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Updated: 1 hour 31 min ago

Journaling of Emotions Helps Worriers Improve Performance

Fri, 09/15/2017 - 12:15

Some people worry more than others. Unfortunately, the concerns may detrimentally influence future performance of tasks. A new study using electroencephalographic feedback finds that the solution to this dilemma may easily accomplished.

In the study, Michigan State University researchers found that simply writing about your feelings may help you perform an upcoming stressful task more efficiently.

Investigators say the research provides the first neural evidence for the benefits of expressive writing.

“Worrying takes up cognitive resources; it’s kind of like people who struggle with worry are constantly multitasking — they are doing one task and trying to monitor and suppress their worries at the same time,” explains lead author Hans Schroder, an MSU doctoral student in psychology and a clinical intern at Harvard Medical School’s McLean Hospital.

“Our findings show that if you get these worries out of your head through expressive writing, those cognitive resources are freed up to work toward the task you’re completing and you become more efficient.”

Schroder conducted the study at Michigan State with Jason Moser, associate professor of psychology and director of MSU’s Clinical Psychophysiology Lab, and Tim Moran, a research scientist at Emory University.

The findings appear online in the journal Psychophysiology.

For the study, college students identified as chronically anxious through a validated screening measure completed a computer-based “flanker task” that measured their response accuracy and reaction times.

Before the task, about half of the participants wrote about their deepest thoughts and feelings about the upcoming task for eight minutes; the other half, in the control condition, wrote about what they did the day before.

While the two groups performed at about the same level for speed and accuracy, the expressive-writing group performed the flanker task more efficiently, meaning they used fewer brain resources, measured with electroencephalography, or EEG, in the process.

Moser uses a car analogy to describe the effect.

“Here, worried college students who wrote about their worries were able to offload these worries and run more like a brand new Prius,” he said, “whereas the worried students who didn’t offload their worries ran more like a ’74 Impala – guzzling more brain gas to achieve the same outcomes on the task.”

While much previous research has shown that expressive writing can help individuals process past traumas or stressful events, the current study suggests the same technique can help people — especially worriers — prepare for stressful tasks in the future.

“Expressive writing makes the mind work less hard on upcoming stressful tasks, which is what worriers often get “burned out” over, their worried minds working harder and hotter,” Moser said.

“This technique takes the edge off their brains so they can perform the task with a ‘cooler head.'”

Source: Michigan State University

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Magnetic Brain Stimulation May Enhance CBT in Treating Anxiety

Thu, 09/14/2017 - 12:15

In the United States, anxiety disorders affect 40 million adults age 18 and older, or 18.1 percent of the population every year. The diagnosis is the most common mental illness in the U.S.

Sadly, less than 37 percent of people with anxiety receive treatment.

For example, some individuals panic upon boarding an aircraft, others find it impossible to enter a room with a spider on the wall and again others prefer the staircase over the elevator — even to get to the 10th floor — because riding in elevators elevates their heart rate.

Therefore, what sounds like funny quirks is often debilitating for the sufferers. Sometimes their anxiety can affect them to a point that they are unable to follow a normal daily routine.

Care for the disorder has improved significantly with the introduction of cognitive behavioral therapy and the technique of deliberately exposing anxiety patients to the situations they feel threatened by — under the individual psychological supervision of an expert.

However, CBT appears to help some more than others.

A new German study led by Professor Martin J. Herrmann, a psychologist at the Center of Mental Health of the Würzburg University Hospital, explored strategies to improve patients’ response to cognitive behavioral therapy.

One supplemental method was the use of transcranial magnetic stimulation. During transcranial magnetic stimulation (TMS), a magnetic coil is placed near the head of the person receiving the treatment.

The coil produces a rapidly changing magnetic field which sends magnetic pulses through the cranium into the brain. There it triggers an action potential in the neurons and the neuron transmits an impulse.

Although the technique has been around only for a few decades, it is routinely used in research and diagnostics. “We knew from previous studies that a specific region in the frontal lobe of the human brain is important for unlearning anxiety,” Herrmann said.

He said initial studies have shown that magnetically stimulating this brain region can improve the effectiveness of unlearning anxiety responses in the laboratory.

In the recently published study, the team investigated whether the technique would help to relieve anxiety associated with a fear of heights.

Researchers studied 39 participants with a pronounced fear of heights. Virtual reality was used to take the participants to dizzying heights during two sessions. “The people feel actual fear also in a virtual reality, although they know that they are not really in a dangerous situation,” Herrmann said.

The scientists stimulated the frontal lobe of some of the anxiety patients for about 20 minutes before entering the virtual world; the other group was only administered a pseudo stimulation.

“The findings demonstrate that all participants benefit considerably from the therapy in virtual reality and the positive effects of the intervention are still clearly visible even after three months,” Herrmann said.

What is more, by stimulating the frontal lobe, the therapy response was accelerated.

Next, the researchers want to study whether this method is also suitable to treat other forms of anxiety by conducting a further virtual reality therapy study for arachnophobic (fear of spiders) patients.

Source: University of Würzburg /EurekAlert
 
Photo: People suffering from a fear of heights experience the anxiety also in virtual reality — even though they are aware that they are not really in a dangerous situation. Credit: VTPlus.

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‘Owning’ Your Mistake Can Enhance Chances of Future Success

Thu, 09/14/2017 - 11:30

Profound new research suggests the common strategy to not dwell on mistakes and to move on to the next experience, may be unproductive.

Ohio State investigators believe truly feeling the pain of failure helps you admit what went wrong and stimulates you to try harder the next time. They believe this approach is a better method to correct mistakes than simply thinking about what went wrong.

Researchers found that people who just thought about a failure tended to make excuses for why they were unsuccessful and didn’t try harder when faced with a similar situation. In contrast, people who focused on their emotions following a failure put forth more effort when they tried again.

“All the advice tells you not to dwell on your mistakes, to not feel bad,” said Dr. Selin Malkoc, co-author of the study and a professor of marketing.

“But we found the opposite. When faced with a failure, it is better to focus on one’s emotions — when people concentrate on how bad they feel and how they don’t want to experience these feelings again, they are more likely to try harder the next time.”

While thinking about how to improve from past mistakes might help — this study didn’t examine that — the researchers found that people who reflect on a failure do not tend to focus on ways to avoid a similar mistake.

When asked to think about their mistakes, most people focus on protecting their ego, Malkoc said. They think about how the failure wasn’t their fault, or how it wasn’t that big of a deal, anyway.

“If your thoughts are all about how to distance yourself from the failure, you’re not going to learn from your mistakes,” she said.

Malkoc conducted the study with Drs. Noelle Nelson of the University of Kansas and Baba Shiv of Stanford University. Their results appear online in the Journal of Behavioral Decision Making.

Researchers conducted several studies to come to their conclusion. In one, 98 college students were asked to price search online for a blender with specific characteristics, and with the possibility of winning a cash prize if they found the lowest price.

Before they found out if they won, half the participants were told to focus on their emotional response to winning or losing, while the other half were instructed to focus on their thoughts about how they did. They were told they would write about their response afterward.

The price search task was rigged, though, and all participants found out that the lowest price was $3.27 less than what they found. After writing about their failure, the students had a chance to redeem themselves.

The researchers wanted to find out if the effort put forth by participants in a new task would be related to whether they focused on their thoughts or emotions involving the previous failure. The researchers believed that a task similar to their failed job — in this case a search for the lowest price — would trigger participants into recalling their unsuccessful attempt, while an unrelated job would not.

So the participants were given another task. Half were asked to search for a gift book for a friend that was the best fit for their limited college-student budget. In other words, they were looking for the lowest price, as they were instructed in the first task.

The other half of the participants were given a non-similar task, which was to search for a book that would be the best choice as a gift for their friend.

The results showed emotional responses to failure motivated participants much more than cognitive ones when they were faced with a similar task.

Emotionally motivated participants spent nearly 25 percent more time searching for a low-priced book than did participants who had only thought about — rather than dwelled on the pain of — their earlier failure.

There was no significant difference in effort made by participants when the second task wasn’t like the first (when they were searching for the best gift, rather than the cheapest).

“When the participants focused on how bad they felt about failing the first time, they tried harder than others when they had another similar opportunity,” Malkoc said.

“But the situation has to be similar enough to trigger the pain of the initial failure.”

One reason why an emotional response to failure may be more effective than a cognitive one is the nature of people’s thoughts about their mistakes.

When the researchers analyzed what participants who thought about their failure wrote about, they found significantly more self-protective thoughts (“This wasn’t my fault,” “I could not have found it even if I tried”) than they did self-improvement thoughts (“I know how I can do better next time”).

Unfortunately, that may be the default mode for most people, at least in many everyday situations.

In another similar study, the researchers didn’t tell some participants how to respond to their failures. They found that these people tended to produce cognitive responses rather than emotional ones, and those cognitive responses were the kinds that protected themselves rather than focused on self-improvement.

Malkoc said that in most real-life situations, people probably have both cognitive and emotional responses to their failures. But the important thing to remember is not to avoid the emotional pain of failing, but to use that pain to fuel improvement.

“Emotional responses to failure can hurt. They make you feel bad. That’s why people often choose to think self-protective thoughts after they make mistakes,” she said.

“But if you focus on how bad you feel, you’re going to work harder to find a solution and make sure you don’t make the same mistake again.”

Source: Ohio State University

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Rejection Tolerance Influences Choice of Dating Sites

Wed, 09/13/2017 - 13:00

Americans are using online dating sites more than ever before as nearly 50 percent of the American public knows someone who has used an online dating site.

Moreover, 5 percent of Americans who are married or in committed relationships today met their significant other online.

The success of dating sites has now lead to an abundance of options. A new study looks into this dilemma and provides suggestions to help users know which company is best for them.

Interestingly, researchers discovered your choice of which site to use should depend on your tolerance of rejection. If you can handle rejection, more choices may be best. However, if you do not want to go the volume route, the site you chose may be more expensive.

The study, “Competing by Restricting Choice: The Case of Search Platforms,” explains that most sites, such as Match.com, compete by building the largest user base possible, and provide users with access to unlimited profiles on the platform.

Others, such as eHarmony.com, pursue user growth with the same intensity, but allow users to only view and contact a limited number of others on the platform.

However, despite the limited choice, eHarmony’s customers are willing to pay an average of 25 percent more than Match’s customers.

The study authors, Drs. Hanna Halaburda of the Bank of Canada and New York University, Mikolaj Piskorksi of IMD Business School, and Pinar Yildirim of the University of Pennsylvania, created a stylized model of online, heterosexual dating.

They found that increasing the number of potential matches has a positive effect due to larger choice, but also a negative effect due to competition between users of the same sex.

This suggests that by offering its members access to a large number of profiles, Match’s users are also more likely to experience rejection, as each of their potential matches will have access to a larger number of options, increasing the competition among members.

With access to only a limited number of profiles, eHarmony users are more likely to successfully and more rapidly identify a match with another user, who because of limited choice, is less likely to reject them.

“Online dating platforms that restrict choice, like eHarmony, exist and prosper alongside platforms that offer more choice, like Match.com,” said Halaburda.

“On a platform that offers more choice, agents also face more competition as their candidates also enjoy a larger choice set.”

Ultimately, for online dating users who can tolerate rejection and aren’t bothered by a potentially longer timeframe to identify a match, Match.com provides much greater choice of options.

However, for users who are looking to more quickly identify a potential mutual match, eHarmony limits competition that may result in rejection.

Source: INFORMS

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Online Aid Can Improve Emotional Regulation after Brain Injury

Tue, 09/12/2017 - 13:00

Recovery from a traumatic brain injury (TBI) frequently includes overcoming physical and mental impairments. Unfortunately, working through emotional issues often becomes one of the largest challenges as options for care, and access to care, may be limited.

These limitations have fueled innovative approaches to care for emotional deficits after TBI. New options includes the use of various forms of health information technology to provide training in emotional regulation skills.

The study is presented in a special issue of the Journal of Head Trauma Rehabilitation (JHTR). The official journal of the Brain Injury Association of America.

Many patients with TBI experience disruptions in emotional functioning, including problems in awareness, recognition, expression, and regulation of emotions.

“Of the vast array of consequences of TBI, emotional deficits are among the most prevalent, persistent, and difficult to treat,” according to Dawn Neuman, Ph.D., of Indiana University School of Medicine at Indianapolis.

Deficits in emotional regulation can affect patients’ lives in many ways, including a reduced ability to participate in and benefit from other rehabilitation treatments.

Yet emotional issues after TBI remain “grossly understudied,” especially in terms of treatment. The seven original research papers in the special issue evaluate innovative treatments for common emotional problems after TBI.

Theo Tsaousides, Ph.D., and colleagues of Icahn School of Medicine at Mount Sinai, New York, evaluated a web-based intervention to improve emotional regulation after TBI. The study included 91 adults with a history of TBI and current problems with emotional regulation, based on the “Difficulties in Emotional Regulation Scale” (DERS).

Average time since TBI was about 10 years. In nearly half of patients, the severity of TBI was rated mild.

Over 12 weeks, participants received 24 one-hour emotional regulation skills training sessions. The group sessions were delivered by videoconference, supervised by experienced rehabilitation neuropsychologists.

The program provided education on how TBI affects emotional functioning, followed by training, practice, and feedback on specific strategies for improving emotional regulation skills in everyday life.

At the end of the 12-week program, the participants showed meaningful improvements in emotional regulation, including “medium to large” effects on all aspects measured by the emotional regulation questionnaire. Follow-up assessment 12 weeks beyond the treatment period showed continued improvement.

Measures of positive emotions, satisfaction with life, and problem-solving skills also improved significantly. Participants felt they made substantial progress toward their personal goals. Nearly 90 percent reported moderate to large improvements in their capacity for emotional regulation skills.

The use of videoconferencing technology could help to overcome distance and travel barriers to treatment, while maintaining the benefits of group interventions.

The study recruited participants from 33 states and five countries. Said Tsaousides, “This technology allowed us to create an online educational environment that, in addition to providing skill training, enabled people who were hundreds and thousands of miles apart–many of whom had been isolated from support communities–to connect, share, and learn from one another.”

Other papers in the special issue report on treatments targeting emotional self-awareness, social-emotional perception, anger and aggression, and depression after TBI. While the studies are an important step forward, “The state of the science for studying and treating emotional deficits in people with TBI is sorely lagging behind the needs,” Neumann writes.

“A lot more evidence-based research is needed to support more confident treatment recommendations.”

Source: Wolters Kluwer Health/EurekAlert

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Facing Threats, Accenting The Positive May Move Relationships Forward

Tue, 09/12/2017 - 11:30

For some couples just staying together is good enough. But others want the relationship to move forward and get better and are willing to put in the effort to get there.

For a new study, researchers at the University of Illinois reviewed more than 1,100 studies on relationships dating back to 1950. They found two primary motives behind a couple’s attempts at staying together: threat mitigation and relationship enhancement.

For the most part, improving a relationship includes both components and requires putting effort into the relationship for the pleasure of it.

“Threats to the relationship come from all kinds of different places,” said Dr. Brian Ogolsky.

“Generally, there are many threats early in relationships that can cause problems, but that is not to say that these disappear later. We know couples cheat in the long-term, people end up in new work places and in new situations where possible alternative partners show up, conflicts arise, or a lack of willingness to sacrifice time for your partner emerges.”

Some threat mitigation tactics can actually become enhancement strategies over time, Ogolsky said, but the reverse is not usually true.

“We get to a place where we are pouring energy into the relationship simply because we want to keep the relationship moving forward rather than just mitigating threats.”

In their integrative model of relationship maintenance, the researchers also illustrate individual versus interactive components of maintenance.

“This question of ‘is this an individual thing or is this a couple-level thing’ often goes unanswered. But as we were doing this review, we started noticing that there are ways to maintain the relationship that we can characterize as ‘more or less in our own heads.’ We are doing something to convince ourselves that this is a good relationship and therefore it’s good for our relationship,” Ogolsky said.

“Things like positive illusions, the idea that we can believe our relationship is better than it is or that our partner is better than he or she is. We can do that without our partner,” he said.

Mitigating conflict, however, is something that partners must do together. “Good conflict management or forgiving our partner for doing something wrong is an interactive process.

“When a threat comes in, we can do one of two things: We can ditch our partner or forgive them over time.”

The same is true of enhancement strategies: Partners can do things individually or interactively.

“Individually, even the act of thinking about our relationship can be enhancing. Whereas engaging in leisure activities together, talking about the state of our relationship, these are all interactive,” Ogolsky said.

While Ogolsky rarely offers direct interventions to couples, he said he tends to study the positive side of relationships because of what can be learned from people going through what is inherently a very turbulent thing.

“Relationships have ups and downs. I never go into my work saying people should stay together or they should break up.

“What we are talking about here are processes that exist across different kinds of couples, some of which work very well for some people, some of which may not work for some people. I am interested in understanding processes that keep relationships moving.”

The study appears in the Journal of Family Theory and Review.

Source: University of Illinois

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Rest Assured, Having Fido in Bedroom Does Not Harm Sleep

Mon, 09/11/2017 - 13:45

Some animal lovers may still worry that sleeping with a pet may disrupt sleep. And this is no small matter as the American Veterinary Association says more than 40 million American households have dogs.

Of these households, 63 percent consider their canine companions to be family. Many draw the line at having their furry family members sleep with them for fear of sacrificing sleep quality.

“Most people assume having pets in the bedroom is a disruption,” said Lois Krahn, M.D., a sleep medicine specialist at the Center for Sleep Medicine on the Mayo Clinic’s Arizona campus and an author of the study.

“We found that many people actually find comfort and a sense of security from sleeping with their pets.”

The study appears in Mayo Clinic Proceedings.

Researchers evaluated the sleep of 40 healthy adults without sleep disorders and their dogs over five months. Methodologically, participants and their dogs wore activity trackers to track their sleeping habits for seven nights.

According to the study, sleeping with dogs helps some people sleep better, no matter if they’re snoozing with a small schnauzer or dozing with a Great Dane.

There is one caveat, however. Don’t let your canines crawl under the covers with you.

The sleep benefit extends only to having dogs in your bedroom, not in your bed. According to the study, adults who snuggled up to their pups in bed sacrificed quality sleep.

“The relationship between people and their pets has changed over time, which is likely why many people in fact do sleep with their pets in the bedroom,” Krahn said.

“Today, many pet owners are away from their pets for much of the day, so they want to maximize their time with them when they are home. Having them in the bedroom at night is an easy way to do that.

And, now, pet owners can find comfort knowing it won’t negatively impact their sleep.”

So, go ahead. Turn your sheepdog into a sleep dog. Just make sure they are relegated to their own bark-o-lounger, rather than your bed.

Source: Mayo Clinic

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What Makes Alcoholics Drink?

Sun, 09/10/2017 - 14:45

New research has found that a major factor predicting how much an alcoholic will drink is immediate mood.

The new study also found that suffering from long-term mental health problems did not affect alcohol consumption, with one important exception: Men with a history of depression had a different drinking pattern than men without a history of depression. Surprisingly, the researchers found that those men were drinking less often than men who were not depressed.

“This work once again shows that alcoholism is not a one-size-fits-all condition,” said lead researcher Victor Karpyak of the Mayo Clinic. “So the answer to the question of why alcoholics drink is probably that there is no single answer. This will probably have implications for how we diagnose and treat alcoholism.”

The study, presented at the 2017 European College of Neuropsychopharmacology (ECNP) Congress, determined the alcohol consumption of 287 males and 156 females with alcohol dependence over the previous 90 days, using the accepted Time Line Follow Back method and standardized diagnostic assessment for life time presence of psychiatric disorders (PRISM).

The researchers were then able to associate this with whether the drinking coincided with a positive or negative emotional state (feeling “up” or “down”), and whether the individual had a history of anxiety, depression, or substance abuse.

The results showed that alcohol dependent men tended to drink more alcohol per day than alcohol dependent women.

As expected, alcohol consumption in both men and women was associated with feeling either up or down on a particular day, with no significant association with anxiety or substance use disorders.

However, men with a history of major depressive disorder had fewer drinking days and fewer heavy drinking days than men who never a major depressive disorder, according to the study’s findings.

“Research indicates that many people drink to enhance pleasant feelings, while other people drink to suppress negative moods, such as depression or anxiety,” Karpyak said.

“However, previous studies did not differentiate between state-dependent mood changes and the presence of clinically diagnosed anxiety or depressive disorders. The lack of such differentiation was likely among the reasons for controversial findings about the usefulness of antidepressants in treatment of alcoholics with comorbid depression.”

While the study will need to be replicated and confirmed, Karpyak said the reasons alcoholics drink depend on their background, as well as the immediate circumstances.

“There is no single reason,” he said. “And this means that there is probably no single treatment, so we will have to refine our diagnostic methods and tailor treatment to the individual.”

It also means that treatment approaches may differ depending on targeting different aspects of alcoholism, such as craving or consumption. Treatment also needs to take into account whether the alcoholic patient is a man or a woman and whether the patient has a history of depression or anxiety, he noted.

Source: The European College of Neuropsychopharmacology (ECNP)

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Strong Coping Skills Tied to Less Anxiety in Stressed Women

Sun, 09/10/2017 - 14:00

A new U.K. study finds that strong coping skills may be key to keeping anxiety levels low during stressful situations.

The findings show that among women with poor coping skills, those living in a deprived area are twice as likely to suffer from anxiety compared to those living in more affluent communities. On the other hand, living in a deprived or affluent community makes very little difference to the levels of anxiety experienced by women with strong coping skills.

The study is the largest ever conducted on how coping skills might impact anxiety levels in women in adverse circumstances. The findings, recently presented at the European College of Neuropsychopharmacology (ECNP) Conference in Paris, suggest that teaching women coping strategies may be a way to help them overcome the anxiety stemming from adverse circumstances, such as living in deprivation.

“Individuals with this sense of coherence, with good coping skills, view life as comprehensible and meaningful,” said lead researcher Olivia Remes, doctoral student at the University of Cambridge in England.

“In other words, they feel they can manage their life, and that they are in control of their life, they believe challenges encountered in life are worthy of investment and effort; and they believe that life has meaning and purpose. These are skills which can be taught.”

The University of Cambridge researchers surveyed 10,000 women over the age of 40 who were participating in a major cancer study in Norfolk, U.K.. The women completed health and lifestyle questionnaires on their living conditions, history of physical health, and mental health problems. The researchers then linked this information to 1991 census data to determine if the women were living in a deprived community.

They also measured each person’s sense of coherence using a questionnaire developed from Aaron Antonovsky’s research on how people find meaning and purpose in life. They found that 261 (2.6 percent) of the 10,000 women had generalized anxiety disorder.

Among women without coping skills, those living in a deprived area were about two times (98 percent) more likely to have anxiety than those living in more affluent communities. On the other hand, living in a deprived or affluent community made very little difference to the levels of anxiety experienced by women if they had good coping skills.

“In general, people with good coping skills tend to have a higher quality of life and lower mortality rates than people without such coping skills,” said Remes.

“Good coping can be an important life resource for preserving health. For the first time, we show that good coping skills can buffer the negative impact of deprivation on mental health, such as having generalized anxiety disorder. And importantly, these skills, such as feeling like you’re in control of your life and finding purpose in life, can be taught.”

Many people live in deprivation, and a significant portion of these have generalized anxiety disorder. For the first time, the researchers have shown that coping skills can significantly impact levels of anxiety.

“Many people with anxiety are prescribed medication-and while it is useful in the short-term-it is less effective in the long run, is costly, and can come with side effects. Researchers are therefore now turning to coping mechanisms as a way to lower anxiety. This is particularly important for those people who do not experience any improvement in their anxiety symptoms following commonly-prescribed therapies,” said Remes.

Source: European College of Neuropsychopharmacology

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Chemo’s Psychosocial Impacts May Outweigh Physical Side Effects

Sun, 09/10/2017 - 13:15

The psychosocial impacts of chemotherapy have become more significant for patients than physical side effects such as nausea and vomiting, according to the preliminary results of a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress.

The new study shows that perceptions of chemotherapy side effects in breast and ovarian cancer patients change not only over time, but also throughout the course of treatment.

“With the most recent analysis dating back to 2002, we felt it was time to collect new data and update the interview format,” said study author Dr. Beyhan Ataseven from Kliniken Essen Mitte Evang, Huyssens-Stiftung in Essen, Germany.

“Living conditions have changed, and so have the accompanying therapies linked to chemotherapy. As doctors, we want to know what our patients care about,” she said.

Contrary to previous studies, the researchers focused exclusively on breast and ovarian cancer patients and added a longitudinal analysis by carrying out three separate interviews before, during, and at the end of their chemotherapy.

At each interview, 141 patients scheduled for or undergoing chemotherapy were presented with two groups of cards featuring physical and non-physical side effects. The patients selected their five most burdensome symptoms in each group and ranked them by importance. Out of these 10 main side effects, they were then asked to select the five most significant ones and to rank these as well.

“What we found is that, on the one hand, side effects like nausea and vomiting are no longer a major problem for patients,” said Ataseven. “This can be explained by the fact that modern medication against these symptoms is very effective.

“On the other hand, hair loss is still a persistent, unsolved issue that particularly affects patients at the start of their treatment. As time passes and patients get used to this, however, their concerns evolve and other side effects become more significant.”

Ataseven said the most difficult side effects these patients deal with are sleep disorders — which become increasingly important over time — and anxiety about the effects of their illness on their partner or family, which persists as a top issue.

“As doctors, these findings might lead us to consider possible improvements to the accompanying therapies we offer our patients,” she said. “For instance, sleeping tablets were not until now a part of the routine regimen. There is also a clear case for providing stronger psychological support to address patients’ social anxieties and family-related concerns.”

Source: European Society for Medical Oncology (ESMO)

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Antidepressant Use During Pregnancy Increases Risk for Offspring but Heredity Also Involved

Fri, 09/08/2017 - 12:15

A new Dutch study finds that the maternal use of antidepressants during pregnancy appears to increase the risk of the child developing a mental health issue. Risk increased for conditions such as autism, depression, anxiety and attention deficit hyperactivity disorder (ADHD).

However, investigators are uncertain as to the role of hereditary as part of the elevated risk. Moreover, untreated severe depression during pregnancy can lead to negative outcomes for both the mother and child.

Experts acknowledge that the use of antidepressants among pregnant women has been on the rise for many years. Currently, between 2 and 8 percent of pregnant women are on antidepressants.

In the new study, researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.

The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.

They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.

“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu.

Liu is the lead author of the article, which appears in the BMJ-British Medical Journal.

Researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy.

The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.

The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy.

Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5 percent) than in group 1 (8 percent). In groups 2 and 3 respectively, 11.5 percent and 13.6 percent were diagnosed with a psychiatric disorder at age 16 years.

Despite the apparent medication link, researchers are quick to note that psychiatric disorders are hereditary.

Therefore, the investigators took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb.

“We chose to conduct the study on the assumption that psychiatric disorders are highly heritable. For this reason, we wanted to show that is too narrow if you only look at autism, which is what many previous studies have done.

If heritability plays a part, other psychiatric disorders such as depression, anxiety, ADHD-like symptoms would also appear in the data,” says Trine Munk-Olsen, who is also one of the researchers behind the study.

Indeed, the study also shows that the increase covers not only autism but also other psychiatric disorders such as depression, anxiety, and ADHD.

Thus it becomes clear that the mother’s underlying psychiatric disorder matters in relation to the child’s mental health later in life. At the same time, it cannot be ruled out that the use of antidepressants further increases the risk of psychiatric diseases in the child.

“Our research shows that medication seems to increase the risk, but that heritability also plays a part,” says Trine Munk-Olsen, who also points out that it might be the mothers who suffer from the most severe forms of depression who need to take medication during their pregnancy.

The findings are murky. Indeed, the researchers hope the study can increase the focus on the fact that the research results are not just black and white.

This could help doctors advise women on the use of antidepressants both before and after their pregnancy. Some women might be able to discontinue treatment with the medication while pregnant.

However, the researchers also acknowledge that some women need medication and stress that the consequences of an untreated depression are severe and can lead to serious consequences to both mother and child.

The most important message is that we ensure and safeguard the mental well-being of the pregnant women, and for some women, this involves the use of antidepressants.

“These women should not feel guilty about taking antidepressants. Even though there is an increased risk of the child developing a psychiatric disorder later in life, our research shows that we cannot blame medication alone. Heritability also plays a part,” says Trine Munk-Olsen.

Source: Aarhus University

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Dads Can Develop Postpartum Depression if ‘T’ Drops

Thu, 09/07/2017 - 13:45

Postpartum depression is a relatively common occurrence among females. Now, a new study finds that an elevation or a decline in a father’s testosterone level after childbirth may play a significant role in emotional health and relationship satisfaction.

Researchers from the University of Southern California (USC) discovered fathers face a risk of experiencing depression if their testosterone levels drop nine months after their children are born.

Moreover, researchers also found that a father’s low testosterone may affect his partner, but in an unexpectedly positive way. Women whose partners had lower levels of testosterone postpartum reported fewer symptoms of depression themselves nine and 15 months after birth.

Paradoxically, fathers whose testosterone levels spiked faced a greater risk of experiencing stress due to parenting and experienced a greater risk of acting hostile. Characteristics of hostile behaviors include showing emotional, verbal, or physical aggression toward their partners.

The findings support prior studies that show men have biological responses to fatherhood, said Dr. Darby Saxbe, the study’s lead author and an assistant professor of psychology at USC.

“We often think of motherhood as biologically driven because many mothers have biological connections to their babies through breastfeeding and pregnancy,” Saxbe said.

“We don’t usually think of fatherhood in the same biological terms. We are still figuring out the biology of what makes dads tick.

“We know that fathers contribute a lot to child-rearing and that on the whole, kids do better if they are raised in households with a father present,” she added. “So, it is important to figure out how to support fathers and what factors explain why some fathers are very involved in raising their children while some are absent.”

Saxbe worked with a team of researchers from USC, University of California at Los Angeles, and Northwestern University.

For the study, which appears in the journal Hormones and Behavior, researchers examined data from 149 couples in the Community Child Health Research Network. The study by the National Institute for Child Health and Human Development involves sites across the country, but the data for this study came from Lake County, Illinois, north of Chicago.

Mothers in the study were 18 to 40 years old; African-American, white, or Latina; and low-income. They were recruited when they gave birth to their first, second, or third child. Mothers could invite the baby’s father to participate in the study as well. Of the fathers who participated and provided testosterone data, 95 percent were living with the mothers.

Interviewers visited couples three times in the first two years after birth: around two months after the child was born, about nine months after birth, and about 15 months after birth.

At the nine-month visit, researchers gave the fathers saliva sample kits. Dads took samples three times a day — morning, midday, and evening — to monitor their testosterone levels.

Participants responded to questions about depressive symptoms based on a widely-used measure, the Edinburgh Postnatal Depression. They also reported on their relationship satisfaction, parenting stress and whether they were experiencing any intimate partner aggression. Higher scores on those measures signaled greater depression, more stress, more dissatisfaction, and greater aggression.

Relatively few participants — fathers and mothers — were identified as clinically depressed, which is typical of a community sample that reflects the general population. Instead of using clinical diagnoses, the researchers looked at the number of depressive symptoms endorsed by each participant.

Men’s testosterone levels were linked with both their own and their partners’ depressive symptoms — but in opposing directions for men and for women.

For example, lower testosterone was associated with more symptoms in dads, but fewer symptoms in moms. The link between their partners’ testosterone levels and their own depression was mediated by relationship satisfaction. If they were paired with lower-testosterone partners, women reported greater satisfaction with their relationship, which in turn helped reduce their depressive symptoms.

“It may be that the fathers with lower testosterone were spending more time caring for the baby or that they had hormone profiles that were more synced up with mothers,” she said. “For mothers, we know that social support buffers the risk of postpartum depression.”

Fathers with higher testosterone levels reported more parenting stress, and their partners reported more relationship aggression.

To measure parenting stress, parents were asked how strongly they related to a set of 36 items from the Parenting Stress Index-Short Form. They responded to statements such as “I feel trapped by my responsibilities as a parent” and “My child makes more demands on me than most children.” A high number of “yes” responses signaled stress.

Relationship satisfaction questions were based on another widely-used tool, the Dyadic Adjustment Scale. Parents responded to 32 items inquiring about their relationship satisfaction, including areas of disagreement or their degree of closeness and affection. Higher scores signaled greater dissatisfaction.

Mothers also answered questions from another scientific questionnaire, the HITS (Hurts, Insults, and Threats Scale), reporting whether they had experienced any physical hurt, insult, threats, and screaming over the past year. They also were asked if their partners restricted activities such as spending money, visiting family or friends, or going places that they needed to go.

“Those are risk factors that can contribute to depression over the long term,” Saxbe said.

Although doctors may try to address postpartum depression in fathers by providing testosterone supplements, Saxbe said that the study’s findings indicate a boost could worsen the family’s stress.

“One takeaway from this study is that supplementing is not a good idea for treating fathers with postpartum depression,” she said. “Low testosterone during the postpartum period may be a normal and natural adaptation to parenthood.”

She said studies have shown that physical fitness and adequate sleep can improve both mood and help balance hormone levels.

In addition, both mothers and fathers should be aware of the signs of postpartum depression and be willing to seek support and care, Saxbe said. Talk therapy can help dads or moms gain insight into their emotions and find better strategies for managing their moods.

“We tend to think of postpartum depression as a mom thing,” Saxbe said. “It’s not. It’s a real condition that might be linked to hormones and biology.”

Source: USC

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Off-Label Use of Antidepressants May Provide Pain Relief

Wed, 09/06/2017 - 13:45

A new study suggests some of the most effective medications for chronic pain are the same medications that are used for depression.

At doses lower than those needed to treat depression, antidepressants can relieve chronic pain in conditions ranging from diabetic neuropathy, migraine and tension headaches, to osteoarthritis and fibromyalgia.

Experts explain, however, that most medications have significant associated side-effects and the ability to tolerate these side effects varies between individuals.

Side effects may depend on other medications an individual is using, or could be influenced by other existing health issues. Therefore, predicting the ability to tolerate such side effects could be crucial for the success of an antidepressant in treating pain.

This scenario is discussed in a recent article by Dr. Carina Riediger and colleagues in Dr. Timo Siepmann’s group at the University Hospital Carl Gustav Carus, in Dresden, Germany. The paper appears in the online journal Frontiers in Neuroscience.

“Understanding adverse effects and their impact on patients’ quality of life is crucial in modern clinical medicine and poses a substantial challenge to clinicians who face a exponentially growing range of available medical therapies” said Siepmann, the principal investigator of this study.

To help physicians match a chronic pain sufferer to a suitable antidepressant, their group performed a systematic study and meta analysis of the reported adverse effects for a wide variety of commonly used antidepressant drugs, each with its own side effect profile.

These antidepressants fall into different categories based on their mechanism of action, such as tricyclic antidepressants amitriptyline (Elavil) and nortriptyline (Pamelor), and serotonin reuptake inhibitors venlafaxine (Effexor), duloxetine (Cymbalta) and milnacipram (Ixel), among others.

The study collected all reported adverse effects for these drugs in the clinical literature from the past two decades. These side effects ranged from dizziness, dry mouth, and drowsiness, to palpitations, weight gain, sexual and urinary dysfunction, and hypertension, to name a few. The researchers also took into account whether treatment was discontinued due to the severity of these side effects.

Researachers found that almost all antidepressants presented significant side effects, and no drug was clearly superior to others. However, clinical data also showed that some individuals might better tolerate certain side effects than others, and therefore, the authors recommend personalized medicine.

For instance, dizziness and drowsiness as side effects may not be acceptable for individuals who drive vehicles or operate heavy machinery. On the other hand, some sedation might be tolerated, and perhaps even be desirable, in a chronic pain patient with sleep disruptions or insomnia.

These results may help physicians improve treatment outcomes by better matching the health status of chronic pain patients to their antidepressant medication.

“Dr. Riediger’s work contributes to this understanding, but further research is needed to improve general treatment recommendations and enable personalized multimodal therapy which is tailored to the patient’s individual health situation and includes non-pharmacological strategies in addition to pharmacotherapy,” Siepmann said.

Source: Frontiers/EurekAlert

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Increased Risk for Suicidal Thoughts Among Transgender Students

Wed, 09/06/2017 - 13:00

Emerging evidence suggests school-based mental health services are urgently needed to protect against suicidal thoughts among transgender students.

A new study discovered that nearly 35 percent of transgender youth in California reported suicidal thoughts in the past year, almost double that of non-transgender youth.

Experts explain that transgender youth and adults received unprecedented public attention regarding their lives and well-being in the last year. Moreover, in the context of public debates about bathrooms, the armed services, and other legal protections, there has been growing concern about discrimination and mental health for transgender youth in the U.S.

Although much debate on transgender issues has occurred, little high-quality, population-based research on transgender youth exists; this information is necessary to accurately document the health and well-being of this population.

To narrow this void, the new study is the first to use statewide representative data from the U.S. to document significantly higher risk of suicidal thoughts among transgender students in California.

Data came from over 910,000 high school students that participated in the 2013-2015 California Healthy Kids Survey (CHKS), and a weighted subsample of nearly 36,000 youth representative of the Californian student population. The CHKS is administered biennially by WestEd with support from the California Department of Education.

Nearly 35 percent of transgender youth in California reported suicidal thoughts in the past year, compared to 19 percent among non-transgender youth.

“It is crucial that studies of adolescent health include measures of gender identity alongside sexual orientation to better understand and create programs to address the needs of these youth across the United States,” said Amaya Perez-Brumer, M.Sc., lead author of the study.

The study also reports that higher rates of depression and victimization among transgender youth compared to non-transgender youth partly explain higher risk of suicidal thoughts among transgender students.

According to co-author Stephen Russell, Ph.D., “Like all students, transgender youth deserve to be safe and supported at school. These results show that reducing depression and victimization for transgender students should significantly reduce their suicide-related risk.”

The authors underscore that the results of the study should be understood as a first step in detailing the complexity of suicidal thoughts among transgender youth.

While findings support the need for school-based interventions that address depression and victimization, more research is also needed to understand the relationship between co-occurring psychosocial risk factors (e.g., anxiety, substance abuse) and suicidal thoughts.

Study authors explain that this research is only a beginning as the results may represent an underestimate of the gender identity-related disparity in suicidal thoughts. This may have occurred because the sample was limited to youth who were currently attending school in California.

As such, the researchers warn that youth who have been expelled or dropped out of school may be a more vulnerable population at risk of suicidality.

Notably, while transgender-specific mental health services are scarce and often inaccessible for adults, this barrier is often magnified among youth. This study highlights the urgent need to develop and implement school-based interventions that address victimization, train faculty and staff on the needs of transgender youth, and provide access to gender-affirming health care and mental health services.

Source: Elsevier

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Study Probes Impact of Poor Sleep on Memory, Overall Well-Being

Wed, 09/06/2017 - 11:30

New research discovers inadequate sleep at night leads to poor memory and increases the risk of depression, anxiety and stress.

The new U.K. study found that those who receive less than five hours of sleep a night found it difficult to function effectively during the day.

The sleep deficit was related to life challenges such as people forgetting to carry out tasks, struggling to remember where things were, and forgetting to do something they had set out to do such as post a letter or take medication.

In the study, University of Leeds psychologists Drs. Anna Weighall and Ian Kellar looked at data from a survey of the sleeping habits of more than 1,000 U.K. adults aged 18 to 80.

Results from the study were presented by Weighall at a meeting of the European Society of Cognitive Psychology in Postdam, Germany.

Weighall said the study was unique in that “A lot of previous sleep research has been based on lab studies – this is the first time we have surveyed people in their everyday lives.

“What is emerging is the debilitating impact of poor patterns of sleep. People who are not getting enough sleep are at risk of experiencing a much lower quality of life and it hinders their ability to function effectively when they are awake.”

Scientists have recognized that sleep is important for laying down new memories and in re-processing what is already “stored” in the brain, selecting what needs to be retained and what can be forgotten.

This study looked at the relationship between quality and quantity of sleep and the cognitive processes around memory and recall, as well as wider indicators of physical and mental well-being.

Researchers asked volunteers to fill out a questionnaire about their sleep patterns, memory performance, mental wellbeing and quality of life.

An analysis of the responses found a statistically significant relationship between poor sleep and reduced mental well-being, and a highly significant relationship between lack of sleep and an increase in everyday memory problems.

These relationships were even stronger in those who habitually sleep for less than five hours a night.

“There is now a very compelling case to say there is a strong relationship between getting a good night’s sleep and experiencing better health, well-being and memory function,” Weighall said.

The findings indicate that many U.K. adults are sleep deprived and that this presents a real issue for public health.

Kellar, a health psychologist, said sleep needed to be seen as a public health priority in just the same way as maintaining a healthy weight, eating a healthy diet and engaging in physical activity.

Although the standard recommendation is for adults to receive between seven and eight hours of sleep a night, it is estimated that one in four adults receives less than five hours sleep a night.

Source: University of Leeds

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Molecular Changes May Impact Risk of PTSD

Tue, 09/05/2017 - 13:00

New research suggests the reason some people develop post-traumatic stress disorder while others do not may be because of molecular changes, specifically alteration in micro-RNA as related to gene regulation.

In a controlled study involving military personnel on deployment to a combat zone in Afghanistan, researchers from the Netherlands discovered evidence that blood-based miRNAs may be biomarkers for symptoms of PTSD.

The new discovery may offer an approach towards screening for symptoms of PTSD, and holds promise for understanding other trauma-related psychiatric disorders. However, given the small pilot study design, the findings will need to be validated, extended, and confirmed.

PTSD is a psychiatric disorder which can manifest following exposure to a traumatic event, such as combat, assault, or natural disaster. Among individuals exposed to traumatic events, only a minority of individuals will develop PTSD, while others will show resiliency.

Little is known of the mechanisms behind these different responses. The last few years have seen much attention given to whether the modification and expression of genes — epigenetic modifications — might be involved. But there are several practical and ethical challenges in designing a research study on humans undergoing such experiences, meaning that designing relevant study approaches is difficult.

In the new study, researchers worked with just over 1,000 Dutch soldiers and the Dutch Ministry of Defense to study changes in biology in relation to changes in presentations of symptoms of PTSD in soldiers who were deployed to combat zone in Afghanistan.

In the longitudinal study investigators collected blood samples before deployment, as well as six months after deployment. Most of the soldiers had been exposed to trauma, and some of the soldiers had developed symptoms of PTSD.

MiRNAs (micro ribonucleic acids) are small molecules with chemical building blocks similar to DNA. Unlike the more famous DNA, miRNAs are typically very short, comprising only around 20 to 25 base units (the building blocks of nucleic acids), and they do not code; in other words, they do not specify the production of a protein or peptide.

However, they have very important roles in biology (every miRNA regulates the expression, and thereby also the activity of several other genes), and they are known to regulate the impact of environmental factors on biology. In addition, brain-derived miRNA can circulate throughout the human body and can be detected in the blood.

Differences in miRNA levels have been associated with certain diseases, such as some cancers, kidney disease, and even alcoholism. This regulatory role makes them also a candidate for investigation in PTSD.

“We discovered that these small molecules, called miRNAs, are present in different amount in the blood of persons suffering from PTSD compared to trauma-exposed and control subjects without PTSD,” said first author Dr. Laurence de Nijs (Maastricht University).

“We identified over 900 different types of these small molecules. 40 of them were regulated differently in people who developed PTSD, whereas there were differences in 27 of the miRNAs in trauma-exposed individuals who did not develop PTSD.”

“Interestingly, previous studies have found circulating miRNA levels to be not only correlated with different types of cancer, but also with certain psychiatric disorders including major depressive disorders.”

However, the researcher cautions that several steps need to be performed before such results can really have an impact on the larger field and in clinical practice. Nevertheless, the discovery of biomarkers may also provide novel information about the biological mechanisms underlying the development of PTSD.

“Most of our stressful experiences don’t leave a long-lasting psychological scar. However, for some people who experience chronic severe stress or really terrible traumatic events, the stress does not go away. They are stuck with it and the body’s stress response is stuck in ‘on’ mode. This can lead to the development of mental illness such as PTSD,” de Nijs said.

Source: European College of Neuropsychopharmacology

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More Middle-Aged Adults Seeking Help for Memory Issues

Sat, 09/02/2017 - 14:00

Swedish researchers find that a growing number of middle-aged adults between the ages of 50 and 60 appear to be seeking help for memory-related problems — often concerned they are in the beginning stages of dementia — but after testing, they are found to be quite normal.

“We are seeing a growing number of people who are seeking help because of self-perceived cognitive problems, but have no objective signs of disease despite thorough investigation,” said Marie Eckerström, doctoral student at the Institute of Neuroscience and Physiology and licensed psychologist at the Memory Unit of Sahlgrenska University Hospital in Gothenburg.

These patients represent one-third of those coming to the memory unit at the hospital, and clinicians wanted to get an idea of who they are. The memory unit investigates suspicions of early stages of dementia in those who seek help.

For her study, Eckerström followed a few hundred of these patients, both women and men, for an average of four years.

These patients are often highly educated professionals who are relatively young in this context, between the ages of 50 and 60. When tested at the hospital, their memory functions are intact. However, in their daily environment where they are often under pressure to learn new things, they believe something is not right.

The link between self-perceived memory problems and stress was shown to be quite strong. Seven out of 10 in the group had experiences of severe stress, clinical burnout, or depression.

“We found that problems with stress were very common. Patients often tell us they are living or have lived with severe stress for a prolonged period of time and this has affected their cognitive functions to such an extent that they feel like they are sick and are worried about it,” said Eckerström.

“In some cases, this is combined with a close family member with dementia, giving the patient more knowledge but also increasing their concern.”

Perceived memory problems are common and may be an early sign of future development of dementia. Among the study participants who also had deviating biomarkers in their cerebrospinal fluid (beta-amyloid, total-tau, and phospho-tau), the risk of deteriorating and developing dementia was more than double. And yet, the majority of participants showed no signs of deterioration after four years.

“These individuals have no objective signs of dementia. The issue instead is usually stress, anxiety, or depression,” Eckerström said.

Only one in 10 patients with self-perceived memory problems only developed dementia during the study period. And while this is a higher percentage than the population in general, it is still low, according to Eckerström.

“It is not a matter of just anyone who has occasional memory problems in everyday life. It is more a matter of individuals who sought medical attention to investigate whether they are developing serious problems,” said Eckerström.

Source: University of Gothenburg

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School Suspensions Tied to Poor Mental Health

Fri, 09/01/2017 - 14:50

Children who are suspended from school are more likely to develop a range of mental disorders, such as depression and anxiety as well as behavioral disturbances, according to a new study published in the journal Psychological Medicine.

Researchers at the University of Exeter in England investigated the impact of exclusion from school among the general population and found that suspension may lead to a new onset mental disorder, and that, separately, poor mental health can lead to suspension from school.

The findings show that consistently poor behavior in the classroom is the primary reason for school exclusion, with many students, particularly those in middle and high school, facing repeated dismissal from school. Relatively few pupils are completely expelled from school, but the researchers warn that even temporary exclusions can exacerbate psychological distress.

The researchers assert that identifying and supporting children who struggle in class could prevent suspension and improve their success at school.

“For children who really struggle at school, exclusion can be a relief as it removes then from an unbearable situation with the result that on their return to school they will behave even more badly to escape again,” said Professor Tamsin Ford, a child and adolescent psychiatrist at the University of Exeter’s Medical School.

“As such, it becomes an entirely counterproductive disciplinary tool as for these children it encourages the very behavior that it intends to punish. By avoiding exclusion and finding other solutions to poor behavior, schools can help children’s mental health in the future as well as their education.”

Suspension is more common among boys, secondary school students and those living in socio-economically deprived circumstances. Poor general health and learning disabilities, as well as having parents with mental illness, is also associated with suspension.

The study involved analyzing the responses of more than 5000 school-aged children, their parents and their teachers in the British Child and Adolescent Mental Health Surveys. The research team omitted children who had a previous mental disorder from this analysis.

The findings show that children with learning difficulties and mental health problems such as depression, anxiety, ADHD, and autism spectrum conditions were more likely to be excluded from the classroom. In addition, during the follow-up, the researchers found more children with mental disorders among those who had been excluded from school, than those who had not been excluded.

The researchers conclude that there is a “bi-directional association” between psychological distress and suspension: Children with psychological distress and mental-health problems are more likely to be suspended in the first place but suspension predicted greater levels of psychological distress three years later.

“Although an exclusion from school may only last for a day or two, the impact and repercussions for the child and parents are much wider. Exclusion often marks a turning point during an ongoing difficult time for the child, parent and those trying to support the child in school,” said Claire Parker, a researcher at the University of Exeter Medical School, who carried out doctoral research on the project.

Source: University of Exeter

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Drugs Better than Transcranial Stimulation (tDCS) for Depression

Fri, 09/01/2017 - 13:50

A new study from Brazil compares the benefit of medicinal therapy against low-intensity electrical brain stimulation for relief of depression.

Specifically, investigators attempted to determine if transcranial direct-current stimulation (tDCS) is a comparable alternative to treatment with antidepressant drugs.

In the clinical trial, researchers at the University of São Paulo’s teaching hospital (HU-USP) and the Psychiatry Institute of Hospital das Clínicas (HC-FMUSP-IP), the largest general hospital in Brazil, compared tDCS to escitalopram (Lexapro), a common antidepressant medication.

André Brunoni, a professor in the Psychiatry Department of the University of São Paulo’s Medical School and colleagues randomly divided 245 patients with depression into three groups.

One group was treated with tDCS plus oral placebo, the second received sham tDCS treatment plus the anti-depressant, and the third received sham tDCS treatment plus oral placebo.

The tDCS treatment was administered in 30-minute sessions for 15 consecutive weekdays, followed by seven once-weekly sessions. Escitalopram was administered at a dose of 10 mg per day for three weeks and 20 mg per day for another seven weeks.

tDCS treatment involves transmission of very mild direct current stimulation via a headband with twin electrodes placed on the patient’s temples. Positioning the electrodes is important so that the current runs through the dorsolateral prefrontal cortex – a brain area that displays diminished activity in depressed people.

In the trial, researchers found that tDCS treatment was less beneficial that oral medications.

“We found that treatment with tDCS was not half as effective as treatment with escitalopram and concluded that transcranial stimulation cannot be recommended as first-line therapy. The anti-depressant is easier to administer and much more effective. On the other hand, tDCS performed better than placebo in our previous studies,” explains Brunoni.

The discovery is important as about 12 -14 percent of the world’s population is estimated to suffer from depression. Moreover, given the ubiquity of the internet it is relatively easy to find self-help websites with videos showing how to administer tDCS at home.

“It’s very striking,” Brunoni said. “These sites that claim to show how to stimulate your brain represent a huge risk for patients with depression.

“‘Do-it-yourself’ solutions are strongly contra-indicated. In fact, they’re dangerous. I expect our study to have an impact on this phenomenon because we’ve proved there are adverse side effects and that it’s not as effective as many people think.”

According to the study, patients who received tDCS treatment presented with higher rates of skin redness, tinnitus (ringing in the ears) and nervousness than the other two groups, and new-onset mania developed in two patients in this group.

Brunoni stressed the importance of not confusing tDCS with other methods such as electroconvulsive therapy (ECT). ECT involves a far stronger current — typically 800 milliamperes, or 800 times the current used in tDCS — and is designed to produce a controlled seizure.

Other differences include the fact that ECT delivers a brief pulse rather than a steady current.

“People with depression display cerebral hypoactivity, especially in this brain region but also in others,” Brunoni said. “The action mechanism of stimulation was believed to increase brain activity in this region, but no such effect has yet been proven.”

Other techniques designed to change the brain’s electrical activity include transcranial magnetic stimulation, transcranial alternating-current stimulation, deep-brain stimulation and focused ultrasound.

“Of these, only transcranial magnetic stimulation and electroconvulsive therapy are currently cleared by the Food and Drug Administration [FDA] for the treatment of depression, and deep-brain stimulation has a humanitarian device exemption for the treatment of obsessive-compulsive disorder,” writes Sarah H. Lisanby, director of the Division of Translational Research at the US National Institute of Mental Health (NIMH), in an editorial in the same issue of the New England Journal of Medicine.

Lisanby believes the study performed in Brazil shows that parameters are needed to measure the functioning of tDCS.

Brunoni agreed. “There are no parameters that enable us to know whether the tDCS dose is right,” he said. “I know two pills are a higher dose than one. Moreover, some drugs can be measured in the bloodstream. The most common example is lithium. You can dose magnetic stimulation. In electrical stimulation, however, it isn’t what you see. It’s a very weak current that can be altered even by anatomical aspects in each patient.”

Brunoni is currently a visiting postdoctoral fellow at the University of Munich in Germany, where he plans to finish analyzing data collected from his clinical trial. He hopes the data will suggest if tDCS works better for a particular patient profile — as some believe those who have never experienced stimulation will show a better response.

He also plans to question the stimulation parameters to discover if a specific type of depression may respond more readily to the treatment.

Study findings appear in the New England Journal of Medicine.

Source: University of São Paulo

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Children’s Sleep Quality May Be Linked to Mother’s Sleep Pattern

Fri, 09/01/2017 - 13:27

Emerging research suggests children are at a greater risk of sleeping poorly if their mothers suffer from insomnia symptoms.

Experts say attention to sleep challenges is an important health issue as sleep plays an essential role for adults’ and children’s well-being.

In the study, investigators from the University of Basel and the University of Warwick assessed sleep characteristics among nearly 200 school-aged children and their parents.

Researchers focused on the relationship between parents’ insomnia symptoms and their children’s sleep. Short sleep and poor sleep quality may affect mental health, learning, memory, and school achievement in children. In Switzerland and America, around 28 percent of adult women and 20 percent of men suffer from disturbed sleep.

Sleep was measured in healthy 7-12-years old children by in-home electroencephalography (EEG); around half of the children were born pre-term. In addition, parents reported their own insomnia symptoms and their children’s sleep problems.

As reported in the journal Sleep Medicine, researchers discovered children of mothers with insomnia symptoms fall asleep later, get less sleep, and spend less time in deep sleep as measured by EEG. However, there was no association between the fathers’ sleep problems.

It is possible that mothers’ sleep is more closely related to children’s sleep than fathers’ sleep. Researchers posit that this may occur because mothers on average still spend more time with their children than fathers. Therefore, the mother’s sleeping behavior has a stronger influence on the child.

When parents reported their children’s sleep, both mothers and fathers with sleep problems more often reported that their children had difficulties getting into bed and did not sleep enough.

Investigators note that several mechanisms could account for the relationship between parents’ and children’s sleep:

  1. Children may learn sleep habits from their parents.
  2. Poor family functioning could affect both parents’ and children’s sleep. For instance, family fights in the evening before bedtime may prevent the whole family from a good night’s sleep.
  3. It is possible that parents suffering from poor sleep show “selective attention” for their own as well as their children’s sleep problems leading to increased monitoring of sleep. It is possible that increased monitoring and attempts to control sleep may negatively affect sleep quality.
  4. Finally, children may also share genes with their parents that predispose for poor sleep.

Source: University of Basel

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