A first of its kind research approach suggests depression can lead to hindsight bias, a distorted view of the past.
It is well known that depression influences a person to cast a sad perception of the present and the future. However, the new research is the first to show that depression can also blemish people’s memories of the past.
That is, rather than glorifying the good old days, people with depression project their generally bleak outlook on to past events.
The research by psychologists at Germany’s Heinrich Heine Universität Düsseldorf and at the UK’s University of Portsmouth appears in the journal Clinical Psychological Science.
Dr. Hartmut Blank, in the University of Portsmouth’s Department of Psychology, is one of the authors.
He said, “Depression is not only associated with a negative view of the world, the self and the future, but we now know with a negative view of the past.”
Hindsight bias includes three core elements:
- exaggerated perceptions of foreseeability — we think we knew all along how events would turn out;
- inevitability — something ‘had’ to happen, and;
- memory bias — misremembering what we once thought when we know the outcome of something.
Hindsight bias has been studied in various settings, including sports events, political elections, medical diagnoses, or bankers’ investment strategies. Until now, it hasn’t been used to study depression.
Blank said, “Everyone is susceptible to hindsight bias, but it takes on a very specific form in depression. While non-depressed people tend to show hindsight bias for positive events but not negative events, people with depression show the reverse pattern.
“Making things worse, depressed people also see negative event outcomes as both foreseeable and inevitable — a toxic combination, reinforcing feelings of helplessness and lack of control that already characterize the experience of people with depression.
“Everyone experiences disappointment and regret from time to time and doing so helps us adapt and grow and to make better decisions. But people with depression struggle to control negative feelings and hindsight bias appears to set up a cycle of misery.
“We have shown hindsight bias in people who are depressed is a further burden on their shoulders, ‘helping’ to sustain the condition in terms of learning the wrong lessons from the past.”
The researchers tested over 100 university students, about half of whom suffered from mild to severe depression.
They were asked to imagine themselves in a variety of everyday scenarios with positive or negative outcomes (from different domains of everyday life, e.g. work, performance, family, leisure, social, romantic).
For each scenario, the researchers then collected measures of hindsight bias (foreseeability, inevitability, and distorted memory for initial expectations).
The results showed that with increasing severity of depression, a specific hindsight bias pattern emerged — exaggerated foreseeability and inevitability of negative (but not positive) event outcomes, as well as a tendency to misremember initial expectations in line with negative outcomes.
Characteristically, this “depressive hindsight bias” was strongly related to clinical measures of depressive thinking, suggesting that it is part of a general negative worldview in depression.
According to Blank, “This is only a first study to explore the crucial role of hindsight bias in depression; more work needs to be done in different experimental and real-life settings, and also using clinical samples, to further examine and establish the link between hindsight bias and depression.”
Competitive situations can lead to a strong display of feelings, including the chance of heated arguments and disputes. However, as emotions get hot, not everyone reacts in the same way.
A new study finds that men respond differently to women, and the reactions of individuals are dissimilar to those of groups of persons.
In the research, psychologists at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) examined the correlations between competitiveness, aggression and hormones.
Participants in a laboratory study were required to master competitive tasks over 10 rounds. They competed against each other either as individuals or as teams, and one side lost the competition while the other side won.
Participants were allowed to give full rein to their aggressive impulses during the competition.
For this purpose, at the beginning of each round, they were asked to specify how loud an unpleasant noise would be that the opponent would be required to listen to through headphones if they lost the round.
Saliva samples were collected from the participants prior to and after the competition in order to document changes to hormone levels.
Dr. Oliver Schultheiss and Dr. Jonathan Oxford found that men tended to behave more aggressively than women, that losers were more aggressive than winners, and that teams were more aggressive than individuals.
Furthermore, the researchers also detected a correlation between aggression and levels of the stress hormone cortisol; the more aggressively a person behaved, the lower their cortisol level was.
The study appears in the journal PLOS ONE.
“Our results show that the usual suspects are the ones who become aggressive — namely participants who are male and frustrated.
“But our analysis also revealed that it was easier for participants who were part of a team to attack others than it was for individuals. At the same time, elevation of stress hormones when encountering a threat that cannot be mastered is in actual fact associated with less aggression,” explains Schultheiss.
A unique aspect of the study included close inspection of female subjects.
Interestingly, researcher’s discovered the hormonal reaction to victory or defeat that occurred in women or female teams was significantly dependent on their personal thirst for power.
Women with a particularly marked thirst for power had higher levels of the sex hormones testosterone and estradiol after a victory than after a defeat.
This reaction was not recorded in women who have a less pronounced power-orientated outlook. Experts believe this hormonal reaction is the reason dominant behavior in women is intensified by a victory, and then subdued by a defeat.
A newly developed universal blood test can help to predict if a person is at high suicide risk. Indiana University researchers say the test is unique as it can be given to everyone. The scientists also report the development of personalized blood tests for different subtypes of suicidality, and for different psychiatric high-risk groups.
Researchers explain that two apps — one based on a suicide risk checklist and the other on a scale for measuring feelings of anxiety and depression – have been designed to be used in conjunction with the blood tests to enhance the precision of tests and to suggest lifestyle, psychotherapeutic and other interventions.
The scientist have also identified a series of medications and natural substances that could be developed for preventing suicide.
“Our work provides a basis for precision medicine and scientific wellness preventive approaches,” said Alexander B. Niculescu III, MD, PhD, professor of psychiatry and medical neuroscience at IU School of Medicine.
The article, “Precision medicine for suicidality: from universality to subtypes and personalization,” appears in the online edition of the journal, Molecular Psychiatry.
The research builds on earlier studies from the Niculescu group.
“Suicide strikes people in all walks of life. We believe such tragedies can be averted. This landmark larger study breaks new ground, as well as reproduces in larger numbers of individuals some of our earlier findings,” said Dr. Niculescu.
There were multiple steps to the research, starting with serial blood tests taken from 66 people who had been diagnosed with psychiatric disorders, followed over time, and who had at least one instance in which they reported a significant change in their level of suicidal thinking from one testing visit to the next.
The candidate gene expression biomarkers that best tracked suicidality in each individual and across individuals were then prioritized using the Niculescu group’s Convergent Functional Genomics approach, based on all the prior evidence in the field.
Next, working with the Marion County (Indianapolis, Ind.) Coroner’s Office, the researchers tested the validity of the biomarkers using blood samples drawn from 45 people who had committed suicide.
The biomarkers were then tested in another larger, completely independent group of individuals to determine how well they could predict which of them would report intense suicidal thoughts or would be hospitalized for suicide attempts.
The biomarkers identified by the research are RNA molecules whose levels in the blood changed in concert with changes in the levels of suicidal thoughts experienced by the patients. Among the findings reported in the current paper were:
• An algorithm that combines biomarkers with the apps that was 90 percent accurate in predicting high levels of suicidal thinking and 77 percent accurate in predicting future suicide-related hospitalizations in everybody, irrespective of gender and diagnosis.
• A refined set of biomarkers that apply universally in predicting risk of suicide among both male and female patients with a variety of psychiatric illnesses, including new biomarkers never before linked to suicidal thoughts and behavior.
• Four new subtypes of suicidality were identified (depressed, anxious, combined, and non-affective/psychotic), with different biomarkers being more effective in each subtype.
• Biomarkers that were associated with specific diagnoses and genders, such as one, known as LHFP, that appears to be a very strong predictor for depressed men.
• Two of the biomarkers, APOE and IL6, have broad evidence for involvement in suicidality and potential clinical utility as targets for drug therapies, as well as suggest a neurodegenerative and inflammatory component to the predisposition to suicide. APOE is responsible for proteins involved with managing cholesterol and fats, and some forms of the gene have been strongly implicated as risks for Alzheimer’s disease. IL6 expresses proteins involved in the body’s inflammation response.
• Potential drug therapies and natural substances for preventing suicide, using the blood biomarker signatures and bioinformatics approaches. They included medications already in use to treat psychiatric illnesses and drugs approved for other uses, such as the diabetes medication metformin.
Source: University of Indiana/EurekAlert
New research confirms what many Americans already know — that their jobs are hard and draining, and it is difficult to separate work from home.
The new study finds that workers frequently face unstable work schedules, unpleasant and potentially hazardous working conditions, and an often hostile social environment.
The findings stem from research conducted by investigators at the RAND Corporation, Harvard Medical School and University of California, Los Angeles. Investigators analyzed responses from the American Working Conditions Survey, one of the most in-depth surveys ever done to examine conditions in the American workplace.
Remarkably, more than one in four American workers say they have too little time to do their job, with the complaint being most common among white-collar workers.
In addition, workers say the intensity of work frequently spills over into their personal lives, with about one-half of people reporting that they perform some work in their free time in order to meet workplace demands.
Despite these challenges, American workers appear to have a certain degree of autonomy on the job, most feel confident about their skill set and many do report that they receive social support while on the job.
“I was surprised how taxing the workplace appears to be, both for less-educated and for more-educated workers,” said lead author Dr. Nicole Maestas, an associate professor at Harvard Medical School and an adjunct economist at RAND.
“Work is taxing at the office and it’s taxing when it spills out of the workplace into people’s family lives.”
Researchers say that while eight in 10 American workers report having steady and predictable work throughout the year, just 54 percent report working the same number of hours on a day-to-day basis.
One in three workers say they have no control over their schedule. Despite much public attention focused on the growth of telecommuting, 78 percent of workers report they must be present at their workplace during regular business hours.
Nearly three-fourths of American workers report either intense or repetitive physical exertion on the job at least a quarter of the time. While workers without a college education report greater physical demands, many college-educated and older workers are affected as well.
Emotional stress and challenges to mental health are a relatively common experience at the worksite. Researchers discovered more than half of Americans report exposure to unpleasant and potentially hazardous social environments.
Nearly one in five workers — a “disturbingly high” fraction, researchers said — say they face a hostile or threatening social environment at work. Younger and prime-aged women are the workers most likely to experience unwanted sexual attention, while younger men are more likely to experience verbal abuse.
The findings are from a survey of 3,066 adults who participate in the RAND American Life Panel, a nationally representative, computer-based sample of people from across the United States. The workplace survey was fielded in 2015 to collect detailed information across a broad range of working conditions in the American workplace, as well as details about workers and job characteristics.
Despite the importance of the workplace to most Americans, researchers say there is relatively little publicly available information about the characteristics of American jobs today.
The American Working Conditions survey is designed to be harmonious with the European Working Conditions Survey, which has been conducted periodically over the last 25 years among workers from a broad range of European nations.
The American Working Conditions Survey found that while many American workers adjust their personal lives to accommodate work matters, about one-third of workers say they are unable to adjust their work schedules to accommodate personal matters.
In general, women are more likely than men to report difficulty arranging for time off during work hours to take care of personal or family matters.
Jobs interfere with family and social commitments outside of work, particularly for younger workers who don’t have a college degree. More than one in four reports a poor fit between their work hours and their social and family commitments.
The report also provides insights about how preferences change among workers as they become older.
Older workers are more likely to value the ability to control how they do their work and setting the pace of their work, as well as less physically demanding jobs. Older workers are also generally less likely than younger workers to have some degree of mismatch between their desired and actual working conditions.
The survey also confirms that retirement is often a fluid concept. Many older workers say they have previously retired before rejoining the workforce, and many people aged 50 and older who are not employed say they would consider rejoining the workforce if conditions were right.
Other highlights from the report include:
- The intensity of work such as pace, deadlines, and time constraints differ across occupation groups, with white-collar workers experiencing greater work intensity than blue-collar workers.
- Jobs in the U.S. feature a mix of monotonous tasks and autonomous problem solving. While 62 percent of workers say they face monotonous tasks, more than 80 percent report that their jobs involve “solving unforeseen problems” and “applying own ideas.”
- The workplace is an important source of professional and social support, with more than one half of American workers describing their boss as supportive and that they have very good friends at work.
- Only 38 percent of workers say their job offers good prospects for advancement. All workers — regardless of education — become less optimistic about career advancement as they become older.
- Four out of five American workers report that their job provides “meaning” always or most of the time. Older college-educated men were those most likely to report at least one dimension of meaningful work.
- Nearly two-thirds of workers experience some degree of mismatch between their desired and actual working conditions, with the number rising to nearly three-quarters when job benefits are taken into account. Nearly half of workers report working more than their preferred number of hours per week, while some 20 percent report working fewer than their preferred number of hours.
Future reports will explore how conditions of the American workplace compare to those in Europe and in other parts of the world and selected findings from follow-up surveys using the same panel of participants.
Source: RAND Corporation
A new study suggests it is okay if we are not always happy. In fact, investigators discovered life satisfaction is a product of experiencing both negative and positive emotions.
In an international study, researchers discovered people may be happier when they feel the emotions they desire, even if those emotions are unpleasant, such as anger or hatred.
“Happiness is more than simply feeling pleasure and avoiding pain. Happiness is about having experiences that are meaningful and valuable, including emotions that you think are the right ones to have,” said lead researcher Maya Tamir, Ph.D., a psychology professor at The Hebrew University of Jerusalem.
“All emotions can be positive in some contexts and negative in others, regardless of whether they are pleasant or unpleasant.”
The cross-cultural study included 2,324 university students in eight countries: the United States, Brazil, China, Germany, Ghana, Israel, Poland and Singapore.
The research is the first study to find this relationship between happiness and experiencing desired emotions, even when those emotions are unpleasant, Tamir said.
The study appears online in the Journal of Experimental Psychology: General.
Participants generally wanted to experience more pleasant emotions and fewer unpleasant emotions than they felt in their lives, but that wasn’t always the case.
Interestingly, 11 percent of the participants wanted to feel fewer transcendent emotions, such as love and empathy, than they experienced in daily life, and 10 percent wanted to feel more unpleasant emotions, such as anger or hatred. There was only a small overlap between those groups.
For example, someone who feels no anger when reading about child abuse might think she should be angrier about the plight of abused children, so she wants to feel more anger than she actually does in that moment, Tamir said. A woman who wants to leave an abusive partner but isn’t willing to do so may be happier if she loved him less, Tamir said.
Participants were surveyed about the emotions they desired and the emotions they actually felt in their lives. They also rated their life satisfaction and depressive symptoms.
Across cultures in the study, participants who experienced more of the emotions that they desired reported greater life satisfaction and fewer depressive symptoms, regardless of whether those desired emotions were pleasant or unpleasant.
Further research is needed, however, to test whether feeling desired emotions truly influences happiness or is merely associated with it, Tamir said.
The study assessed only one category of unpleasant emotions known as negative self-enhancing emotions, which includes hatred, hostility, anger and contempt. Future research could test other unpleasant emotions, such as fear, guilt, sadness or shame, Tamir said.
Pleasant emotions that were examined in the study included empathy, love, trust, passion, contentment and excitement. Prior research has shown that the emotions that people desire are linked to their values and cultural norms, but those links weren’t directly examined in this research.
The study may shed some light on the unrealistic expectations that many people have about their own feelings, Tamir said.
“People want to feel very good all the time in Western cultures, especially in the United States,” Tamir said.
“Even if they feel good most of the time, they may still think that they should feel even better, which might make them less happy overall.”
Emerging research out of the University of Illinois suggests that some mothers’ and fathers’ psychological well-being may suffer when their work and family identities — and the amount of financial support they provide — conflict with conventional gender roles.
Researchers found that when women’s paychecks increased to compose the majority of their families’ income, these women reported more symptoms of depression.
However, the investigators found the opposite effect in men: Dads’ psychological well-being improved over time when they became the primary wage-earners for their families.
Dr. Karen Kramer and graduate student Sunjin Pak reviewed a data sample that included more than 1,463 men and 1,769 women who participated in the National Longitudinal Surveys of Youth.
A majority of the individuals in the study, all born between 1957 and 1965, were members of the baby-boom generation. Participants’ psychological well-being was measured in 1991 and 1994 using a seven-item scale that assessed their levels of depressive symptoms.
Kramer and Pak found that although women’s psychological well-being was not affected by exiting the workforce to become stay-at-home moms, men’s mental health declined when they stayed home to care for the kids.
“We observed a statistically significant and substantial difference in depressive symptoms between men and women in our study,” said Kramer, who is a professor of human development and family studies.
“The results supported the overarching hypothesis: Well-being was lower for mothers and fathers who violated gendered expectations about the division of paid labor, and higher for parents who conformed to these expectations.”
While women’s educational and career opportunities have multiplied in recent decades, societal norms and expectations about gendered divisions of labor in the workplace and the home have been slower to evolve, according to the researchers.
Mothers and fathers who deviate from conventional gender roles — such as dads who leave the workforce to care for their children full time — may be perceived negatively, potentially impacting their mental health, Kramer and Pak wrote.
The researchers also explored whether parents who held more egalitarian ideas about men’s and women’s responsibilities as wage earners and caretakers for their families fared better — and Kramer and Pak found gender differences there as well.
Women in the study who viewed themselves and their spouses as equally responsible for financially supporting their families and caring for their homes and offspring experienced better mental health when their wages and share of the family’s income increased.
However, regardless of their beliefs, men’s mental health diminished when their earnings as a proportion of the family income shrank. This finding led researchers to suggest that “work identity and (the) traditional role of primary earner are still critical for men, even when they have more egalitarian gender ideology.”
The paper will be presented at the annual meeting of the American Sociological Association.
Source: University of Illinois
New findings published in the Harvard Review of Psychiatry show that school-based mental health programs can reach large numbers of children and effectively improve mental health and related outcomes.
Approximately 13 percent of children and teens worldwide have significant mental health problems including anxiety, disruptive behavior disorders, attention-deficit/hyperactivity disorder (ADHD), and depression. If left untreated, these disorders can remain throughout adulthood and have negative effects in many aspects of life.
A large number of interventions have been designed to deliver preventive mental health services in schools, where children and teens spend so much of their time. Now a growing body of evidence shows that school-based mental health programs can be widely implemented and can lead to population-wide improvements in mental health, physical health, educational, and social outcomes.
For the review, Dr. J. Michael Murphy, EdD, of Massachusetts General Hospital and colleagues identified and analyzed school-based mental health programs that have been implemented on a large scale and have collected data on specific mental health outcomes. Their findings show that the eight largest programs have reached at least 27 million children over the last decade.
The programs vary in their focus, methods, and goals. For example, the largest intervention, called “Positive Behavior Interventions and Supports” (PBIS), focuses on positive social culture and behavioral support for all students. The second-largest program, called “FRIENDS,” aims to ease anxiety and teach skills for managing stress and emotions — not only for children, but also for parents and teachers.
While some of the school-based mental health interventions target students at high risk of mental health problems, most are designed to focus on mental health promotion or primary prevention for all students in the school. Most of the programs have been implemented across school districts, while some have been introduced on the state or national level.
Evidence is “moderate to strong” that these interventions are successful in contributing to good mental health and related outcomes. For example, studies of FRIENDS have reported reductions in anxiety, while PBIS has shown improved reading scores and fewer school suspensions.
Other interventions have shown benefits in areas such as bullying and substance abuse.
“This review provides evidence that large-scale, school-based programs can be implemented in a variety of diverse cultures and educational models as well as preliminary evidence that such programs have significant, measurable positive effects on students’ emotional, behavioral, and academic outcomes,” write the researchers.
“Data sets of increasing quality and size are opening up new opportunities to assess the degree to which preventive interventions for child mental health, delivered at scale, can play a role in improving health and other life outcomes,” said Murphy and colleagues.
With ongoing data collection and new evaluation frameworks, they believe that school-based mental health programs have the potential to “improve population-wide health outcomes of the next generation.”
Source: Wolters Klewer Health
Research on an animal models shows that being bullied can lead to sleep disorders and a variety of stress-related mental illnesses.
Neuroscientists determined that being bullied produces long-lasting, depression-like sleep dysfunction and can lead to circadian rhythm-related issues. This disruption of daily biological rhythms can lead to clinical depression and stress-related disorders.
The researchers, however, also found that it may be possible to mitigate these effects with the use of an experimental class of drugs that can block stress.
“While our study found that some stress-related effects on circadian rhythms are short-lived, others are long-lasting,” said William Carlezon, Ph.D., senior author of the study.
“Identifying these changes and understanding their meaning is an important step in developing methods to counter the long-lasting effects of traumatic experiences on mental health.”
Stress is known to trigger psychiatric illnesses, including depression and PTSD, and sleep is frequently affected in these conditions. Some people with stress disorders sleep less than normal, while others sleep more than normal or have more frequent bouts of sleep and wakefulness.
To demonstrate the effects of bullying, the researchers used an animal model simulating the physical and emotional stressors involved in human bullying — chronic social defeat stress.
For this procedure, a smaller, younger mouse is paired with a larger, older, and more aggressive mouse. When the smaller mouse is placed into the home cage of the larger mouse, the larger mouse instinctively acts to protect its territory.
In a typical interaction lasting several minutes, the larger mouse chases the smaller mouse, displaying aggressive behavior and emitting warning calls. The interaction ends when the larger mouse pins the smaller mouse to the floor or against a cage wall, establishing dominance by the larger mouse and submission by the smaller mouse.
The mice are then separated and a barrier is placed between them, dividing the home cage in half. A clear and perforated barrier is used, enabling the mice to see, smell, and hear each other, but preventing physical interactions. The mice remain in this arrangement, with the smaller mouse living under threat from the larger mouse, for the rest of the day. This process is repeated for 10 consecutive days, with a new aggressor mouse introduced each day.
To collect data continuously and accurately, researchers outfitted the smaller mice with micro-transmitters that are akin to activity trackers used by people to monitor their exercise, heart rate, and sleep.
These mice micro-transmitters collected sleep, muscle activity, and body temperature data, which revealed that the smaller mice experienced progressive changes in sleep patterns, with all phases of the sleep-wake cycle being affected. The largest effect was on the number of times the mice went in and out of a sleep phase called paradoxical sleep, which resembles REM (rapid eye movement) sleep in humans, when dreams occur and memories are strengthened.
Bullied mice showed many more bouts of paradoxical sleep, resembling the type of sleep disruptions often seen in people with depression. Bullied mice also showed a flattening of body temperature fluctuations, which is also an effect seen in people with depression.
“Both the sleep and body temperature changes persisted in the smaller mice after they were removed from the physically and emotionally threatening environment, suggesting that they had developed symptoms that look very much like those seen in people with long-term depression,” said Carlezon.
“These effects were reduced, however, in terms of both intensity and duration, if the mice had been treated with a kappa-opioid receptor antagonist, a drug that blocks the activity of one of the brain’s own opioid systems.”
Carlezon explained that these findings not only reveal what traumatic experiences can do to individuals who experience them, but also that we may someday be able to do something to reduce the severity of their effects.
“This study exemplifies how measuring the same types of endpoints in laboratory animals and humans might hasten the pace of advances in psychiatry research. If we can knock out stress with new treatments, we might be able to prevent some forms of mental illness.”
Source: Mclean Hospital
A new review by researchers at UC San Francisco finds that pregnant women who are diagnosed with sleep disorders appear to be at risk of delivering their babies before reaching full term.
Investigators found the link was associated with conditions such as sleep apnea and insomnia.
The prevalence of preterm birth – defined as delivery before 37 weeks’ gestation – was 14.6 percent for women diagnosed with a sleep disorder during pregnancy, compared to 10.9 percent for women who were not.
The odds of early preterm birth – before 34 weeks – was more than double for women with sleep apnea and nearly double for women with insomnia.
Importantly, researchers discovered complications were more severe among early preterm births.
In contrast to the normal sleep changes that typically occur during pregnancy, the new study focused on major disruptions likely to result in impairment.
Unfortunately, the true prevalence or the number of pregnant women experiencing sleep disorders, is unknown because the sleep issue is often un-diagnosed among pregnant women.
Researchers believe treating sleep disorders during pregnancy could be a way to reduce the preterm rate, which is about 10 percent in the United States — more than most other highly developed countries.
The study is the first to examine the effects of insomnia during pregnancy. Because of a large sample size, the authors were able to examine the relationship between different types of sleep disorders and subtypes of preterm birth.
Investigators were able to examine factors associated with early vs. late preterm birth, or spontaneous preterm labor vs. early deliveries that were initiated by providers due to mothers’ health issues.
Study findings appear in the journal Obstetrics & Gynecology.
In the case-control study, researchers were able to separate the effects of poor sleep from other factors that also contribute to a risk of preterm birth.
This involved matching 2,265 women with a sleep disorder diagnosis during pregnancy to controls who did not have such a diagnosis, but had identical maternal risk factors for preterm birth, such as a previous preterm birth, smoking during pregnancy, or hypertension.
“This gave us more confidence that our finding of an earlier delivery among women with disordered sleep was truly attributable to the sleep disorder, and not to other differences between women with and without these disorders,” said Jennifer Felder, PhD, a postdoctoral fellow in the UCSF Department of Psychiatry and the lead author of the study.
Investigators were surprised by how few women in the dataset – well below 1 percent – had a sleep disorder diagnosis, and suspect that only the most serious cases were identified.
“The women who had a diagnosis of a sleep disorder recorded in their medical record most likely had more severe presentations,” said Aric Prather, PhD, assistant professor of psychiatry at UCSF and senior author of the study.
“It’s likely that the prevalence would be much higher if more women were screened for sleep disorders during pregnancy.”
Researchers note that cognitive behavioral therapy has been shown to be effective in the general population and does not require taking medications that many pregnant women prefer to avoid.
To find out if this therapy is effective among pregnant women with insomnia, and ultimately whether it may improve birth outcomes, Felder and colleagues are recruiting participants for the UCSF Research on Expecting Moms and Sleep Therapy (REST) Study.
“What’s so exciting about this study is that a sleep disorder is a potentially modifiable risk factor,” said Felder.
A new series of studies suggests ignoring negative emotions to remain optimistic may not be the best approach in the long run.
UC Berkeley researchers discovered embracing your darker moods can actually make you feel better as the pressure to feel upbeat can make you feel downbeat.
“We found that people who habitually accept their negative emotions experience fewer negative emotions, which adds up to better psychological health,” said study senior author Iris Mauss, an associate professor of psychology.
Researchers are unsure why accepting joyless emotions helps to defuse the mood.
“Maybe if you have an accepting attitude toward negative emotions, you’re not giving them as much attention,” Mauss said. “And perhaps, if you’re constantly judging your emotions, the negativity can pile up.”
Researchers tested the link between emotional acceptance and psychological health in more than 1,300 adults in the San Francisco Bay Area and the Denver, Co., metropolitan area.
The results, published in the Journal of Personality and Social Psychology, suggest that people who commonly resist acknowledging their darkest emotions, or judge them harshly, can end up feeling more psychologically stressed.
By contrast, those who generally allow such bleak feelings as sadness, disappointment and resentment to run their course reported fewer mood disorder symptoms than those who critique them or push them away, even after six months.
“It turns out that how we approach our own negative emotional reactions is really important for our overall well-being,” said study lead author Brett Ford, an assistant professor of psychology at the University of Toronto. “People who accept these emotions without judging or trying to change them are able to cope with their stress more successfully.”
Three separate studies were conducted on various groups both in the lab and online, and factored in age, gender, socio-economic status and other demographic variables.
“It’s easier to have an accepting attitude if you lead a pampered life, which is why we ruled out socio-economic status and major life stressors that could bias the results,” Mauss said.
In the first study, more than 1,000 participants filled out surveys rating how strongly they agreed with such statements as “I tell myself I shouldn’t be feeling the way that I’m feeling.” Those who, as a rule, did not feel bad about feeling bad showed higher levels of well-being than their less accepting peers.
A second study, delivered in a laboratory setting to more than 150 participants challenged the participants to deliver a three-minute videotaped speech to a panel of judges. The speech was designed as part of a mock job application, and a way in which to showcase their communication skills and other relevant qualifications. They were given two minutes to prepare.
After completing the task, participants rated their emotions about the ordeal. As expected, the group that typically avoids negative feelings reported more distress than their more accepting peers.
In the final study, more than 200 people completed a journal on their most taxing experiences over a two-week period. When surveyed about their psychological health six months later, the diarists who typically avoided negative emotions reported more mood disorder symptoms than their nonjudgmental peers.
Researchers plan to expand the study by reviewing the influence of such factors as culture and upbringing to better understand why some people are more accepting of emotional ups and downs than others.
“By asking parents about their attitudes about their children’s emotions, we may be able to predict how their children feel about their emotions, and how that might affect their children’s mental health,” Mauss said.
Conflicting parental opinions on how to manage a baby crying at night can undermine the co-parenting relationship — especially when the mother has stronger beliefs than the father.
Parental teamwork is key to healthy child development, and the findings underscore the importance of early and frequent communication between parents.
In the new study, researchers asked mothers and fathers how they felt about responding to night wakings — for example, whether they should attend to their crying infant right away or let him or her self-soothe — and their perceptions about their co-parenting.
Investigators found that when mothers had stronger beliefs than the fathers, the mothers also reported feeling worse about their co-parenting relationships.
Jonathan Reader, a doctoral candidate at Penn State and lead author, said the study was an important step in learning more about how parents can work together to promote child well-being.
“Setting limits about how to respond to night wakings is stressful, and if there are discrepancies in how mothers and fathers feel they should respond, that can reduce the quality of that co-parenting relationship,” Reader said.
“We found that for mothers in particular, they perceived co-parenting as worse when they had stronger beliefs than the father.”
While previous research has examined how a mother’s beliefs about infant sleep affects her baby’s quality of sleep, few studies have explored the father’s beliefs or how their beliefs about sleep affect co-parenting quality.
The study’s participants — 167 mothers and 155 fathers — answered questions about how they feel they should respond to night wakings.
For example, “My child will feel abandoned if I don’t respond immediately to his/her cries at night,” when the baby was one, three, six, nine, and 12 months old.
At the same time, participants also answered questions about co-parenting. Researchers asked if partners have the same goals for our child, and if they were experiencing depressive or anxiety symptoms.
After analyzing the data, the researchers found that mothers generally had stronger beliefs about how to respond to night wakings than fathers, although both parents started to become less concerned about how to set limits as the infant got older.
But when mothers had stronger beliefs, their perceptions of co-parenting went down.
“During the study, we saw that in general mothers were much more active at night with the baby than the fathers were,” Reader said.
“So perhaps because the mothers were the more active ones during the night, if they’re not feeling supported in their decisions, then it creates more of a drift in the co-parenting relationship.”
Reader said the findings, published recently in the Journal of Family Psychology, confirm the importance of early and frequent communication between parents.
“It’s important to have these conversations early and upfront, so when it’s 3:00 a.m. and the baby’s crying, both parents are on the same page about how they’re going to respond,” Reader said. “Constant communication is really important.”
Dr. Douglas Teti, department head of the Human Development and Family Studies department in the College of Health and Human Development, also participated in the study. He added that the health and mindset of the parents are just as important as that of the baby’s.
“What we seem to be finding is that it’s not so much whether the babies are sleeping through the night, or how the parents decide to do bedtime, but more about how the parents are reacting and if they’re stressed,” Teti said.
“That seems to be much more important than whether you co-sleep or don’t co-sleep, or whatever you choose to do. Whatever you decide, just make sure you and your partner are on the same page.”
Moving forward, Teti said the next step is more research into how best to develop and enhance the co-parenting relationship, with attention paid to infant sleep.
“We want to learn more about how to put families in a position where they know that not every baby will be sleeping on their own by three months, and that’s ok,” Teti said.
“Most kids learn how to go to sleep eventually. Parenting has a lot to do with it.”
Source: Penn State
University of Illinois researchers report the trauma associated with a sexual assault places victims at increased risk of a wide range of mental health conditions.
Investigators analyzed nearly 200 studies involving more than 230,00 adult participants and discovered the elevated risk was apparent regardless of how a researcher may have defined the sexual assault.
Researchers found a history of sexual assault is associated with significantly increased risk of anxiety, depression, suicidality, post-traumatic stress disorder, substance abuse, obsessive-compulsive disorder and bipolar disorder.
The analysis, reported in the journal Clinical Psychology Review, represents a summary of 40 years of research on the subject.
“We compared people who had been sexually assaulted with those who hadn’t and found a significant difference in mental health,” said Emily Dworkin, who conducted the study as a graduate student with University of Illinois psychology professor Nicole Allen.
“We also compared people who had been sexually assaulted with people who had experienced other forms of trauma and found that the difference was still there, suggesting that sexual assault is associated with significantly increased risk for these mental health conditions as compared with other types of trauma.”
The association between sexual assault and mental health conditions was generally apparent across studies, regardless of how researchers defined sexual assault, Dworkin said. For example, some studies only examined forced assault, others included coercion or incapacitation, while others included any unwanted sexual contact.
“It doesn’t seem to matter how broadly or narrowly you define sexual assault — if you’re only looking at penetrative forms of assault or if you’re also including people who experienced assaults limited to fondling — the association is still there,” Dworkin said.
About 24 percent of participants across studies had been victims of a sexual assault, the researchers report.
The analysis also found that adults who had experienced a sexual assault were at higher risk of some mental health problems than others. The risk of contemplating or attempting suicide, for example, was highest relative to other conditions. The risks of PTSD, obsessive-compulsive conditions and bipolar conditions were almost as high as those for suicidality.
“We often think of obsessive-compulsive conditions and bipolar conditions as more biological or genetic in origin,” Dworkin said.
“While these findings are based on a smaller number of studies, they suggest that maybe those conditions are more trauma-related than we previously thought.”
The risk of mental disorders associated with sexual assault was consistent regardless of the age, race or gender of the participants in a study, the researchers found.
The analysis also suggests that having been assaulted by a stranger or by someone using a weapon “appears to be associated with more risk of mental health consequences,” Dworkin said.
Not all sexual assault survivors experience mental health problems after an assault, the researchers said. The analysis suggests only that sexual assault survivors are at higher risk.
“Just because you’ve had this experience doesn’t mean you will have a negative mental health effect,” Allen said. “But if you do, our findings demonstrate that you are most definitely not alone. These are not uncommon responses to sexual assault.”
“I want to emphasize that conditions like post-traumatic stress disorder, suicidality, depression and anxiety disorders are very treatable, and they’re often treatable within the course of a few months,” said Dworkin.
“As a clinician, I see such tremendous benefits of cognitive behavioral therapy for people who have experienced a sexual assault. They say that they feel like they got their lives back.”
Source: University of Illinois
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
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