhat acceptable.

HWLs on high-density snacks depicting bowel cancer, followed by those depicting non-specific cancer were associated with the highest level of negative emotions and lowest desire to consume the product, with those depicting bowel cancer considered to be the least acceptable.

HWLs on energy-dense snacks were judged on average more acceptable than those on alcohol, with 13 out of 18 snack HWLs rated as at least somewhat acceptable.

The authors suggest that the response to labels depicting bowel cancer HWLs may indicate those that have the greatest potential for reducing alcohol and snack food selection and consumption.

“The finding that health warning labels may be judged to be relatively more acceptable to use on snack foods, than on alcohol, could be due to heightened public awareness of the health consequences of excess energy intake and obesity, particularly in children. In general, however, many of the participants expressed negative views of the possible use of such labels,” said Hollands.

The authors warn that the study did not demonstrate whether negative emotional arousal and impacts on desire to consume are actually effective in changing behavior. And since the research was conducted online, responses may differ when HWLs are applied to physical products in real-world settings.

More research is needed to investigate the real-world potential of these labels to reduce selection and consumption of alcohol and energy-dense snacks.

Source: BMC (BioMed Central)

Revisiting Psychedelic Drugs to Treat Psychiatric Illness

Sun, 04/05/2020 - 8:06am

Before psychedelic drugs were banned in the 1970’s, psilocybin (the active compound in “magic mushrooms”) and LSD (acid) had shown promise for treating conditions such as alcoholism and some psychiatric disorders.

In a new commentary published in the journal Cell, part of a special issue on medicine, researchers say it’s time for regulators, scientists, and the public to “revisit drugs that were once used but fell out of use because of political machinations, especially the war on drugs.”

“If we changed the regulations, we would have an explosion in this kind of research,” said first author Dr. David Nutt, a professor and neuropharmacologist at Imperial College London.

“An enormous opportunity has been lost, and we want to resurrect it. It’s an outrageous insult to humanity that these drugs were abandoned for research just to stop people from having fun with them. The sooner we get these drugs into proper clinical evaluation, the sooner we will know how best to use them and be able to save lives.”

Brain imaging over the past 20 years has taught scientists a lot about how these drugs act on different areas of the brain.

In general, psychedelics appear to disrupt the default mode network, a region that is active during thought processes like daydreaming, recalling memories, and thinking about the future — when the mind is wandering, essentially. It’s also an area that is overactive in people with disorders like depression and anxiety.

Psychedelics appear to have long-term effects on the brain by activating 5-HT2A receptors in  the default mode network. More studies are needed to determine why these effects last so long, both from a psychological perspective and in terms of altered brain functioning and anatomy.

“There’s mechanistic evidence in humans of how these drugs affect the brain,” Nutt says. “By back-translating from humans to rodent models, we can see how these drugs produce the powerful neuroplastic changes that explain the long-term alterations we see in humans.”

In the commentary, the researchers write about the “psychedelic revolution in psychiatry.” They look at specific questions in research, including what is known about the receptors in the brain affected by these drugs and how stimulating them might impact mental health.

The authors also address what’s been learned so far about microdosing, the value of the psychedelic “trip,” and what researchers know about why the effects of these trips are so long-lasting.

The authors note the challenges in obtaining materials and funding for this type of research. “Before LSD was banned, the US NIH funded over 130 studies exploring its clinical utility,” they write. “Since the ban, it has funded none.”

Nutt highlights the early potential of psychedelic drugs for treating alcoholism, which the World Health Organization estimates to be the cause of about one in 20 deaths worldwide every year.

Nutt is a prominent proponent of conducting controlled trials to examine the potential benefits of psychedelics. He is also chair of the scientific advisory board for COMPASS Pathways, a for-profit company that is leading clinical research to test the safety and efficacy of psilocybin-assisted therapy for treatment-resistant depression.

The treatment has been granted breakthrough therapy designation from the U.S. Food and Drug Administration. The group also plans to launch a similar study for obsessive-compulsive disorder.

Source: Cell Press

 

More Mental Health Visits Can Decrease Kids’ Risk of Suicide

Sat, 04/04/2020 - 7:00am

A new study has found that the risk of suicide is highest among youth with epilepsy, depression, schizophrenia, substance use, and bipolar disorder.

But researchers at Ohio State University Wexner Medical Center also found that the risks of suicide decreased among the youth who had more mental health visits in the 30 days before the date of suicide.

The population-based case-control study merged mortality data with U.S. Medicaid data from 16 states spanning all regions of the country and accounting for 65 percent of the total child Medicaid population, according to the researchers.

The study looked at 910 youth aged 10-18 years who died by suicide between Jan. 1, 2009, and Dec. 31, 2013, compared to a control group of 6,346 youth that was matched based on gender, race, ethnicity, Medicaid eligibility category, state, and age, the researchers explained.

For both groups, researchers examined health and behavioral health visits in the six-month period prior to the date of suicide. Associations between visits, clinical characteristics, and suicide were examined, according to the researchers.

Clinical characteristics included psychiatric diagnoses, including attention deficit hyperactivity disorder, conduct disorders, depression, bipolar disorder and other mood disorders, anxiety disorders, schizophrenia/psychosis, substance use, and other mental health disorders. It also included chronic medical conditions, such as diabetes, seizure disorders, cerebral palsy, asthma or cancer.

“Our study found that 41 percent of youth who died by suicide had at least one mental health diagnosis in the six months prior to death, a finding similar to those of previous studies on adults,” said lead researcher Dr. Cynthia Fontanella, an associate professor in the department of psychiatry and behavioral health at The Ohio State Wexner Medical Center.

“Our findings suggest that youths with psychiatric disorders, particularly mood disorders, schizophrenia, and substance use, should be routinely assessed for suicide risk and receive high-intensity, evidence-based treatments for suicidality, such as cognitive behavioral therapy.”

“To the best of our knowledge, no studies have examined the clinical profiles and health and mental health service utilization patterns prior to suicide for children and adolescents within the Medicaid population,” added Fontanella. “Understanding how health care utilization patterns of suicidal decedents differ from the general population is critical to target suicide prevention efforts.”

In the United States, the suicide rate among people between the ages of 10 and 24 years has increased by 50 percent since 1999. Suicide is currently the second leading cause of death in this age group, accounting for nearly 6,800 deaths in 2017.

“Suicide among young people is a major public health problem. Based on our findings, we believe that implementing suicide screening protocols for youth enrolled in Medicaid — targeted on the basis of frequency of visits and psychiatric diagnoses — has the potential to decrease suicide rates,” Fontanella said.

Fontanella, who also is a member of Ohio State’s Neurological Institute, conducts research on mental health services for children and adolescents with serious emotional disturbances, especially disadvantaged populations. She collaborated with researchers from The Ohio State University College of Medicine, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Ohio Department of Mental Health and Addiction Services, and Rockefeller Neuroscience Institute at West Virginia University on the new study.

The study was published in JAMA Pediatrics.

Source: The Ohio State University Wexner Medical Center 

Placebo Effect in Psychedelic Drug Studies May Be Stronger Than Once Believed

Sat, 04/04/2020 - 6:30am

While there has been a lot of recent interest in using psychedelic drugs to treat depression, a new study suggests that — in the right context — some people may experience psychedelic-like effects from placebos alone.

In the new study, researchers at McGill University in Montreal, Quebec, Canada, reported some of the strongest placebo effects on consciousness in the scientific literature relating to psychedelic drugs. In fact, researchers note that 61 percent of the participants in their experiment reported some effect after taking the placebo.

“The study reinforces the power of context in psychedelic settings. With the recent re-emergence of psychedelic therapy for disorders such as depression and anxiety, clinicians may be able to leverage these contextual factors to obtain similar therapeutic experiences from lower doses, which would further improve the safety of the drugs,” said Jay Olson, a Ph.D. candidate in McGill’s Department of Psychiatry and the lead author on the research paper.

The study participants, who were expecting to take part in a study of the effects of drugs on creativity, spent four hours together in a room that had been set up to resemble a psychedelic party, with paintings, colored lights, and a DJ. To make the context seem credible and hide the deception, the study also involved 10 research assistants in white lab coats, psychiatrists, and a security guard, the researchers described.

The 33 participants had been told they were being given a drug that resembled the active ingredient in psychedelic mushrooms. They also were told they would experience changes in consciousness over the four-hour period.

In reality, everyone consumed a placebo, according to the researchers.

Among the participants were several actors who had been trained to slowly act out the effects of the supposed drug. The researchers said they thought this would help convince the participants that everyone had taken a psychedelic drug, which might lead them to experience placebo effects.

When asked near the end of the study, the majority of the participants — 61 percent — reported some effect of the drug, ranging from mild changes to effects resembling taking a moderate or high dose of an actual drug.

The researchers report there was considerable variation among the participants. For example, several participants stated that they saw the paintings on the walls “move” or “reshape” themselves. Others described themselves as feeling “heavy… as if gravity had a stronger hold,” and one had a “come down” before another “wave” hit her. Several participants told the researchers they were certain they had taken a psychedelic drug.

“These results may help explain ‘contact highs’ in which people experience the effects of a drug simply by being around others who have consumed it,” said Dr. Samuel Veissière, a cognitive anthropologist who teaches in McGill’s Department of Psychiatry and supervised the study. “More generally, our study helps shed light on the ‘placebo boosting’ component inherent in all medical and therapeutic intervention, and the social influences that modulate these enhancing effects.

“Placebo effects may have been underestimated in psychedelic studies. The current trend towards ‘micro-dosing,’ consuming tiny amounts of psychedelic drugs to improve creativity, for example, may have a strong placebo component due to widespread cultural expectations that frame the response.”

The study was published in the journal Psychopharmacology.

Source: McGill University

Stress Hinders Ability to Plan Ahead By Disrupting Memory

Sat, 04/04/2020 - 6:00am

Stress can thwart our ability to plan ahead by preventing us from making decisions based on memory, according to a new study at Stanford University.

“We draw on memory not just to project ourselves backward into the past but to project ourselves forward, to plan,” said Stanford psychologist Dr. Anthony Wagner, who is the senior author of the paper. “Stress can rob you of the ability to draw on cognitive systems underlying memory and goal-directed behavior that enable you to solve problems more quickly, more efficiently and more effectively.”

The findings are published in the journal Current Biology.

Combined with previous work from Wagner’s Memory Lab and others, the research could have broad implications for understanding how individuals plan for the future — and how a lack of stress may give some people a greater neurologically-based opportunity to think ahead.

“It’s a form of neurocognitive privilege that people who are not stressed can draw on their memory systems to behave more optimally,” said Wagner, the Lucie Stern Professor in the Social Sciences at Stanford’s School of Humanities and Sciences.

“And we may fail to actually appreciate that some individuals might not be behaving as effectively or efficiently because they are dealing with something, like a health or economic stressor, that reduces that privilege.”

For the study, the research team monitored participants’ behavior and brain activity, via functional magnetic resonance imaging (fMRI), as they navigated through virtual towns. After participants became very familiar with the winding routes in a dozen towns, they were dropped onto one of the memorized paths and told to navigate to a goal location.

To test the effects of stress, the researchers warned some participants that they could receive a mild electric shock, unrelated to their performance, during their virtual walks.

The results show that participants who didn’t have to worry about being randomly shocked tended to envision and take novel shortcuts based on memories acquired from previous journeys. Meanwhile, the stressed participants tended to fall back on the meandering, habitual routes.

Before beginning their journey, the participants were virtually held in place at their starting position. Brain scans during this time showed that the stressed subjects were less likely than their counterparts to activate the hippocampus, a brain structure that would have been active if they were mentally reviewing previous journeys.

The stressed individuals also had less activity in their frontal-parietal lobe networks, a part of the brain which allows us to bring neural processes in line with our current goals. Previous research by the team had shown that stress hinders this neural machinery, making it harder for us to retrieve and use memories.

The researchers believe their new study is the first to show how hippocampal-frontal lobe network disruption can thwart a planning session.

“Its kind of like our brain is pushed into a more low-level thought-process state, and that corresponds with this reduced planning behavior,” said Dr. Thackery Brown, who was a postdoctoral scholar in the Memory Lab during this research and is lead author of the paper.

Looking forward, the team is particularly interested in how the link between stress and memory affects older populations, who often experience both health and economic issues. Older adults are also more likely to be concerned about memory loss. Together, these combined stressors could contribute to a declining memory, which could worsen their stress and also impair their ability to deal with it.

Brown has begun conducting research similar to the virtual navigation experiments with participants, ages 65 to 80, to investigate how the links between stress, memory and planning play out in older populations.

“It’s a powerful thing to think about how stressful events might affect planning in your grandparents,” said Brown, now an assistant professor at Georgia Institute of Technology.

“It affects us in our youth and as we interact with and care for older members of our family, and then it becomes relevant to us in a different way when we are, ourselves, older adults.”

Source: Stanford University

 

Mindfulness Training May Reduce Physician Burnout

Fri, 04/03/2020 - 7:00am

As health professionals on the front lines face the frightening realities of COVID-19 and the absence of a curative vaccine, many worry our county’s brave defenders are at risk of burnout.

“Healthcare providers are under tremendous pressure right now,” said Dr. Jud Brewer, director of research and innovation at the Mindfulness Center at Brown University. “Physician burnout was already reaching ‘epidemic’ proportions before this pandemic hit.”

In fact, a 2014 study found that nearly half of all physicians experience significant symptoms of burnout, and further research suggests that the risk is particularly high for those who perceive that they are not in control of what unfolds around them. Theoretically, this perceived lack of control leads to anxiety, which can then lead to burnout.

Mindfulness-based stress reduction has demonstrated decreases in anxiety, yet physicians have reported reluctance to engage in it due to significant time commitments.

Brewer and his colleagues worked to address these conditions with a smartphone-app mindfulness training program called Unwinding Anxiety. They examined the app’s effects in a pilot study of 34 physicians. The study, “Physician Anxiety and Burnout: Symptom Correlates and a Prospective Pilot Study of App-Delivered Mindfulness Training,” appears in JMIR mHealth and uHealth.

The study was the first to test the effectiveness of an app-based mindfulness program as an intervention for anxiety in physicians.

“Clinicians need effective tools to help them reduce anxiety and burnout,” Brewer said. “Digital therapeutics are an ideal solution because people can use them in small doses, at home, on their own schedule.

The app-based mindfulness training that we studied does just that: It provides short daily trainings — about 10 minutes per day — that people can access from their smartphone, and it gives them tools they can use throughout the day.”

The app aimed to reduce anxiety by helping users recognize maladaptive thought patterns and become less reactive to anxious thoughts. And it worked. Three months after using the app for 30 days, participants exhibited a 57% decrease in anxiety scores.

Brewer and his colleagues also found clear links between anxiety and certain aspects of burnout — cynicism and emotional exhaustion — which suggests that the app could effectively treat burnout as well. Sure enough, at the three-month follow-up, participants exhibited a 50% decrease in cynicism and a 20% decrease in emotional exhaustion.

“These results provide clear implications that this mindfulness-based digital therapeutic may be a useful tool for busy clinicians to both reduce anxiety and help build resilience against getting burnt out,” Brewer said.

He and his colleagues are already at work on the next steps: a randomized controlled trial of app-based mindfulness training for broader populations.

“The pharmaceutical industry hasn’t released any new anti-anxiety medications in decades and to my knowledge has no new drugs in the pipeline,” he said.

“We need effective treatments, especially those that can be widely disseminated at low cost. Digital therapeutics, like app-based treatments, are the next wave of treatment.”

Source: Brown University

Mindfulness Improves as We Age

Fri, 04/03/2020 - 6:30am

New research may provide an answer for why many people say life gets better with age. A new study by Australian investigators suggests this may be because older people have the wisdom and time to use mindfulness as a means to improve wellbeing.

Healthy aging researchers at Flinders University say certain characteristics of mindfulness seem more strongly evident in older people compared to younger people. The new findings may help people of all ages better deal with life circumstances.

Mindfulness refers to the natural human ability to be aware of one’s experiences and to pay attention to the present moment in a purposeful, receptive and non-judgmental way. Using mindful techniques can be instrumental in reducing stress and promoting positive psychological outcomes.

From middle age to old age, the Flinders University survey highlights the tendency to focus on the present-moment. The strategy to adopt a non-judgmental orientation may become especially important for well-being with advancing age.

“This suggests that mindfulness may naturally develop with time and life experience,” says behavioral scientist Associate Professor Tim Windsor. Windsor co-authored the study which was based on an online community survey of 623 participants, aged between 18 and 86 years.

The study, ‘Older and more mindful? Age differences in mindfulness components and well-being,’ appears online in Aging and Mental Health.

“The significance of mindfulness for wellbeing may also increase as we get older, in particular the ability to focus on the present moment and to approach experiences in a non-judgmental way.

“These characteristics are helpful in adapting to age-related challenges and in generating positive emotions.”

In one of the first age-related studies of its kind, the researchers assessed participants’ mindful qualities such as present-moment attention, acceptance, non-attachment and examined the relationships of these qualities with wellbeing more generally.

“The ability to appreciate the temporary nature of personal experiences may be particularly important for the way people manage their day-to-day goals across the second half of life,” says study lead author Leeann Mahlo. Mahlo is investigating mindfulness in older adulthood as part of her PhD research.

“We found that positive relationships between aspects of mindfulness and wellbeing became stronger from middle age onwards,” she says.

“Our findings suggest that if mindfulness has particular benefits in later life, this could be translated into tailored training approaches to enhanced wellbeing in older populations.”

Mindfulness skills can help build wellbeing at any age, adds Mahlo. Tips to develop mindful techniques include:

    • Becoming aware of our thoughts and surroundings and paying attention to the present moment in an open and nonjudgmental way. This can prevent us from focusing on the past or worrying about the future in unhelpful ways.
    • Understanding that our thoughts, feelings and situations exist in the moment and will not last. This can help us to respond in flexible, more optimistic ways to challenging circumstances, including those that we are facing with concerns related to COVID-19.
    • Finding out more about mindfulness via app-based programs such as Calm, Headspace, Insight Timer, Smiling Mind, and Stop, Breathe & Think. These are available for use on computers or smartphones and offer flexible ways of learning and practicing mindfulness — including for people now spending more time at home.

Source: Flinders University/EurekAlert

Heavy Drinking Into Older Age Linked to Greater Risk of Stroke, Larger Waistline

Fri, 04/03/2020 - 6:00am

More than half of drinkers ages 59 and older had been heavy drinkers at some point in their lifetime, and this is linked to significantly larger waistlines and an increased risk of stroke, according to a new study U.K. study published in the journal Addiction.

Researchers from University College London (UCL) examined the link between heavy drinking over a lifetime and a range of health indicators, such as cardiovascular disease.

The team looked at data from the Whitehall II study, which collected information from U.K. civil servants, ages 34 to 56 years at study outset, from 1985 to 1988. The final sample for this study consisted of 4,820 older adults, 59 to 83 years. The mean (average) age was 69, and 75% were male.

Overall, the researchers found that heavy alcohol consumption over a lifetime is linked to higher blood pressure, poorer liver function, increased stroke risk, larger waist circumferences and body mass index (BMI) in later life, even if the participants quit drinking heavily before age 50. However, stopping heavy drinking at any point in life is likely to be beneficial for overall health.

“Alcohol misuse, despite the common perception of young people binge drinking, is common among older adults, with alcohol related hospital admissions in England being the highest among adults aged over 50,” said Dr. Linda Ng Fat (UCL Institute of Epidemiology & Health Care), first author on the study.

“Previous studies have focused on single snapshots of consumption, which has the potential to mask the cumulative effects of drinking. This study raises awareness of the effect of alcohol consumption over the life-course.”

A heavy drinker was identified using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C), a standard screening tool for GPs. The screening tool consists of just three questions, and assesses how often you drink, how much you drink, and how often you binge (have six or more drinks). For example, a person who has three or four drinks, four or more times a week, would score positive as a hazardous drinker on the AUDIT-C.

Participants were asked on a single occasion to complete the AUDIT-C retrospectively for each decade of their life, from 16-19 to 80 and over.

This information was used to categorize their life-time drinking pattern: never hazardous drinker, former early hazardous drinker (stopped before age 50), former later hazardous drinker (stopped at age 50 or after), current hazardous drinker, and consistent hazardous drinker (during every decade of their life).

More than half of drinkers (56%) had been hazardous drinkers at some point in their life, with 21% being current hazardous drinkers and 5% being consistent hazardous drinkers.

Current and consistent heavy drinkers were primarily male (80% and 82%, respectively), predominately white, and likely to be in senior level jobs (61% compared with 52% in the total sample).

Former later, current and consistent hazardous drinkers had significantly higher systolic blood pressure and poorer liver function than never hazardous drinkers after adjusting for lifestyle factors.

Current hazardous drinkers had three times greater risk of stroke and former later hazardous drinkers had about double the risk of non-cardiovascular disease mortality compared with never hazardous drinkers.

“Despite high prevalence of stroke and liver disease steadily increasing in the United Kingdom, heavy drinking remains common among older adults,” said Professor Annie Britton (UCL Institute of Epidemiology & Health Care), senior author on the study.

“Early intervention and screening for alcohol consumption, as part of regular check-ups, could help reduce hazardous drinking among this demographic.”

In addition, lifetime hazardous drinkers had significantly larger waist circumferences and BMI than never hazardous drinkers, with the magnitude increasing with more current and consistent hazardous drinking.

Former early hazardous drinkers on average had a 1.17 centimeters larger waist than never hazardous drinkers, whereas former later hazardous drinkers, current hazardous drinkers and consistent hazardous drinkers had a waist circumference that was 1.88 cm, 2.44 cm and 3.85cm larger respectively.

“This suggests that the longer adults engage in heavy drinking the larger their waistline in older age. That is why it is beneficial, along with other health benefits, that adults reduce heavy drinking earlier rather than later,” said Ng Fat.

Source: University College London

Skin-to-Skin Touch Boosts Baby’s Brain Development

Fri, 04/03/2020 - 5:30am

As the world prioritizes social distancing to stop or slow down the spread of COVID-19, a new study demonstrates that mother-infant touch and contact are essential for optimal brain development in early infancy.

Kangaroo Care, a skin-to-skin, chest-to-chest method of caring for a baby, especially one who is premature, has been associated with promoting neurophysiological development, according to researchers at Florida Atlantic University. This method of caring emphasizes the importance of holding the naked or partially dressed baby against the bare skin of a parent, typically the mother.

New research is showing that extended use of Kangaroo Care can positively benefit full-term infants and their mothers during the postpartum period.

The longitudinal randomized, controlled trial investigated if Kangaroo Care influences markers of brain development and function in healthy, full-term infants. They focused on the potential association between Kangaroo Care and infant brain development, specifically measures of EEG (electroencephalogram) asymmetry/power and coherence, the researchers explained.

In addition to EEG patterns in infants, the researchers looked at basal oxytocin — the “cuddle” hormone — and cortisol reactivity — the “stress” hormone — in infants and their mothers. Oxytocin is the hormone associated with caregiving and affectionate behavior, while cortisol reactivity is implicated in the stress response system.

For the new study, researchers compared six weeks of Kangaroo Care to standard care during the first three months of life.

For the study, mothers assigned to the Kangaroo Care group were given a Kangaroo Care wrap called the Kangaroo Zak from the company Nurtured by Design. They also were taught proper procedures by a certified trainer at the prenatal visit.

Mothers were asked to use Kangaroo Care, skin-to-skin, chest-to-chest contact with their infants for one hour a day for six weeks. They were provided with journals to record the frequency of Kangaroo Care use.

Mothers in the control group — the standard care group — were given infant feeding pillows and journals and were asked to record infant feedings for six weeks.

Babies were fitted with a stretch Lycra cap to measure EEG activity during a five-minute quiet-alert state at three months. Oxytocin was measured by collecting maternal and infant urine, and infant cortisol reactivity was measured by collecting infant saliva samples before and after a mild stressor, the researchers reported.

The study provides evidence that the physiology of mothers and their full-term infants is influenced by obtaining Kangaroo Care training and utilizing it during the postpartum period, according to the researchers.

“We wanted to know if exposure to extended tactile stimulation using the Kangaroo Care method would increase peripheral basal oxytocin and suppress cortisol reactivity in the babies in our study,” said Nancy Aaron Jones, PhD, senior author, an associate professor, director of the FAU WAVES Emotion Laboratory in the Department of Psychology, and a member of the FAU Brain Institute (I-BRAIN). “We also wanted to examine if Kangaroo Care increases oxytocin levels in mothers, which has important implications for postpartum depression.”

Findings showed that the infants’ left frontal area of the brain — implicated in higher-order cognitive and emotional regulatory skills — appears to be stimulated from the Kangaroo Care method. In addition, the mother and infants showed increased oxytocin, along with decreases in stress reactivity, suggesting regulatory abilities are prompted by experiences with positive caregiving in infancy, according to the researchers.

The study’s findings indicate that Kangaroo Care training and the level of use by caregivers during infancy can favorably influence both neurodevelopmental trajectories and infant neurobiological functioning, the researchers added.

“Our findings across several studies demonstrate a link between the supportive dimensions of maternal caregiving behavior and left hemisphere neurodevelopment, with maternal warmth and sensitivity predicting greater regulatory abilities and secure attachment,” said Jones. “Full-term infants and their mothers likely benefit from the positive interactive experiences inherent in extended Kangaroo Care use.”

The study was published in the journal Infant Behavior and Development.

Source: Florida Atlantic University

What Happens When Men Outnumber Women in a Population?

Thu, 04/02/2020 - 11:16am

What happens when the number of men is greater than the number of women in a population? Do the men in that population become more prone to competitive risk taking and violent behavior?

According to a new study by Florida State University Professor of Psychology Jon Maner, the answers might not be what you expect.

“When men outnumber women in a given ecology, intuition might suggest that rates of violent crime would skyrocket, marriages would destabilize and many children would be born out of wedlock,” he said. “Intriguingly, the opposite has been observed.”

The study was based on a review and an analysis of previous work on the topic conducted by Maner and other researchers.

Although ecological sex ratios have been studied extensively in nonhuman species, they play a crucial role in humans as well. Many factors can produce sex ratio imbalances, including wars, which kill more men than women, and sex-differentiated migration patterns.

“One of the central ideas is that when there is an imbalance in sex ratios, whichever sex is in the majority faces a lot more competition when it comes to finding and retaining romantic partners,” Maner said.

“One way in which that competition expresses itself is in the way both men and women shift their overall mating strategy toward the typical mating strategy of the other gender.”

In order to compete for a mate, many male species will resort to competitive risk taking or violent behaviors to attract females. In human males this might mean attention-grabbing, riskier behaviors such as overextending themselves financially to purchase status symbols, riding motorcycles and fighting.

But there are other male responses that are less well-known and, Maner pointed out, more typical of females.

“Another way men can compete with one another is by being quicker to settle down with one woman, get married and really devote himself more fully to having kids and being a good parent,” he said.

“On the other hand, if he isn’t able to find a partner, he might be inclined to compete in other ways and that’s where you might find increased violence, risk taking and competition with other men.”

Maner said his study also found that this crisscross of traits works in the opposite direction with women taking on behaviors more typical of men when they are in the overrepresented population.

“When women are more abundant, they are more open to casual sexual relationships, less likely to get married,” he said. “They are essentially catering to what is often the trait among men, which is to play the field.”

For those in overrepresented populations who might already have trouble finding a mate, competition to win a mate’s affections can become especially difficult. As an example, Maner mentioned men of low socioeconomic status.

“They are generally less desirable to potential partners and their mating opportunities are limited,” he said. “They face especially fierce competition, so they are especially inclined to find a partner and settle down quickly.”

The study is published in the journal Trends in Cognitive Sciences. Associate Professor of Psychology Joshua Ackerman of the University of Michigan co-authored the research.

Source: Florida State University

 

Finland Study: Seclusion, Restraint Still Common in Psychiatric Care

Thu, 04/02/2020 - 7:00am

While the use of coercive measures in psychiatric care such as seclusion, restraint and involuntary medication has declined over the years, a new Finnish study reveals that these measures are still frequently used, and periods of both seclusion and mechanical restraint can be prolonged.

The findings are published in the Nordic Journal of Psychiatry.

Reducing the use of coercive measures is a significant goal in psychiatric care both in Finland and abroad, yet coercive measures are regularly used in psychiatric care. The most common reason for using coercive measures is violence or threat thereof, resulting from the patient’s mental illness.

For the study, the research team looked at data on the use of seclusion, mechanical and physical restraint, and involuntary medication in 2017 from all Finnish psychiatric wards offering specialized health care and from the wards of Finland’s forensic psychiatry hospitals.

A total of 140 psychiatric wards in 21 different organizations reported having used a coercive measure in 2017. Of these, 127 were psychiatric wards offering specialized health care in hospital districts.

Seclusion was the most frequently used coercive measure: seclusion was used by 109 wards a total of 4,006 times. The average duration of a seclusion period was nearly three days.

The use of mechanical restraint was reported by 106 wards, but the frequency was considerably lower, amounting to 2,113 times. On average, the duration of a mechanical restraint episode was 17 hours.

Involuntary medication was administered to patients 2,178 times by 95 wards, and the use of physical restraint was reported by 83 wards, amounting to a total of 1,064 times. The average duration of a physical restraint episode was less than one hour.

The study found differences between the different organizations and wards in how they use coercive measures and report their use. In Finland, the use of seclusion and mechanical restraint must be regularly reported to the Regional State Administrative Agencies. The requirement to report does not apply to other coercive measures, although the wards are told to collect and retain the related data for a period of two years.

However, all wards could not provide data on the use of mechanical restraint and involuntary medication. Finland’s forensic psychiatry hospitals, in contrast, were able to provide extensive data on all coercive measures used.

The root-level data on the use of coercive measures collected from psychiatric wards was considerably different from the data collected from the Care Register for Health Care for the same year.

“Some of the differences can be explained by the specific features of the system via which notifications are submitted to the Care Register for Health Care, but most discrepancies can probably be explained by the fact that not all coercive measures are entered in the system,” says PhD student Emilia Laukkanen, Master of Health Sciences, from the University of Eastern Finland.

The research was conducted in collaboration between the University of Eastern Finland, Niuvanniemi Hospital and Kuopio University Hospital.

The study used root-level data on the use of coercive measures, i.e., data collected directly from psychiatric wards. Although data from the Care Register for Health Care can be used for annual comparisons, the researchers point out that findings of the study emphasize the importance of collecting data directly from wards.

Source: University of Eastern Finland

 

 

Creative Improvisation in Jazz Can Draw On Either Side of the Brain

Thu, 04/02/2020 - 6:00am

In a study of jazz musicians, researchers found that the left hemisphere of the brain was the primary source of creativity in performers who were highly experienced in improvisation; the right brain was more dominant in those who were less experienced.

The results suggest that creativity is a “right-brain ability” when a person deals with an unfamiliar situation but that creativity draws on well-learned, left-hemisphere routines when a person is experienced at the task.

The findings are published in the journal NeuroImage.

Most people think of creativity as being linked to the brain’s right hemisphere. For example, innovative people are considered “right-brain thinkers” while “left-brain thinkers” are thought to be analytical and logical.

However, many neuroscientists have argued that there is not enough evidence to support this idea and that an ability as complex as human creativity must draw on wide sections of both hemispheres.

Now a new brain-imaging study out of Drexel University’s Creativity Research Lab in Philadelphia sheds light on this controversy by studying the brain activity of jazz guitarists during improvisation.

The study showed that creativity is, in fact, driven primarily by the right hemisphere in musicians who are comparatively inexperienced at improvisation. However, musicians who are highly experienced at improvisation rely primarily on their left hemisphere.

By taking into consideration how brain activity changes with experience, the study may contribute to the development of new methods for training people to be creative in their field.

For example, when a person is an expert, his or her performance is produced primarily by relatively unconscious, automatic processes that are difficult for a person to consciously alter, but easy to disrupt in the attempt, as when self-consciousness causes a person to “choke” or falter.

In contrast, novices’ performances tend to be under deliberate, conscious control. Thus, they are better able to make adjustments according to instructions given by a teacher or coach.

Recordings of brain activity could reveal the point at which a performer is ready to release some conscious control and rely on unconscious, well-learned routines. Releasing conscious control prematurely may cause the performer to lock-in bad habits or poor techniques.

For the study, the researchers recorded high-density electroencephalograms (EEGs) from 32 jazz guitar players, some of whom were highly experienced and others less experienced. Each musician improvised to six jazz lead sheets (songs) with programmed drums, bass and piano accompaniment.

The 192 recorded jazz improvisations (six jazz songs by 32 participants) were subsequently played for four expert jazz musicians and teachers individually so they could rate each for creativity and other qualities.

The research team compared the EEGs of the highly rated performances with those rated to be less creative. In highly rated performances, there was greater activity in posterior left-hemisphere areas of the brain; for performances with lower ratings, there was greater activity in right-hemisphere, mostly frontal, areas.

By themselves, these results might suggest that highly creative performances are associated with posterior left-hemisphere areas and that less-creative performances are associated with right-hemisphere areas. This pattern is misleading, however, because it does not take the experience of the musician into consideration.

Some of these musicians were highly experienced, having given many public performances over decades. Others were much less experienced, having given only a very small number of public performances.

When the research team reanalyzed the EEGs to statistically control for the level of experience of the performers, a very different pattern emerged. Virtually all of the brain-activity differences between highly creative and less-creative performances were found in the right hemisphere, mostly in the frontal region.

This finding is in line with the team’s other research that used electrical stimulation to study how creative expression is generated in musicians’ brains and its study of how experienced and inexperienced jazz musicians reacted to being exhorted to play “even more creatively.”

“If creativity is defined in terms of the quality of a product, such as a song, invention, poem or painting, then the left hemisphere plays a key role,” said John Kounios, Ph.D., professor of psychology and director of the doctoral program in applied and cognitive brain sciences in Drexel’s College of Arts and Sciences.

“However, if creativity is understood as a person’s ability to deal with novel, unfamiliar situations, as is the case for novice improvisers, then the right hemisphere plays the leading role.”

Source: Drexel University

Study: Parents Should Limit All Screen Media for Pre-K Kids

Wed, 04/01/2020 - 7:00am

A new study suggests that parents should delay introducing their young children to any screen media, and should limit preschoolers’ use of mobile devices, including smartphones and tablets.

The findings are published in the Journal of the American Medical Association Pediatrics.

For more than two-and-a-half-years, a research team from the University of California, Davis observed 56 children (ages 32 to 47 months) and surveyed their parents. The researchers assessed children’s self-regulation skills — those skills needed to plan, control, and monitor their thoughts, feelings, and behaviors.

Previous research has shown that young children’s self-regulation skills can predict later academic success, social functioning, physical and mental health, income and criminality.

The findings reveal that self-regulation skills were lower among children who began using any screen media devices (including television, computers, smartphones, and/or tablets) earlier in life, or who currently used mobile devices (smartphones and/or tablets) more often than others in the sample.

“Young children are often exposed to substantial amounts of screen media,” said the study’s primary author, Amanda C. Lawrence, a doctoral candidate in the Human Development Graduate Group at UC Davis.

“Even though consumption of moderate amounts of high-quality children’s media has been established to have a positive influence on development, the current findings support limiting children’s use of mobile devices.”

The researchers cited other reasons for cautious use of mobile devices by young children. “The portable nature of mobile devices allows them to be used in any location, such as while waiting for appointments, or in line at a grocery store. The screen use, then, could interfere with sensitive and responsive interactions with parents or practicing self-soothing behaviors that support optimal development,” said Lawrence.

For the study, children and their parents participated in 90-minute visits to an on-campus research laboratory, where the children were asked to complete 10 tasks to evaluate their ability to self-regulate. Tasks were as varied as walking a line slowly, taking turns with the researcher in building a tower out of blocks, and delaying gratification — for example, being asked to hold off unwrapping a gift while the researcher briefly left the room.

Parents reported their child’s screen use in a novel survey designed by Lawrence, and the researchers calculated the children’s reported age at first use of screen media and average time spent per week on each device.

The study results include the following:

  • There was substantial variation in the amount of time children spent with screen media devices in the average week in this community sample. Screen time for traditional devices (television, computers) ranged from 0 to 68 hours per week, and 0 to 14 hours per week for mobile devices (tablets, smartphones).
  • Children’s screen time in the average week was not linked to their family’s income in this sample, but children growing up in higher-income households started using mobile devices at a younger age than lower-income households.
  • Screen time also did not differ by racial/ethnic minority status in this sample.

In addition, children’s exposure to traditional screen devices (televisions, computers) in the average week was not related to their self-regulation, in contrast to most previous studies.

Lawrence speculates that messaging about providing child-directed, educational content and cautioning parents to monitor children’s viewing has reached parents and has been effective, at least among some groups.

This is a small study, but the beginning of a long-term longitudinal study of children’s development of self-regulation and looking at all screen media devices over multiple years with more children and parents, researchers said.

Co-authors of the study are Dr. Daniel Ewon Choe, assistant professor of human development and family studies, and Madhuri S. Narayan, who was an undergraduate student when working on the research.

Source: University of California- Davis

Gender, Ethnicity May Shape How Emotional Neglect and Abuse Impact Teen Depression

Wed, 04/01/2020 - 6:30am

Physical and sexual abuse are known risk factors for depression in adolescents. But less is known about the role of emotional abuse and neglect in teen depression.

Now, a new longitudinal study by researchers at the University of Illinois at Urbana-Champaign and the University of Nebraska-Lincoln finds that emotional abuse and neglect affect adolescent depression differently, depending on gender and ethnicity.

“Even though both types of maltreatment predict depression, they may predict depression for different reasons. Furthermore, female teenagers may be more sensitive to emotional abuse, while the impact of emotional neglect may differ based on the adolescent’s racial or ethnic identity,” said Dr. Joseph Cohen.

Cohen is an assistant professor of psychology at the University of Illinois at Urbana-Champaign and one of the study’s authors. “Understanding how different youth are affected by different parenting behaviors can lead to more personalized, trauma-informed interventions.”

The study appears in Child Development, a journal of the Society for Research in Child Development.

Researchers used self-reports from 657 youth ages 11 to 14 years from a range of racial and ethnic backgrounds. The youth were part of the National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal study. The assessment evaluates the outcomes of children who had Child Protective Services investigations for child abuse or neglect closed during a 15-month period beginning in February 2008 in the United States.

The teenagers were initially assessed on emotional maltreatment, relationships with peers, school engagement (the extent to which students participated in the academic and nonacademic activities of school, and felt connected at school), and depression. Peer involvement included assessment of feelings of loneliness and social dissatisfaction in relationships with other youth.

Participants were assessed again 18 months and 36 months later. Emotional abuse was defined as parental psychological aggression and emotional neglect was defined as parental noninvolvement.

The study found that both psychological aggression and parental non-involvement were related to depression in the adolescents. Psychological aggression predicted an increase in symptoms of depression through increasing problems associated with peer relationships, especially for girls.

The study also found that decreasing school engagement mediated the relation between parental non-involvement and increasing symptoms of depression, but only for Hispanic adolescents.

The study’s authors acknowledge limitations to their work: the study assessed teenagers through self-reports, including the assessment of emotional abuse and neglect.

Recommendations for future research includes development of a multimethod approach (e.g., parent reports, administrative data) to provide a more comprehensive picture of how different forms of emotional maltreatment may manifest and predict depression.

In addition, the 18-month gap between follow-up assessments prevented researchers from detecting fluctuations in symptoms in briefer intervals.

“Current clinical services and policies are more focused on abuse than maltreatment,” said Shiesha McNeil, a doctoral student in psychology at the University of Illinois at Urbana-Champaign, who co-authored the study.

“By articulating the consequences of emotional neglect for different genders and ethnicities, we can develop better ways to address maltreatment and alleviate depression.”

Source: Society for Research in Child Development/EurekAlert