Mental illness related to early childhood trauma may be passed from generation to generation, according to new research appearing in JAMA Psychiatry.
The study, which looked at adults whose parents had either evacuated or remained in Finland as children during World War II, found that daughters of female evacuees had the same high risk for mental health disorders as their mothers, even though they had not faced the same trauma.
The study was conducted by researchers at the National Institutes of Health, Uppsala University in Sweden, and Helsinki University in Finland.
Although the study did not determine why this risk persists across generations, possible explanations include changes in the evacuees’ parenting behavior resulting from their childhood trauma or epigenetic changes — chemical alterations in gene expression, without any changes to underlying DNA.
“Many studies have shown that traumatic exposures during pregnancy can have negative effects on offspring,” said study author Stephen Gilman, Sc.D., of the Division of Intramural Population Health Research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
“Here, we found evidence that a mother’s childhood traumatic exposure — in this case separation from family members during war — may have long-lasting health consequences for her daughters.”
From 1941 to 1945, approximately 49,000 Finnish children were evacuated from their homes into Swedish foster homes in order to protect them from bombings, malnutrition and other hazards during war with the Soviet Union.
Many of these children were only preschool age. These children faced the trauma of separation from their families, adapting to their new foster families, and in many cases, learning a new language. Upon their return, many of these children experienced the additional stress of re-adjusting to Finnish society. On the other hand, thousands of Finnish families chose not to evacuate all their children and often kept some at home.
For the study, the researchers compared the risk of being hospitalized for a psychiatric (mental health) disorder among offspring of the evacuees to the risks of psychiatric hospitalization among the offspring of the siblings who remained with their parents.
Studying both groups allowed the researchers to compensate for family-based factors that can contribute to mental health problems and to focus instead on the evacuees’ wartime experience.
Findings from a previous study had shown that children who had been evacuated were more than twice as likely to be hospitalized as an adult for a psychiatric disorder than their female siblings who remained at home.
For the current study, the researchers linked the records of more than 46,000 siblings born between 1933 and 1944 — to those of their offspring, more than 93,000 individuals born after 1950. Of these, nearly 3,000 were offspring of parents who had been evacuated to Sweden as children, and more than 90,000 were offspring of parents who remained in Finland during the war.
The findings show that female evacuees and their daughters were at the greatest risk for being hospitalized for mood disorders, such as depression and bipolar disorder. In fact, the daughters of evacuees faced more than four times the risk of hospitalization for a mood disorder, compared to the daughters of mothers who stayed home — regardless of whether their mothers were hospitalized for a mood disorder.
The researchers did not find any increase in psychiatric hospitalizations for the sons or daughters of males who had been evacuated as children.
While the study could not determine why the daughters of female evacuees faced a greater risk, one possibility is that the evacuation trauma may have impacted their mental health in ways that influenced their parenting style.
Another possibility is that the evacuee experience resulted in epigenetic changes. For example, previous research has shown that Holocaust survivors have higher levels of compounds known as methyl groups bound to the gene FKBP5 and have passed this change on to their children. This higher level of methyl groups appears to alter the production of cortisol, a hormone that regulates the stress response.
“The Finnish evacuation was intended to protect children from the many harms associated with the country’s wars with the Soviet Union,” said study co-author Torsten Santavirta, Ph.D., of Uppsala University. “Our observation of long-term psychiatric risk that reached into the next generation is concerning and underscores the need to weigh benefits as well as potential risks when designing policies for child protection.”
The researchers conclude that more studies are needed to understand how the experience of war impacts the mental health of parents and their offspring and to develop interventions to help families affected by armed conflict.
New research reveals that obese adolescents have disrupted connectivity in the complex regions of the brain involved in regulating appetite, emotions, and impulse control, and reward and pleasure in eating.
The study, presented at the annual meeting of the Radiological Society of North America (RSNA), used advanced imagining technology to discover the disrupted white matter integrity in several regions of the brain.
Obesity is an epidemic in America and across the world. According to the Centers for Disease Control and Prevention (CDC), obesity has more than quadrupled in adolescents over the past 30 years.
It is estimated that more than one-third of children and adolescents in the U.S. are overweight or obese. Obesity in adolescence is associated with a number of health risks, including cardiovascular disease and diabetes.
The study at the University of Sao Paulo in Brazil included 59 obese adolescents between the ages of 11 and 18 and 61 healthy control adolescents matched for gender, age, socio-economical classification, and education level.
The adolescents were classified by the World Health Organization criterion for obesity. They had no other known chronic diseases or conditions. The study participants underwent diffusion tensor imaging (DTI) of the brain to evaluate white matter integrity.
DTI is a type of MRI exam that measures functional anisotropy (FA), the microscopic motion, or anisotropy, of water molecules within and surrounding the brain’s white matter fibers. Low FA values indicate greater disruption within the white matter.
“DTI is a relatively new MRI technique not widely used in clinical diagnosis,” said study author Pamela Bertolazzi, a biomedical scientist and Ph.D. student in the neuroimaging laboratory at the University of Sao Paulo.
The results showed loss of white matter integrity in several brain regions in the obese patients. Compared to the healthy controls, the brains of the obese adolescents showed a decrease in FA values in many areas of the brain including several regions involved in appetite regulation, impulse control, emotions, and reward and pleasure in eating.
“The data reveal a pattern of involvement among brain regions that are important in the control of appetite and emotions,” Bertolazzi said. “There was no region of higher FA in obese patients compared to the control group,” she added.
The researchers hope that these findings will offer new tools to combat this global public health crisis.
“Childhood obesity has increased 10 to 40 percent in the last 10 years in most countries,” Bertolazzi said.
“If we are able to identify the brain changes associated with obesity, this DTI technique could be used to help prevent obesity and avoid the complications associated with the condition.”
Researchers have found young people addicted to smartphones and the internet display an imbalance in their brain chemistry. The finding is salient as a recent Pew Research Center study discovered 46 percent of Americans say they could not live without their smartphones.
While this sentiment is clearly hyperbole, more and more people are becoming increasingly dependent on smartphones and other portable electronic devices. Many are concerned that in addition to the obsession with smart devices, the behavior among young people may lead to immediate effects on the brain and the possible long-term consequences of such habits.
In a new study, Hyung Suk Seo, M.D., professor of neuroradiology at Korea University in Seoul, South Korea, and colleagues used magnetic resonance spectroscopy (MRS) to gain unique insight into the brains of smartphone- and internet-addicted teenagers. MRS is a type of MRI that measures the brain’s chemical composition.
The study involved 19 young people (mean age 15.5, 9 males) diagnosed with internet or smartphone addiction and 19 gender- and age-matched healthy controls.
Twelve of the addicted youth received nine weeks of cognitive behavioral therapy, modified from a cognitive therapy program for gaming addiction, as part of the study.
Researchers used standardized internet and smartphone addiction tests to measure the severity of internet addiction. Questions focused on the extent to which internet and smartphone use affects daily routines, social life, productivity, sleeping patterns, and feelings.
“The higher the score, the more severe the addiction,” Dr. Seo said.
Dr. Seo reported that the addicted teenagers had significantly higher scores in depression, anxiety, insomnia severity, and impulsivity.
The researchers performed MRS exams on the addicted youth prior to and following behavioral therapy and a single MRS study on the control patients.
The MRS imaging technique was used to measure levels of gamma aminobutyric acid, or GABA, a neurotransmitter in the brain that inhibits or slows down brain signals, and glutamate-glutamine (Glx), a neurotransmitter that causes neurons to become more electrically excited.
Previous studies have found GABA to be involved in vision and motor control and the regulation of various brain functions, including anxiety.
The results of the current study revealed that compared to the healthy controls, the ratio of GABA to Glx was significantly increased in the anterior cingulate cortex of smartphone- and internet-addicted youth prior to therapy.
The investigators discovered the ratios of GABA to creatine and GABA to glutamate were significantly correlated to clinical scales of internet and smartphone addictions, depression and anxiety.
The findings are important because having too much GABA can result in a number of side effects, including drowsiness and anxiety. Nevertheless, researchers note that more study is needed to understand the clinical implications of the findings.
Dr. Seo believes that increased GABA in the anterior cingulate gyrus in internet and smartphone addiction may be related to the functional loss of integration and regulation of processing in the cognitive and emotional neural network.
Interestingly, cognitive behavioral therapy appears to be able to restore the GABA to Glx ratios in the addicted youth.
“The increased GABA levels and disrupted balance between GABA and glutamate in the anterior cingulate cortex may contribute to our understanding the pathophysiology of and treatment for addictions,” Dr. Seo said.
A new study discovers a combination of personality traits may annul the effects of other traits, especially as related to the risk of depression and anxiety.
Specifically, investigators discovered that while high levels of neuroticism put people at risk for depression and anxiety, if those same individuals are also highly extraverted and conscientious, they could have a measure of protection against those disorders.
University at Buffalo psychologists believe the findings, published in the Journal of Research in Personality, point to the importance of stepping away from focusing on single personality traits in clinical settings.
Instead, they recommend looking at how combinations of traits might work together to help either prevent or predict specific symptoms.
“We know individually how these traits relate to symptoms, but now we are beginning to understand how the traits might impact one another,” said Dr, Kristin Naragon-Gainey, an assistant professor and the paper’s lead author with Dr, Leonard Simms, associate professor of psychology.
“We have to consider the whole person in order to understand the likelihood of developing negative symptoms down the road.”
Neuroticism is the tendency to experience different negative emotions and to react strongly to stress. Along with extraversion and conscientiousness, it is among the “Big Five” personality traits — a group that also includes agreeableness and openness to experience.
Everyone has these characteristics but individuals express each of the traits somewhere on a continuum. Someone high in extraversion would be very social, while another person low in extraversion would be much less outgoing. Conscientiousness, meantime, is the tendency to be organized, goal-oriented and non-impulsive.
The researchers interviewed 463 adult participants who reported receiving psychiatric treatment within the past two years. Each participant also completed numerous questionnaires. The study examined the traits of neuroticism, extraversion and conscientiousness because those three have the strongest associations with mood and anxiety disorders.
Naragon-Gainey says all things being equal, there are risks for disorders associated with certain traits, but a better image of what’s at stake emerges when there’s an understanding of how a group of behavioral tendencies might work together.
The results could provide an improved understanding of the mechanisms through which people develop mood disorders and explain the factors that might put someone at risk for symptoms like depression and anxiety.
Additionally, the findings might assist clinicians in how to capitalize on people’s strengths with treatments that utilize what the study’s results suggest are protective traits.
“I think there’s a tendency in treatment and clinical psychology to concentrate on the problems and the negatives,” said Naragon-Gainey. “If you utilize the preexisting strengths that clients bring with them, it can positively affect treatment and the level of symptoms going forward, as well as reinforcing what the person is already doing well.”
Conceptually, the strengths linked to high levels of extraversion and conscientiousness relate to the fact that social interactions and effective engagement in meaningful activities are rewarding for people, according to Naragon-Gainey.
“If someone has high levels of extraversion they might be very good at gathering social support or increasing their positive affectivity through social means,” said Naragon-Gainey.
“Similarly, conscientiousness has a lot to do with striving toward goals and putting plans in action, which can combat the withdrawal and avoidance that can go along with neuroticism.”
Source: University of Buffalo
A new study finds that giving employees more authority and asking their opinion may actually be counterproductive for a noncreative job task.
University of Exeter researchers discovered managerial attempts to empower staff by delegating different work to them or asking for their opinions can be detrimental for employee productivity.
Giving employees more authority can have a negative impact on their day to day performance and perhaps give the impression that their boss is just seeking to avoid doing their own work, according to the study.
Managers have increasingly sought to empower workers because they had thought it allowed staff to develop their skills and would result in better job satisfaction.
New research suggests, however, that promoting good relationships between bosses and staff can be a more effective way to make them more efficient. Still, investigators found that empowering some workers can help improve creativity.
The study appears in the Journal of Organizational Behavior.
The style of empowering leadership, developed 20 years ago, has become more popular in the past decade as the organizational structures of companies have become flatter.
The managerial approach involves giving employees authority to get on with their work without regular monitoring, asking for their opinions, and letting them participate in decision making.
Research by the University of Exeter Business School, Alliance Manchester Business School and Curtin Business School shows empowering workers can be effective when used for employees who have to carry out creative tasks.
The managerial style motivates employees to work harder and to help others, and helps them be proactive. But if used for staff who only carry out routine, structured tasks, empowering them may be counterproductive. The danger is that an employee may interpret this style of leadership as just a way of their boss delegating more of their workload to others.
For the study, researchers examined information about 105 companies around the world, and looked at the performance of 8,500 individual people working in mixture of industries, including manufacturing, healthcare, sales, and schools.
Researchers discovered trust is also a key component for choice of managerial style bosses and employees need to trust each other if empowering leadership is to be effective.
Bosses need to show they trust their subordinates, and allow them to be creative. Workers need to show they can be trusted to work without being closely supervised.
Dr. Allan Lee, from the University of Exeter Business School, who led the research, said, “Using an empowered style of leadership can be detrimental and create uncertainly and even chaos if used for workers who have non-creative tasks.
“Workers have got to feel that their boss supports them to take risks when empowering leadership is being used. But bosses are also vulnerable when they manage people in this way. People could take advantage of the trust put in them. Trust is a powerful factor in how effective empowering leadership can be.”
Source: University of Exeter/Wiley
A new study finds that over 60 percent of individuals who died from an opioid overdose had been diagnosed with a chronic pain condition, and many had been diagnosed with a psychiatric disorder.
Researchers at Columbia University Medical Center reviewed more than 13,000 overdose deaths with the study the first to determine the proportion of those who died of an opioid overdose with chronic pain.
The analysis is timely as according to the US Centers for Disease Control, the number of opioid-related deaths has quadrupled, from 8,048 in 1999 to 33,091 in 2015.
The findings underscore the importance of providing substance use treatment services in conjunction with behavioral interventions for people with chronic pain.
The study, “Service Use Preceding Opioid-Related Fatality,” appears online in the American Journal of Psychiatry.
The researchers analyzed clinical diagnoses and filled medication prescriptions for more than 13,000 adults in the Medicaid program who died of an opioid overdose. During the last year of life, more than half of these individuals had been diagnosed with chronic pain. Many had also been diagnosed with depression and anxiety.
“The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems.
“Such a strategy might increase early clinical intervention in patients who are at high risk for fatal opioid overdose,” said Mark Olfson, M.D., professor of psychiatry at CUMC and lead investigator of the study.
Approximately one-third of those who died had been diagnosed with a drug use disorder in the prior year. However, fewer than one in twenty had been diagnosed with opioid use disorder in the last month.
“Because clinical diagnoses generally indicate treatment, this service pattern suggests that dropout from drug treatment is common before fatal opioid overdose. Improving treatment retention with contingency management or other effective behavioral interventions might help lower the risk of fatal overdose in these patients,” said Dr. Olfson.
In the year before death, more than half had filled prescriptions for opioids or benzodiazepines (Librium, diazepam-valium, lorazepam), and many had filled prescriptions for both types of medications.
“This medication combination is known to increase the risk of respiratory depression, which is the unusually slow and shallow breathing that is the primary cause of death in most fatal opioid overdoses,” said Dr. Olfson, who added that the data from the current study were collected between 2001 and 2007.
“In the years since, there has been an increase in the proportion of US overdose deaths involving benzodiazepines and opioids.”
The authors urged providers to restrict the combination, in the lowest possible dose and duration, to those patients for whom alternative strategies have proven inadequate.
New research explores whether the fear of a relationship ending may be a self-fulfilling prophecy. Can the fear of a relationship ending actually lessen love and cause a breakup?
In the study, Drs. Simona Sciara and Giuseppe Pantaleo of the Vita-Salute San Raffaele University in Italy found that “perceived risk“ can greatly influence the outcome of a romantic relationship. That is, fear of relationship failure can lead to less commitment and then to actual relationship dissolution.
Their findings complement what is already known about how obstacles to a romantic relationship affect attraction and commitment towards a partner.
The study appears in the journal Motivation and Emotion.
For the investigation, participants provided basic information about themselves and the state and dynamics of their relationship. The researchers then manipulated the participants’ perception that their relationship could end.
Manipulation techniques included providing statistics about the failure of relationships to one group, and giving false feedback to some participants about the chances of their romantic affiliations ending. Participants were then asked how committed they were to their relationship, and how they felt towards their partner.
Sciara and Pantaleo found that participants’ romantic feelings and levels of commitment towards their partners were more intense when no mention was made about the possibility that their relationships could end.
Romance and commitment diminished when they heard that there could be either a high or low risk of a break-up. When participants were told that there was only a moderate chance the relationship would end, commitment was stronger.
The researchers also established that the influence of such manipulated risk on romantic commitment was fully mediated by feelings of romantic affect. That is, “when faced with a ‘too high’ risk of ending the relationship, participants clearly reduced the intensity of their positive feelings towards the romantic partner,” Sciara said.
Pantaleo believes it is important for psychologists, clinicians and counselors to understand the causal role that perceived risk plays in the outcomes of their clients’ romantic relationships.
“Reduced relationship commitment, for instance, leads to dissolution considerations and, thereby, to actual relationship breakup. Relationship breakup, in turn, plays a critical role in the onset of depression, psychological distress and reduced life satisfaction,” Pantaleo said.
Tinnitus or the perception of ringing in the ears is a pervasive condition affecting nearly 15 percent of the general public — over 50 million Americans. Emerging research now suggests neurofeedback training has the potential to reduce the severity of tinnitus or even eliminate it.
The U.S. Centers for Disease Control estimates that over two million Americans have extreme and debilitating cases of ringing in the ears. A new study, presented at the annual meeting of the Radiological Society of North America (RSNA), finds that neurofeedback training can help individuals turn their focus away from these sounds.
Tinnitus is the perception of noise, often ringing, in the ear. As sufferers start to focus on it more, they become more frustrated and anxious, which in turn makes the noise seem worse. The primary auditory cortex, the part of the brain where auditory input is processed, is believed to be the source of tinnitus-related distress.
In the study, researchers looked at a way to treat tinnitus by having people use neurofeedback training to turn their focus away from the sounds in their ears. Neurofeedback is a way of training the brain by allowing an individual to view some type of external indicator of brain activity and attempt to exert control over it.
“The idea is that in people with tinnitus there is an over-attention drawn to the auditory cortex, making it more active than in a healthy person,” said Matthew S. Sherwood, Ph.D., research engineer and adjunct faculty at Wright State University in Fairborn, Ohio. “Our hope is that tinnitus sufferers could use neurofeedback to divert attention away from their tinnitus and possibly make it go away.”
To determine the potential efficacy of this approach, the researchers had 18 healthy volunteers with normal hearing undergo five fMRI-neurofeedback training sessions. Study participants were given earplugs through which white noise could be introduced for periods of time. The earplugs also served to block out the scanner noise.
To obtain fMRI results, the researchers used single-shot echoplanar imaging, an MRI technique that is sensitive to blood oxygen levels, providing an indirect measure of brain activity.
“We started with alternating periods of sound and no sound in order to create a map of the brain and find areas that produced the highest activity during the sound phase,” Dr. Sherwood said. “Then we selected the voxels that were heavily activated when sound was being played.”
The participants then participated in the fMRI-neurofeedback training phase while inside the MRI scanner. They received white noise through their earplugs and were able to view the activity in their primary auditory cortex as a bar on a screen. Each fMRI-neurofeedback training run contained eight blocks separated into a 30-second “relax” period followed by a 30-second “lower” period.
Participants were instructed to watch the bar during the relax period and actively attempt to lower it by decreasing primary auditory cortex activity during the lower phase.
The researchers also gave the participants techniques to help them do this, such as trying to divert attention from sound to other sensations like touch and sight.
“Many focused on breathing because it gave them a feeling of control,” Dr. Sherwood said. “By diverting their attention away from sound, the participants’ auditory cortex activity went down, and the signal we were measuring also went down.”
A control group of nine individuals were provided sham neurofeedback — they performed the same tasks as the other group, but the feedback came not from them but from a random participant. By performing the exact same procedures with both groups using either real or sham neurofeedback, the researchers were able to distinguish the effect of real neurofeedback on control of the primary auditory cortex.
The study represents the first time fMRI-neurofeedback training has been applied to demonstrate that there is a significant relationship between control of the primary auditory cortex and attentional processes. This is important to therapeutic development, Sherwood said, as the neural mechanisms of tinnitus are unknown but likely related to attention.
The results represent a promising avenue of research that could lead to improvements in other areas of health like pain management, according to Dr. Sherwood.
“Ultimately, we’d like take what we learned from MRI and develop a neurofeedback program that doesn’t require MRI to use, such as an app or home-based therapy that could apply to tinnitus and other conditions,” he said.
An unexpected finding from a small study suggests a link between negative emotions, such as sadness and anxiety, and higher opioid use. Johns Hopkins researchers found that among people with sickle cell disease, opioid use hinged on negative emotions when pain levels were self-reported as relatively low.
Investigators discovered the linkage from an analysis of data obtained from daily electronic patient diaries. Nevertheless, they caution that their study wasn’t set up to show that negative emotions or thinking causes people to take more opioid pills but only to see if there was an association.
People with the inherited disorder have misshapen red blood cells that clog blood vessels, causing chronic pain and episodes of severe pain that frequently send patients to emergency rooms.
Their study, described online in The Journal of Pain, adds to efforts to better identify those at risk for overuse of opioids, improve pain control, and decrease dependency and side effects of long-term opioid use.
“We showed that the way we think about pain is associated with opioid use even if our pain levels are low,” said Patrick Finan, Ph.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
“These data argue that physicians need better communication with patients on how to take their medications from day to day to minimize fluctuations based on mood or way of thinking.”
About 100,000 Americans have sickle cell disease, or one out of every 365 births in African-Americans, according to the Centers for Disease Control and Prevention. Patients with sickle cell disease are commonly prescribed a daily, long-acting painkiller taken at a constant dose, and a short-acting painkiller to be taken as needed for episodes of more severe pain.
Long-acting drugs include morphine, oxycodone, methadone, and a fentanyl patch, and rescue pain killers include oxycodone, hydromorphone, meperidine, tramadol, and hydrocodone.
To determine the factors that could put one at risk of overusing opioids, the researchers recruited 85 adults from Baltimore with sickle cell disease to fill out electronic diaries on a handheld personal computer every evening for 90 days.
For their analysis, the researchers included only 45 participants, those who filled out the diary more than 25 percent of the time and had taken opioid pills at least once during the study period. Participants were an average age of 37; 71 percent were women and 93 percent were African-American.
At the start of the study, participants reported on the dosage and type of opioid pill they were prescribed for long-acting daily and short-acting use. The daily diary collected data on the number of long-acting and short-acting opioid pills taken per day.
Participants rated their daily pain level on a scale of zero to 10, with zero being no pain and 10 being worst pain imaginable. Participants also individually rated positive emotions — including happy, calm, and cheerful — and negative emotions — including lonely, sad, anxious, and tired — on a scale of zero to 10 with zero being no emotion and 10 being the most intense emotion. The scores were converted to a zero to 100 scale for the data analysis.
Separately, the researchers measured negative thinking (different than negative emotions) by using a Pain Catastrophizing Scale to rate “rumination,” or focus on pain, helplessness, and magnification of a current pain situation.
Among the 31 participants who took long-acting, daily opioids, negative emotions were associated with increased levels of using opioid pills. Opioid dosage increased by 3.4 morphine milligram equivalents — a standard measurement that compares dosages between various opioids — for every 10-point increase of negative emotions.
Daily pain level, positive emotions, and negative thinking through catastrophizing did not affect the amount of long-acting, daily opioids taken.
“When someone is prescribed a daily, long-acting opioid, it is typically supposed to be at a fixed dose and their pain level or emotions shouldn’t dictate whether they take more of this prescription or not,” says Finan.
“Although we can’t prove misuse of the medication in our study, these data suggest that physicians and patients should clearly communicate about how patients should be taking their daily, long-acting opioids in order to minimize the potential for misuse.”
When looking at levels of short-acting opioids taken at times of pain, the researchers found that pain levels and negative thinking by catastrophizing were associated with levels of short-acting opioid use.
For every 10-point increase on the pain scale, the amount of short-acting opioids increased by 1.8 morphine milligram equivalents, and for every 10-point increase on the catastrophizing scale, pain medicine dosage increased by 2.5 morphine milligram equivalents. Positive and negative emotions had no effect on the use levels of short-acting opioids.
“When pain was reported as low, sickle cell disease patients reported higher opioid use if they catastrophized, or focused their thinking on their pain, than if they didn’t,” says Finan.
“When pain levels were higher, negative thinking played less of a role in influencing opioid use,” he adds.
Finan cautions that studies such as his have some weaknesses, including the fact that self-reports are always uncertain, and the study only looked at one time point per day, although a person’s mood may fluctuate throughout the day based on life events and experiences.
Source: Johns Hopkins
Mothers of teenagers with autism spectrum disorder (ASD) or intellectual disability (ID) report higher levels of stress and other mental health problems, such as depression or anxiety, than mothers of typically developing teens, according to a new study published online in the Journal of Autism and Developmental Disorders.
The findings show that stress levels were highest among moms whose teens also show signs of clinical-level disruptive behavior disorders in addition to ASD and/or ID.
However, moms in the study who maintained an optimistic outlook on life — believing that good rather than bad things would happen to them — experienced fewer negative effects associated with parenting a child with ASD or ID and comorbid behavior disorders.
For the study, Dr. Jan Blacher, autism expert and distinguished professor in the Graduate School of Education at the University of California, Riverside (UCR), and her research colleague Dr. Bruce L. Baker from the University of California, Los Angeles (UCLA), wanted to investigate how such disorders affect mothers in particular.
They surveyed 160 young teens (age 13) and their families. A total of 84 of the participants were classified as having typical development, or TD; 48 had ASD; and 28 had ID.
Blacher is the director of UCR’s SEARCH (Support, Education, Advocacy, Resources, Community, and Hope) Family Autism Resource Center and works with kids of all ages with ASD. She said this study, however, is special because it focuses on a pool of adolescents who are the same age.
“Usually when studies have looked at the impacts of autism on families, the children involved have reflected wide ranges of ages,” said Blacher. “Here, we’ve eliminated the variance related to developmental stage.”
The first mother and teen assessments took place during in-person visits at the research site. Later, the researchers asked mothers to complete separate questionnaires privately to measure youth behavior problems and parental well-being.
“ASD group mothers scored highest on each of the two distress indicators,” the researchers wrote, adding that ASD group mothers’ levels of stress and mental health symptoms did not differ significantly from those of ID group mothers.
The findings harken back to previous research suggesting that parents of children with ASD have reported levels of stress consistent with those of people with post-traumatic stress disorder (PTSD).
Furthermore, mothers’ levels of parenting-related stress and other psychological symptoms are magnified by the presence of one or more clinical-level behavior disorders, added the researchers.
“The most common disruptive behavior disorder is attention-deficit hyperactivity disorder, or ADHD, but children with autism can also show signs of oppositional defiant disorder, depression, and anxiety,” Blacher said. “The disorders that are most disruptive to parents are those we describe as ‘acting out’ disorders and involve behaviors like not following rules, hitting, screaming, arguing, lashing out, and breaking things.”
Still, the researchers emphasize that parents who face these types of challenges need not resign themselves to a lifetime of overwhelming stress. In fact, the moms in the study who showed the most resilience had one thing in common: an optimistic outlook on life.
Using the Life Orientation Test, which measures individuals’ optimism or pessimism, the researchers found that mothers who were more optimistic experienced fewer negative effects associated with parenting a child with ASD or ID and comorbid behavior disorders.
In those cases, a more positive outlook on life became a buffer against parenting-related stressors.
“It’s in the face of stress when optimism really becomes important,” Blacher said. “A mom that has a high level of optimism is going to be able to better weather stress and be better prepared mentally for the challenges ahead.”
A new UK study reviews the benefits and stress associated with technology enabling contact with work tasks on a 24/7 basis. Researchers discovered the ‘opportunity’ for individuals to work at home during non-working hours may be good for some but for others the capability may lead to stress and angst.
Researchers from the University of Surrey in collaboration with Birkbeck, University of London and the University of Exeter reviewed 56 studies on the subject. They found that a ‘one size fits all’ approach to the use of technology outside working hours, such as switching off email servers outside of office hours, is not conducive to the needs of every employee.
In the study, investigators identified a number of factors that contribute to people choosing to work outside of hours. The internet and improvements in information and computer technologies have made non-manual work increasingly portable and accessible. This ‘wired’ phenomenal results in employees finding it far easier to work during non-contractual hours.
Researchers discovered that many employees felt pressure from their organization to be constantly available and to engage in work during non-work time. The stress was exacerbated when expectations about what was required was vague.
A desire to prove dedication and ‘go the extra mile’ were also found to be reasons why people were working more than their contracted hours. An employee’s behavior may in turn also shape what is expected and lead to additional out of hours working (e.g. a colleague who has been available at all times is expected to be available in the future).
However, the researchers also found that increased access to technology and working outside of office hours is actually preferred by some employees. Employees explain that this flexibility improves their control over their workload, leading to increases in self-reported efficiency and performance.
Researchers also found that employees appreciated the benefits of being able to monitor continuously the information flow and stay on top of their work.
The study, “Voluntary Work-related Technology Use during Non-work Time: A Narrative Synthesis of Empirical Research and Research Agenda” appears in the International Journal of Management Reviews.
Given the disparity in how employees chose to work, researchers recommend that employers give individuals control over their working patterns. Employers should also actively involve the worker in any decisions or policies about technology use so employees can reap the benefits of modern technologies without being enslaved by them.
Lead author Svenja Schlachter from the University of Surrey said: “A failure to disconnect from work can negatively impact on a person’s well-being and health. Many individuals report feeling pressured into logging in after hours to complete work, a task that is becoming more commonplace with the advance of technology. However, the flip side of this is that some actually prefer the flexibility this offers.
“Although employers implementing policies such as restricting accessibility to emails outside of office hours take a step in the right direction to ensure a good work/life balance for their workers, such regimented approaches to when you should and shouldn’t be working do not work for everyone.
Employers need to work with their staff to understand their individual needs wherever possible. However, employees also need to take responsibility for their working behavior, as it is ultimately up to them if they switch their phone off or not.”
Dr Almuth McDowall, from Birkbeck, University of London said: “Our research stresses two facts. First, there is no blanket solution to how to maximize technology use for communication. Second, we need to put the issue on the table and spell out expectations about what is reasonable. Then agree on some boundaries whilst retaining flexibility.”
Professor Ilke Inceoglu, from the University of Exeter Business School, said: “We have found the internet and new technology can give people flexibility in the way they work, and they feel this can make them more efficient and feel empowered.
But other people feel enslaved by the constant need to check and reply to emails, and managers must lead by example to ensure their well-being is protected.”
Source: University of Surrey
As I have discussed in other articles, Complex Post Traumatic Stress Disorder (C-PTSD) is a unique condition that is the result of suffering a series of traumatic incidents over a long period of time at the hands of someone the victim has a dependent relationship with, usually a parent or other primary caregiver. C-PTSD shares many features of the better known PTSD (Post Traumatic Stress Disorder) which is the result of a small number of impersonal traumas, such as car accidents. However, it also has many unique features, which give it a dual nature, in some ways more similar to some personality disorders, or other disorders such as bipolar disorder, with which it is often confused.
In my work with clients who suffer from C-PTSD, I am frequently struck with how difficult it is for them to lead fulfilling lives. It is one thing to analyze symptoms like dissociation, emotional dysregulation, depression, or anxiety, but another to appreciate how they interfere with the life of C-PTSD victims on a daily basis. One of the most tragic ways that plays out is the way that C-PTSD makes it difficult for sufferers to form and sustain strong and fulfilling interpersonal relationships. While there are some people who are genuinely happiest on their own, for the vast majority, successful relationships are essential to long-term happiness and life satisfaction. The difficulty that sufferers from C-PTSD face in maintaining stable relationships, is, in fact, one of the major obstacles to their overcoming the legacy of their earlier traumatic experiences. Among those who successfully “recover” from C-PTSD and go on to lead satisfying lives, a supportive loving relationship almost always plays a key role in getting them there. It is therefore doubly tragic that C-PTSD frequently prevents its victims from forming relationships of this sort.
There are many reasons why C-PTSD sufferers find it hard to form healthy relationships, but these are some of the most common.They often choose the wrong partner.
As a rule, sufferers from C-PTSD had unhealthy relationships growing up and, often, this influences their choice of romantic partners later in life. Behaviors that others would see as warning signs go under their radar or, worse, they are positively attractive to them. Another factor is that they are often so desperate for the experience of love and validation that they are open to exploitation by abusive and manipulative partners. Such people can easily recognize the signs of someone who is easy to abuse and control and may even actively seek them out.
Sufferers from C-PTSD should therefore always be alert for the signs of a potentially abusive relationship and be open to discussing new relationships with their therapist.They are uncomfortable with intimacy.
People with C-PTSD have the same desire for intimacy and attachment as anyone else. At the same time, however, they often find it difficult to engage it in practice, sometimes withdrawing in ways that are bewildering or hurtful to their partner. This is particularly true when there was a sexual component to the abuse the sufferer experienced earlier in life. Working through such difficulties with intimacy is a major task in therapy for C-PTSD.They are often difficult to live with.
This is a difficult issue to discuss, but it is important for both sides of the relationship to recognize. The fact is that living with someone who, for example, is triggered by innocuous remarks or certain TV shows into having dissociative episodes or extreme emotional outbursts is hard. Life with a C-PTSD sufferer can be bewildering, stressful, and draining. At the very least it’s hard work.
Hard, however, is not the same thing as impossible and there are plenty of men and women out there who have successfully found love with a C-PTSD sufferer. The key to success is openness and full disclosure. If a partner is aware of what triggers your symptoms then he or she can take steps to avoid these triggers, taking a major source of stress out of your relationship. In addition, simply having a better understanding of what the C-PTSD sufferer is going through can help them put up with the difficult times and provide the emotional support they need. It may often be appropriate for the partner to join in some sessions with the therapist to help this process.They find it difficult to trust.
People with C-PTSD have it precisely because they were abused by people who were in a position of trust. It’s not surprising, therefore, that they often have issues with trust. This can frequently be bewildering for their partners. The person they found that was once, if anything, overly eager for connection and affection, suddenly draws away for reasons that seem to them unclear. Once again, the key is mutual understanding guided by a therapist.
Those in a relationship with a C-PTSD sufferer need to understand that they cannot always help behaving the way they do, and need love and support as they learn to control their behavior. The partner with C-PTSD needs to appreciate that he or she is not always easy to be around and be open about their struggles. Both sides should reflect on and discuss what the C-PTSD sufferer is learning about him or herself in therapy and how they can use that knowledge to make the relationship stronger.
- Cronin, E., Brand, B. L., & Mattanah, J. F. (2014). The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders. European Journal of Psychotraumatology, 5, 10.3402/ejpt.v5.22676. http://doi.org/10.3402/ejpt.v5.22676
- Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. (2013). Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study. Clinical Case Studies, 12(3), 228–245. http://doi.org/10.1177/1534650113479442
- Kaysen, D., Dillworth, T. M., Simpson, T., Waldrop, A., Larimer, M. E., & Resick, P. A. (2007). Domestic Violence and Alcohol Use: Trauma-related Symptoms and Motives for Drinking. Addictive Behaviors, 32(6), 1272–1283. http://doi.org/10.1016/j.addbeh.2006.09.007
- Lawson, D.M. Treating Adults With Complex Trauma: An Evidence-Based Case Study. (2017)Journal of Counseling and Development, 95(3), 288-298. http://doi.org/10.1002/jcad.12143
- Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 10.3402/ejpt.v5.25097. http://doi.org/10.3402/ejpt.v5.25097