A new study published in the Journal of Alzheimer’s Disease shows that women’s brains are significantly more active in several regions, particularly in the prefrontal cortex (involved with focus and impulse control) and in the limbic or emotional areas of the brain (involved with mood and anxiety). The brains of men showed more activity in the visual and coordination centers.
Understanding these differences is important because brain disorders affect men and women differently. Women have significantly higher rates of Alzheimer’s disease, depression (which is itself is a risk factor for Alzheimer’s disease) and anxiety disorders while men have higher rates of attention-deficit/ hyperactivity disorder (ADHD), conduct-related problems, and incarceration (by 1,400 percent).
The study, conducted by nine Amen Clinics, is the largest functional brain imaging study to date. Researchers compared 46,034 brain SPECT (single photon emission computed tomography) scans, looking for differences between the brains of men and women.
SPECT can measure blood perfusion in the brain. Images acquired from subjects at rest or while performing various cognitive tasks are able to show different blood flow in specific brain regions.
“This is a very important study to help understand gender-based brain differences,” said lead author Daniel G. Amen, M.D., psychiatrist and founder of Amen Clinics, Inc.
“The quantifiable differences we identified between men and women are important for understanding gender-based risk for brain disorders such as Alzheimer’s disease. Using functional neuroimaging tools, such as SPECT, are essential to developing precision medicine brain treatments in the future.”
The study involved 119 healthy volunteers and 26,683 patients with a variety of psychiatric conditions such as brain trauma, bipolar disorders, mood disorders, schizophrenia/psychotic disorders, and attention/deficit hyperactivity disorder (ADHD).
The researchers analyzed 128 brain regions in the participants at baseline and while they were performing a concentration task.
“Precisely defining the physiological and structural basis of gender differences in brain function will illuminate Alzheimer’s disease and understanding our partners,” said Dr. George Perry, editor-in-chief of the Journal of Alzheimer’s Disease and dean of the College of Sciences at The University of Texas at San Antonio.
The study findings of increased prefrontal cortex blood flow in women compared to men may explain why women tend to exhibit greater strengths in the areas of empathy, intuition, collaboration, self-control, and appropriate concern.
The researchers also found increased blood flow in limbic areas of the brains of women, which may also partially explain why women are more vulnerable to anxiety, depression, insomnia, and eating disorders.
Source: IOS Press
New research clarifies the challenges many people with bipolar face in the workforce while suggesting opportunities to improve the worksite experience.
Investigators discovered workplace environments may be unsupportive as people with bipolar disorder often find themselves unemployed due to exclusion, stigma and stereotypes directed at them at work.
These workers had to disclose their condition to co-workers and employers to receive special accommodations or more support, but often the outcomes are negative, say researchers at the University of Michigan and the University of California, Los Angeles.
“Our findings suggest disclosure may risk job security,” said Lisa O’Donnell, the study’s lead author a former doctoral student at U-M’s School of Social Work.
The study examined the relationship between social stressors at work — such as isolation, conflict with others and stigmas — and how a person functions on the job.
The 129 research participants, whose average age ranged between 47 to 51, came from the Prechter Longitudinal Study of Bipolar Disorder.
They answered questions about conflict at work, exclusion and stigma by co-workers, social support and their mood.
Investigators discovered high depressive symptoms and conflict contributed to greater work impairments. Meanwhile, exclusion at work and impact of stigma (identified as weak, lazy or incompetent) with keeping a job predicted the person’s work status.
Exclusion at work — which is a passive form of bullying–can lead to negative consequences, such as less social support from others, the researchers say.
“The results…underscore the importance of intervening to improve relationships with co-workers and supervisors,” said Joseph Himle, U-M associate dean for research and professor of social work and psychiatry.
The researchers say more research is needed to identify the challenges found in the work environment–including inflexible hours, lower wages, access to adequate health care coverage — that individuals with severe mental illness commonly experience.
“These innovations have the potential to improve how this disadvantaged population functions at work and potentially prevent unemployment,” said O’Donnell, a postdoctoral fellow at UCLA.
Individuals with bipolar disorder could benefit from working with mental health clinicians, such as social workers, to develop more strategic ways to disclose their illness work, Himle says.
Source: University of Michigan
Self-talk is is common, a kind of an internal dialogue commonly used to moderate anxiety before a potentially stressful event. But not all self-talk is equally effective, and that is where the notion of “self-distancing” comes in.
New research suggest a self-distancing language, such as using the third person, can help us see ourselves through someone else’s eyes and can lead to improved confidence and performance.
“Being a fly on the wall might be the way to put our best foot forward,” said researcher Dr. Mark Seery, an associate professor in the University of Buffalo’s Department of Psychology and an expert on stress and coping.
“And one way to do that is by not using first-person pronouns like ‘I’. For me, it’s saying to myself, ‘Mark is thinking this’ or ‘Here is what Mark is feeling’ rather than ‘I am thinking this’ or ‘Here is what I’m feeling.’ It’s a subtle difference in language, but previous work in other areas has shown this to make a difference — and that’s the case here, too.”
reduce stress and improve performance. However, self-talk can be either self-distancing or self-immersing dependent on strategic use of language.
Experts explain that the self-talk is
Mark Seery, a University at Buffalo discovered that taking a “distanced perspective,” or seeing ourselves as though we were an outside observer, leads to a more confident and positive response to upcoming stressors than seeing the experience through our own eyes.
illustrate how the strategic use of language in the face of tension helps people feel more confident.
In the new study, investigators applied cardiovascular measures to test participants’ reactions while giving a speech. Researchers told 133 participants that a trained evaluator would assess a two-minute speech on why they were a good fit for their dream job.
The participants were to think about their presentation either with first-person (self-immersing) or third-person pronouns (self-distancing).
While they delivered their speeches, researchers measured a spectrum of physiological responses. Parameters included heart rate, and heart volume (how much blood the heart is pumping and the degree to which blood vessels dilated or constricted).
The data helped investigators correlate the self-talk perspective to data on whether the speech is important to the presenter and the presenter’s level of confidence.
“What this allows us to do is something that hasn’t been shown before in studies that relied on asking participants to tell researchers about their thoughts and feelings,” Seery said.
“Previous work has suggested that inducing self-distancing can lead to less negative responses to stressful things, but that can be happening because self-distancing has reduced the importance of the event. That seems positive on the face of it, but long-term that could have negative implications because people might not be giving their best effort,” he said.
“We found that self-distancing did not lead to lower task engagement, which means there was no evidence that they cared less about giving a good speech. Instead, self-distancing led to greater challenge than self-immersion, which suggests people felt more confident after self-distancing.”
The findings, with co-authors Lindsey Streamer, Cheryl Kondrak, Veronica Lamarche and Thomas Saltsman, are published in the Journal of Experimental Social Psychology.
Source: University of Buffalo
Art therapy has experienced tremendous growth over the past two decades, not only advancing treatment options but also advancing into different populations and treatment settings. In particular, art therapists have been working with a very special and unique population — the military.
For over 15 years, post-9/11 military service members and veterans have been coming home after serving sometimes multiple tours to Iraq and Afghanistan. Many have sustained physical and psychological combat injuries and require extensive care. While medical advancements have made it possible to survive catastrophic injuries, the reality for those who do survive is that they may require extensive physical, hands-on care for many years to come. In addition to physical impacts, post-traumatic stress disorder (PTSD) and traumatic brain injuries (TBIs) are prevalent in the Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn veteran populations, which poses tremendous daily challenges for the veteran and his or her entire family.
Stark cultures exist between the military and art therapy. The military — an institution and culture of rigid protocol, disciplined training, mission-focus; and art therapy — a profession based in creativity and the therapeutic relationship, within a fluid and flexible approach that offers myriad ways to openly express one’s feelings and thoughts. Yet many who serve in the military are finding art therapy to be their preferred method of treatment.
It’s a simple answer to a not-so-simple and pervasive issue challenging many military members who return from war: trauma. These two contrasting worlds of military service and art therapy intersect because art therapy has the means to assist service members, veterans and their families in dealing with combat trauma.
The American Art Therapy Association explains Art therapy is an integrative mental health and human services profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship (AATA, 2017).
In 2016, the Defense and Veterans Brain Injury Center reported that 352,619 US military service members worldwide have been diagnosed with TBI, with 82.3% cases classified as mild. Research points to the connection between PTSD and TBIs in military service members. In fact, recent studies link TBIs sustained during deployment to significant predictors of the service member developing symptoms of PTSD (Walker et. al., 2017).
Combat veterans are seeking art therapy to assist with trauma resolution, integrate with their TBI treatment plan, and provide coping mechanisms for PTSD symptoms. These therapies have become an increasingly accepted form of complementary care for military veterans (Nanda, Gaydos, Hathron, & Watkins, 2010). Art therapy, facilitated by a professional art therapist, effectively supports personal and relational treatment goals as well as community concerns (AATA, 2017).
Over the past 20 years, the field of neuroscience has grown exponentially and has contributed to advancing art therapy to the forefront of trauma-focused treatment today. Significant to the use of art therapy in trauma work is understanding the neurobiology of trauma, the biological study of the effects of trauma on the nervous system.
Advances in medical technology, such as brain imaging, now allow physicians, therapists, and scientists to literally see and understand what art therapists have known all along: creating, such as art-making, can change neural pathways in the brain; and that potentially changes the way one thinks and feels.
Art Therapy is a profession that facilitates psychic integration through the creative process and within the context of the therapeutic relationship. Conscious and unconscious mental activity, mind-body connectedness, the use of mental and visual imagery, bi-lateral stimulation, and communication between the limbic system and cerebral cortex functioning underscore and illuminate the healing benefits of art therapy — none of which could take place without the flexibility of neuronal processes, otherwise known as neuroplasticity (King, 2016).
Creative arts therapists know through creating — whether through art, music, poetry, or drama — that traumatic memory can be readily accessed in a way that is far less threatening than traditional verbal therapies. Traumatic memories are often stored in images and other sensations rather than in words or through verbalization, and many art therapists have observed how making art helps in releasing traumatic memories that were previously inaccessible.
Recent developments in neuroscience have provided information about areas of the brain responsible for the verbal processing of traumatic events. Brain imaging illustrates that for many, when recounting a traumatic event, the Broca’s area (language) of the brain shuts down, and at the same time, the amygdala becomes aroused (Tripp, 2007). Right brain activation through art media and process allow for less reliance on the verbal languages area of the brain, which provides some substantiation for why nonverbal therapies like art therapy might be more effective when working with trauma (Klorer, 2005).
Art Therapy operates on multiple levels, addressing immediate symptoms and underlying conditions that cause symptoms to persist (Howie, 2016). The American Art Therapy Association identified four major contributions of art therapy to the treatment of PTSD (AATA, 2012).
1 – Reducing anxiety and mood disorders
2 – Reducing behaviors that interfere with emotional and cognitive functioning
3 – Externalizing, verbalizing, and resolving memories of traumatic events
4 – Reactivating positive emotions, self-worth, and self-esteem (American Art Therapy Association)
For many service members, being able to express memories, feelings and thoughts in a nonverbal way is a big relief. The artwork provides a safe way to depict and confront recurrent nightmares, flashbacks and traumatic memories. Art therapy practice encourages the healthy expression and integration of imprinted memories as they are brought to consciousness within the safety of the therapeutic relationship (Wadeson, 2010).
Art therapy was introduced into military treatment facilities years ago because it is an effective treatment for service men and women who have experienced the trauma of war. Today, art therapy has become a more widely accepted treatment for those experiencing trauma from their military service. Many are learning that to overcome combat trauma, art therapy is a critical part of their treatment plan.
American Art Therapy Association, Inc. (2013). Art therapy, posttraumatic stress disorder, and service members [Electronic Version]. Retrieved July 24, 2017 from www.arttherapy.org/upload/file/RMveteransPTSD.pdf.
American Art Therapy Association, Inc. (2017). Definition of profession [Electronic Version]. Retrieved July 24, 2017 from https://www.arttherapy.org/upload/2017_DefinitionofProfession.pdf
Howie, P. (2016). The Wiley Handbook of Art Therapy, First Edition. In D. Gussak & M. Rosal (Eds.), Art therapy with Trauma (pp. 375-386). Oxford, UK: John Wiley & Sons.
King, J. (2016). The Wiley Handbook of Art Therapy, First Edition. In D. Gussak & M. Rosal (Eds.), Art Therapy: A Brain-based Profession (pp. 77-89). Oxford, UK: John Wiley & Sons.
Klorer, P.G. (2005). Expressive therapy with severely maltreated children: Neuroscience contributions. Art Therapy: Journal of the American Art Therapy Association, 22 (4), 213-220.
Nanda, U., Gaydos, H. L. B., Hathron, K., & Watkins, N. (2010). Art and posttraumatic stress: A review of the empirical literature on the therapeutic implications of artwork with war veterans with posttraumatic stress disorder. Environment and Behavior, 42(3), 376-390. dio:10.1177/0013916510361874
Tanielian, Terri, Rajeev Ramchand, Michael P. Fisher, Carra S. Sims, Racine S. Harris and Margaret C. Harrell. Military Caregivers: Cornerstones of Support for Our Nation’s Wounded, Ill, and Injured Veterans. Santa Monica, CA: RAND Corporation, 2013.
Tripp, T. (2007). A short term therapy approach to processing trauma: Art therapy and bilateral stimulation. Art Therapy Journal of the American Art Therapy Association, 24 (4), 176-183.
van der Kolk, B. (2003). Post-traumatic stress disorder and the nature of trauma. In M. Solomon & D. Siegel (Eds.), Healing trauma: Attachment—mind, body, brain (pp.168-196). New York, NY: W.W. Norton.
Wadeson, H. (2010). Art psychotherapy (2nd ed.). Hoboken, NJ: John Wiley & Sons.
Walker, M.S., Kaimel, G. Gonzaga, A.M.L., Myers-Coffman, K.A., & DeGraba, T.J. (2017). Active-duty military service members’ visual representations of PTSD and TBI in masks, International Journal of Qualitative Studies on Health and Well-being, 12:1, 1267317.
Yoga-based interventions show significant promise for treating patients with depression, including those with chronic, treatment-resistant symptoms, according to findings of several studies presented at the 125th Annual Convention of the American Psychological Association (APA).
In one of the studies, researcher Lindsey Hopkins, Ph.D., of the San Francisco Veterans Affairs Medical Center, focused on the acceptability and antidepressant effects of hatha yoga, the branch of yoga that emphasizes physical movement, along with meditative and breathing exercises, to enhance well-being.
For eight weeks, 23 male veterans participated in hatha yoga classes twice a week. By the end of the program, veterans with elevated depression scores before the yoga program had a significant reduction in depression symptoms.
In addition, the average enjoyment rating for the yoga classes for these veterans was 9.4 on a scale of one to 10. And every single one of the veterans said they would recommend the program to other veterans.
“Yoga has become increasingly popular in the West, and many new yoga practitioners cite stress-reduction and other mental health concerns as their primary reason for practicing,” said Hopkins. “But the empirical research on yoga lags behind its popularity as a first-line approach to mental health.”
In another experiment, Hopkins and researcher Sarah Shallit, M.A., of Alliant University in San Francisco, investigated the effects of Bikram yoga (heated yoga), a type of hatha yoga commonly practiced in the West.
Just more than half of the 52 participants aged 25 to 45 were assigned to participate in twice-weekly classes for eight weeks. The rest were told they were wait-listed and used as a control group.
All participants were tested for depression symptoms at the beginning of the study, as well as at weeks three, six, and nine. By the end of the study period, Bikram yoga had significantly reduced symptoms of depression compared with the control group.
During the same APA presentation, Maren Nyer, Ph.D., and Maya Nauphal, B.A., of Massachusetts General Hospital, revealed the findings from a pilot study of 29 adults that also showed eight weeks of at least twice-weekly Bikram yoga significantly reduced symptoms of depression and improved other secondary measures including quality of life, optimism, and cognitive and physical functioning.
“The more the participants attended yoga classes, the lower their depressive symptoms at the end of the study,” said Nyer, who currently has funding from the National Center for Complementary and Integrative Health to conduct a randomized controlled trial of Bikram yoga for individuals with depression.
In addition, Nina Vollbehr, M.S., of the Center for Integrative Psychiatry in the Netherlands, presented data from two studies on the potential for yoga to help reduce chronic and/or treatment-resistant depression.
In the first study, 12 patients who had experienced depression for an average of 11 years participated in nine weekly yoga sessions of approximately 2.5 hours each. The researchers measured participants’ levels of depression, anxiety, stress, rumination, and worry before the yoga sessions, directly after the nine weeks and four months later.
The findings show that participants’ levels of depression, anxiety, and stress decreased throughout the program, a benefit that persisted four months after the training. Rumination and worry did not change immediately after the treatment, but at follow up rumination and worry were decreased for the participants.
In another study, involving 74 university students with mild depression, Vollbehr and her research team compared yoga to a relaxation technique. Participants received 30 minutes of live instruction on either yoga or relaxation and were asked to perform the same exercises at home for eight days using a 15-minute instructional video.
While scores taken immediately after the treatment showed yoga and relaxation were equally effective at reducing symptoms, two months later, the yoga students had significantly lower scores for depression, anxiety and stress than the relaxation group.
“These studies suggest that yoga-based interventions have promise for depressed mood and that they are feasible for patients with chronic, treatment-resistant depression,” said Vollbehr.
The concept of yoga as complementary or alternative mental health treatment is so promising that the U.S. military is investigating the creation of its own treatment programs.
Hopkins noted that the research on yoga as a treatment for depression is still preliminary. “At this time, we can only recommend yoga as a complementary approach, likely most effective in conjunction with standard approaches delivered by a licensed therapist,” she said.
“Clearly, yoga is not a cure-all. However, based on empirical evidence, there seems to be a lot of potential.”
Sports psychologists have developed a multi-step program based on the practice of mindfulness to increase coaches’ and athletes’ mental readiness for the game.
Mindfulness involves being aware of the present moment and accepting things as they are without judgment. When it comes to sports, athletes who are able to simply observe moments as they come and go rather than latch onto them and overthink are better able to focus on their performance rather than on distracting negative experiences.
“It’s been suggested that many coaches regard sport as at least 50 percent mental when competing against opponents of similar ability. In some sports, that percentage can be as high as 80 to 90 percent mental,” said Keith Kaufman, Ph.D., a Washington, D.C.-area sports psychology practitioner and research associate at The Catholic University of America presenting at the APA convention.
His six-session program, developed in collaboration with Carol Glass, Ph.D., also of The Catholic University of America, and clinical psychologist Timothy Pineau, Ph.D., is outlined in the soon-to-be-published book “Mindful Sport Performance Enhancement.”
There are several psychological studies that point to the importance of mental preparation, according to Kaufman. One study involved more than 200 Canadian athletes from the 1984 Olympics who were assessed for three major readiness factors: mental, physical and technical. Of the three, only mental readiness was significantly associated with how successful they were at the Olympics.
“With popular belief and scientific evidence being in such harmony, one might expect that mental training would be a top priority within the athletic community. However, curiously, this is not the case,” said Kaufman.
“We have met so many athletes and coaches who know that mental factors, such as concentrating, relaxing and letting go of thoughts and feelings, can aid performance, but have no idea how to actually do those things under the pressures of training and competition.”
Kaufman outlined a multi-step program he and his co-authors developed based on the concept of mindfulness which would allow coaches and athletes at all levels to increase their mental readiness.
Mindfulness entails being aware of the present moment and accepting things as they are without judgment. When people are able simply to watch experiences come and go, rather than latch onto and overthink them, they are better able to intentionally shift their focus to their performance rather than distracting negative experiences such as anxiety, Kaufman said.
“For example, an athlete could identify that ‘right now, I’m having the thought that I can’t finish this race,’ so rather than reflecting an objective truth, it’s seen as just a thought,” said Kaufman.
The program includes six group-based sessions that contain educational, discussion and experiential components, as well as recommendations for daily home practice.
The training begins with sedentary mindfulness practice in which participants are instructed to focus on experiences like eating and breathing. Gradually more and more movement is incorporated, culminating in a sport-specific meditation in which athletes or coaches apply mindful attention to their actual sport performance.
The program is easily adapted to accommodate any sport at any level, from amateur to professional, according to Kaufman. It can also be adapted for use by a single performer or by people in business or the performing arts.
Recent studies cited by Kaufman points to the significant potential for this approach. Two studies found that college athletes who completed the program showed significant increases in various dimensions of mindfulness and flow, the mindset associated with being “in the zone.”
The athletes also rated their own performances higher and experienced lower levels of sports-related anxiety. In one of the studies, which involved two teams that had losing records the previous year, both teams went on to have winning seasons after using the mindfulness approach.
The new approach was presented at the 125th Annual Convention of the American Psychological Association (APA).
Although being married to someone significantly younger may be fun at first, a new study finds that a large age gap between spouses is linked to declining marital satisfaction over time.
Specifically, University of Colorado Boulder investigators found men and women both report greater marital satisfaction with younger spouses, but that satisfaction fades over time in marriages with a significant age gap between the partners.
Moreover, researchers discovered economic challenges appear to be more of an issue among partners with large age gaps relative to their similarly-aged counterparts.
In the study, published online in the Journal of Population Economics, investigators examined 13 years’ worth of longitudinal data from thousands of Australian households.
Perhaps unsurprisingly, the findings show that men reported greater marital satisfaction when paired with a younger spouse, especially in the early years of marriage. But the reverse appears to be true as well.
“We find that men who are married to younger wives are the most satisfied, and men who are married to older wives are the least satisfied,” said Terra McKinnish, a professor of economics at CU Boulder and a co-author of the new study.
“Women are also particularly dissatisfied when they’re married to older husbands and particularly satisfied if they’re married to younger husbands.”
That initial satisfaction erodes rapidly, however, after six to 10 years of marriage for the couples with a big age gap between the partners.
“Over time, the people who are married to a much older or younger spouse tend to have larger declines in marital satisfaction over time compared to those who are married to spouses who are similar in age,” said McKinnish.
One mechanism for this decline could be how the age difference between spouses affects the couple’s ability to respond to negative economic shocks, such as a job loss, McKinnish said.
“We looked at how couples respond to negative shocks and in particular, if they have a major bad economic shock or worsening of their household finances,” she said.
“We find that when couples have a large age difference, that they tend to have a much larger decline in marital satisfaction when faced with an economic shock than couples that have a very small age difference.”
A possible explanation for this, McKinnish said, is that similarly-aged couples are more in sync on life decisions that affect both partners (having children; general spending habits) and thus may be better equipped to adjust to a negative financial shock.
By contrast, an unexpected financial shakeup could expose underlying tensions and mismatches in couples with a larger age gap.
The findings are based on data from the Household, Income and Labor Dynamics in Australia (HILDA) survey, a longitudinal study that began in 2001.
The nationally representative sample was initially comprised of 7,682 households containing 19,914 individuals and participants are re-surveyed every year with questions that measure various aspects of life satisfaction.
Wang-Sheng Lee, a professor of economics at Deakin University in Australia and a research associate at IZA, co-authored the research.
Source: University of Colorado
New research suggests a person’s awareness of a diagnosis of mild cognitive impairment or mild Alzheimer’s may lead to unintended consequences.
Researchers at Penn Medicine discovered a person’s awareness of their cognitive decline is associated with greater depression, higher stress, and a lower quality of life, than that experienced by individuals unaware of their diagnosis.
Investigators also found that older adults who had an expectation that their disease would worsen over time reported lower overall satisfaction with daily life.
The study appears in the Journal of Gerontology: Psychological Sciences.
“These findings suggest that a patient’s quality of life could be impacted by a diagnostic label and their expectations for the prognosis. So, when a clinician discloses the diagnosis and prognosis of Mild Cognitive Impairment or mild stage Alzheimer’s disease, a patient may experience additional symptoms, like anxiety or depression,” said the study’s lead author, Shana Stites, PsyD, MA, MS.
For many years, a diagnosis of Alzheimer’s disease was often not made until a patient had substantial memory and cognitive problems – by which time patients themselves were often unaware of their diagnosis.
Advances in awareness, as well in diagnostic methods, mean doctors are diagnosing Alzheimer’s disease earlier, and in the future, routine diagnosis may occur before symptoms even begin.
According to Stites, early diagnosis holds the promise for opportunities to prevent cognitive and functional losses and to plan for these losses. But study results show that an early diagnosis of Alzheimer’s disease can also bring challenges.
The Penn Researchers studied how awareness of diagnosis impacts on self-ratings of quality of life in people with one of two disorders, Mild Cognitive Impairment — a disorder defined by slight but noticeable declines in cognitive abilities — or mild stage Alzheimer’s disease dementia.
They compared these ratings to a group of adults above the age of 65 with normal cognition.
Study participants completed measures of multiple domains of quality of life including cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one’s daily life.
Investigators also compared the measure of quality of life by cognitive performance, diagnosis awareness, and diagnostic group.
The findings help to identify psychological processes underlying relationships between cognitive decline and quality of life. According to Stites, the study has practical implications for current and future clinical practice.
“It’s not just an issue of to tell or not to tell, it’s an issue of how you tell and what you tell because when you give someone a diagnosis you’re also communicating, either directly or indirectly, a lot of information that can affect the activities people do in daily life, their planning for employment and lifestyle, emotional wellbeing, and social relationships with close friends and family members.
These issues need to be explicitly addressed with patients,” Stites said. “Maybe at this point we can’t prevent cognitive decline, but we certainly have effective interventions for treating depression and for managing other symptoms.”
The researchers note that further study is needed to understand what drives the impact of awareness of diagnosis and prognosis on quality of life.
Future studies might include pre-clinical research that is being done in Alzheimer’s disease. In this area, clinicians are working to diagnose people who are at risk of developing the disease based on genes and biomarkers. The scientist hope to determine how diagnosis awareness might affect an individual’s sense of identity and functioning in the world if they learn that they have a high probability of developing Alzheimer’s disease in the future.
A diagnosis of Alzheimer’s disease can evoke assumptions, stereotypes, feelings, and attitudes that can affect a person’s quality of life, how they view themselves and how they are treated by others.
This study is part of the research team’s ongoing efforts to understand how early diagnosis can impact a person’s quality of life and wellbeing. The results add to what they’ve been learning about the stigma of Alzheimer’s disease.
A new Canadian study discovers parents of children with autism benefit from being integrally involved in their child’s cognitive-behavioral therapy (CBT).
York University investigators found that parents experience a greater impact from their child’s therapy than once thought as co-participation with therapy improves the family experience.
Approximately 70 percent of children with autism struggle with emotional or behavioral problems, and may benefit from CBT to improve their ability to manage their emotions.
“Most of the time when parents bring in their kids for cognitive behavior therapy, they are in a separate room learning what their children are doing, and are not being co-therapists,” said Dr. Jonathan Weiss, an associate professor and chair in Autism Spectrum Disorders (ASD) Treatment and Care Research.
“What’s unique about what we studied is what happens when parents are partners in the process from start to finish. Increasingly we know that it’s helpful for kids with autism, specifically, and now we have proven that it’s helpful for their parents too.”
Parents who took part in the study were involved in a randomized controlled trial. They were asked to complete surveys before and after the treatment and were compared to parents who had not begun therapy.
Weiss and doctoral student Andrea Maughan examined changes in parent mental health, mindfulness, and perceptions of their children, during a trial of CBT for 57 children with ASD aged eight to 12 who did not have an intellectual disability.
Researchers discovered that parents who participated in the therapy with their children experienced improvements in their own depression, emotion regulation, and mindful parenting.
Study findings appear in the Journal of Autism and Developmental Disorders.
“The research showed that parents improved their abilities to handle their own emotions and to see themselves in a more positive light,” said Weiss. “It helped them to become more aware of their parenting and all of the good they do as parents.”
In the study, parents were co-therapists with their child’s therapist and were tasked with employing the same strategies alongside their children.
This allowed the parents learn to help themselves in the process. Parents were required to write down their children’s thoughts during activities.
“As a parent participating in the program, I have grown as much as my son did. I used to use a “one size fits all” strategy with my son — now he and I have many tools to manage through difficult moments,” said Jessica Jannarone, a parent involved in study.
“The ability to talk about our feelings, identify triggers, and think proactively about approaches has brought both positivity and comfort to our lives. Watching my son develop in this program and find a way to start handling his feelings has been the greatest gift of all.”
Weiss added the findings also speak to the importance for health care providers to involve parents in the process of delivering care to children with autism.
“We know parents of children with autism, in addition to all the positive experiences they have, also experience high levels of distress. So if we can do something to reduce that, we have a responsibility to try to do so.”
Source: York University
Emerging research suggests adolescent depression increases the risk of violence later in life.
Using a longitudinal study design, investigators discovered a consistent pattern of teen depression then increased risk of later violence. Since both depression and violence are prevalent in adolescents and young adults, the findings indicate the importance of early detection and treatment of depression.
The study examined the longitudinal association between depression and subsequent violence from three representative samples in the Netherlands, United Kingdom, and Finland.
Researchers for these three cohorts used complementary measures of depression, including self-report and clinical diagnoses, and different measurements of violence including informant reports of violence and official convictions for violent crimes.
The study appears in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
The research team, led by Professor Seena Fazel, from the Forensic Psychiatry Group at the University of Oxford, United Kingdom, found modest increases in risk of violence in depression.
In absolute terms, for instance, in the Finnish sample, 7.1 percent of individuals with depression were convicted of one or more violent crimes, compared with 3.6 percent in the general population without depression.
In relative terms, across samples and measurements, the study shows a consistent pattern of increased relative risk of later violence.
In the Dutch and UK samples, an increase in depressive symptoms was associated with a significant elevated risk of later violence.
In the Finnish sample, the odds of violence in individuals with a diagnosis of depression were increased two-fold, compared to those without depression.
Investigators believe these findings highlight the need for active and early treatment of depression in adolescents and young people.
The mechanisms behind this link need further investigation, and may involve increased impulsivity, hostility, and poor self-regulation.
“We know that high rates of depression have been reported among adolescents in juvenile detention and correctional facilities (e.g.,11 percent in boys and 29 percent in girls),” said Dr. Rongqin Yu, lead researcher at the University of Oxford, United Kingdom.
“However, the longitudinal link between depression and violence was unclear. Our longitudinal design allowed us to take into account previous violence, enabling us to test whether adolescent depression is associated with changes in violence over time.
We found a consistent pattern of increased risk of later violence across samples. Both depression and violence are prevalent in adolescents and young adults; our findings indicate the importance of early detection and treatment of depression.”
Said Fazel, “This research is important for two main reasons. First, it adds to the evidence of the many potential harms of untreated depression in young people. Second, it suggests that closer liaison between criminal justice and mental health might prevent violence in high-risk individuals.”
A new U.K. study finds that men with high sugar intakes have an increased likelihood of common mental disorders when compared to men with low sugar diets.
University College London investigators discovered men consuming a high sugar diet face a higher risk of mood disorders including anxiety and depression, over a five year comparison period.
The study also showed that having a mood disorder did not make people more inclined to eat foods with a high sugar content.
The report, published in Scientific Reports, used data from the Whitehall II cohort and analyzed the sugar intake from sweet food and beverages and occurrence of common mental disorders in over 5000 men and over 2000 women for a period of 22 years between 1983 and 2013.
Although previous studies have found an increased risk of depression with higher consumption of added sugars, none examined the role of “reverse causation.“ If people with anxiety and/or depression tended to consume more sugary foods and drinks, this could be the real reason why a link between sugar intake and poorer mental health is observed.
However, researchers did not find this link as they discovered men and women with mental disorders were not more likely to consume more sugar. As a result, the evidence that mental health is adversely affected by a high sugar intake is strengthened.
The study categorized daily sugar intake (in grams) from sweet food and beverages into three similar sized groups.
Men in the top third, who consumed more than 67 g, had a 23 percent increased chance of incident common mental disorders after five years. This relationship was independent of health behaviors, sociodemographic and diet-related factors, adiposity, and other diseases. The bottom third of men consumed less than 39.5 g per day.
According to the National Diet and Nutrition Survey, men in the U.K. consume an average 68.4 grams of added sugar per day (75 percent from sweet foods and beverages).
Men and women with mood disorders and high sugar consumption also had an increased chance of being depressed again after five years compared to those with lower intakes, but this finding was not independent of other socio-demographic, health, and diet-related factors.
Said lead author Anika Knüppel (UCL Institute of Epidemiology and Public Health),
“High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men. There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel’s back.
“The study found no link between sugar intake and new mood disorders in women and it is unclear why. More research is needed to test the sugar-depression effect in large population samples.
“There is increasing evidence for the physical damage sugar has on our health. Our work suggests an additional mental health effect. This further supports the evidence for policy action such as the new sugar levy in the U.K., but this is not addressed in many other European countries.”
In Britain, adults consume approximately double, and in the U.S. triple, the recommended level of added sugar, with sweet foods and drinks contributing three-quarters of the intakes.
The finding is salient as major depression is predicted to become the leading cause of disability in high income countries by 2030.
Knüppel added, “Sweet food has been found to induce positive feelings in the short-term. People experiencing low mood may eat sugary foods in the hope of alleviating negative feelings.
“Our study suggests a high intake of sugary foods is more likely to have the opposite effect on mental health in the long-term.”
Source: University College London
A new study for the first time has described how SSRIs initiate their action by targeting a particular type of nerve cell. The findings, published last week in the journal Neuron, may provide a path to new antidepressants that would not only be safer to use than existing ones, but that would also act more quickly.
For the past 30 years, pills like Prozac or Zoloft — collectively known as selective serotonin reuptake inhibitors, or SSRIs — have offered millions of people a way to shed the heavy cloak of depression.
These medications were designed to increase nerve cells’ access to serotonin, a chemical that helps the brain regulate certain emotions. Yet researchers still don’t know precisely how the drugs work to adjust errant brain chemistry, or how to make them work better.
Dr. Lucian Medrihan, who led the study, explains that while existing SSRIs can produce moderate effects within hours or even minutes, most people don’t really begin to feel better until they’ve been on the drugs for a significant amount of time. Medrihan is a research associate in the lab of neuroscientist and Nobel laureate Dr. Paul Greengard.
The delay in action is a major drawback when it comes to treating clinical depression. The drugs may also cause a wide range of uncomfortable side effects, including nausea, dizziness, weight gain, and sexual dysfunction.
Researchers say the basic idea behind SSRIs is relatively simple. When a neuron releases serotonin to signal another cell, it normally reabsorbs excess amounts of the neurotransmitter, preventing it from lingering in the space where the two nerve cells meet.
The drugs interfere with this mopping-up step, essentially prolonging the signal. What happens next has been a hard nut for neuroscientists to crack, however, because of the intrinsic complexity of the brain.
At least 1000 types of neurons could potentially be affected by a surge in serotonin, and they don’t all respond in the same way —
some get triggered, for example, while others calm down.
“That’s because there are 14 types of serotonin receptors present in various combinations in different neurons,” said Dr. Yotam Sagi, a senior research associate in Greengard’s lab. How a cell reacts to the neurotransmitter depends on the particular hodgepodge of receptors it carries.
Sagi and Medrihan set out to identify the earliest molecular steps by which SSRIs curb depression. To narrow their search, they honed in on a region of the brain known as the dentate gyrus, and on a particular group of cells called cholecystokinin (CCK)-expressing neurons, which they suspected were affected by SSRI-induced serotonin changes.
Using a technique called translating ribosome affinity purification, developed at Rockefeller by Nathaniel Heintz and Greengard, Sagi was able to identify the serotonin receptors present on CCK cells.
“We were able to show that one type of receptor, called 5-HT2A, is important for SSRIs’ long-term effect,” he says, “while the other, 5-HT1B, mediates the initiation of their effect.”
Next, Medrihan set up a series of intricate experiments to see if he could mimic an SSRI response by manipulating CCK neurons in living mice.
He suppressed the activity of these cells with chemogenetics, a technique that makes it possible to switch nerve cells on or off at will, and placed panels of tiny electrodes inside mouse brains. He then monitored the firing of other neurons in the dentate gyrus.
“Only five years ago, this research would not have been feasible,” he said of the methods involved.
The results were unmistakable: when a mouse’s CCK neurons were inhibited, the same neural pathways that mediate responses to SSRIs lit up. In targeting these cells, the scientists had seemingly recreated a quickened, Prozac-like response without the drug itself.
They also performed behavioral experiments by placing the mice in a pool and monitoring their swimming patterns.
After the CCK neurons had been briefly silenced, the behavior of these animals, which had not received any drugs, was similar to that seen in other mice after Prozac treatment: They swam with prolonged zest.
Greengard says the research resolves an important question in the field. “Many different types of synapses throughout the brain use serotonin as their neurotransmitter,” he said.
“An issue of major importance has been to identify where in the myriad of neurons the antidepressants initiate their pharmacological action.”
The findings, which identify CCK neurons in the dentate gyrus as the site of interest, will advance scientists’ understanding of how SSRI antidepressants work, and “should also facilitate development of new classes of potent and selective drugs,” Greengard said.
Such future therapies would presumably act faster than existing SSRIs, and might also produce fewer side effects.
Source: Rockefeller University
Researchers have developed a web tool designed to retrain the brain to think of positive outcomes to various scenarios.
The software aims to reduce the anxiety and depression that affects millions of people’s lives. Investigators note that in some cases, the mental disorders lead to isolation, poverty and poor physical health, things that often cascade to impact future generations.
University of Virginia researchers say the program hopes to shift the rigid, negative thoughts that come with mental disorders.
For many, anxiety is often intertwined with negative thoughts leading to stress. The mind-traps frequently lead to inaction which can be detrimental to social or professional relationships.
The new, online program being developed at UVA can train people to imagine different, positive outcomes to lots of different scenarios. Unlike other online applications that might seem similar, this program will go through continuous study and be refined as needed.
“It is four sessions long and each session is about 15 to 20 minutes,” said Dr. Bethany Teachman, a licensed clinical psychologist and a professor of psychology at UVA.
“People will see a variety of brief stories that are missing an ending. We encourage them to fill in those endings in different ways across the different sessions.”
In essence, Teachman said the program, which is anonymous, is designed to teach users to develop a new style of thinking.
“We want to give people practice in learning how to think about those situations in new ways, because we think that people who are prone to anxiety, depression and negative mood tend to have a pattern of thinking that things will turn out badly, and that can have really serious, negative consequences.”
People can access the free program using a computer, smart phone or tablet. The ability to participate where and when users want is deliberate.
“We really want people to incorporate it into their lives and say, ‘Oh, this is a time where I really need to work on that negative habit that I have in my thinking style and see if I can make a shift. Let me grab 15 minutes and see if I can turn that around a little bit,’” Teachman said.
The program’s public launch continues a study piloted by 201 college students at UVA including a control group.
The students who took the online training reported relatively more positive expectancies about the future, an increased belief that one can effectively achieve one’s goals and the belief that a person can change and grow.
That work was done in collaboration with Teachman’s graduate students, Nauder Namaky and Jeff Glenn.
One of those 201 participants was Eileen Hernon, a fourth-year student majoring in psychology and elementary education. She took the four-session program two years ago as part of a psychology course requirement.
At first skeptical, Hernon said after participating that she didn’t feel like the future was out of her control any more. In fact, the work inspired her to study more about positive psychology, a recent subfield that looks at what helps people experience more happiness.
Is she still feeling pretty positive about things? “Oh, definitely. I just finished this book called ‘The Happiness Project,’ and it changed my whole summer,” she said.
Teachman said now that the program is open for general consumption, she and her team will continue to analyze and refine its design as necessary.
“This is still a research study to find out for whom it will work best, in what ways, and what is the best way to deliver this,” she said. “We think some people are going to do it on their phone as they are sitting outside their boss’ office.
For other people, they’ll prefer to do it on the computer in the privacy of their own home. There are a lot of ways that this can work for people, and we want to find out how people can benefit most from it.”
Many online applications purport to offer relief to people with mental health illnesses, but Teachman said most are untested.
“A recent review identified 52 apps to treat anxiety, and there were a total of two studies done – total – on any of them – and those were two preliminary studies,” she said.
“That’s really, really alarming, because we know lots of things don’t work and some interventions can even cause harm. We are committed to doing evidence-based approaches to working on these problems.”
Source: University of Virginia
Osteoarthritis patients who have high confidence in their own ability to get tasks done in the morning tend to be more physically active throughout the whole day, regardless of their mood or pain levels, according to a new study at Penn State.
While prior research has investigated physical activity among people with other chronic conditions, the study is one of the first to explore the psychological aspect of activity in people with osteoarthritis.
The findings suggest that self-efficacy (confidence in one’s abilities) influences physical activity levels independent from other such factors as pain, mood, and support from a spouse. The researchers believe the findings, published in the journal Health Psychology, shed light on new ways to better design physical activity interventions.
Lead author Dr. Ruixue Zhaoyang, a postdoctoral fellow in Penn State’s Center for Healthy Aging, said that although previous research has found physical activity to be one of the best ways to reduce and manage symptoms of osteoarthritis, pain often prevents these patients from being as physically active as they should be. This may result in further stiffness and deterioration in muscle strength.
“Osteoarthritis is a common condition, and we wanted to look at how we can help people who suffer from it improve their activity levels,” Zhaoyang said. “Self-efficacy is a very strong predictor of people’s physical activity, and we wanted to see how it specifically affects this population.”
For 22 days, a total of 135 participants recorded their self-efficacy each morning by answering such questions as, “How confident are you that you can be physically active today despite pain?” They also answered questions about their mood and how much pain they were feeling.
The patients then wore an accelerometer throughout the day, which recorded the intensity of their physical activity and how many steps they took.
The results show that participants’ self-efficacy had a significant positive effect on their steps and moderate-intensity activity throughout that day, even when controlling for such factors as pain, mood and support from a spouse.
One interesting aspect of the study was that it not only compared self-efficacy from person to person, but also day to day within the same person, noted Zhaoyang. This gave the researchers a better idea about how daily fluctuations in self-efficacy may influence a person’s activity.
The researchers noted that even if a person’s self-efficacy was lower than another person’s, it still resulted in more physical activity as long as it was higher for them personally.
“It’s all about what you think you’re able to do. If you feel more confident than you generally are, you’re more likely to be physically active that day,” Zhaoyang said. “It’s not about your confidence compared to other people, it’s about comparing it within yourself. If you feel more confident than yesterday, you are more likely to be more active than yesterday.”
Interestingly, the effect of a bump in self-efficacy failed to carry over to the following day.
“We measured whether self-efficacy can influence activity into the next day, and we did not find that was true,” Zhaoyang said. “So for someone who’s trying to help someone become more active, if you boost their confidence today, but don’t do it tomorrow, the effect will disappear.”
Dr. Lynn Martire, a professor in the Department of Human Development and Family Studies who also worked on the study, said the new findings could help researchers develop better intervention programs aimed at helping people become more active. Since the effect of self-efficacy only appears to last one day, the timing of motivational messaging is key.
“There are many exercise interventions that aim to increase activity through self-efficacy, and we’re seeing that the number one way to do that is to help people become more physically active to begin with and then build on it,” Martire said.
“And with mobile technologies like smartphones and FitBits, it’s getting easier to give people feedback in the right amount of time.”
Source: Penn State