Patients with post-traumatic stress disorder (PTSD) show differences in gut bacteria compared to other trauma-exposed people who never went on to develop PTSD, according to a new study led by researchers at Stellenbosch University in South Africa.
In recent years, research has shown just how vital the gut microbiome is to human health. These microbes perform important functions, such as metabolizing food and medicine and fighting infections. It has also been shown that gut microbes influence the brain and brain function by producing neurotransmitters/hormones, immune-regulating molecules and bacterial toxins.
However, stress hormones can have a negative impact on gut bacteria and compromise the integrity of the intestinal lining, allowing bacteria and toxins to enter the bloodstream. This can lead to inflammation, which has been shown to play a role in several types of psychiatric disorders.
“Our study compared the gut microbiomes of individuals with PTSD to that of people who also experienced significant trauma, but did not develop PTSD (trauma-exposed controls). We identified a combination of three bacteria (actinobacteria, lentisphaerae and verrucomicrobia) that were different in people with PTSD,” said lead researcher Dr. Stefanie Malan-Muller from the Faculty of Medicine and Health Sciences.
The findings show that people with PTSD had significantly lower levels of these three types of bacteria compared to trauma-exposed control groups. Individuals who experienced trauma during their childhood also had lower levels of two of these bacteria: actinobacteria and verrucomicrobia.
“What makes this finding interesting, is that individuals who experience childhood trauma are at higher risk of developing PTSD later in life, and these changes in the gut microbiome possibly occurred early in life in response to childhood trauma,” said Malan-Muller.
One of the known functions of these bacteria is immune system regulation, and scientists have found increased levels of inflammation and altered immune regulation in patients with PTSD.
“Changes in immune regulation and increased inflammation also impact the brain, brain functioning and behaviour. Levels of inflammatory markers measured in individuals shortly after a traumatic event, was shown to predict later development of PTSD,” said Malan-Muller.
“We therefore hypothesize that the low levels of those three bacteria may have resulted in immune dysregulation and heightened levels of inflammation in individuals with PTSD, which may have contributed to their disease symptoms.”
However, researchers are unable to determine whether this bacterial deficit contributed to PTSD susceptibility, or whether it occurred as a consequence of PTSD.
“It does, however, bring us one step closer to understanding the factors that might play a role in PTSD,” Malan-Muller said.
“Factors influencing susceptibility and resilience to developing PTSD are not yet fully understood, and identifying and understanding all these contributing factors could in future contribute to better treatments, especially since the microbiome can easily be altered with the use of prebiotics (non-digestible food substances), probiotics (live, beneficial microorganisms), and synbiotics (a combination of probiotics and prebiotics), or dietary interventions.”
Source: Stellenbosch University
A team of U.K. researchers has developed a mathematical equation to identify signals in the human brain that explain why self-esteem goes up and down when we learn other people’s judgments of us.
Scientists learned that self-esteem is influenced not only by our perception of the way people think of us, but also by our expectations of whether they will like us or not.
University College of London investigators believe the model may help to predict when people are at risk of psychiatric disorders.
The study appears in the scientific journal eLife.
“Low self-esteem is a vulnerability factor for numerous psychiatric problems including eating disorders, anxiety disorders and depression. In this study, we identified exactly what happens in the brain when self-esteem goes up and down,” said the study’s lead author, Dr. Geert-Jan Will.
“We hope that these findings inform our understanding of how mental health problems develop, which may ultimately improve diagnostic tools and treatments,” he said.
For the study, 40 healthy participants did a social evaluation task while in an MRI scanner. After uploading a profile to an online database, they received feedback, ostensibly given by 184 strangers (actually an algorithm), in the form of a thumbs-up (like) or thumbs-down (dislike).
The ‘strangers’ were in different groups so that participants learned to expect positive feedback from some groups of raters, and negative feedback from other groups. After every 2-3 trials, participants reported on their self-esteem at that moment.
Participants expected to be liked by ‘strangers’ in the groups that mostly gave positive feedback, so when they received a thumbs-down from a person in that group, their self-esteem took a hit. These social prediction errors – the difference between expected and received feedback – were key for determining self-esteem.
“We found that self-esteem changes were guided not only by whether other people like you, but were especially dependent on whether you expected to be liked,” Dr Will said.
The research team developed a model of the neural processes at play when appraisals impact self-esteem, finding that social prediction errors and changes in self-esteem resulting from these errors were tied to activity in parts of the brain important for learning and valuation.
The researchers then combined their computational model with clinical questionnaires to explore the neural mechanisms underlying vulnerability to mental health problems.
They found that people who had greater fluctuations in self-esteem during the task also had lower self-esteem more generally and reported more symptoms of depression and anxiety.
People in this group showed increased prediction error responses in a part of the brain called the insula, which was strongly coupled to activity in the part of the prefrontal cortex that explained changes in self-esteem.
This finding is important as the researchers hypothesize this pattern of neural activity could be a neurobiological marker that confers increased risk for a range of common mental health problems.
“By combining our mathematical equation for self-esteem with brain scans in people as they found out whether other people liked them, we identified a possible marker for vulnerability to mental health problems. We hope these tools can be used to improve diagnostics, enabling mental health professionals to make more specific diagnoses and targeted treatments,” said Dr. Robb Rutledge.
The authors are continuing their line of work by studying people with particularly low self-esteem, and plan to follow up by studying people diagnosed with psychiatric disorders.
Source: University College London
The mission to prevent or delay the onset of Alzheimer’s dementia is not an easy task for providers or patients alike — large areas of uncertainty remain. The task is now taking on new meaning as clinical trials commence on individuals who have a higher risk of Alzheimer’s but are still cognitively normal.
Researchers need to test drugs yet seniors are often confused as to their prognosis and how the medications may or may not be of benefit. A new study from the Perelman School of Medicine at the University of Pennsylvania has shed light on how seniors cope with the knowledge that they are at high risk for Alzheimer’s disease.
Researchers examined cognitively normal adults 65 years and older who had been accepted into a large Alzheimer’s prevention trial based on brain scans showing an “elevated” level of beta amyloid protein plaques.
Beta Amyloid plaques are one of the biomarkers of Alzheimer’s-disease. The Penn Medicine researchers found that for many of these seniors, being told that that their amyloid levels were “elevated” on brain scans led to frustration and a desire for more detailed information.
“Clinicians who give these results to people should be prepared to explain how and why measurements of amyloid are termed ‘elevated’ and what that means in terms of Alzheimer’s dementia risk,” said Jason Karlawish, M.D., a co-director of the Penn Memory Center.
The study, published in JAMA Neurology, comes as Alzheimer’s researchers and the pharmaceutical industry have begun to think more in terms of preventing dementia than in trying to treat after it has been diagnosed.
Unfortunately, to date, every candidate drug tested in large-scale clinical trials in patients with Alzheimer’s dementia has failed to show a significant effect in slowing the usual five to 10 year course of this fatal illness.
Developing a preventive therapy is challenging for a number of reasons, not least because it entails the ethically challenging task of testing potentially risky drugs on people who are cognitively normal.
Research over the past two decades has found, however, that certain types of brain scan as well as blood and spinal fluid tests can sort people into categories of higher or lower risk of developing Alzheimer’s dementia.
For example, positron emission tomography (PET) using a radiotracer that sticks specifically to Alzheimer’s-associated amyloid plaques can measure the extent of amyloid plaques in the brain.
Researchers have learned that having no plaques means having essentially no near-term risk of Alzheimer’s dementia.
Most elderly people however, will have some amyloid plaque burden, and although that doesn’t make Alzheimer’s dementia a certainty in a normal lifespan, plaque loads beyond a certain threshold have been linked to a higher risk of this illness.
The most prominent Alzheimer’s prevention trial now underway, the NIH-sponsored A4 trial, has enrolled seniors based on the PET finding elevated amyloid.
Karlawish and colleagues sought to determine how these seemingly healthy seniors handled the information that they had elevated brain amyloid.
The researchers interviewed 50 seniors (ages 65-85) who had enrolled into the A4 trial. They found that about half had expected their amyloid PET scan result, based on a family history of Alzheimer’s or a recent experience with memory problems.
Most understood the basic facts provided by the A4 trial clinicians, namely that their brain amyloid levels were elevated, indicating a higher but not certain risk of developing Alzheimer’s dementia.
A smaller percentage appeared to believe mistakenly that they either had no increased risk of dementia or had 100 percent risk — even “early Alzheimer’s.”
A large minority of the subjects (20 of the 50) were dissatisfied with the ambiguity of the message that their brain amyloid level was “elevated.”
One 71-year old woman commented, accurately enough, “I don’t know how elevated the risk is. It could be like right over the edge, and other people are right under the edge.” Similarly a 75-year old man complained that he found the uncertainty frustrating: “my background is in a technical area, and I’m used to having facts and data.”
“What this is telling us is that, in the future, Alzheimer’s biomarkers will have to get more predictive, or we’ll simply have to educate people to cope with the uncertainty,” Karlawish said.
He emphasized that for now, disclosing amyloid PET result to cognitively normal adults is something that occurs only in experimental contexts such as the A4 trial. Amyloid PET scans are available for people who already have cognitive problems, to help distinguish Alzheimer’s from other forms of dementia.
Alzheimer’s researchers hope, however, that trials such as the A4 trial, which is testing an anti-amyloid drug, will lead eventually to preventive therapies to cognitively normal adults, particularly those considered to have high Alzheimer’s risk based on PET amyloid levels and other biomarkers.
“In the future, learning this kind of information will be a normal part of going to the doctor, like finding out you have a high cholesterol level,” Karlawish said. “The challenge is to anticipate what it will be like for seniors to learn this, and to develop effective strategies to help them cope with problems that may result, such as being stigmatized socially or losing their usual sense of well-being.”
Source: Penn State
New research supports the use of mindfulness meditation mobile apps as a method to reduce the body’s response to biological stress.
The Carnegie Mellon University-led study discovered that one component of mindfulness interventions is particularly important for impacting stress biology. Acceptance, or learning how to be open and accepting of the way things are in each moment, is critical for the training’s stress reduction effects.
Researchers believe their findings provide the first scientific evidence that a brief mindfulness meditation mobile app that incorporates acceptance training reduces cortisol and systolic blood pressure in response to stress.
“We have known that mindfulness training programs can buffer stress, but we haven’t figured out how they work,” said Dr. David Creswell, associate professor of psychology in CMU’s Dietrich College of Humanities and Social Sciences.
The study, published in Psychoneuroendocrinology, was led by Emily Lindsay, Ph.D., and provides initial evidence that the acceptance training component is critical for driving the stress reduction benefits of mindfulness training programs.
Investigators studied 144 stressed adults. The participants were randomly assigned to one of three smartphone-based interventions: training in monitoring the present moment with acceptance, training in monitoring the present moment only or active control training.
Each participant completed one 20-minute daily lesson for 14 days. Then, they were placed in a stressful situation while their cortisol levels and blood pressure were measured.
The results showed that the participants in the combined monitoring and acceptance program had reduced cortisol and systolic blood pressure reactivity. Their blood pressure responses were approximately 20 percent lower than those in the two interventions that did not include acceptance training. Their cortisol responses were also more than 50 percent lower.
“Not only were we able to show that acceptance is a critical part of mindfulness training, but we’ve demonstrated for the first time that a short, systematic smartphone mindfulness program helps to reduce the impact of stress on the body,” said Lindsay, a postdoctoral research fellow at the University of Pittsburgh.
“We all experience stress in our lives, but this study shows that it’s possible to learn skills that improve the way our bodies respond to stress with as little as two weeks of dedicated practice. Rather than fighting to get rid of unpleasant feelings, welcoming and accepting these feelings during stressful moments is key.”
Source: Carnegie Mellon University
A new study suggests that the powerful anesthetic ketamine may help alleviate migraine pain in patients who have not been helped by other treatments.
Ketamine is commonly used as a general anesthetic and increasingly used for depression. In an April 2017 article in the journal JAMA Psychiatry, a number of studies have shown that ketamine can have “rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment.”
The study of 61 patients found that almost 75 percent experienced an improvement in their migraine intensity after a three- to seven-day course of inpatient treatment with ketamine.
“Ketamine may hold promise as a treatment for migraine headaches in patients who have failed other treatments,” said study co-author Eric Schwenk, M.D., director of orthopedic anesthesia at Thomas Jefferson University Hospital in Philadelphia, Penn.
“Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term. Our work provides the basis for future, prospective studies that involve larger numbers of patients.”
Migraines are relatively common, affecting an estimated 12 percent of the U.S. population. The disorder is characterized by recurring attacks of throbbing or pulsing moderate to severe pain.
A subset of these patients, along with those who suffer from other types of headaches, do not respond to treatment. During a migraine, people are often very sensitive to light, sound and may become nauseated or vomit.
Migraines are three times more common in women than in men.
The researchers reviewed data for patients who received ketamine infusions for intractable migraine headaches that have failed all other therapies. On a scale of 0-10, the average migraine headache pain rating at admission was 7.5, compared with 3.4 on discharge.
The average length of infusion was 5.1 days, and the day of lowest pain ratings was day 4. Adverse effects were generally mild. Schwenk said while his hospital uses ketamine to treat intractable migraines, the treatment is not yet widely available.
Thomas Jefferson University Hospital will be opening a new infusion center this fall that will treat more patients with headaches using ketamine.
“We hope to expand its use to both more patients and more conditions in the future,” he said.
Researchers are optimistic, yet cautious, as the study was small in scale.
“Due to the retrospective nature of the study, we cannot definitively say that ketamine is entirely responsible for the pain relief, but we have provided a basis for additional larger studies to be undertaken,” Schwenk added.
The new study was presented at the ANESTHESIOLOGY® 2017 annual meeting.
A new study from the University at Buffalo Research Institute on Addictions in New York finds that having a parent with an alcohol use disorder increases the risk for dating violence among teenagers.
“Although teen dating violence is typically viewed as a problem related specifically to adolescent development, our findings indicate that the risk for aggressive behavior and involvement in dating violence are related to stressors experienced much earlier in life,” said researcher Jennifer A. Livingston, Ph.D.
The study appears in the Journal of Youth and Adolescence.
For the research, Livingston evaluated 144 teenagers who had fathers with an alcohol use disorder and who had been initially recruited for study at 12 months of age.
By analyzing data collected regularly over the course of their lifespan, Livingston was able to identify factors that led to abusive dating relationships for some of the teens.
“It appears that family dynamics occurring in the preschool years and in middle childhood are critical in the development of aggression and dating violence in the teenage years,” she said.
Mothers living with partners who have alcohol use disorder tended to be more depressed and, as a result, were less warm and sensitive in their interactions with their children, beginning in infancy.
“This is significant because children with warm and sensitive mothers are better able to regulate their emotions and behavior,” Livingston says. “In addition, there is more marital conflict when there is alcohol addiction.”
These conditions can interfere with children’s abilities to control their own behavior, resulting in higher levels of aggression in early and middle childhood.
Research has found that children who are more aggressive in childhood, particularly with their siblings, are more likely to be aggressive with their romantic partners during their teen years.
“Our findings underscore the critical need for early intervention and prevention with families who are at-risk due to alcohol problems. Mothers with alcoholic partners are especially in need of support,” Livingston said.
“Our research suggests the risk for violence can be lessened when parents are able to be more warm and sensitive in their interactions with their children during the toddler years.
“This in turn can reduce marital conflict and increase the children’s self-control, and ultimately reduce involvement in aggressive behavior.”
Source: University of Buffalo
A new study suggests many people significantly overestimate how much pain they will be in after surgery — often resulting in unnecessary anxiety.
The finding, presented at the ANESTHESIOLOGY® 2017 annual meeting, found that individuals who receive regional anesthesia, such as peripheral nerve blocks, epidurals or spinal anesthesia, were most likely to overestimate their postoperative pain.
“We believe providers need to do a better job of counseling patients on realistic pain expectations,” said study co-author Jaime L. Baratta, M.D., director of regional anesthesia at Thomas Jefferson University Hospital in Philadelphia, Penn.
“This is especially true for patients receiving regional anesthesia who may not fully understand the benefits of nerve blocks and other regional anesthesia procedures aimed at preventing postoperative pain.”
During regional anesthesia, the physician anesthesiologist makes an injection near a cluster of nerves to numb the area of the body that requires surgery. The patient may remain awake or be given a sedative. Either way, the patient does not feel the surgery taking place.
The findings suggest that individuals receiving regional anesthesia before surgery may experience unnecessary anxiety and have exaggerated pain expectations simply because they do not understand regional anesthesia’s pain relieving benefits.
The study included 223 patients, averaging 61 years old, who were undergoing orthopedic, neurosurgical, or general surgery procedures. Of these, 96 received some type of regional anesthesia (spinal, epidural or peripheral nerve block). Of the 96 patients, 80 had no general anesthesia, while 16 had general anesthesia with a peripheral nerve block before or after surgery.
The remaining 127 patients received only general anesthesia. Patients completed a questionnaire before surgery to evaluate what level of postoperative pain they expected on a 0-10 scale.
Following surgery, they were asked about their level of pain in the post-anesthesia care unit (PACU) one hour following surgery and on the first day after surgery.
Patients’ average expected pain rating immediately following surgery was 4.66, compared to an actual pain rating of 2.56. The average expected pain rating on the first day after surgery was 5.45, compared to an actual pain rating of 4.30.
Patients who had regional anesthesia had an average expected pain rating in the PACU of 4.63, compared to an actual pain rating of 0.92. The average expected pain rating for these patients on the first day after surgery was 5.47, compared to an actual pain rating of 3.45.
Researchers believe the study results will improve the way in which medical providers explain the surgical procedure so as to alleviate unfounded anxiety.
“With advancements in regional anesthesia, great strides have been made in preventing postoperative pain. Given the clear benefit of patient education and anxiety alleviation on postoperative pain, providers must find ways to effectively manage patient expectations to help improve outcomes,” said study co-author Amir C. Dayan, M.D.
Women who give birth in winter or spring are less likely than women who deliver in the fall or summer to suffer from postpartum depression (PPD), according to a new study.
The study, presented at the ANESTHESIOLOGY 2017 annual meeting, also found that women who delivered babies at a higher gestational age — further along in their pregnancy — were less likely to develop PPD.
Researchers also found that women who did not have anesthesia, such as an epidural, during delivery had an increased risk of PPD.
Researchers theorize that women who did not have anesthesia may have been at an increased risk for PPD because the pain associated with labor may have been traumatizing to the women during delivery. Another possibility is that the women who declined anesthesia just happened to have intrinsic characteristics that made them more vulnerable to experiencing PPD, the researchers postulated.
The study also found that Caucasian women had a lower risk of PPD compared to women of other races.
Additionally, increased body mass index (BMI) was associated with an increased risk of PPD.
There was no association found between delivery mode and PPD, according to the study’s findings.
“We wanted to find out whether there are certain factors influencing the risk of developing postpartum depression that may be avoided to improve women’s health both physically and mentally,” said lead study author Jie Zhou, M.D., of Brigham & Women’s Hospital in Boston.
According to the researchers, at least 10 percent of women suffer from anxiety or depressive disorders following childbirth. Symptoms of PPD include sadness, restlessness and/or agitation, and decreased concentration.
PPD typically arises from a combination of hormonal changes, psychological adjustments to motherhood and fatigue. Left untreated, PPD can interfere with mother-child bonding and cause distress to the mother, baby, and the entire family.
The study included a review of medical records of 20,169 women who delivered babies from June 2015 through August 2017. Of those, 817 women — or 4.1 percent — experienced PPD.
While the study did not examine why certain factors might influence the development of PPD, Zhou said the higher the gestational age, the more mature the baby will be at delivery.
“It is expected that the mother will do better and be less mentally stressed when delivering a mature, heathy baby,” he noted.
Additionally, the researchers suggest the protective mechanism seen for women delivering in winter and spring may be attributed to the seasonal enjoyment of indoor activities mothers experience with newborns. Outdoor activities, although not as convenient, with newborns are also good, as this will help to increase sun exposure, researchers add.
“The significant difference in the risk of developing PPD between Caucasian and other populations may be due to differences in socioeconomic status among these ethnicities,” he said, adding “while women with increased BMI needed more hospital-based maternal outpatient follow-ups and had more pregnancy-related complications, which could affect maternal outlook.”
Psychologists often turn to a variety of methods to analyze how people express and manage their emotions. Now in a new study, researchers at The City College of New York (CCNY) have developed a novel assessment model, called the Mentalized Affectivity Scale (MAS), which allows clinicians to approach mental health disorders in a new way.
The new assessment model breaks emotion regulation into three basic elements:
- identifying: the ability to identify emotions and to reflect on the factors that influence them (e.g. childhood or other traumatic events);
- processing: the ability to modulate and distinguish complex emotions;
- expressing: the tendency to express emotions outwardly or inwardly.
For the study, Drs. Elliot Jurist and David M. Greenberg from The City College of New York administered the MAS to nearly 3,000 adults online. Statistical modeling of the findings revealed the following: processing emotions delineates from identifying them and expressing emotions delineates from processing them.
The team of psychologists discovered that emotion regulation was related to personality and well-being in surprising and unexpected ways. They also found that the ability to process and modulate emotions was a significant predictor of well-being beyond personality and demographic information.
“We have introduced a way for psychologists and psychiatrists to use emotion regulation to supplement diagnoses,” said Greenberg, a postdoctoral student at Colin Powell School for Civic and Global Leadership and lead author of the study.
One of the most important findings was how the three elements — identifying emotions, processing emotions and expressing emotions — were linked to the participants’ previous clinical diagnoses involving anxiety, mood, eating and neurodevelopmental disorders.
“For the first time we have empirical evidence for the validity and usefulness of the theory that can be carried out into the mainstream by neuroscientists, emotion researchers and psychiatrists,” said Jurist, senior author and director of the Mentalized Affectivity Lab at CCNY and professor at the Colin Powell School for Civic and Global Leadership.
The new model can be applied to many psychological conditions, such as anxiety, mood, and developmental disorders. According to the National Alliance on Mental Illness (NAMI), approximately 1 in 5 adults in the U.S. — 43.8 million, or 18.5 percent — experiences mental illness in a given year. About 18.1 percent of adults in the U.S. experienced an anxiety disorder such as post-traumatic stress disorder, obsessive-compulsive disorder and specific phobias.
The new findings are published in the journal PLOS ONE.
Source: The City College of New York
Research has shown that gardening or even just the presence of plants has a positive psychological effect on people, making them happier and more social. Now, in a new review published in the journal Open Agriculture, researchers at the University of Florida assert that plants may play a key role in maintaining the mental well-being of space crews.
Long periods of space travel can lead to sleep problems, reduced energy, inattentiveness, difficulty in problem-solving and even memory loss. It can also increase hostility, impulsivity and, despite the danger and excitement, it can be quite boring.
Ever since people started going into outer space, researchers have taken these mission opportunities to test whether plants can survive in a zero-gravity atmosphere. While scientific curiosity was one reason for sending plants into space, it was also realized how cost effective and healthier it would be to grow fresh fruits and vegetables on demand during long space missions, rather than to rely on processed foods.
Once it was confirmed that plants could survive in zero gravity situations, more experiments were conducted to see if they could be used in other ways, such as for purifying the air inside a spacecraft. Plants consume carbon dioxide and produce oxygen and clean the air of pollutants.
Now in the paper entitled “Gardening for Therapeutic People-Plant Interactions during Long-Duration Space Missions,” researchers Raymond Odeh and Charles L. Guy from the University of Florida wrote a review of the existing literature on plant-people interactions to find that plants may play a major role in the mental health of astronauts.
In their research, the authors uncovered how humans have a tendency to look for natural life, a behavior referred to as the “biophilia hypothesis,” which might help to explain why space travel can be so dangerous for the human psyche.
The researchers conclude that what applies to humans on Earth also applies to astronauts in space. Plants can help reduce both social and cognitive problems related to space travel, and suggest that plants should be part of the design of future space missions for both nutritional and psychological reasons.
“A review of this topic for space research is long overdue, and should provide a strong argument to systems analysts and biomedical researchers to look more closely at the ‘other’ contributions of plants to exploration of space,” said Dr. Raymond Wheeler, a senior scientist for NASA at the Kennedy Space Center.
“I highly recommend this paper for anyone who has an interest in human space travel, and the notion of using plants for bioregenerative life support.”
Source: De Gruyter
The gentle touch of another may help ease the negative emotional effects of social exclusion, according to a new study at University College London (UCL).
Researchers tested the impact of a slow, affectionate touch against a fast, neutral touch following social rejection and found a connection between gentle touch and social bonding.
“As our social world is becoming increasingly visual and digital, it is easy to forget the power of touch in human relations. Yet we’ve shown for the first time that mere slow, gentle stroking by a stranger can reduce feelings of social exclusion after social rejection,” said lead author Mariana von Mohr at UCL.
The new findings follow on the heels of other research showing that affective social touch and in particular, gentle stroking of the skin, may be coded by a special physiological system linking the skin to the brain.
While a few other studies have investigated the buffering effects of social support on ostracism through the presence of friends, teddy bears and supportive text messages, this is the first to investigate social touch.
For the study, 84 healthy women were told they would be playing a computerized ball-tossing game with two other participants to measure their mental visualisation skills. Although the participants thought they were playing games with other study participants, the other players were actually computer-generated.
After throwing and catching the ball several times, the participants answered a questionnaire asking how they felt about ostracism, the feelings of belonging, self-esteem, meaningful existence, and control.
When the participants went back to playing the game after a 10 minute break, the other players unexpectedly stopped throwing balls to them after a couple of ball-tosses, causing them to feel socially excluded.
Next, the women were blindfolded and their left forearms were touched with a soft-bristled brush on either slow or fast speed. They then completed the same questionnaire and the results were compared and controlled against a baseline.
Participants touched at a slow speed had reduced feelings of negativity and social exclusion caused by the game compared to those who received a fast, “neutral” touch, even though general mood remained the same among both groups. Neither type of touch was sufficient to eliminate all of the negative effects of being socially rejected.
“Mammals have a well-recognised need for closeness and attachment, so it wasn’t a big surprise that social support reduced the emotional pain of being excluded in social interactions,” said senior author Dr. Katerina Fotopoulou at UCL.
“What is interesting however is that social support was optimally conveyed only by a simple, yet specific, instance of touch. No words, or pictures were necessary, at least in the short term. This finding builds on evidence that the same kind of touch can have unique effects on physical pain and it can have implications for the role of touch in various mental and physical care settings”
The researchers say that more studies are needed to specify the neurophysiological mechanisms involved and that future studies might consider the effect of skin-on-skin contact, social context and how results vary with temperature.
The findings are published in the journal Scientific Reports.
Source: University College London
A new survey finds nearly half of American workers express concern about the changing nature of work. Although most workers report that they have the skills they need to perform their current job well, those without supervisor support for career development are more likely to distrust their employer and plan on leaving within the next year.
The American Psychological Association’s “2017 Job Skills Training and Career Development Survey,” was conducted online by Harris Poll, and surveyed 1,076 U.S. adults who are employed full or part time.
“Employee growth and development is a key element of a psychologically healthy workplace, but it’s often overlooked in employers’ workplace well-being efforts,” said David Ballard, Psy.D., M.B.A., head of APA’s Center for Organizational Excellence.
“Our surveys of the U.S. workforce consistently find that training and development is one of the areas employees are least satisfied with. The lack of opportunity for growth and advancement is second only to low pay as a source of work stress.
“In a rapidly changing work environment, making participation in job-related training and career development activities an expectation and preparing employees for a successful future are one way to protect workers and enhance our nation’s workforce readiness.”
For employees whose supervisors do not support and encourage their career development, only 15 percent say their employer provides opportunities for them to develop the technical skills they will need in the future.
Furthermore, only 20 percent say their employer provides training in necessary “soft skills,” such as teamwork and communication, and just eight percent report having the opportunity to develop necessary leadership and management skills.
Lack of supervisor support for career development was also linked to important organizational outcomes. For working Americans without supervisor support:
less than half (48 percent) say they are motivated to do their best at work (vs. 88 percent who report having supervisor support);
- 39 percent are satisfied with their job (vs. 86 percent);
- 16 percent say their company or organization makes them feel valued (vs. 80 percent);
- 22 percent would recommend their organization as a good place to work (vs. 79 percent), and;
- more than half of U.S. workers say they do not trust their employer (56 percent) and intend to seek employment outside the organization within the next year (53 percent).
As talk of automation, artificial intelligence, and skills retraining dominate conversations about the future of jobs, 43 percent of employed Americans say they are concerned about the changing nature of work.
As a whole, 87 percent of working Americans report that they have the skills they need to perform their current job well, and 61 percent say their employer is providing opportunities for development of the technical and soft skills needed in the future.
But fewer (52 percent) report they have adequate time for career development activities and only half (50 percent) say their employer provides career development opportunities that meet their needs and sufficient opportunities for advancement (50 percent).
The survey also found differences between how men and women view their opportunities for training and career development, with women faring worse than men.
Both men (89 percent) and women (85 percent) report that they have the technical skills necessary to perform their current jobs well, but fewer women than men report that their employer is providing them with opportunities to develop the technical, soft or leadership skills they’ll need in the future.
The gender perception of skill training is revealing:
- 68 percent of men said their employer provides training for technical skills needed in the future (vs. 53 percent of women);
- 65 percent of men report trainings for future-needed soft skills (vs. 56 percent of women);
- and 60 percent of men report opportunities for them to develop the leadership and management skills they’ll need (vs. 47 percent of women).
Despite these differences, fewer women than men are concerned about the changing nature of work (37 percent of women vs. 49 percent of men) and women and men equally (77 percent) feel motivated to do their best at work.
An education divide also seems to persist as the survey highlights gaps between employees with and without a college degree. Nearly three-fourths (74 percent) of employees with a college degree said their employer values training and development while 64 percent of those without one said the same.
Regarding technical skills needed for the future, 72 percent of those with college degrees said their employer provides opportunities for training and development vs. 52 percent without a degree.
“While there are many uncertainties about the future of work, research is clear that employees and organizations benefit from an emphasis on growth and development,” Ballard said.
University of Michigan researchers believe many of the 2 million Americans addicted to opioids can receive treatment and assistance in getting off prescription painkillers or heroin from a primary care team.
The collaborative team-based intervention typically includes physicians, nurses, medical assistants, social workers and pharmacists, as they coordinate to help individuals break their addiction by using anti-opioid medication.
The researchers hope their findings will encourage more general practitioners to start offering medication-assisted therapy or MAT. To that end, a new paper of peer-reviewed evidence showing the benefits of MAT, and the process by which primary care clinic have had success with MAT, appears in the journal PLOS.
MAT combines a medication called buprenorphine with counseling. It has a track record of success for easing the withdrawal from opioid dependence – but it requires frequent check-in visits, drug monitoring tests and prescription refills for months or even years on end.
In addition, the federal government requires that physicians take an eight-hour course to before they can prescribe buprenorphine.
These factors have slowed intervention efforts where primary care physicians provide buprenorphine as addiction treatment.
Use of MAT has increased in recent years, driven by the opioid crisis and MAT coverage through Medicaid expansion in many states. The federal government has increased the number of MAT patients that one physician can treat at any given time. Nurse practitioners and physician assistants can also get permission to prescribe MAT in states where they have prescribing privileges.
But the number of people who need addiction care still far outpaces the number who can provide MAT using buprenorphine or its more-intensive and more-restricted cousin methadone.
“There is a major need to do this,” says Pooja Lagisetty, M.D., M.Sc., the study’s lead author and a University of Michigan primary care doctor who provides MAT to her own patients at the VA Ann Arbor Healthcare System.
“It’s hard to convince primary care physicians to do this work when they’re already busy and they don’t have additional addiction-related training or experience. But if we can learn from others and find a way to offer physicians logistical support, then maybe it’s possible.”
Lagisetty and her colleagues looked globally for common elements in successful primary care MAT models. They compiled data from 41 studies conducted in several U.S. states, as well as Great Britain, Australia, Canada, Ireland, France and Italy.
In general, they find that patients had the highest chance of successful opioid addiction treatment when their primary care physician worked with a team of non-physicians to deliver MAT.
The successful models featured coordinated care, in which physicians handled the patient encounters where their skills were required or most needed, and other team members helped patients between doctor appointments. Nurse case managers, who handled duties including regular phone calls to track patients’ symptoms and cravings, were a common element. A few care models were based solely on a physician handling all MAT duties.
“Multidisciplinary teams featured in the bulk of the studies we evaluated, though every one took a different approach and many ended up with similar results,” says Lagisetty, a clinical lecturer in the Division of General Internal Medicine at Michigan Medicine, U-M’s academic medical center, and a member of U-M’s Institute for Healthcare Policy and Innovation.
A large majority of the sites included in the studies did not have a specific addiction focused counselor. “This suggests primary care clinics have a bit of ‘wiggle room’ to use the resources and staff already available at their respective clinics to manage all the components of MAT,” Lagisetty notes.
In the review, researchers zeroed in on 7 studies that showed the best success – with 60 percent or more of patients staying on their MAT regimen for three months or more, and a good score on the standard scale the U-M investigators developed.
Lagisetty notes that many of the clinics in these best studies did not have an addiction psychologist or other addiction counselor as part of their teams. Many, but not all, required patients to sign contracts pledging they would avoid opioids.
The new analysis also shows that primary clinics do not need to give the first dose of buprenorphine to patients while they’re physically in the clinic.
These “inductions,” which occur hours after the patient has stopped using opioids and is beginning to feel the symptoms of withdrawal, can occur at home as long as the patient has someone to call about any cravings or symptoms they may feel after starting to take the medication.
She hopes the new systematic review of the evidence for primary care MAT will spur more clinics to consider offering the option. She also points to a recent Annals of Internal Medicine review that evaluated the different models for MAT laid out by local and state government agencies.
Primary care teams already provide intensive treatment for other conditions and medication regimens, Lagisetty observes. These range from anticoagulation medicine for people with high risk of blood clots, to managing heart failure patients and people on insulin for diabetes.
Such patients also often require checks between physician appointments while they are being stabilized. Non-physician team members help with dose monitoring and frequent check-ins by phone or in person with the patient. “We can build upon these existing resources to similarly treat patients with MAT,” she says.
In fact, Lagisetty and two of her co-authors on the new paper, Amy Bohnert, Ph.D., and Michele Heisler, M.D., M.S., published a paper last year setting forth the anticoagulation clinic model as a model for MAT. She notes that anticoagulation medications don’t come with the kind of federal regulations that buprenorphine has.
“We already have studies showing that MAT in primary care can produce similar results to providing it in specialty care settings, and patients might be more willing to seek help in a primary care setting because of the lack of stigma and the ability to address their other health concerns,” she said. “Doing MAT in primary care makes sense.
“I don’t think that many primary care physicians went into medicine with a desire to focus on treating addiction,” said Lagisetty.
“However, opioid addiction is increasingly becoming common in our practices and our patients are struggling to find help. Primary care doctors don’t need to all be treating 100 patients. It can just be five. We should just have the medication in our tool box and be able to screen and potentially treat patients in our own setting.”
A new study by German researchers suggests that exposure to urban green space may reduce the risk of mental health issues among city dwellers.
Experts explain that the noise, pollution, and high population density of typical city life can cause chronic stress. As such, city dwellers are at a higher risk of psychiatric illnesses such as depression, anxiety disorders, and schizophrenia than country dwellers.
Investigators at the Max Planck Institute for Human Development studied the brain area called the amygdala, a central region in the brain that plays an important role in stress processing and reactions to danger. Comparisons show higher activity levels in city dwellers’ than in country dwellers’ amygdala.
Taking this information, a research team led by psychologist Dr. Simone Kühn searched for factors that could have a protective influence in relieving the stress. They examined how nature located near people’s homes such as forest, urban green, or wasteland influences stress-processing brain regions such as the amygdala.
“Research on brain plasticity supports the assumption that the environment can shape brain structure and function. That is why we are interested in the environmental conditions that may have positive effects on brain development.
Studies of people in the countryside have already shown that living close to nature is good for their mental health and well-being. We therefore decided to examine city dwellers,” explains Kühn, the first author and leader of the study.
Indeed, the researchers found a relationship between place of residence and brain health: those city dwellers living close to a forest were more likely to show indications of a physiologically healthy amygdala structure und were therefore presumably better able to cope with stress.
This effect remained stable when differences in educational qualifications and income levels were controlled for. However, it was not possible to find an association between the examined brain regions and urban green, water, or wasteland.
With these data, it is not possible to distinguish whether living close to a forest really has positive effects on the amygdala or whether people with a healthier amygdala might be more likely to select residential areas close to a forest. Based on present knowledge, however, the researchers regard the first explanation as more probable. Further longitudinal studies are necessary to accumulate evidence.
Researchers studied participants from the Berlin Aging Study II (BASE-II), a large longitudinal study examining the physical, psychological, and social conditions for healthy aging. In total, 341 adults aged 61 to 82 years took part in the present study.
Apart from carrying out memory and reasoning tests, the structure of stress-processing brain regions, especially the amygdala, was assessed using magnetic resonance imaging (MRI).
In order to examine the influence of nature close to peoples’ homes on these brain regions, the researchers combined the MRI data with geoinformation about the participants’ places of residence. This information stemmed from the European Environment Agency’s Urban Atlas, which provides an overview of urban land use in Europe.
Source: Max Planck Institute
New research finds that a family approach helps a loved one learn to live with their chronic illness in the most productive manner possible.
Penn State researchers discovered family intervention approaches such as working together to make dietary changes can be an effective strategy for improving chronic illness management.
“For some family groups, setting goals together for making lifestyle changes such as healthier eating habits and regular exercise, helps patients to stay on track and may benefit family members as well,” said Dr. Lynn Martire, a professor of human development and family studies.
Martire said this approach could have positive implications on health care costs as well as the treatment of patients.
“The vast majority of health care spending is for treatment of chronic health problems in children and adults. Self-management of chronic illness can reduce these health care costs, and close family members such as a parent or the spouse play an important role in helping patients to manage their illness,” Martire said.
“Therefore, psychological or behavioral treatments that target the patient-family member dyad may decrease health care costs or have more long-lasting effects than treatments that target only the patient.”
The paper, co-authored by Martire and Dr. Vicki Helgeson, a professor of psychology at Carnegie Mellon University, appears in the journal Current Directions in Psychological Science.
According to the authors, patients and family members can work together to monitor patients’ illness symptoms, keep medical appointments, and help the patient stick to medication regimens as a strategy for chronic illness management.
“A key feature of these programs is improving communication around health issues and identifying obstacles to good self-management,” Martire said.
Emerging use of technology to maintain behavior change may also be a promising approach, Martire said. Some treatment programs require frequent travel on the part of patients and families, which limits their accessibility. Technology-supported approaches such as web- or mobile phone-based telehealth programs could reach a broader population of patients and family members.
Increasing internet usage across broad segments of the U.S. population offers an especially appealing method for delivering programs to large numbers of patients and families at low cost. Moreover, web-based interventions for health and illness management could be modified for dyads, she said.
Source: Penn State University
A new study from Brigham Young University finds that stress damages the GI system of mice in a similar manner as junk food, especially among females.
Dr. Laura Bridgewater, a professor of microbiology and molecular biology found that when female mice were exposed to stress, their gut microbiota — the microorganisms vital to digestive and metabolic health — changed to look like the mice had been eating a high-fat diet.
The study appears in Nature Scientific Reports.
“Stress can be harmful in a lot of ways, but this research is novel in that it ties stress to female-specific changes in the gut microbiota,” Bridgewater said.
“We sometimes think of stress as a purely psychological phenomenon, but it causes distinct physical changes.”
Bridgewater and her collaborators at Shanghai Jiao Tong University in China took a large group of eight week-old mice and exposed half of the males and half of the females to a high-fat diet. After 16 weeks, all of the mice were exposed to mild stress over the course of 18 days.
Researchers then extracted microbial DNA from the mice fecal pellets before and after the stress to test how the gut microbiota was affected. They also measured mouse anxiety based on how much and where the mice traveled in an open field arena.
The researchers found fascinating differences between genders: Male mice on the high-fat diet exhibited more anxiety than females on the high-fat diet, and high-fat males also showed decreased activity in response to stress.
However, it was only in female mice that stress caused the gut microbiota composition to shift as if the animals were on a high-fat diet.
While the study was only carried out on animals, researchers believe there are could be significant implications for humans.
“In society, women tend to have higher rates of depression and anxiety, which are linked to stress,” said Bridgewater, who also serves as associate dean of the BYU College of Life Sciences.
“This study suggests that a possible source of the gender discrepancy may be the different ways gut microbiota responds to stress in males vs. females.”
Source: Brigham Young University
A new study suggests that six weeks of midday light therapy can help people with bipolar disorder improve mood and enhance functional abilities.
Bright light therapy has been used for years to reduce symptoms of depression in patients with Seasonal Affective Disorder (SAD). The therapy is typically delivered in the morning to theoretically reset circadian rhythms.
Experts have found, however, that for patients with bipolar disorder the early morning use of bright light may result in side effects including mania or mixed symptoms.
Northwestern University researchers implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid side effects.
Investigators found that compared to dim placebo light, study participants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning).
More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light (see graph below).
The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn’t been able to finish prior to treatment.
“Effective treatments for bipolar depression are very limited,” said lead author Dr. Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine.
“This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks.”
Researchers were pleased that patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus, and risk-taking behaviors.
“As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this,” said Sit, also a Northwestern Medicine psychiatrist.
The study included 46 participants who had at least moderate depression, bipolar disorder, and who were on a mood stabilizer.
Patients were randomly assigned to either a 7,000 lux bright white light or a 50 lux placebo light. The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start.
Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.
“By starting at a lower dose and slowly marching that dose up over time, we were able to adjust for tolerability and make the treatment suitable for most patients,” Sit said.
Sit and her colleagues also observed a noticeable effect of bright light therapy by four weeks, which is similar to other studies that test light therapy for non-seasonal depression and depression during pregnancy.
Light therapy has conventionally been tested using morning light at awakening because previous research has suggested that morning light helps reset circadian rhythms and can be helpful in the treatment of SAD, Sit said.
But the mechanism of response is unclear in bipolar disorder. To understand the possible effects of midday bright light on circadian rhythms in patients with depression and bipolar disorder, Sit and colleagues are planning new studies to investigate.
Source: Northwestern University/Newswise
New research suggests the rate of substance abuse among African-American and Latino adults in a high-risk urban community is low, and comparable to the general U.S. population.
Investigators say the rate of substance abuse among these ethnic groups is similar to that found in the U.S. population despite a very high prevalence of serious risk factors and structural and environmental challenges.
The study suggests risk factors for substance use problems include homelessness and incarceration. On the other hand, researchers discovered the presence of protective factors — such as support, education, and employment — help to instill resiliency and appear to mitigate the risk of substance abuse.
The findings have the potential to pave the way for targeted intervention and prevention programs for communities most vulnerable to substance misuse.
“The many risk factors that can contribute to an increased likelihood of substance use problems by African-American and Latino adults living in a poor, urban community have been well documented, but protective factors are often ignored,” said Dr. Charles Cleland, lead author of the study, from the New York University Meyers College of Nursing.
“We wanted to address this knowledge gap and found that people with the highest rates of risk factors and least evidence of resilience were the most likely to suffer substance use problems.”
Dr. Marya Gwadz, principal investigator of this study, also based at Meyers College of Nursing continues, “People hold stereotypes about those living in high-risk urban settings, for example, that these populations have elevated rates of unemployment, homelessness, and substance use problems.
“Yet we found a substantial proportion of participants had relatively low rates of risk factors, overcoming obstacles, and thriving, even in difficult situations beyond their control, such as high local unemployment rates. We believe our study challenges some of the preconceptions people may hold about African-American/Black and Latino adults living in high-risk urban communities.”
The researchers explored many factors believed to contribute to the risk for substance misuse, in nearly 3,000 African-American/Black and Latino adults from a community suffering high rates of poverty.
Homelessness and incarceration were some of the “risks”, and “resilience” was comprised of factors such as emotional and instrumental support (i.e. childcare or provision of transport), as well as education and employment.
Participants were enrolled to the study by their peers, a recruitment method that engaged more isolated or vulnerable members of the target population, who may not typically want to take part in research.
“The individual risk and resilience factors of these thousands of people provided an almost overwhelming amount of information. To deal with this high level of complexity, we used a method that simplified and organized participants into a few groups with similar risk and resilience profiles,” said Cleland. “This helped us to understand how these factors are related to substance use problems.”
The study examined males and females separately and found both sexes could be described by three groups, with each comprised of a combination of factors. The groups were ranked according to their likelihood of substance misuse.
Almost one-third of women (27 percent) and 38 percent of men were in the lower risk groups, with the likelihood of substance use problems comparable to the general U.S. adult population.
The profiles from the higher risk groups indicated that homelessness and incarceration were strongly associated with an increased probability of substance use problems, whereas education, as well as instrumental (ways in which people assist in physical or tangible ways) and emotional support, were protective factors.
In fact, a lack of instrumental and emotional support, which may be indicative of social isolation and fractured social relationships, emerged as a serious concern for the functioning and wellbeing of these participants.
Restless legs syndrome can become a chronic illness with long-lasting effects on patients’ mental and physical health. A new study into the genetics underlying restless legs syndrome has identified 13 previously unknown genetic risk variants, findings that researchers believe will someday help scientists develop new treatment options for the condition.
European researchers explain that as many as one in 10 people of European ancestry is affected by restless legs syndrome. The condition is characterized by feeling an overwhelming urge to move, often in conjunction with unpleasant sensations, usually in the legs.
Rest and inactivity often inflame the symptoms, whereas movement can lead to temporary relief. The condition is chronic and can get progressively worse.
People with restless legs syndrome have substantially impaired sleep, reduced overall quality of life, and increased risk of depression, anxiety disorders, hypertension, and, possibly, cardiovascular disease.
For around one in 50 people, the condition can be severe enough to require chronic medication, which may in turn have potentially serious side effects.
Studies of families and twins have shown that there is a strong genetic component to the disorder and led to the discovery of six genetic variants that increased the risk of developing the condition.
“We have studied the genetics of restless legs syndrome for more than 10 years and the current study is the largest conducted so far,” said Dr. Barbara Schormair from the Institute of Neurogenomics at the Helmholtz Zentrum München, first author of the study.
“We are convinced that the newly discovered risk loci will contribute substantially to our understanding of the causal biology of the disease.”
Now, an international team of researchers has compared the genetic data from over 15,000 patients with more than 95,000 controls, and identified a further 13 genetic risk variants. The findings were then replicated in a sample of 31,000 patients and 287,000 controls.
The study results appear in Lancet Neurology.
“Restless legs syndrome is surprisingly common, but despite this, we know little about what causes it – and hence how to treat it,” said Dr. Steven Bell from the Department of Public Health and Primary Care at the University of Cambridge, also one of the first authors on the study.
“We already know that it has a strong genetic link, and this was something we wanted to explore in more detail.”
Several of the genetic variants have previously been linked to the growth and development of nerve cells – a process known as neurogenesis – and to changes in the formation of neuronal circuits.
Investigators believe these findings strengthen the case for restless legs syndrome being a neurodevelopmental disorder whose origins may go back to development in the womb as well as impaired nerve cell growth in later life.
“The genetic risk variants that we’ve discovered add more weight to the idea that this condition is related to the development of our nervous system,” said Dr. Emanuele Di Angelantonio, also from Cambridge.
“It also gives us some clues to how we may treat patients affected by the condition.”
Prof. Juliane Winkelmann, who heads the Institute of Neurogenomics at the Helmholtz Zentrum as well as a restless legs syndrome outpatient clinic at the Klinikum Rechts der Isar in Munich, adds: “Our genetic findings are an important step towards developing new and improved treatment options for our patients.”
One particular biological pathway implicated by the findings is known to be a target for the drug thalidomide. While the drug has a controversial reputation due to its previous use when treating pregnant women that led to serious birth defects in their offspring, it is now used to treat some cancers.
The researchers suggest that thalidomide or similar drugs may offer potential treatment options for male patients with restless leg syndrome and female patients beyond reproductive age, but they stress the necessity of rigorous clinical testing for efficacy and side-effects before any such use.
Source: University of Cambridge
Military personnel are significantly more likely to disclose post-traumatic stress symptoms while being interviewed by a virtual human compared to when they are taking a computer survey, according to a new study published in the journal Frontiers in Robotics and AI.
The researchers believe that the computer-generated “human” interviewer offers the advantages of anonymity while also giving a sense of social connection and rapport, which can help service men and women reveal more about their mental health symptoms.
Following a tour of duty, the US military evaluates the mental health of its troops with a written survey called the Post-Deployment Health Assessment (PDHA). This survey measures post-traumatic stress disorder (PTSD) symptoms, which may include agitation, anxiety, depression, nightmares, and/or disturbing thoughts and feelings.
The results of this survey, however, can affect a respondent’s career prospects in the military. This means that the respondents may be reluctant to be completely honest. In addition, the stigma surrounding mental health problems may deter a person from admitting to symptoms or seeking help.
Earlier research has shown that people are often more likely to provide sensitive information in anonymous surveys, as they feel safer and less exposed. However, human interviewers can build rapport with interviewees, which isn’t possible in an anonymous survey. When an interviewer forms a social connection with an interviewee, they tend to open up more easily.
A computer-generated “human” interviewer could provide a solution that combines the rapport-building skills of real human interviewers with the feelings of anonymity and safety provided by anonymous surveys. These virtual interviewers can use a variety of techniques to build rapport, including a welcoming expression and posture, and being attentive and responsive.
The researchers hypothesized that a virtual interviewer would help soldiers disclose PTSD symptoms more easily. They tested this hypothesis in a group of soldiers who had returned from a year-long deployment in Afghanistan.
The troops completed the official PDHA survey as well as an anonymous version on a computer. They also participated in an anonymous interview with a virtual interviewer, who built rapport beforehand by asking them questions about common post-traumatic stress symptoms.
Strikingly, the troops revealed significantly more PTSD symptoms to the virtual interviewer than in either of the surveys. The research team repeated the experiment in a larger group of soldiers and veterans, this time comparing only the anonymous PDHA survey and an anonymous interview with a virtual interviewer.
In this second experiment, soldiers and veterans with milder PTSD symptoms opened up and disclosed more symptoms to the virtual interviewer compared to the anonymous PDHA survey. This suggests that virtual interviews could help to uncover PTSD symptoms that current interview techniques are unable to detect, and help soldiers gain access to much-needed treatments.
“Allowing PTSD to go untreated can potentially have disastrous consequences, including suicide attempts,” says Gale Lucas of the University of Southern California.
“These kinds of technologies could provide soldiers a safe way to get feedback about their risks for post-traumatic stress disorder. By receiving anonymous feedback from a virtual human interviewer that they are at risk for PTSD, they could be encouraged to seek help without having their symptoms flagged on their military record.”