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Magnetic Brain Stimulation Relieves Symptoms of Severe Depression

Fri, 04/24/2020 - 5:30am

A new type of magnetic brain stimulation rapidly relieved symptoms of severe depression in 90% of treatment-resistant participants in a small study by Stanford University School of Medicine.

The treatment, called Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), is a form of transcranial magnetic stimulation approved by the Food and Drug Administration for the treatment of depression.

The therapy improves on current FDA-approved protocols by increasing the number of magnetic pulses, speeding up the pace of the treatment and targeting the pulses according to each patient’s neurocircuitry.

Before receiving the treatment, all 21 study participants were severely depressed, according to several diagnostic tests for depression. After the treatment, 19 of them scored within the nondepressed range.

Although all of the participants had suicidal thoughts before the therapy, none reported having suicidal thoughts after treatment. All 21 participants had previously not experienced improvements with medications, FDA-approved transcranial magnetic stimulation or electroconvulsive therapy.

The only side effects of the new therapy were fatigue and some discomfort during treatment.

“There’s never been a therapy for treatment-resistant depression that’s broken 55% remission rates in open-label testing,” said Nolan Williams, MD, assistant professor of psychiatry and behavioral sciences and a senior author of the study.

“Electroconvulsive therapy is thought to be the gold standard, but it has only an average 48% remission rate in treatment-resistant depression. No one expected these kinds of results.”

In transcranial magnetic stimulation, electric currents from a magnetic coil placed on the scalp excite a region of the brain implicated in depression. The treatment requires six weeks of once-daily sessions. Only about half of patients who undergo this treatment improve, and only about a third experience remission from depression.

Stanford researchers hypothesized that some modifications to transcranial magnetic stimulation could improve its effectiveness. For example, some research had shown that a stronger dose — 1,800 pulses per session instead of 600 — might be more effective. The team was cautiously optimistic regarding the safety of the treatment, as that dose of stimulation had been used without harm in other forms of brain stimulation for neurological disorders, such as Parkinson’s disease.

Other studies suggested that accelerating the treatment would help relieve patients’ depression more rapidly. With SAINT, the patients in the study were given 10 sessions per day of 10-minute treatments, with 50-minute breaks in between. On average, three days of the therapy were enough for participants to feel relief from depression.

“The less treatment-resistant participants are, the longer the treatment lasts,” said postdoctoral scholar Eleanor Cole, PhD, a lead author of the study.

The researchers also hypothesized that targeting the stimulation more precisely would improve the treatment’s success. In transcranial magnetic stimulation, the treatment is aimed at the location where most people’s dorsolateral prefrontal cortex lies. This region regulates executive functions, such as selecting appropriate memories and inhibiting inappropriate responses.

For SAINT, the team used magnetic-resonance imaging of brain activity to locate not only the dorsolateral prefrontal cortex, but a particular subregion within it. They pinpointed the subregion in each participant that has a relationship with the subgenual cingulate, a part of the brain that is overactive in depression.

In people with depression, the link between the two regions is weak, and the subgenual cingulate becomes overactive, said Keith Sudheimer, PhD, clinical assistant professor of psychiatry and a senior author of the study. Stimulating the subregion of the dorsolateral prefrontal cortex reduces activity in the subgenual cingulate, he said.

To test safety, the researchers evaluated the participants’ cognitive function before and after treatment. They found no negative side effects; in fact, they found that the subjects’ ability to switch between mental tasks and to solve problems had improved — a typical outcome for people who are no longer depressed.

One month after treatment, 60% of the patients were still in remission from depression. Follow-up studies are underway to determine the duration of the antidepressant effects.

The team is conducting a larger, double-blinded trial in which half of the subjects are receiving fake treatment. The researchers are optimistic the second trial will turn out to be similarly effective in treating people whose condition hasn’t improved with medication, talk therapy or other forms of electromagnetic stimulation.

The researchers also plan to study the effectiveness of SAINT on other conditions, such as obsessive-compulsive disorder, addiction and autism spectrum disorders.

The new findings are published in the American Journal of Psychiatry.

Source: Stanford Medicine

Most States Do Not Require Day Care Providers to Inform Parents of In-House Guns

Thu, 04/23/2020 - 7:00am

A new study finds that a majority of U.S. states and territories — 47 out of 56 — do not require home- and center-based child care providers to inform parents when guns are stored on the premises.

The researchers found that fewer than 67 percent of states and territories completely prohibit center-based child care providers from having firearms on the premises and only a handful — 7 of 56 — prohibit home-based child care providers from having firearms on site.

The study also found that nearly a fourth of states and territories (13) had no regulations governing firearms in child care centers, and one-sixth (9) had no regulations governing firearms in family child care homes.

The findings are published online in the journal JAMA Network Open.

There are more than 20 million children age 5 and under in the U.S., and almost two-thirds of them spend a substantial amount of time in center-based or home-based early care and education settings. The study is believed to be the first to systematically examine firearm-related policies that apply to home- and center-based child care settings.

Researchers from Johns Hopkins Bloomberg School of Public Health investigated state regulations covering the presence and storage of firearms at child care facilities in the U.S., including dedicated centers as well as home-based facilities. They reviewed fire-arm regulations, as of June 2019, for early care and education settings in all 50 states, Washington D.C., and the five U.S. territories.

The study did not examine the consequences for noncompliance or the number of firearm-related incidents in these settings.

“It’s surprising how few states require notification to parents on whether or not a handgun is present — I think that’s a critical gap that should be filled so that parents can make a more informed decision about child care,” says study first author Sara Benjamin-Neelon, PhD, JD, the Helaine and Sid Lerner Professor in the Department of Health, Behavior and Society at the Bloomberg School.

Benjamin-Neelon conducted the study with co-author Elyse Grossman PhD, JD, a policy fellow at the Bloomberg School.

Although regulations were more likely to prohibit firearms in child care centers, home-based child care providers generally face restrictions on storage procedures only.

For example, 46 U.S. states or territories require firearms present in home-based child care settings to be kept under lock and key; 29 require the ammunition to be stored separately; and 23 require the firearms to be unloaded.

The lack of fire-arm prohibition in home-based child care settings may stem from legislators’ concerns that the Second Amendment to the U.S. Constitution protects homeowners’ rights to keep firearms, Benjamin-Neelon says. She notes that there is an ongoing legal challenge against an Illinois law banning guns from homes that serve as child care facilities.

The researchers say they were most surprised by the limited notification requirements, with only 9 of the 56 jurisdictions requiring either operators of child care centers or family child care homes to notify parents when there are firearms present in the home.

“States should consider regulations requiring notification to parents if there’s a firearm on the premises,” Benjamin-Neelon says.

The researchers plan to do more work in this area to determine if stricter laws against firearms correlate with fewer gun-related injuries to children in home- and center-based child care settings.

Source: Johns Hopkins University Bloomberg School of Public Health

How to Protect Yourself from Online ‘Sextortion’

Thu, 04/23/2020 - 6:30am

New criminal justice research suggests that “sextortion” is the latest method to harm or damage a person online. Sextortion is a lesser-known internet crime that includes the use of intimate images or videos that have been captured to then extort compliance from a victim. The tactic sheds light on the importance of protecting the public from online criminals.

“What makes it different from any other crime is the threat to release. A perpetrator could say, ‘I have these images of you and will publish them unless you…’ to get more images or even in exchange for money,” said Roberta Liggett O’Malley, a Michigan State University doctoral student and co-author of the study.

In many cases of sextortion, perpetrators don’t actually possess the images or videos they’re using as leverage. Instead, offenders manipulate victim behavior by tapping into the fear of not knowing whether the threat is real.

Investigators believe the current focus on dissemination of images online may overshadow the issue of threat-based harassment online, like sextortion. While most U.S. states have laws against revenge porn, the study makes a case for increasing awareness and changing legislation to include other forms of internet-based sexual abuse crimes.

The study appears in Journal of Interpersonal Violence.

“Much of the fear comes from the belief that hackers can do anything involving technology, from the ability to see someone’s web browser history to hacking into a webcam or Nest device,” said Karen Holt, assistant professor of criminal justice and co-author.

“That’s why sextortion is so effective — it creates a huge amount of uncertainty and fear that victims end up complying versus saying, ‘I think you’re bluffing, and if I ignore you, then I’m fine.'”

Liggett O’Malley and Holt said men are less likely to report these crimes to police out of embarrassment or shame, but also don’t experience the longevity of harassment experienced by minors.

“The victims are overwhelmingly minors and females, but if the objective is to get money, they’re almost always targeting men,” Liggett O’Malley said. “These two groups of people experience a similar crime in very different ways.”

Analysis of 152 cyber sextortion offenders uncovered four distinct types:

• minor-focused, targeting victims under 18 years of age;
• cybercrime, targeting victims using computer-based tactics like hacking;
• intimately violent, targeting former or current romantic partners;
• and transnational, targeting strangers strictly for financial reasons.

Holt explained that the four themes reflect different motivations for what offenders want from their victims. A survey of 1,631 cyber sextortion victims found 46 percent were minors, making crimes against minors a focus for law enforcement and in research literature.

“The disproportionate focus on minor victims has led to new laws that protect minors from adult sexual solicitation online, but there are few legal protections for adult male and female victims,” Liggett O’Malley said.

Researchers are starting to see sextortion being used by a lot of other perpetrators. Indeed, within a domestic violence context, partners may share images consensually, only to have those images later used as leverage in the relationship.

In other instances, transnational organizations employ scams in which individuals pretend to be a man or women on the internet, engaging in webcam sessions with victims and immediately threatening to release a recording unless money is provided.

Awareness and reporting of sextortion crimes, while acting responsibly online, are key in protecting adults and children.

“As digital citizens, we have to start advocating for more accountability on behalf of platforms to take these images down, or to report harassment,” Holt said.

“A lot of offline crimes have an online component, and oftentimes law enforcement and our behavior don’t catch up. We need to think about our own personal safety, both offline and online.”

Source: Michigan State University/EurekAlert

Mood Regulation May Be New Target for Treating Depression

Thu, 04/23/2020 - 6:00am

A new study suggests that supporting natural mood regulation may be a new target for treating and reducing depression.

Healthy mood regulation involves choosing activities that help settle one’s mood. However, in situations where personal choices of activities are constrained such as during periods of social isolation and quarantine this natural mood regulation is impaired which can lead to depression in some people.

Researchers from the department of psychiatry at the University of Oxford say the current COVID-19 lockdown is likely to exacerbate problems with mood regulation. They propose that helping people regulate their moods may be a new target for alleviating depression.

“By training people to increase their own mood homeostasis, how someone naturally regulates their mood via their choices of activities, we might be able to prevent or better treat depression,” said Maxime Taquet, Academic Foundation Doctor at the University of Oxford.

“This is likely to be important at times of lockdown and social isolation when people are more vulnerable to depression and when choices of activities appear restricted. Our research findings open the door to new opportunities for developing and optimising treatments for depression and this could potentially be well adapted to treatments in the form of smartphone apps, made available to a large population which sometimes lack access to existing treatments.”

For the study, the research team evaluated 58,328 participants from low, middle and high income countries, comparing people with low mood or a history of depression with those of high mood. In a series of analyses, the researchers looked at how people regulate their mood through their choice of everyday activities.

In the general population, there was a strong link between how people currently feel and what activities they choose to do next. This mechanism — mood homeostasis, the ability to stabilize mood through activities — is impaired in people with low mood and may even be absent in those who have been diagnosed with depression.

Importantly, some links between activities and mood were highly culture-specific. For example, exercise led to the greatest mood increase in high income countries, while religion did so in low and middle income countries. Interventions aimed at improving mood regulation will need to be culture specific, or even individual specific, as well as account for people’s constraints and preferences.

“When we are down we tend to choose to do things that cheer us up and when we are up we may take on activities that will tend to bring us down,” said Guy Goodwin, Professor Emeritus of Psychiatry, University of Oxford.

“However, in our current situation with COVID-19, lockdowns and social isolation our choice of activity is very limited. Our research shows this normal mood regulation is impaired in people with depression, providing a new, direct target for further research and development of new treatments to help people with depression.”

One in five people will develop major depression at some point in their life. The current lockdown strategies used by different countries to control the COVID-19 pandemic is expected to cause even more depression.

About 50% of people do not see their symptoms improve significantly with an antidepressant and the same applies to psychological treatments. A key priority for mental health research is therefore to develop new treatments or optimize existing ones for depression.

Using computer simulations, the study showed that low mood homeostasis predicts more frequent and longer depressive episodes. Research suggests that by monitoring mood in real time, intelligent systems could make activity recommendations to increase mood regulation, and such an intervention could be delivered remotely, improving access to treatment for patients for whom face-to-face care is unavailable, including low and middle income populations.

The findings are published in the journal JAMA Psychiatry.

Source: University of Oxford

Study: Benefits of Modest Fish Intake in Pregnancy Outweigh Risks

Wed, 04/22/2020 - 7:28pm

Children whose mothers ate fish between one and three times a week during pregnancy are more likely to have a better metabolic profile — despite the risk of exposure to mercury — than those whose mothers rarely ate fish (less than once a week), according to a new study by the University of Southern California (USC).

Whether pregnant women should eat fish or not has been a long-debated topic. While fish is a major source of omega-3 long-chain polyunsaturated fatty acids (vital for fetal development), it is well-known that some types of fish, including swordfish, shark and mackerel, have high levels of mercury, a potent toxin that can cause permanent neurological damage.

The findings, published in JAMA Network Open, show that the children of women who ate fish from one to three times a week during pregnancy had lower metabolic syndrome scores than the children of women who ate fish less than once a week. But the benefit declined if women ate fish more than three times a week.

Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

“Fish is an important source of nutrients, and its consumption should not be avoided,” said Dr. Leda Chatzi, associate professor of preventive medicine at the Keck School of Medicine of USC and the senior investigator on the study.

“But pregnant women should stick to one to three servings of fish a week as recommended, and not eat more, because of the potential contamination of fish by mercury and other persistent organic pollutants.”

For the study, the researchers evaluated 805 mother-child pairs from five European countries participating in a collaborative research project known as the HELIX study, which follows women and their children from pregnancy onwards.

During their pregnancy, the women were asked about their weekly fish consumption and tested for mercury exposure. When the children were between 6 and 12 years old, they were given a clinical examination with various measurements including waist circumference, blood pressure, high-density lipoprotein cholesterol, triglyceride levels and insulin levels. These measures were combined to calculate a metabolic syndrome score.

Overall, children whose moms ate fish from one to three times a week during pregnancy had lower metabolic syndrome scores than children whose moms ate fish less than once a week. But if pregnant women ate fish more than three times a week, the benefit was reduced.

“Fish can be a common route of exposure to certain chemical pollutants which can exert adverse effects,” said Nikos Stratakis, Ph.D., a USC postdoctoral scholar who was one of the study authors.

“It is possible that when women eat fish more than three times a week, that pollutant exposure may counterbalance the beneficial effects of fish consumption seen at lower intake levels.”

The researchers found that higher mercury concentration in a woman’s blood was linked to a higher metabolic syndrome score in her child.

The team also looked at how fish consumption by the mother affected the levels of cytokines and adipokines in her child. These biomarkers are related to inflammation, a contributor to metabolic syndrome. Compared with low fish intake, moderate and high fish consumption during pregnancy were associated with reduced levels of proinflammatory cytokines and adipokines in the children.

This is the first human study to reveal that the reduction in these inflammation biomarkers could be the underlying mechanism explaining why maternal fish consumption is associated with improved child metabolic health.

Next, the team plans to examine the effects of consuming different types of fish with different nutrients and mercury levels and to follow up on these children until the age of 14-15 years.

Source: Keck School of Medicine of USC

 

 

Dancing With Grandma to Boost Mood, Strengthen Familial Bonds

Wed, 04/22/2020 - 7:05am

In old age, meeting one’s physical and social needs can become increasingly difficult. In a unique study, Israeli researchers observed what happens when grandmothers and grandchildren come together to participate in dance movement therapy (DMT).

They discovered that dance movement therapy can be used as an enjoyable and effective tool to promote exercise, boost mood, improve quality of life and create intergenerational closeness.

The findings are published in the journal Frontiers in Psychology.

For the study, researchers from the Kibbutzim College and University of Haifa in Israel recruited 16 dance movement therapists to meet with their grandmothers for three free-form dance sessions.

Dance movement therapy is defined by the American Dance Therapy Association (ADTA) as the psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the individual, for the purpose of improving health and well-being.

Dance was chosen as a unique and versatile intervention since it can improve muscle strength, balance, and endurance, prevent anxiety and depression, and aid with dementia — all issues commonly faced among the elderly population. It also offers a model for low-cost and accessible community support.

The goal of the study was to see how these sessions would affect each group, and whether intergenerational bonds might strengthen as a result. The researchers also wanted to examine a potential low-cost method to treat issues commonly faced by an aging population, such as depressed mood and limited mobility.

“The increase of the proportion of elderly in the population, along with the increase in the age group of adult grandchildren necessitates creativity and innovation in providing diverse resources and support,” said author Dr. Einat Shuper Engelhard.

Shuper Engelhard analyzed taped videos of the sessions, personal diaries, and semi-structured interviews between granddaughters and grandmothers to analyze the effect of dance movement therapy.

She also found that for grandmothers, dancing promoted positive feelings and improved mood. For granddaughters, dancing shifted their perspective of aging and allowed them to process their grandparent’s eventual death. Both groups expressed gratitude and felt their bond was stronger after the sessions.

Each of the three sessions was conducted one week apart and took place in the grandmother’s home for just 10 to 15 minutes. At first, the granddaughters were nervous over their ability to provide a meaningful experience, but they were instructed to mirror their grandmother’s movements, encourage their abilities, and give them space to rest when it was needed.

Shuper Engelhard said familiarity was vital to the intervention’s success. The dancing sessions “promoted physical activity even when the body was fatigued and weak,” Shuper Engelhard says. “This emphasizes the significance of the close and familiar relationship as a means to promote new experiences (which can occasionally seem impossible) for the older person.”

The research had some limitations as only 32 individuals participated (16 grandmother-granddaughter pairs), and although the study was open to grandchildren of all genders, all participants were female. In addition, all granddaughters in this study were dance/movement therapists.

Shuper Engelhard would like to conduct similar research in other populations. With an activity as simple and accessible as free-form dancing, aging populations can improve their physical and mental health and also connect with their loved ones.

Source: Frontiers

The Behaviors That Can Help Couples Manage Financial Stress

Wed, 04/22/2020 - 7:00am

The COVID-19 crisis may affect financial as well as physical health. New research suggests the financial challenges can put a significant strain on romantic relationships.

Nevertheless, some couples may be better equipped to manage that kind of stress than others, according to a study by Ashley LeBaron, a doctoral student in the University of Arizona Norton School of Family and Consumer Sciences. Researchers discovered relationships can remain strong and perhaps improve in difficult times if partners respect, support and show each other love and affection.

LeBaron, whose research was conducted prior to the COVID-19 pandemic, has studied how financial stress impacts married and unmarried couples from different socioeconomic backgrounds. Her findings provide insight into what might make some couples more resilient.

In 2018, LeBaron co-authored a paper in the Journal of Family and Economic Issues that focused on married couples affected by financial stress during the 2008 recession. She found that some couples reported that their relationships grew stronger not just in spite of, but because of, the financial challenges they had endured together.

However, most of the couples in that study were white, middle- or upper-class married couples.

In the recent study, LeBaron set out to see if her previous findings would hold true for people for whom financial stress might have higher stakes: unmarried, low-income couples expecting their first child together.

Most of the couples in the new study were low-income and black. All of them had experienced at least one of three financial stressors in the year prior: the inability to pay rent or a mortgage in full, having their utilities shut off or eviction.

“Financial stress isn’t good for anyone, but for lower-income couples, it can really affect the time and energy and focus they can put on relationships,” LeBaron said.

In both of her studies, LeBaron zoomed in on the relationships in which partners remained highly committed to one another after financial hardship.

In both studies, she found that the strongest relationships were those in which partners remembered to practice “relationship maintenance behaviors,” including respecting one another, being there for one another, and showing love and affection for one another.

“A big take-home message is the importance of these relationship maintenance behaviors, especially when you’re experiencing financial stress,” LeBaron said.

“It’s hard to remember to do that when you’re in the middle of financial stress. But making sure that your partner knows that you’re there for them, and doing things that show love and affection for them is really important.”

LeBaron also found that receiving financial support from family and friends was associated with higher levels of commitment for the couples in both of her studies.

In her second study, LeBaron measured the success of the unmarried, low-income, expectant couples not only by how committed they reported being to their relationship, but also by how well they reported co-parenting.

Some additional factors emerged as important for the low-income unmarried couples that LeBaron didn’t see in the married couples. Those factors included having health insurance, having a support network and having children with no more than one partner.

“It can be stressful and financially demanding to have kids with multiple partners,” LeBaron said. She added that health insurance didn’t emerge as a factor, and wasn’t asked about, in the study of married couples.

The study appears in Journal of Family and Economic Issues .

LeBaron’s findings suggest that there may not be a one-size-fits-all approach to maintaining a strong relationship in times of financial stress.

“One of the takeaways for policymakers or therapists is that it really depends on the context of the couple you’re trying to help, because something that works for one couple might not work for the other one,” she said.

Source: University of Arizona/EurekAlert

Inhibited Infants More Likely to Become Introverted Adults

Wed, 04/22/2020 - 5:30am

A new study over more than two decades reveals that infants with greater behavioral inhibition are more likely to be reserved and introverted at age 26.

Behavioral inhibition (BI) is characterized by cautious, fearful, and avoidant behavior toward unfamiliar people, objects, and situations. BI has been found to be relatively stable across toddlerhood and childhood, and children with BI have been found to be at greater risk for developing social withdrawal and anxiety disorders than those without BI.

The findings are published in the journal Proceedings of the National Academy of Sciences.

“While many studies link early childhood behavior to risk for psychopathology, the findings in our study are unique,” said Daniel Pine, M.D., a study author and chief of the NIMH Section on Development and Affective Neuroscience. “This is because our study assessed temperament very early in life, linking it with outcomes occurring more than 20 years later through individual differences in neural processes.”

Temperament refers to biologically-based individual differences in the way people emotionally and behaviorally respond to the world. During infancy, temperament serves as the foundation of later personality.

Although these findings hint at the long-term outcomes of inhibited childhood temperament, only two studies to date have followed inhibited children from early childhood to adulthood.

The current study, conducted by researchers at the University of Maryland, College Park, the Catholic University of America, Washington, D.C., and the National Institute of Mental Health, observed their participant sample at 4 months of age and characterized them for BI at 14 months.

At age 15, the participants returned to the lab to provide neurophysiological data. These neurophysiological measures were used to assess error-related negativity (ERN), which reflects the degree to which people are sensitive to errors.

ERN shows as a negative dip in the brain’s electrical signal following incorrect responses on computerized tasks. A larger error-related negativity signal has been associated with internalizing conditions such as anxiety, and a smaller error-related negativity has been associated with externalizing conditions such as impulsivity and substance use.

The participants returned at age 26 for assessments of psychopathology, personality, social functioning, and education and employment outcomes.

“It is amazing that we have been able to keep in touch with this group of people over so many years. First their parents, and now they, continue to be interested and involved in the work,” said study author Nathan Fox, Ph.D., of the University of Maryland Department of Human Development and Quantitative Methodology.

Overall, the researchers found that BI at 14 months of age predicted, at age 26, a more reserved personality, fewer romantic relationships in the past 10 years, and lower social functioning with friends and family.

BI at 14 months also predicted higher levels of internalizing psychopathology in adulthood, but only among those who also displayed larger error-related negativity signals at age 15. BI was not associated with externalizing general psychopathology or with education and employment outcomes.

This study highlights the enduring nature of early temperament on adult outcomes and suggests that neurophysiological markers such as error-related negativity may help identify individuals most at risk for developing internalizing psychopathology in adulthood.

“We have studied the biology of behavioral inhibition over time and it is clear that it has a profound effect influencing developmental outcome,” said Fox.

Source: NIH/ National Institute of Mental Health

Emotional Distress of Dealing With COVID-19 May Hike Risk of Depression and Anxiety

Mon, 04/20/2020 - 7:30am

Almost all Americans will experience emotional distress — some more than others — in the psychological fallout from the COVID-19 pandemic and its economic aftermath.

The emotional distress increases the risk of psychiatric disorders such as depression and anxiety, according to a new article published in the New England Journal of Medicine.

That’s why it’s important for health care providers to monitor the psychosocial needs of their patients, as well as themselves and fellow health care workers, during this time, according to Dr. Carol North, a crisis psychiatrist at UT Southwestern in Dallas, who has studied survivors of disasters, including the 9/11 terrorist attacks and Hurricane Katrina.

“Almost everyone may experience some distress — some more than others,” said North, a member of UT Southwestern’s Peter O’Donnell Jr. Brain Institute, who wrote the article with Betty Pfefferbaum, M.D., a psychiatrist at the University of Oklahoma College of Medicine.

While conditions arising from COVID-19 do not meet the criteria for trauma required to diagnose post-traumatic stress disorder (PTSD), depression and anxiety could result from this pandemic, according to the researchers. In fact, some people may even become suicidal, they say.

Shortages of resources needed to treat patients, uncertain prognoses, and public health measures such as shelter-in-place orders — along with the resulting financial upheaval — are among the “major stressors that undoubtedly will contribute to widespread emotional distress and increased risk for psychiatric illness associated with COVID-19,” the researchers said in the paper.

Certain groups will be more highly affected, including people who contract the disease, those at heightened risk including the elderly and people living with underlying health conditions, and those with preexisting psychiatric or substance abuse problems, the researchers claim.

Health care providers are also especially vulnerable to emotional distress during the pandemic, given their risk of exposure amid shortages of personal protective equipment, long work hours, and involvement in the “emotionally and ethically fraught” need to allocate scarce resources when treating patients, the researchers continued.

A recent review of the effects on quarantined people and health care providers in earlier disease outbreaks found stress, depression, insomnia, fear, anger, and boredom, among other problems, the researchers noted.

While not directly comparable, many who went through other catastrophic events, such as 9/11 or 1995’s Oklahoma City bombings, developed depression, as well as PTSD, according to North.

After 9/11, 26 percent of the attack’s survivors developed a new episode of major depression, according to an earlier study she co-authored.

But COVID-19 is new territory, she said.

“We haven’t studied depression in pandemics,” she said.

The pandemic is creating a multilayered disaster, North added.

“There is the fear of being exposed and getting sick and dying, as well as loss of the lives of friends and relatives,” she explained. “Then there are secondary effects — lost paychecks and the economic woes. Rates of suicide go up in populations when economic times get bad. People get stressed more in general when times are bad.”

First responders and health care professionals should be trained to evaluate the psychosocial issues surrounding COVID-19, and health care systems need to pay attention to the stress levels of their workers and change assignments and schedules if needed, the researchers advised.

Health care workers should ask patients about COVID-19-related stress factors, such as an infected family member and any depression or anxiety, and also check for vulnerabilities like a preexisting psychological condition, the researchers continued. While some patients will need a referral for mental health care, others may benefit simply from support to improve their ability to cope or suggestions for stress management, they noted.

Because parents often underestimate their children’s distress, they should be encouraged to have open discussions to address their children’s reactions and concerns, the researchers added.

People in quarantine or sheltering at home should try to reach out to loved ones electronically, North said. And avoid following the COVID-19 news if that adds to stress, according to North.

“Most people are resilient. Most people don’t develop psychiatric illness after even horrible things, and most people who develop psychiatric illness can recover,” she said. “After 9/11, only a third of the people directly exposed developed PTSD.”

Source: UT Southwestern Medical Center

Tools Forged to Help Emergency Response Groups Coordinate Volunteers

Mon, 04/20/2020 - 7:00am

In the wake of a disaster, many people reach out to emergency assistance organizations asking how they can help, but organizing all of the new volunteers can prove difficult.

Now a research team from North Carolina State University and the University of Alabama has developed tools to help emergency response and relief managers most effectively coordinate volunteer efforts.

“Spontaneous volunteers are people who, in the wake of a disaster, impulsively contribute to response and recovery efforts without affiliations to recognized volunteer organizations (e.g. the Red Cross) or other typical first responders,” said Dr. Maria Mayorga, corresponding author of two studies on the issue and a professor in NC State’s Edward P. Fitts Department of Industrial and Systems Engineering.

“These people constitute a labor source that is both invaluable and hard to manage. Assigning volunteers after a disaster can be difficult, because you don’t know how many volunteers are coming or when they will arrive. In addition, the challenge can be complicated for efforts, such as food distribution, where you also don’t know the amount of supplies you will have to distribute or how many people will need assistance.”

For the study, the team used advanced computational models to address these areas of uncertainty in order to develop guidelines, or rules of thumb, that emergency relief managers can use to help volunteers make the biggest difference.

The most recent paper focuses on assigning volunteers to deal with tasks where the amount of work that needs to be done can change over time, such as search and rescue, needs assessment and distribution of relief supplies.

“Essentially, we developed a model that can be used to determine the optimal assignment of volunteers to tasks when you don’t know how much work will be required,” Mayorga said. “For example, in relief distribution, there is uncertainty in both the supply of relief items and what the demand will be from disaster survivors.”

“We then used the model to create and test rules of thumb that can be applied even when relief managers don’t have access to computers or the internet.”

The researchers found that a simple policy that performs well is the “Largest Weighted Demand (LWD) policy,” which assigns volunteers to the task that has the most work left to be done. In this case, work is prioritized by its importance. For example, fulfilling demand for water is more important than fulfilling demand for cleaning supplies.

However, if the difference in importance between tasks becomes large enough, then the best option is for managers to assign volunteers based on “Largest Queue Clearing Time (LQCT),” which is the time needed to complete the current work if the current number of volunteers is unchanged.

“In fact, the LQCT heuristic worked well in all of the instances we tested, but it is harder to assess quickly,” Mayorga says. “So we recommend that managers use the LWD rule unless there is a really large difference in the importance of the tasks.”

However, the LWD and LQCT rules of thumb don’t work for all tasks.

In fact, the team found that the guidelines that make sense for volunteer tasks where you don’t know how much work will be required are actually a bad fit for tasks with clearly defined workloads such as clearing debris after a disaster.

In a 2017 paper, the researchers found that a good rule of thumb for clearing debris was “Fewest Volunteers,” in which volunteers are simply assigned to whichever task has the fewest volunteers working on it.

“Our work in these papers provides strategies for incorporating spontaneous volunteers into organized relief efforts to help us achieve safe and responsive disaster management,” says Mayorga.

“It’s also worth noting that these works focused on a single organization assigning volunteers to tasks. In our future work, we are focusing on strategies that can be used by multiple agencies to coordinate efforts and amplify the volunteer response.”

The findings are published in the journal Omega.

Source: North Carolina State University

Less Connection, Loneliness May Be Cost of Striving for Financial Success

Mon, 04/20/2020 - 6:00am

With apologies to the Beatles, new research confirms what the group fabulously articulated over 50 years ago – money cannot buy love. A new study reviewed the observation that individuals who base their self-worth on their financial success often feel lonely in everyday life. Researchers from University at Buffalo and Harvard Business School wanted to learn why this link exists.

“When people base their self-worth on financial success, they experience feelings of pressure and a lack of autonomy, which are associated with negative social outcomes,” said Dr. Lora Park, an associate professor of psychology at UB and one of the paper’s co-authors.

“Feeling that pressure to achieve financial goals means we’re putting ourselves to work at the cost of spending time with loved ones, and it’s that lack of time spent with people close to us that’s associated with feeling lonely and disconnected,” said Deborah Ward, a UB graduate student and adjunct faculty member who led the research team.

Team members included Dr. Ashley Whillans, an assistant professor at Harvard Business School, Kristin Naragon-Gainey, at the University of Western Australia, and Han Young Jung, a former UB graduate student.

Their findings emphasize the role of social networks and personal relationships in maintaining good mental health and why people should preserve those connections, even in the face of obstacles or pursuing challenging goals.

The research appears in the journal Personality and Social Psychology Bulletin.

“Depression and anxiety are tied to isolation, and we’re certainly seeing this now with the difficulties we have connecting with friends during the COVID-19 pandemic,” said Ward.

“These social connections are important. We need them as humans in order to feel secure, to feel mentally healthy and happy. But much of what’s required to achieve success in the financial domain comes at the expense of spending time with family and friends.”

Ward said it’s not financial success that’s problematic or the desire for money that’s leading to these associations.

At the center of this research is a concept psychologists identify as Financial Contingency of Self-Worth.

When people’s self-worth is contingent on money, they view their financial success as being tied to the core of who they are as a person. The degree to which they succeed financially relates to how they feel about themselves — feeling good when they think they’re doing well financially, but feeling worthless if they’re feeling financially insecure.

The research involved more than 2,500 participants over five different studies that looked for relationships between financial contingency of self-worth and key variables, such as time spent with others, loneliness and social disconnection. This included a daily diary study that followed participants over a two-week period to assess how they were feeling over an extended time about the importance of money and time spent engaged in various social activities.

“We saw consistent associations between valuing money in terms of who you are and experiencing negative social outcomes in previous work, so this led us to ask the question of why these associations are present,” said Ward. “We see these findings as further evidence that people who base their self-worth on money are likely to feel pressured to achieve financial success, which is tied to the quality of their relationships with others.”

Ward says the current study represents the beginning of efforts to uncover the processes at work with Financial Contingency of Self-Worth.

“I hope this is part of what becomes a longer line of research looking at the mechanisms between valuing money and social-related variables,” said Ward. “We don’t have the final answer, but there is a lot of evidence that pressures are largely playing a role.”

Source: University of Buffalo

Strategies to Relieve COVID-19 Anxiety

Sun, 04/19/2020 - 8:49am

A new Harris poll confirms what most of us already know – we are stressed and anxious about the effects of COVID-19. Pollsters found that more Americans are fearful of experiencing increased anxiety than paying their bills or job-related issues.

Researchers respond that the finding does present some good news as there are several ways to maintain good mental health by making small behavior changes. Investigators also discovered Americans continue to express feelings of gratitude, hope, and resilience.

University of Phoenix researchers discovered more than two in five (41 percent) of Americans say they are most concerned about experiencing increased anxiety. This concern is reported more so than not being able to pay their bills (33 percent), reduced job salary/work hours (26 percent), or losing employment and not being able to get a new job (22 percent).

Respondents expressed other mental health concerns as well. More than 2 in 3 Americans (68 percent) say they feel like everything is out of their control right now and more than half (56 percent) say they are balancing more now than ever before during this pandemic.

Although Americans report feelings of being overwhelmed and anxious, they also express feelings of gratitude and hope with 65 percent saying they are thankful for their health, family and friends.

Moreover, researchers discovered Americans are also looking toward the future when social distancing guidelines are lifted. The survey found nearly 2 in 5 (38 percent) are optimistic that the country will come out of this pandemic stronger than ever and 30 percent are making plans for a post-pandemic future.

Still, many Americans are worried about the long- term mental health repercussions of being quarantined. The vast majority of Americans (84 percent) say that if the social distancing continues longer than they expect, it will have an impact on their mental health.

“While many people are currently feeling anxiety, there can be several ways to maintain good mental health by making small behavior changes,” said Dr. Dean Aslinia, counseling department chair at University of Phoenix.

“Instead of texting or emailing, make a phone call or use video chat to build a more meaningful connection. Build activity in your day by trying something new or setting a goal for yourself to start a new project.”

Experts believe that people should understand that it is okay to seek professional help, if your negative feelings persist. Many mental health practitioners are offering virtual counseling sessions so you can have someone to talk to without leaving the house.

Another positive finding from the survey was that people are implementing personal strategies to improve their mental health.

Indeed, if there is a silver lining in social distancing, the survey suggests that many people are engaging in activities to maintain connections and improve their mental health. Some tactics include:

• checking in with a loved one — 60 percent;
• increasing exercise — 35 percent;
• limiting news consumption — 30 percent;
• performing acts of kindness for others — 29 percent.

“It is encouraging to see some people take this time to practice habits that will improve their mental health,” said Aslinia.

Researchers believe that some of our current anxiety may result from our prior activities, actions and choices.

“Feelings of anxiety are not solely due to isolation or social distancing. The everyday choices we make including technology overuse, impersonal interactions and engaging with people that are unhealthy for us, all lead to anxiety.” Aslinia said.

“If something good can come from this pandemic, we can hopefully recognize the need for intentional behaviors that maintain and improve our mental health.”

Source: University of Phoenix

Mouse Study IDs Key Brain Region Involved in Binge Drinking

Sun, 04/19/2020 - 8:44am

Researchers from the Medical University of South Carolina (MUSC) have discovered that binge drinking in mice decreases when a particular stress-signaling system in the brain is deactivated.

The findings are published online in the journal Neuropharmacology.

“Binge drinking is one of the most common patterns in which alcohol is consumed,” said team leader Howard C. Becker, Ph.D., director of the Charleston Alcohol Research Center and professor in the Department of Psychiatry & Behavioral Sciences.

“It’s a risky behavior, and one consequence of repeated binge drinking is increasing risk for developing an alcohol use disorder.”

Further, according to Becker, people who consistently binge drink, particularly during adolescent and college years, have almost 10 times the risk of developing an alcohol use disorder.

A binge is defined as drinking alcohol to the legal limit of intoxication within two hours, according to the National Institute on Alcohol Abuse and Alcoholism, or NIAAA,

“This is four standard drinks for a woman or five drinks for a male – consumed over about a two-hour period,” said Becker.

JR Haun, a graduate student in the Becker laboratory and first author on the article, described what the NIAAA considers ‘standard’ related to certain beverage types.

“A drink is defined as roughly one 12-ounce can of beer, a five-ounce glass of wine or a standard 1.5 ounce shot of distilled spirits,” he explained, adding that the serving sizes can vary based on the percentage of pure alcohol in the drink.

In their study, the team tested a potential strategy for reducing risky binge drinking.

“Binge drinking is a destructive behavior,” said Haun. “And our goal was to curb that. Through our investigation, we found a brain region and a system that we can manipulate to decrease binge drinking.”

The system that Becker’s team investigated — the opioid receptor system — is well-recognized in the addiction field.

Common drugs of abuse, including morphine, heroin and oxycontin/oxycodone, act on the opioid-receptor system, producing the pleasurable effects that make these drugs so addictive.

However, there is an odd opioid receptor out, so to speak, that is not involved in signaling pleasure.

“The kappa opioid-receptor system is the antithesis to other opioid receptors,” explained Haun. “It’s often referred to as an anti-reward system.”

Instead of feelings of pleasure, the kappa opioid receptor produces stress and discontent.

When people drink and experience positive effects, it is partially due to pleasurable opioid receptors being activated. However, after they have finished drinking and nausea, headache, and the stress of withdrawal start to set in, the kappa opioid receptor system has been activated.

The researchers discovered that turning off the kappa opioid receptors in the brain decreased binge drinking. This finding suggests that the kappa opioid receptor system is important not only in the negative state of withdrawal but also in driving binge drinking itself.

At first glance, this finding might sound counterintuitive: How does turning off the negative effects of the kappa opioid receptor decrease drinking?

“It’s not entirely clear why,” said Haun. “But what we do know is that kappa opioid receptors play an important role in the negative emotional state that drives drinking when it becomes compulsive in alcohol use disorders.”

The researchers hypothesize that the kappa opioid receptor system may drive binge and compulsive alcohol use in a similar way, in addition to contributing to stress and unease during the withdrawal period.

To begin testing their hypothesis, Becker and Haun first identified the exact region in the brain that is involved in binge drinking driven by kappa opioid receptors.

They homed in on the extended amygdala, a brain region that is involved in motivational behavior, is very responsive to stress, and is implicated in compulsive drinking, said Haun. This network of circuits in the brain also contains a number of kappa opioid receptors, making it the team’s top candidate to investigate for its role in regulating excessive drinking.

To determine how kappa opioid receptors in the extended amygdala affect binge drinking, Becker’s team specifically inactivated kappa opioid receptors in this region in mice.

“Haun actually introduced a drug that blocks kappa opioid receptors right into the extended amygdala,” explained Becker.

This study used a binge-drinking mouse model, which allowed the mice to drink freely for four hours each night.

“The mice will drink enough alcohol in this relatively short period of time to achieve blood alcohol levels that would define it as a binge episode,” said Becker.

After blocking the kappa opioid receptors in these mice, the researchers tested how much alcohol the animals voluntarily consumed. What they found could have important implications for future treatments of chronic binge drinking.

“Blocking these kappa receptors in the extended amygdala didn’t completely abolish drinking,” explained Haun. “It brought it down to a more moderate level, the equivalent being a glass of wine at dinner opposed to a bottle.”

So will there soon be a pill to curb the urge to binge? According to Becker, if such a therapy were developed, he believes it would be best tailored for those who have difficulty controlling more chronic heavy drinking, such as those with an alcohol use disorder.

“I think the ultimate goal is to better understand new potential treatment targets and how new therapeutics may have some value in helping to quell the desire and motivation to drink excessively in those who have developed an alcohol use disorder or are on the threshold of doing so,” Becker said.

Source: Medical University of South Carolina

Can Binge-Watching Your Favorite Show Meet Your Social Needs?

Sun, 04/19/2020 - 6:00am

A  new study suggests that non-traditional social strategies such as listening to your favorite band, reading a novel or binge-watching a favorite TV show may be just as effective at fulfilling critical social needs as family connections, romantic relationships or strong social support systems.

The results have significant implications during the COVID-19 pandemic as people struggle with direct social connections hindered by social distancing and other necessary precautions, according to Dr. Shira Gabriel, a professor of psychology at the University of Buffalo’s College of Arts and Sciences and one of the paper’s co-authors.

The findings are published in the journal Self and Identity.

“There’s a basic need for social connections, just as we have a basic need for food,” said Gabriel, whose work as a social psychologist looks at how individuals fulfill their interpersonal needs and navigate a social world. “The longer you go without those sorts of connections, the lower the fuel tank, and that’s when people start to get anxious, nervous or depressed, because they lack needed resources.

“What’s important is not how you’re filling the social fuel tank, but that your social fuel tank is getting filled.”

Gabriel noted that many people don’t realize that non-traditional connections are as beneficial as her research has found. “Don’t feel guilty, because we found that these strategies are fine as long as they work for you,” she said.

And these non-traditional strategies all predict positive outcomes, according to doctoral student Elaine Paravati, co-author of the paper.

“People can feel connected through all sorts of means. We found that more traditional strategies, like spending time with a friend in person, doesn’t necessarily work better for people than non-traditional strategies, like listening to a favorite musician,” said Paravati.

“In fact, using a combination of both of these types of strategies predicted the best outcomes, so it might be especially helpful to have a variety of things you do in your life to help you feel connected to others.”

For over a decade, Gabriel has researched the importance of non-traditional social strategies. These include everything from getting lost in pulp fiction page-turners to preparing and enjoying comfort foods. Volumes of research also exist on the importance of traditional social strategies, like interpersonal relationships or group memberships.

But the new study is the first to combine the traditional and non-traditional for comparative purposes to simultaneously test their relative effectiveness.

The findings represent the first evidence that not only reinforces the effectiveness of non-traditional social strategies, but also suggest that doing something like binge watching a favorite television drama is as useful as other traditional means of fulfillment.

The study involved 173 participants who were asked questions about their well-being and their social connections. Their answers provided a measurement inspired by previous research, which the team calls the “social fuel tank.”

Participants filled their tanks as many as 17 different ways (with a median of seven), using a variety of strategies in their lives to fill their social needs, with a majority of participants reporting both traditional and non-traditional social strategies.

“Symbolic social bonds don’t function as a second-place option to traditional means.They are an effective way of reaping positive mental benefits,” Paravati said. “It’s not about only using them when you can’t access ‘better’ options — these options are helpful to use any time.”

“We have evidence that as long as you feel like you’re fulfilling your belongingness needs, it doesn’t really matter how you’re doing it,” she said. “This is especially relevant now, with social distancing guidelines changing the ways people connect with others. “We can utilize these non-traditional strategies to help us feel connected, fulfilled, and find more meaning in our lives, even as we safely practice social distancing.”

And at a time when quarantine restrictions have motivated questions about how to be social, Gabriel notes how these findings differ from cultural perceptions regarding the unwritten rules for what’s appropriate for creating a sense of belonging.

“We live in a society where people are questioned if they’re not in a romantic relationship, if they decide not to have children, or they don’t like attending parties,” said Gabriel. “There are implicit messages that these people are doing something wrong. That can be detrimental to them.

“The message we want to give to people, and that our data suggest, is that that’s just not true.”

And even before Gabriel had evidence to support these conclusions, her previous research had raised the very questions addressed in the new study.

“People had assumed these non-traditional connections weren’t valuable. In fact, we used to call them ‘social surrogates,’ as if they were a surrogate for a real social connection,” says Gabriel.

“But after researching these connections for so long, we never found evidence that they weren’t valuable. Nothing suggested that people using non-traditional strategies were lonelier, or less happy, less socially skilled, or feeling any less fulfilled.”

“These aren’t surrogates for real social connections; these are real ways of feeling connected that are very important to people.”

Graduate student Esha Naidu also contributed to the study.

Source: University at Buffalo

Challenging Sports With Complex Movement May Boost Mental Fitness

Sat, 04/18/2020 - 7:00am

A new study suggests that people who engage in challenging sports requiring complex movements and interactions with other players may enjoy greater cognitive fitness (defined as an optimized ability to reason, remember, learn, plan and adapt).

The findings are published in the journal Nature Human Behaviour.

It’s well-established that good physical fitness is linked to better cognitive health. And since cognitive function is associated with academic achievement, career success and mental health, there is a need to understand how the cognitive benefits of long-term exercise can be optimized.

In the new study, Swiss researchers from the University of Basel and their Japanese colleagues from the University of Tsukuba conducted a large-scale analysis to identify which types of exercise are most associated with cognitive fitness.

After analyzing 80 studies, the research team found that coordinated and challenging sports that require complex movement patterns and interaction with fellow players are the most beneficial for cognitive fitness. Endurance training, strength training or a mix of these components also seem to improve cognitive performance, but not as much.

“To coordinate during a sport seems to be even more important than the total volume of sporting activity,” said Dr. Sebastian Ludyga from the University of Basel.

In fact, a greater amount of physical activity does not necessarily lead to a correspondingly higher level of mental fitness. Longer exercise sessions are only linked to a greater improvement of cognitive performance when performed over a longer period of time.

Just like our physical condition, cognitive performance changes over the course of our lives. There is great potential for improvement during childhood (cognitive development phase) and during old age (cognitive degradation phase), according to the research.

However, the research group from the Department of Sport, Exercise and Health (DSBG) at the University of Basel was unable to find an indicator of effectiveness within the varying age groups.

In fact, the team found that the ages of people engaged in sporting activities do not have to be fundamentally different in order to improve cognitive performance. In other words, different age groups can be combined for a common goal during sports.

“This is already being implemented selectively with joint exercise programs for children and their grandparents,” says Professor Uwe Pühse from the University of Basel. Such programs could thus be further expanded.

Previous research has shown that men and women experience different physical effects from the same amount of sports activities. However, the research team has now been able to verify this for mental fitness. Men accordingly benefit more from sporting activity.

Differences between the sexes are particularly evident in the intensity of movement, but not in the type of sport. A hard workout seems to be particularly worthwhile for boys and men. Paired with a gradual increase in intensity, this leads to a significantly greater improvement in cognitive performance over a longer period of time.

In contrast, the positive effect on women and girls disappears if the intensity is increased too quickly. The results suggest that they should choose low to medium intensity sporting activities if they want to increase their cognitive fitness.

The study, titled “Systematic review and meta-analysis investigating moderators of long-term effects of exercise on cognition in healthy individuals” is published in the journal Nature Human Behaviour.

Source: University of Basel

How Brain’s Expectations Affect Learning

Sat, 04/18/2020 - 6:30am

When we are learning something new, our brains are continually making predictions about our environment, then registering whether those assumptions are true.

A new study has found that our expectations during these predictions affects the activity of various brain networks.

Neuroscientists at the Ruhr-Universität Bochum in Germany recently reported their findings in two articles in the journals Cerebral Cortex and Journal of Neuroscience.

The neuroscientists say they identified two key regions in the brain involved in this process. The thalamus plays a central role in decision-making. The insular cortex, on the other hand, is particularly active when it is clear whether the right or wrong decision has been made.

“The expectation during learning then regulates specific connections in the brain and thus the prediction for learning-relevant sensory perception,” said Associate Professor Dr. Burkhard Pleger from the Neurological Clinic of Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil.

For their study, the researchers used a learning task that focuses on the decision-making process during the perception of skin contact in the brain.

“It’s like learning a computer strategy game using a game pad, which gives sensory feedback to certain fingers on certain stimuli,” explained Pleger. “The point is that a certain touch stimulus leads to success and that this has to be learned from stimulation to stimulation.”

For the experiment, 28 participants were given either tactile stimulus A or B on the index finger in each trial run. At the push of a button, they then had to predict whether the subsequent tactile stimulus would be the same or not. The probability of A and B was constantly changing, which the participant had to learn from prediction to prediction, the researchers said.

During the test, the participants’ brain activity was examined using functional magnetic resonance imaging (fMRI). The researchers said they were particularly interested in the trial runs in which the participants changed their decision-making strategy. They then asked the question to what extent the change in expectations influenced brain activity.

To the researchers, two brain regions stood out: the thalamus and the insular cortex.

The thalamus processes information that comes from the sensory organs or other areas of the brain and passes it on to the cerebrum. It is also called the gateway to consciousness, according to the neuroscientists.

Using functional magnetic resonance images, the researchers were able to show that different brain connections between the prefrontal cortex and the thalamus were responsible for maintaining a learning strategy or changing the strategy.

The higher the expectations before the decision, the sooner the strategy was maintained and the lower the strength of these connections, according to the study’s findings. With low expectations, there was a change of strategy and the regions seemed to interact much more strongly with each other.

“The brain appears to be particularly active when a learning strategy has to be changed while it takes significantly less energy to maintain a strategy,” Pleger noted.

“So far, the thalamus has been viewed as a switch. Our results underline its role in higher cognitive functions that help decision-making while learning. So the thalamus is not only a gateway to sensory consciousness, but rather it seems to link it to cognitive processes that serve, for example, to make decisions.”

The insular cortex, on the other hand, is involved in perception, motor control, self-confidence, cognitive functions, and interpersonal experiences. This part was particularly active when a participant had already made his decision and then found out whether he was right or wrong, according to the study’s findings.

“Different networks that are anchored in the insular cortex are regulated by expectations and thus seem to have a direct influence on future sensory perception,” said Pleger.

Source: Ruhr-Universität Bochum
 
Photo: Burkhard Pleger (left) and Bin Wang collaborated for the studies. Credit: RUB, Marquard.

Why Some People Don’t Social Distance

Sat, 04/18/2020 - 6:00am

Why are some people failing to comply with social distancing recommendations in the midst of the COVID-19 pandemic?

A team of researchers at Stanford University in California found that work requirements from non-essential businesses, the desire to exercise, and a belief that other precautions were enough were reasons cited by people who were not following the recommendations.

They also found that people between the ages of 18 and 31 had the lowest compliance rate at 52.4 percent, compared to other age groups.

“As I looked around my own neighborhood in early March, some people were rushing to gather supplies and isolate, while others were going about their normal lives,” said study co-author Eleni Linos, M.D., Dr.P.H., a dermatologist and epidemiologist at the Stanford School of Medicine. “Our study shows that different people are experiencing this crisis in different ways. Not everyone has the same opportunities.”

For the new study, the researchers, an interdisciplinary team from the Department of Communication and from the Department of Epidemiology, conducted a survey between March 14-23, 2020, when shelter-in-place orders were first introduced in some parts of the United States. They collected 20,734 responses to a survey that was posted on social media networks Twitter and Facebook, as well as the neighborhood social networking service NextDoor.

The researchers found that 39.8 percent of respondents reported not complying with social distancing recommendations in the middle of March.

The most common reason for failing to social distance was work requirements for non-essential industries (28.2 percent). One respondent told the researchers, “Work is not canceled, if I don’t go I’ll lose my job.”

Another frequent explanation for not following orders included worries about mental and physical well-being. Some 20.3 percent said they engaged in social, physical, or routine activities to manage unease from sheltering in place, such as “cabin fever.”

As one respondent said, “Staying in my home 24 hours of every day is depressing.” Another emphasized, “I have to get outside now and then for my own sanity.”

Other rationales that people cited for failure to comply with social distancing included the belief that other precautions, such as hand washing, were sufficient (18.8 percent). Some 13.9 percent of people said they wanted to continue everyday activities and 12.7 percent believed that society is overreacting.

Children were another factor mentioned by respondents. About 4.8 percent of people said they did not comply with social distancing orders because they felt they had to take their children outdoors or to social events for the welfare of both their children and themselves. As one respondent said, “I have kids and it’s impossible to keep them grounded all the time.”

“Clearly different parts of the population have different kinds of concerns and reasons for not social distancing, and government communication should address those,” said Dr. Jeff Hancock, a professor of communication in the School of Humanities and Sciences and a co-author on the paper.

The researchers also analyzed what words participants used in their responses to better understand what people were feeling and focused on. They found that younger people between the ages of 18 to 31 were more likely to use first-person singular words such as “I” and “me,” which, according to the researchers, indicated they were more self-centered than other groups surveyed.

They also found that young people, the group least at risk for COVID-19, displayed more anxiety in their survey answers than other age groups, using words like “anxious,” “disturb” and “nervous,” more frequently than other age demographics.

Meanwhile, the oldest and most at-risk group (65-years-old and up) showed the least anxiety in their responses.

“A key takeaway for me was how resilient the older population seems,” said Hancock. “They are not as anxious or self-focused as young people. I think this runs counter to the narrative that the old are weak and frail, and instead, they are practiced at social distancing and being comfortable in their home.”

The researchers said they hope that these survey results can be used by public health officials and other policymakers for targeted messaging campaigns.

The study’s findings were part of a larger study published in the Journal of the American Medical Association that looked at public concerns in the US of the coronavirus pandemic.

Source: Stanford University

Lab/Human Study: Blood Test May Reveal Which Patients Will Not Respond to Antidepressants

Fri, 04/17/2020 - 7:00am

Depression is a common mental condition that affects around 10% of the population. Antidepressant medications are the first-line treatment for moderate to severe major depressive episodes. Pharmaceutical advances have improved the efficacy of the medications over the past three decades. However, despite the improved effectiveness, only 40% of patients respond to the first antidepressant they try.

This reality is challenging as depression is most common in ages 18 to 25 (10.9%) and in individuals belonging to two or more races (10.5%).

In the new study, Canadian researchers investigated a particular protein — GPR56 — that appears to be involved in the biology of depression and the effect of antidepressants. The McGill University led research team believe that this protein could offer a novel target for new antidepressant drugs.

Currently, selective serotonin reuptake inhibitors (SSRIs) are the first line pharmaceutical therapy for depression. This medication class was developed in the mid to late 1980s and this generation of antidepressants is now the most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), and sertraline (Zoloft).

In the study, Professor Gustavo Turecki of McGill University and the Douglas Mental Health University Institute, led an international consortium of researchers and clinicians to investigate changes in the activity of genes in the blood in over 400 patients who were being treated with antidepressants.

The results showed clearly that there were significant changes in the levels of GPR56 in patients who responded favorably to antidepressants, but not in non-responders, or patients receiving placebo. This discovery is particularly interesting, as GPR56 may represent an easy-to-measure biomarker for response to antidepressants.

McGill researchers studied the action of that GPR56 (which can be detected through a simple blood test) by doing experiments with mice, and by studying human brain tissue obtained from the Douglas Bell-Canada Brain Bank. They found the protein was associated with biological changes in the central nervous.

Their findings appear in a recent paper in the journal Nature Communication.

Researchers found that GPR56 was changed in depression, and that it was modified, both in the blood and the brain, when antidepressants were administered. These changes were particularly evident in the prefrontal cortex, an important area of the brain for the regulation of emotions and cognition.

Investigators hope their findings will help solve the mystery of why many patients with depression do not respond to antidepressant treatment.

Researchers studied three groups of individuals with depression and treated with serotonin-norepinephrine reuptake inhibitor (N = 424). They discovered that individuals who benefit from a SSRI display an increase of GPR56 mRNA in the blood. Conversely, individuals who do not respond to SSRIs and continue to have the same level of depression symptoms did not have an increase of the protein in their blood.

Moreover, researchers discovered GPR56 is downregulated in the pre-frontal cortex (a brain region believed to be responsible for depressive-like behaviors and antidepressant response) of individuals with depression that died by suicide.

“Identifying new therapeutic strategies is a major challenge, and GPR56 is an excellent target for the development of new treatments of depression,” said Gustavo Turecki.

“We are hopeful that this will provide an avenue to alleviate the suffering of patients who face this important, and often chronic, mental illness which is also strongly associated with the risk of addiction and an increased risk of suicide.”

Source: McGill University

Pilot Study: New Approach to Help Adults with Autism and Depression

Fri, 04/17/2020 - 6:30am

New research suggests the use of transcranial magnetic stimulation, or TMS, is effective in reducing depressive symptoms in adults with autism and depression. The intervention was also found to have some positive effects on autistic symptoms.

Researchers at the Medical University of South Carolina (MUSC) believe their findings should lead to additional study on the use of transcranial magnetic stimulation as a potential treatment for adults with both depression and autism.

The research appears in the journal Autism Research.

TMS has been used as a therapy for treatment-resistant depression and is a potential treatment for depressed adults with autism. It uses a magnet placed on the scalp to generate electromagnetic pulses that activate neurons in the brain near the magnet.

The study was performed by a team of MUSC researchers led by M. Frampton Gwynette, M.D., director of the General Psychiatry Clinic, Project Rex and the Autism News Network, and Mark George, M.D., a pioneer in TMS, is the Layton McCurdy Endowed Chair in Psychiatry and director of the Brain Stimulation Lab.

People with autism have challenges with social interactions and communication. They might not make eye contact, or they might hold one-way conversations. They can also have restricted interests. For example, they may fixate on a singular interest, such as trains (for instance), and everything about them. Another characteristic includes exhibiting repetitive behaviors, such as rocking or hand flapping when excited.

Such communication challenges can make autism very isolating, according to Gwynette. The communication challenges can render people with autism more prone to depression.

“You’ll see very high rates of major depressive disorder in adults with autism, up to 26-50 percent,” explained Gwynette. “When they have depression, it tends to be more severe than in typically developing individuals. They’re also more likely to have suicidal ideation and more likely to attempt suicide. In addition, their depression is more likely to be refractory to treatment.”

In Gwynette’s experience, depressive symptoms can in turn make autism symptoms more challenging.

“We’re really swimming upstream trying to treat this group,” said Gwynette.

“We also know that our standard antidepressant medications are not as effective or as well-tolerated in adults with autism because they’re prone to irritability. Sometimes, the antidepressants can make their autism symptoms worse, so it’s a really difficult thing to treat.”

No treatments for core autism symptoms have been approved by the Food and Drug Administration, so new therapies to treat patients with both autism and depression are urgently needed.

In the study, the researchers recruited 13 adults ages 18-65 with depression and autism to participate in 25 daily TMS treatments. The treatments targeted the left dorsolateral prefrontal cortex, a brain region associated with depression.

After treatment, 70% of participants had a decrease in depressive symptoms, and 40% experienced remission. No changes were seen in self-reported autism symptoms. However, people who knew the participants detected decreases in repetitive behaviors, hyperactivity and irritability.

Overall, the repetitive TMS treatments were well-tolerated, with two participants withdrawing due to anxiety or irritability. Side effects included fatigue, headache and scalp discomfort.

Limitations of the study included its small number of participants and the fact that all participants received the treatment and knew about the treatment.

Further conclusions will need to be derived from larger studies that randomize patients to either TMS or a sham intervention and “blind” them as to which treatment group they are assigned.

This study provides early evidence that TMS is safe for treating adults with autism and depression and shows promise in treating depression. These findings will need to be confirmed in future studies. More studies are also needed to elucidate the role of TMS in treating autism symptoms.

George and Gwynette are both optimistic about the future role of TMS in patients with autism and depression and eager to see the results of the next round of studies.

“Daily left prefrontal TMS, as we used in this study, appears to treat not just pure depression but also depression arising in the setting of autism and other disorders like Alzheimer’s,” said George.

“These are promising results. I’m particularly intrigued by the improvements not just in depressive symptoms but also in other symptoms in the autism spectrum. That was unexpected. The true answer will come with a double-blind trial.”

“I’m optimistic, as an autism specialist, that TMS will have a role in treating mental and comorbid conditions that come along with autism but also autism itself,” said Gwynette.

Source: Medical University of South Carolina

Study: Schools Pushed to Prioritize Test-Taking Skills Over Personal Growth

Fri, 04/17/2020 - 5:30am

A new study of thousands of U.S. schools finds that personal growth and job skills have taken a backseat to an increased focus on standardized test scores.

The findings are published in the journal Educational Administration Quarterly.

“The balanced development of both academic and soft skills is crucial, not only for well-rounded child development in schools, but also for career and life success,” says Jaekyung Lee, PhD, lead researcher and professor of learning and instruction in the University at Buffalo (UB) Graduate School of Education.

“Increasing concerns about poor student performance in the United States led states to adopt high-stakes testing policies,” says Lee. “However, working under the constraints of limited resources, complex power dynamics and externally imposed policies, school principals are often faced with challenges in prioritizing educational goals. Forced to focus narrowly on academic skills measured by state tests, other equally important goals were deprioritized.”

For the study, UB researchers analyzed the educational goals of principals at thousands of public, private and charter schools over two decades, and found the shift in priorities has been most pronounced in public schools.

The change in educational goals can be traced to the rise in test-based school accountability policies in the 1990s, which reached a peak with the No Child Left Behind Act (NCLB) of 2001 that mandated statewide testing in the U.S., according to the study.

The study is one of only a few to examine the influence of education policies on school principals’ priorities, rather than on student achievement or teacher practices. A school leader’s perception of educational goals guides, directs and motivates the daily operations and performance of school members, says Lee.

Using data from the Schools and Staffing Survey, the researchers compared the national trends of educational goal priorities between public and private schools from 1991-2012.

In a survey, principals were asked to choose their top three priorities among the following goals: basic literary and numerical skills, academic excellence, personal growth, job skills, work habits and discipline, human relations, moral values, and multicultural awareness.

Academic excellence experienced a significant rise in ranking among public school principals, with 83% choosing it as one of three top priorities in 2012, up from 60% in 1991. The percentage who selected development of basic literacy and numeracy skills also rose, increasing from 76% to 85%.

The shift, however, came at the expense of personal growth (self-esteem and self-awareness), which in 1991 was chosen by 62% of public school principals but only by 32% in 2012. The importance of job skills also declined, with the percentage of principals rating it as one of three top priorities falling from 13% to 9%.

Private school principals experienced a similar but less dramatic shift in priorities. The study findings reflect the influence of educational policy discourse and media reports on private schools which, unlike public schools, are less exposed to government regulations on curriculum standards, said Lee.

The study results regarding the NCLB policy’s impact on narrowing educational goals support Lee’s previous studies, including a recent report published by the Rockefeller Institute of Government that called for renewed education policy actions to improve children’s socioemotional skills and well-being.

“School leaders can and should play an important role in envisioning and realizing educational goals,” says Lee. “Principals need to develop strategies to accomplish the whole educational mission, encompassing academic, socioemotional, moral, multicultural and vocational learning to meet the diverse needs of their students as well as the larger society.”

Source: University at Buffalo