In The News
A major new clinical trial has found that the best method to treat severe, non-chronic depression is a combination of cognitive therapy and antidepressant medicine rather than antidepressants alone.
However, researchers discovered a person with chronic or less severe depression does not receive the same additional benefit from combining the two.
Investigators found the odds that a person who suffers from severe, non-chronic depression will recover are improved by as much as 30 percent if they are treated with the combined approach.
The study is published online by the journal JAMA Psychiatry.
In North America, about one in five women and one in 10 men suffer from major depression in her or his lifetime.
“Our results indicate that combining cognitive therapy with antidepressant medicine can make a much bigger difference than we had thought to about one-third of patients suffering from major depressive disorder,” said Steven Hollon, Ph.D., who directed the study.
“On the other hand, it does not appear to provide any additional benefit for the other two-thirds.”
Previous studies have found that about two-thirds of all patients with major depressive disorder will improve on antidepressant medications and about one-third of patients will achieve full remission, but half then relapse before fully recovering.
Cognitive therapy has proven to be about as effective as medication alone but its effects tend to be longer lasting. Combining the two has been estimated to improve recovery rates by 6 to 33 percent.
“Now, we have to reconsider our general rule of thumb that combining the two treatments keeps the benefits of both,” said Hollon.
The new study was a randomized clinical trial involving 452 adult outpatients with chronic or recurrent major depressive disorder.
Unlike previous studies that followed subjects for a set period of time, this study treated them for as long as it took first to remission (full normalization of symptoms) and then to recovery (six months without relapse), which in some cases took as long as three years.
“This provided us with enough data so that we could drill down and see how the combined treatment was working for patients with different types and severity of depression: chronic, recurrent, severe and moderate,” Hollon said.
According to the psychologist, the results could have a major impact on how major depressive disorder is treated.
The most immediate effect is likely to be in the United Kingdom, which, he said, is 10 years ahead of the U.S. in treatment of depression.
The use of combined cognitive therapy and antidepressant medication is standard for severe cases in the UK, although it is less usually recommended in the United States. The UK’s English National Health Service is actively training its therapists in cognitive therapy and other empirically supported psychotherapies.
Source: Vanderbilt University
New research suggests the reason individuals with schizophrenia have trouble engaging in daily tasks or setting goals for themselves is that they have difficulty assessing the amount of effort required to complete tasks.
The study by San Francisco State researchers is discussed in the Journal of Abnormal Psychology.
Study authors believe the findings can assist health professionals in countering motivation deficits among patients with schizophrenia and help those patients function normally by breaking up larger, complex tasks into smaller, easier-to-grasp ones.
“This is one of the first studies to carefully and systematically look at the daily activities of people with schizophrenia — what those people are doing, what goals are they setting for themselves,” said Dr. David Gard, an associate professor of psychology.
“We knew that people with schizophrenia were not engaging in a lot of goal-directed behavior. We just didn’t know why.”
In 2011, Gard received a grant from the National Institute of Mental Health to study the reasons behind this difficulty in goal-setting.
An earlier article detailing other research from this study, published in the journal Schizophrenia Research, showed that when people with schizophrenia do set goals for themselves, they set them for the same reasons as persons without: to connect with others.
But motivation deficits are still common among these individuals, and his latest study set out to pinpoint the reason.
Through a series of cognitive assessments and random phone calls, Gard and his colleagues collected data from 47 people with and 41 people without schizophrenia.
Participants were called four times a day, randomly throughout the day, for a week and asked about their current mood, as well as what they were doing; how much enjoyment they were getting out of it; and what their goals for the rest of the day were.
The results were coded by variables such as how much pleasure they were getting out of their daily activities and how much effort was involved, then compared that with the results from the cognitive assessments.
Gard and his fellow researchers found that, while people with schizophrenia engage in low-impact, pleasurable goals, such as watching TV or eating food for enjoyment, as much as others, they have greater difficulty with more complex undertakings or goals requiring more effort.
“There’s something breaking down in the process around assessing high-effort, high-reward goals,” Gard said. “When the reward is high and the effort is high, that’s when people with schizophrenia struggle to hold in mind and go after the thing that they want for themselves.”
The findings indicate that health-care providers who want to help individuals with schizophrenia set goals for themselves should break larger tasks into smaller, simpler ones with small rewards. For example, instead of guiding a patient specifically toward the larger goal of getting in physical shape, a provider could instead encourage them to gradually walk a little bit more every day.
“That’s something we would do for everyone else, but it might have been avoided in patients with schizophrenia because we thought they weren’t experiencing as much pleasure from their activities as they actually are,” Gard added.
“We can help them to identify things that are pleasurable and reward them toward larger goals.”
Source: San Francisco State University
New Canadian research finds a reduction in primary care visits among individuals receiving mindfulness-based therapy for depression.
Investigators discovered frequent health service users who received mindfulness-based cognitive therapy showed a significant reduction in non-mental health care visits over a one-year period, compared with those who received other types of group therapy.
The mindfulness therapy group had one fewer non-mental health visit per year, for every two individuals treated with this therapy – which translates into a reduction of nearly 2,500 visits to primary care physicians, emergency departments or non-psychiatric specialists in Ontario over eight years.
“We speculate that mindfulness-based cognitive therapy has elements that could help people who are high health-care utilizers manage their distress without needing to go to a doctor,” said Dr. Paul Kurdyak.
Senior author Zindel Segal, Ph.D., one of the developers of mindfulness-based cognitive therapy, said, “the goal of this therapy is to treat depression or anxiety so this unintended effect is striking, particularly as there is limited evidence on interventions that effectively reduce high health care use.”
Mindfulness-based cognitive therapy is a structured form of psychotherapy that combines elements of cognitive-behavior therapy with mindfulness meditation. It is delivered in a group setting for eight weekly sessions.
The therapy was originally developed to prevent relapse of symptoms among people with recurring depression, as an alternative to ongoing medication treatment. It has been proven effective in multiple studies, and has been applied to other conditions such as anxiety and chronic pain.
To conduct their study, researchers identified 10,633 individuals who received group-based mindfulness-based cognitive therapy between 2003 and 2010, based on billing records from the Ontario Health Insurance Plan (OHIP).
The therapy was delivered by 24 specially trained psychiatrists or family doctors. Among these patients, 4,851 (46 per cent) were considered high health service users, having more than five visits to a primary care physician, emergency department or other specialist in a year.
For comparison, researchers identified 29,795 who received group therapy, such as cognitive-behavior or interpersonal psychotherapy, without a mindfulness component, and who were matched for age, sex and neighborhood income; 13,274 of these controls were high service users.
For both groups, non-mental health care visits were examined one year before the therapy, and one year after it ended.
“Primary care physicians play a large role in managing patients with distress, and they often report feeling overwhelmed and unable to effectively deal with cases of medically unexplained symptoms,” said Kurdyak.
“This study shows the potential of mindfulness-based cognitive therapy to help both patients and their doctors.”
For many, a day without a smartphone a day without sunshine.
The issue becomes much more complicated if we believe we have lost our phones compounding anxiety and stress.
A new study outlines potential coping mechanisms. Surprisingly, few smart-phone users have a plan to minimize repercussions associated with loss of the device.
Experts contend that the smartphone has changed our behavior — sometimes for the better as we are now able to connect and engage with many more people than ever before — sometimes for the worse in that we may have become over-reliant on the device.
Either way, the smart phone is here to stay as hundreds of thousands of people connect through the various social media and other applications available on our cells.
However, our dependence brings anxiety.
The loss of one’s smart phone not only represents an immediate disconnection from one’s online contacts but is also a potential privacy and security risk should the lost phone end up in the hands of a malicious third party.
In the study, Canadian researchers outline the possible coping mechanisms that might be needed following loss or theft and the security problems that the user might face.
The researchers point out that the same anxieties apply equally to lost or stolen laptops, tablet computers and other digital devices.
As found in the International Journal of Mobile Communications, McMaster University researchers explain that the convenience of mobility, wireless communication and the information processing power of smart phones and other portable digital devices has led to more and more people carrying with them valuable data assets wherever they go.
These assets may include personal and business contacts, private pictures and videos, meeting and lecture notes and the like, banking details, utility statements, company spreadsheets and much more.
All such assets are potentially sensitive to abuse by third parties.
DeGroote School of Business researchers Drs. Yufei Yuan and Norm Archer, and graduate student Zhiling Tu, said that as many companies now have a BYOD (bring-your-own-device) policy rather than dispensing a standard corporate device to all employees there are additional security issues that arise from their being centralized control of the data on a given device.
The value of lost hardware might be negligible when compared to the loss of sensitive or proprietary data.
Researchers discovered that while there are various countermeasures that can be used to cope with mobile device loss and theft, users are either unaware of their existence or unwilling to use them. As a result, the cost and convenience of security countermeasures need to be explained.
Investigators discovered many cell phone users are unaware of activities they may do to minimize the effects from a loss of a smart phone.
They found that only a few active and security-conscious users were aware of countermeasures and that many users were either not aware of “time bomb” data deletion settings and remote device locks or such or were simply in denial of the risk of their losing their phone.
Their findings suggest that an awareness campaign might be needed to encourage general users to make their devices more secure and that organizations must enforce certain features on their employees and members to protect sensitive data that might be on those devices beyond their direct control.
In a new study, researchers attempt to determine if the blockbuster “Fifty Shades” series increases the threat of potentially harmful health behaviors and risks.
The widely popular series has sold more than 100 million copies worldwide. A movie adaptation is scheduled for release in early 2015.
Michigan State researchers discovered young adult women who read “Fifty Shades of Grey” are more likely than nonreaders to exhibit signs of eating disorders and have a verbally abusive partner. Moreover, researchers discovered women who read all three books in the blockbuster “Fifty Shades” erotic romance series are at increased risk of engaging in binge drinking and having multiple sex partners.
All are known risks associated with being in an abusive relationship, much like the lead character, Anastasia, is in “Fifty Shades,” said Amy Bonomi, the study’s lead investigator.
And while the study did not distinguish whether women experienced the health behaviors before or after reading the books, it’s a potential problem either way, she said.
“If women experienced adverse health behaviors such as disordered eating first, reading ‘Fifty Shades’ might reaffirm those experiences and potentially aggravate related trauma,” said Bonomi.
“Likewise, if they read ‘Fifty Shades’ before experiencing the health behaviors seen in our study, it’s possible the books influenced the onset of these behaviors.”
The study, which appears in the Journal of Women’s Health, is one of the first to investigate the relationship between health risks and reading popular fiction depicting violence against women.
Experts explain that past research suggests watching violent television programs may lead to real-life violence and antisocial behaviors.
Likewise, some findings associate reading glamour magazines to being obsessed with body image.
In the current study, researchers studied more than 650 women aged 18-24, a prime period for exploring greater sexual intimacy in relationships, Bonomi said.
Compared to participants who didn’t read the book, those who read the first “Fifty Shades” novel were 25 percent more likely to have a partner who yelled or swore at them; 34 percent more likely to have a partner who demonstrated stalking tendencies; and more than 75 percent more likely to have used diet aids or fasted for more than 24 hours.
Those who read all three books in the series were 65 percent more likely than nonreaders to binge drink – or drink five or more drinks on a single occasion on six or more days per month – and 63 percent more likely to have five or more intercourse partners during their lifetime.
Bonomi said she is not suggesting the book be banned or that women should not be free to read whatever books they wish or to have a love life.
However, it’s important women understand that the health behaviors assessed in the study are known risk factors for being in a violent relationship.
Toward that end, Bonomi said parents and educators should engage kids in constructive conversations about sexuality, body image and gender role expectations – and that these conversations start as early as grade school.
Prevention programs can also be beneficial, such as Safe Dates, which targets abuse prevention through relationship skills training and gender role examination.
Finally, kids and young adults should be taught to consume fiction, television, movies, magazines and other mass media with a critical eye, Bonomi said.
“We recognize that the depiction of violence against women in and of itself is not problematic, especially if the depiction attempts to shed serious light on the problem,” Bonomi said. “The problem comes when the depiction reinforces the acceptance of the status quo, rather than challenging it.”
A previous study led by Bonomi found that “Fifty Shades” perpetuated the problem of violence against women.
The results of the study are presented in the article “Fiction or Not? Fifty Shades Is Associated with Health Risks in Adolescent and Young Adult Females.”
Growing up poor appears to influence a person’s sense of control, leading them to give up quickly on challenging tasks.
Moreover, the perceived loss of control may contribute to impulsive decision-making and unwise behaviors, suggests research recently published by the American Psychological Association.
“Two people with different childhood backgrounds are likely to respond to uncertainty in different ways, even if as adults they have a similar socioeconomic status (SES),” said Chiraag Mittal, M.S., a doctoral student at the University of Minnesota.
“We found that adults who grew up poor were more inclined to consider difficult and uncertain living conditions as beyond their control, while those from affluent backgrounds found them to be within their control.”
The finding suggests that a person’s background can influence a variety of reactions for the same situation.
For example, researchers discovered perceptions of control affected whether people were able to postpone a reward — as people from poorer backgrounds were more impulsively in uncertain situations than those from wealthy families.
In addition, after recalling personal financial hardship and then asked to solve a difficult puzzle, those who grew up poor gave up much sooner than those who grew up wealthy, even if they had similar incomes as adults.
One experiment with 95 people (36 men, average age 33) found those with poor compared to wealthier childhoods had a lower sense of control after looking at photos depicting economic hardship, such as unemployment lines, home foreclosure signs, and empty office buildings.
To determine the participants’ sense of control, researchers asked how much they agreed with statements such as “I can do just about anything that I really set my mind to” or “Whether or not I am able to get what I want is in my own hands.”
Participants described their childhood household incomes by indicating agreement with statements such as “My family usually had enough money for things when I was growing up,” or “I felt relatively wealthy compared to the other kids in my school.”
To determine their current SES, they rated their agreement with statements including, “I don’t need to worry too much about paying my bills,” or “I feel relatively wealthy these days.”
Having a low sense of control along with economic uncertainty prompted people from poorer backgrounds to be more impulsive than those from wealthier families in a trial that involved 150 people (56 men, average age 33).
Participants selected from eight ranges of household annual incomes while they were growing up, from less than $15,000 to $150,000 or more.
One group saw photos depicting financial hardship and the other saw photos of office furniture and supplies. Sense of control for participants from both groups was assessed with the same set of questions used in the previous experiment.
To measure impulsivity, the researchers asked participants if they wanted to receive $28 to $58 tomorrow or wait 33 days and receive $62 to $87.
Adults from poorer backgrounds who saw the economic uncertainty photos felt significantly lower sense of control and were more impulsive than those from wealthier backgrounds.
Interestingly, when they were not shown the photos depicting financial hardships, participants from poor and wealthy backgrounds didn’t differ in impulsivity.
Additionally, when participants read a news article about economic uncertainty and the researchers asked them to recall a time when they were in complete control of a situation, they were less impulsive and more capable of delaying gratification even if they grew up poor.
In an experiment with 73 university students (47 men, average age 20), one group was asked to recall feeling uncertain about their finances and then asked to solve an unsolvable puzzle.
Those who came from poorer backgrounds gave up trying to solve the puzzle 25 percent sooner than those from wealthier backgrounds.
However, students from low and high-income backgrounds who were asked to describe a recent ordinary purchase spent the same amount of time on average trying to solve the puzzle.
“Persistence is directly tied to myriad important outcomes, including self-control, academic achievement, substance abuse, criminal behavior, healthy eating, and overspending,” said study co-author Vladas Griskevicius, Ph.D., also of the University of Minnesota.
“Future research should investigate strategies to prevent individuals from poor childhoods from potentially quitting challenging tasks in the face of adversity.”
Social media may now rival girlfriends and playground parents as a source of trusted advice for mothers.
A new Australian study finds that Facebook and other web communities are now the preferred information conduit, a distinction that some believe offers a largely untapped marketing tool for businesses wanting to sell their products.
Researcher Rebecca English, Ph.D., and marketing expert Raechel Johns, Ph.D., from the University of Canberra said word-of-mouth in mothers’ groups and communities had fast become a major influence in mothers’ buying habits.
The study was published in the International Journal of Web Based Communities.
English said where mothers’ primary source of sharing information used to be face-to-face at mothers’ groups or playgroups, the growing popularity of virtual communities specifically for moms was opening the door to a new trusted source of information.
“Our study found that mothers trust mothers and that mothers tend to trust the opinions of other mothers when they recommend a product,” she said.
“It is not surprising that social media makes a contribution towards the buying behavior of its users, but what is surprising is the strength of these non-face-to-face opinions in online mothers’ groups and communities.
“Repeated interactions with the community and the accumulation of trust make the effect stronger still, as the community matures.
“The study found the effect is strongest among mothers with the same number of children who are the similar ages.”
English said in terms of implications for advertisers and marketers hoping to increase sales, fostering word-of-mouth was essential in these online environments.
“Recommendations from other mothers are more powerful than any other structured promotion,” she said.
“Organic promotion, for example using free product trials by well-connected or influential mums, is one way to tap into this market.”
But English warned there were dangers for businesses. She said although there were benefits of positive word-of-mouth, bad reviews could hold as much weight against a product as a positive review.
New research suggests sex is more physically satisfying for a women when she is in love and in a committed relationship.
In the study, Pennsylvania State researchers performed a series of in-depth interviews on 95 heterosexual women between the ages of 20 and 68 from a range of backgrounds. They found that love was necessary for maximum satisfaction in both sexual relationships and marriage.
Researchers discovered the benefits of being in love with a sexual partner are more than just emotional as most of the women in the study said that love made sex physically more pleasurable.
“Women said that they connected love with sex and that love actually enhanced the physical experience of sex,” said Dr. Beth Montemurro, associate professor of sociology.
Women who loved their sexual partners also said they felt less inhibited and more willing to explore their sexuality.
“When women feel love, they may feel greater sexual agency because they not only trust their partners but because they feel that it is OK to have sex when love is present,” Montemurro said.
Montemurro presented her findings at the annual meeting of the American Sociological Association.
While 50 women of the 95 that were interviewed said that love was not necessary for sex, only 18 of the women unequivocally believed that love was unnecessary in a sexual relationship.
Older women who were interviewed indicated that this connection between love, sex, and marriage remained important throughout their lifetimes, not just in certain eras of their lives.
“The connection between love and sex may show how women are socialized to see sex as an expression of love,” Montemurro said.
Culturally, women are still expected to connect sex and love, and despite decades of the women’s rights movement and an increased awareness of women’s sexual desire, the media continues to frown upon girls and women who have sex outside of committed relationships.
“On one hand, the media may seem to show that casual sex is OK, but at the same time, movies and television, especially, tend to portray women who are having sex outside of relationships negatively,” said Montemurro.
In a similar way, the media often portray marriage as largely sexless, even though the participants in the study said that sex was an important part of their marriage, according to Montemurro.
“For the women I interviewed, they seemed to say you need love in sex and you need sex in marriage,” said Montemurro.
Source: Pennsylvania State
Rude and abusive behavior by a supervisor toward individual employees harms more than just the targeted person – it can trigger conflict among the entire work team.
Michigan State University (MSU) researchers conducted a study in China and the United States and found the toxic effect of nonphysical abuse by a supervisor is much broader than believed.
The study is one of the first to examine the effect of bad bosses in employee teams, a common feature of many businesses.
Lead investigator Crystal Farh, Ph.D., said supervisors who belittle and ridicule workers not only negatively affect those workers’ attitudes and behaviors, but also cause team members to act in a similar hostile manner toward one another.
“That’s the most disturbing finding,” Farh said, “because it’s not just about individual victims now, it’s about creating a context where everybody suffers, regardless of whether you were individually abused or not.”
Farh, assistant professor of management in MSU’s Broad College of Business, said the findings could likely be explained by social learning theory, in which people learn and then model behavior based on observing others, in this case the boss.
“Previous research has shown that workers emulate supervisors’ positive behaviors,” she said, “so it only makes sense they would follow negative behaviors as well.”
In the new study, Farh and Zhijun Chen, Ph.D., from the University of Western Australia studied 51 teams of employees from 10 firms in China.
Average team size was about six workers and the teams performed a variety of functions including customer service, technical support, and research and development.
The study looked at nonphysical abuse such as verbal mistreatment and demeaning emails. Employees who directly experienced such abuse felt devalued and contributed less to the team.
“At the same time, the entire team ‘descended into conflicts,’” Farh said, “which also reduced worker contributions.”
“Teams characterized by relationship conflict,” Farh said, “are hostile toward other members, mistreat them, speak to them rudely, and experience negative emotions toward them.”
To test the findings, the study was replicated in a controlled laboratory setting in the U.S., with nearly 300 people participating.
Researchers believe the findings are far-reaching as they will help companies faced with rehabilitating a team of employees following abusive supervision.
Companies will now understand that rather than individual remediation, a comprehensive, team-based intervention to improve interpersonal relationships is necessary.
Source: Michigan State University
Despite recent allegations of misconduct and uproar over delays to obtaining care, a new RAND Corporation study finds U.S. veterans are generally satisfied with the mental health care they receive from the Veterans Health Administration (VA).
However, the study, conducted in 2008 and 2009, found that patients with a substance use disorder were less satisfied than other veterans who received mental health services.
In the study, investigators found that those with substance abuse problems also were less likely than others to report that staff listened to them or respected their decisions.
The findings, published in the journal Psychiatric Services, are from a survey of more than 5,000 veterans who had received services from the Veterans Health Administration for a mental health or substance use problems.
Although dated, researchers say the results are the latest and most complete assessment of veterans’ satisfaction with mental health and substance use care received through the Veterans Health Administration.
Researchers believe the results may be useful as a baseline to judge future patient satisfaction and highlight areas needing improvement as federal policymakers overhaul the veterans’ health system because of recent concerns about quality and access.
“We found that veterans who received services from the VA for mental health or substance use problems reported satisfaction with their care that was similar to or slightly lower than people who receive similar care in other public or private health care systems,” said Kimberly Hepner, Ph.D., the study’s lead author and a senior behavioral scientist at RAND, a nonprofit research organization.
“There certainly was room for improvement in all the areas we studied.”
Researchers used VA records to survey patients who had been treated over the prior year for bipolar disorder, major depression, posttraumatic stress disorder, schizophrenia, or substance use disorder.
Participants were asked about their need for housing and employment services, timeliness and recovery orientation of their care, satisfaction with care, and perceptions of symptom improvement.
Half of the patients reported always receiving routine appointments as soon as requested and 42 percent of those surveyed said they were highly satisfied with the mental health care provided by the Veterans Health Administration.
About 74 percent of patients reported being helped by the treatment, yet just 32 percent said that their symptoms had improved.
Patients who had been treated for substance use disorders were less likely to report being helped by the care they received.
Source: RAND Corporation
A new study shows that nine and 10-year-old kids who are more aerobically fit have more fibrous and compact white-matter tracts in their brains than kids who are less fit.
According to researchers, white matter describes the bundles of axons that carry nerve signals from one region of the brain to another. More compact white matter is associated with faster and more efficient nerve activity, the researchers explain.
“Previous studies suggest that children with higher levels of aerobic fitness show greater brain volumes in gray-matter brain regions important for memory and learning,” said University of Illinois postdoctoral researcher Laura Chaddock-Heyman, Ph.D.
She conducted the study with kinesiology and community health professor Dr. Charles Hillman and psychology professor and Beckman Institute director Dr. Arthur Kramer.
“Now for the first time we explored how aerobic fitness relates to white matter in children’s brains,” she said.
The team used diffusion tensor imaging (DTI) – also called diffusion MRI — to look at five white-matter tracts in the brains of 24 children. DTI analyzes water diffusion into tissues. Less water diffusion in white matter means the tissue is more fibrous and compact, both desirable traits, according to the scientists.
The researchers noted they controlled for several variables, such as social and economic status, the timing of puberty, IQ, or a diagnosis of ADHD or other learning disabilities, that might have contributed to the differences in the brain.
The analysis revealed significant fitness-related differences in the integrity of several white-matter tracts in the brain, including the corpus callosum, which connects the brain’s left and right hemispheres; the superior longitudinal fasciculus, a pair of structures that connect the frontal and parietal lobes; and the superior corona radiata, which connect the cerebral cortex to the brain stem.
“All of these tracts have been found to play a role in attention and memory,” Chaddock-Heyman said.
To take the findings further, the team is now two years into a five-year randomized, controlled trial to determine whether white-matter tract integrity improves in children who begin a new physical fitness routine and maintain it over time. The researchers are looking for changes in aerobic fitness, brain structure and function, and genetic regulation.
“Prior work from our laboratories has demonstrated both short- and long-term differences in the relation of aerobic fitness to brain health and cognition,” Hillman said. “However, our current randomized, controlled trial should provide the most comprehensive assessment of this relationship to date.”
“The new findings add to the evidence that aerobic exercise changes the brain in ways that improve cognitive function,” Chaddock-Heyman said.
“This study extends our previous work and suggests that white-matter structure may be one additional mechanism by which higher-fit children outperform their lower-fit peers on cognitive tasks and in the classroom,” she said.
The study was published in the open-access journal Frontiers in Human Neuroscience.
Nurses who are primarily motivated by a desire to help others, rather than by enjoyment of the work itself or the lifestyle it makes possible, are more likely to burn out on the job, according to a new study.
According to researchers at the University of Akron, nursing is still a female-dominated occupation, and being female is associated with being caring, nurturing, and altruistic. That means many assume the desire to help others is the “right” motivation for choosing a career in nursing, the researchers noted.
However, their study found that nurses who pursue their career for reasons other than — or in addition to — the desire to help others find the job to be less stressful. That results in less burnout, better personal health, and high job commitment, the researchers report.
The researchers — Drs. Janette Dill, an assistant professor of sociology, Rebecca Erickson, a professor of sociology, and James Diefendorff, an associate professor of psychology — based their findings on data collected from surveys of more than 700 registered nurses in Northeast Ohio. About 90 percent were white females.
According to Dill, most people don’t care about a worker’s motivation for choosing a career. For instance, she notes that as long as your car gets fixed properly, it doesn’t matter whether the mechanic loves cars, only cares about making money, or just enjoys using power tools.
“But health care is different,” she said.
“We expect women to go into these jobs because they love the people that they’re caring for, and this is their primary motivator,” she said.
If that assumption can be changed, more men might be attracted to nursing and “might not necessarily feel that their whole self has to be devoted to their patients — that they can value their job for other reasons as well,” she said.
The researchers also found that nurses who are highly motivated by both the lifestyle the job provides and the ability to interact personally with patients are more satisfied with their employer and less inclined to leave their current job.
The study, which was presented at the 109th Annual Meeting of the American Sociological Association, did not attempt to measure how well nurses with different motivations and care approaches performed their jobs. The researchers said those relationships will be explored in a future study of a larger sample of nurses.
A four-year-old child’s drawings of a person can possibly reveal their intelligence levels then and also a decade later, according to a new study at Kings’ College London. But parents shouldn’t worry if their child draws poorly, as it isn’t the only way to determine intelligence.
“The Draw-a-Child test was devised in the 1920s to assess children’s intelligence, so the fact that the test correlated with intelligence at age four was expected. What surprised us was that it correlated with intelligence a decade later,” said lead author Dr. Rosalind Arden, of the MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre at the Institute of Psychiatry at King’s College London.
“The correlation is moderate, so our findings are interesting, but it does not mean that parents should worry if their child draws badly. Drawing ability does not determine intelligence, there are countless factors, both genetic and environmental, which affect intelligence in later life.”
For the study, four-year-old children were asked by their parents to complete a ‘Draw-a-Child’ test. Each figure was scored between zero and 12 depending on the presence and correct quantity of features such as head, eyes, nose, mouth, ears, hair, body, arms etc.
A drawing with two legs, two arms, a body and head, but no facial features, for example, would score a four. The children were also given verbal and non-verbal intelligence tests at ages four and 14.
The findings revealed that higher scores on the Draw-a-Child test were moderately associated with higher scores of intelligence at ages four and 14.
The researchers also looked into the heritability of figure drawing. Identical twins share all their genes, whereas non-identical twins only share about 50 percent, but each pair will have a similar upbringing, family environment, and access to the same materials.
In general, drawings from identical twins at age four were more similar to one another than drawings from non-identical twin pairs. The researchers believe this may be due to a genetic link. They also found that drawing scores at age four and intelligence at age 14 seemed tied to genetics as well.
“This does not mean that there is a drawing gene — a child’s ability to draw stems from many other abilities, such as observing, holding a pencil, etc. We are a long way off understanding how genes influence all these different types of behavior,” said Arden.
“Drawing is an ancient behavior, dating back beyond 15,000 years ago. Through drawing, we are attempting to show someone else what’s in our mind. This capacity to reproduce figures is a uniquely human ability and a sign of cognitive ability, in a similar way to writing, which transformed the human species’ ability to store information, and build a civilization,” said Arden.
Source: King’s College London
Boys who have been physically neglected are at greater risk of becoming violent teenagers than even those who have suffered from physical abuse, according to researchers at Penn State studying incarcerated male adolescents.
Examples of physical neglect include not taking a sick or injured child to the doctor, improperly clothing a child, and not feeding a child.
“One of the problems with studying neglect is that it is an act of omission, rather than one of commission. In other words, it is characterized as the absence of an act, rather than an actual act of mistreatment,” said William McGuigan, Ph.D., associate professor of human development and family studies at Penn State Shenango. “However, now we have better measures and larger databases to document neglect.”
Researchers are just beginning to realize the powerful affects of neglect in influencing adolescent violence, he added. The findings were presented at the annual meeting of the American Sociological Association in San Francisco.
The findings showed that although physical abuse is a strong contributor to violent behavior, physical neglect alone is an even greater predictor of male adolescent violence than physical abuse, or even physical abuse and neglect combined.
“It sounds somewhat contrarian, but the physical abuse might at least show that parents are paying some type of attention to the child,” said McGuigan.
He noted that understanding how neglect can influence violent behavior in teen males may lead to better education for caregivers and better care for at-risk youths.
For the study, researchers analyzed data taken from a survey of 85 residents in a Pennsylvania detention center for delinquent males. In the survey, 25 of the participants, or 29.4 percent of the group, said that they experienced at least one incidence of childhood neglect. Acts of violence included fighting with students or parents, hitting teachers or instructors, and using a weapon to scare, rob, or injure another person.
“We have to look more into neglect and become more aware of how it may cause some of these violent behaviors,” said McGuigan. “From that, we can build early preventative care programs than can help avoid these negative outcomes.”
The research could also lead to assessments that, for example, might help protect people who care for adolescents by identifying those who are more prone to violence.
“Sexual abuse was not included in the survey. Only two participants reported that they were sexually abused in the survey, which was not enough to study,” McGuigan said.
Source: Penn State
Two new drugs in promising clinical trials use genetic engineering to prevent migraine headaches, the third most common and seventh most disabling medical disorder in the world.
Both use genetically engineered “monoclonal antibodies” attacking a new target in migraine prevention, a small protein known as the calcitonin gene-related peptide, or CGRP.
CGRP is involved in the transmission of and heightened sensitivity to pain experienced in migraine. It is critically important at the start of a migraine. CGRP also increases the heartbeat and alters sensory transmission during migraines.
CGRP is produced by neurons around the spinal cord in greater amounts than usual before and during migraines, and mediated through specific receptors. So one way of preventing migraine from occurring is to block CGRP receptors. But never before have drugs been developed to specifically target CGRP.
In the first study, Peter J. Goadsby, M.D., of the University of California, San Francisco, and colleagues investigated an anti-CGRP antibody called ALD403. Either a single intravenous dose of ALD403, or placebo, was given to 163 people who had migraines for five to 14 days per month. Migraines in the following eight weeks were recorded, and participants were followed for 24 weeks in total to observe any side-effects.
The drug was linked to an average of 5.6 fewer days of migraine per month, equating to a 66 percent decrease. However, the placebo also reduced days of migraine by 52 percent. No differences were seen in side-effects between the groups.
“A single intravenous dose of ALD403 1,000 mg demonstrated efficacy for the preventive treatment of migraine in patients with a high monthly frequency of migraine days,” the researchers noted.
They add that ALD403 was generally safe and well tolerated. “These results support the conduct of larger randomized, placebo-controlled studies and may potentially represent a new era in disease-specific and mechanism-based preventive therapy for migraine,” they conclude.
The same team carried out a second study of 217 people who had migraine four to 14 days per month. Participants received injections of another anti-CGRP antibody called LY2951742 at 150 mg, or placebo, every other week for 12 weeks.
The drug was associated with an average of 4.2 fewer migraine days per month in the following 12 weeks, that is, a 63 percent decrease. Placebo was linked to a 42 percent drop.
But this time the drug was linked to side-effects, including pain at the injection site, upper respiratory tract infections, and abdominal pain. Overall however the drug was considered to be safe and well-tolerated.
“In subjects with frequent migraine headache, treatment with LY2951742 resulted in a significant decrease in the number of migraine headache days, headache days, and migraine attacks when compared to placebo,” said the researchers. “The safety and robust efficacy results in this study are promising and justify the conduct of phase III studies,” they add.
Both were phase II studies, so larger studies are needed to confirm the results. They were presented at the American Academy of Neurology’s annual meeting in Philadelphia, PA.
The ALD403 study was supported by Alder Biopharmaceuticals of South Bothell, Washington, USA. The LY2951742 study was supported by Arteaus Therapeutics of Cambridge, Massachusetts, USA. But the rights to LY2951742 have been bought back by Eli Lilly & Co of Indianapolis, after licensing it to Arteaus for three years.
“We will do what we can to accelerate development of this drug because it involves a big patient population,” said Jan Lundberg, Eli Lilly & Co’s research chief.
Co-author on both studies, David Dodick, M.D., of Mayo Clinic Arizona in Phoenix commented, “Migraine remains poorly treated, and there are few effective and well-tolerated treatments approved that prevent attacks from occurring. There is a huge treatment need for migraine.”
Goadsby, P. J. et al. Randomized, Double-blind, Placebo-controlled Trial of ALD403: An Anti-CGRP Peptide Antibody in the Prevention of Frequent Episodic Migraine. Presented on Friday 2 May 2014 at the American Academy of Neurology’s 66th annual meeting in Philadelphia, PA.
Dodick, D. W. et al. CGRP Monoclonal Antibody LY2951742 for the Prevention of Migraine: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study. Presented on Friday 2 May 2014 at the American Academy of Neurology’s 66th annual meeting in Philadelphia, PA.
Beyond postpartum depression, there are several other lesser-known mental health risks during the perinatal period (just before and after a baby is born), and this includes the added pressure of becoming a “super” mom or dad, according to a University of Kansas researcher who will present her findings at the 109th Annual Meeting of the American Sociological Association.
“Both mothers and fathers need to pay attention to their mental health during the perinatal period, and they need to watch for these other types of conditions, not just depression,” said Carrie Wendel-Hummell, a doctoral candidate in sociology.
“Anxiety, post-traumatic stress disorder, psychosis, and bipolar disorder are all shaped by circumstances that surround having a baby.”
For the study, Wendel-Hummell conducted in-depth interviews with 17 new fathers and 30 new mothers primarily from Kansas and Missouri. The participants represented a range of low-income to middle-class parents. There was no requirement that subjects have a perinatal mental health condition, but all participants happened to have prolonged symptoms of at least one.
According to Wendel-Hummell, the goal of the study was to highlight the biological and sociological problems that new parents face. Medical researchers for years had attributed postpartum depression in new mothers to hormonal changes, despite evidence to the contrary.
“It has been framed so much as being a hormonal disorder, but the evidence there is actually very limited,” she said. “Childbirth itself is a life change and a life stressor, so actually there’s far more evidence that those risk factors are the cause, more so than hormones.”
Stressed parents in the study generally reported worries about social problems, including cultural expectations of parenting, relationship stress, family-work balance issues, and struggles with poverty.
At the root of their perinatal mental health issues, low-income parents reported ongoing struggles of tending to their baby’s basic needs in the face of low wages and job insecurity, as well as finding affordable quality childcare, reliable transportation, and safe housing.
“Many of these parents were unable to afford mental health treatment. Frequently, pregnancy-based Medicaid is cut off after a post-birth appointment, which prevents coverage of treatment of postpartum depression or other post-pregnancy mental health disorders,” Wendel-Hummell said.
“They aren’t getting the support they need,” she said.
As for middle-class moms and dads, these parents tend to put too much pressure on themselves to be perfect mothers and fathers.
“Middle-class mothers often try to do everything to balance work and home life, and fathers are increasingly attempting to do the same,” she said. “This pressure can exacerbate mental health conditions. If everything is not perfect, they feel like failures — and mothers tend to internalize that guilt.”
“Fathers often suffer from stress from working in places that did not have family-friendly leave policies and from generally lacking resources to prepare them for fatherhood,” Wendel-Hummell said.
“Nobody is asking about the father and how he’s doing,” she said. “People typically focus on the mom and the infant, so not only is it more difficult for men to express their emotions, nobody is opening up that window for them either.”
She notes a need for more awareness of these perinatal mental health conditions and, in addition, to find ways to screen for them.
“We really only have a screening procedure for depression,” she said. “There should be improved screening, and it should be done in the later stages of women’s pregnancy and throughout that first year after the baby is born, for both mothers and fathers.
“We focus way too much on, ‘how do we fix this individual,’ but we really need to address the state of social and family policy,” Wendel-Hummell said.
A new study suggests that children as young as six have advanced ideas about fairness, and are willing to pay a personal price to intervene in what they believe are unfair situations.
But the study also shows that when reacting to unfair behavior, younger children were biased toward members of their own social group. Children just two year older, however, were more likely to intervene to stop any selfish behavior, whether the victim was a member of their social group or not.
“People have looked at this phenomenon extensively in adults, but this is the first time we’ve been able to investigate it in children,” said Harvard psychologist Felix Warneken, Ph.D.
“The idea that children would care about inequity happening between individuals who aren’t there, that in itself is somewhat surprising. They care about justice or fairness and are willing to intervene against selfish actions, and are even willing to pay a cost to do that.”
For the study, researchers recruited 64 children — 32 six year-olds and 32 eight year-olds. The researchers then created groups by assigning each child to a team based on the colors blue or yellow.
The children then took part in a series of activities to reinforce their membership in their group. For example, members of the blue group wore blue party hats and were asked to draw a picture using only the color blue, the researchers explained.
Once the researchers were sure the children showed preferences for their own group, they then asked them act as third-party judges to determine whether the way other children had divided up six candies the day before was fair.
The children were shown paper bags with faces and hats showing which color team the children receiving the candy were on. The “judges” were told that if the six candies were deemed to be split up fairly, the other children would receive the candy. But if they weren’t, children in the study had to sacrifice one of their own candy pieces, and the candy belonging to the other two players would be thrown away.
The researchers found that children in both age groups showed a willingness to intervene against behavior they saw as unfair, but became far more sensitive to selfish actions as they got older.
Additionally, children showed in-group bias in the way they responded to selfish behavior, according to the researchers.
“In six year-olds, we found that there were two types of in-group bias,” said former Harvard undergrad Jillian Jordan, is now a Ph.D student at Yale. “First, they were more lenient in their punishment of selfish behavior that came from a member of their own group, and second, they were harsher in their punishment of selfish behavior that harmed a member of their group.”
While eight year-olds showed the same lenience when selfish behavior came from a member of their own group, the researchers said they were surprised to find that they were equally willing to punish selfish behavior that harmed members of either group.
“The eight year-olds were less biased than the six year-olds,” Jordan explained. “They were more willing to pay personal costs, and were less biased in the sense that they felt it was equally bad to treat people selfishly, regardless of what group they were in. They started to see out-group members as legitimate victims, or just as legitimate as in-group members.”
The researchers are exploring whether the same trends hold true cross-culturally by working with researchers conducting similar studies in Uganda and Vanuatu.
“It’s a very interesting and important question — the extent to which this is specific to our society,” added Katherine McAuliffe, a former Harvard Ph.D. student who is now a postdoctoral fellow at Yale.
“This study shows children aren’t just going to watch and let unfairness happen, they’re going to put their money where their mouth is, in a sense. When you think of these fairness norms, are they specific to Western culture or are they more general norms that children learn around the world?”
The study was published in the Proceedings of the National Academy of Sciences.
Source: Harvard University
Although physical disabilities have declined among U.S. children, there has been a sharp rise in mental and developmental problems, especially in those from wealthier families, according to a 10-year analysis published in the journal Pediatrics.
Children from poor families, however, still bear the largest burden.
The increases, say the researchers, may be due to a greater overall awareness and recognition that certain conditions, such as autism, require a specific diagnosis to receive special services.
The analysis is the first to look broadly at the 10-year trend but the results confirm what previous studies have found: an increase in autism, attention problems, and other developmental or mental disabilities. The disadvantaged are also more likely to have chronic health problems and limited access to good health care, two factors that contribute to disabilities.
Study author Dr. Amy Houtrow, associate professor of physical medicine and rehabilitation and pediatrics at the University of Pittsburgh, analyzed data from the U.S. National Health Interview Surveys taken in four time periods between 2001 and 2011. Nearly 200,000 children were involved.
Parents answered questions about their children (ages zero to 17) regarding any chronic conditions. These included hearing or vision problems, bone or muscle ailments, and mental, behavioral or developmental problems that have limited their kids’ physical abilities or required them to receive early behavioral intervention or special educational services.
Physical conditions included asthma or breathing problems, vision problems, hearing problems, bone/joint/muscle problems, and injury. Mental/neurodevelopmental conditions included epilepsy or seizures, speech problems, learning disability, ADHD, mental retardation, and other mental/emotional/behavioral problems.
Overall, disabilities of any kind affected eight percent of children in 2010-2011, compared to nearly seven percent a decade earlier. For children living in poverty, the rate was 10 percent at the end of the period; for wealthy families, six percent.
The overall trend shows a 16 percent increase, while disabilities in kids from wealthy families rose more than 28 percent, the researchers found. The trend was led by increases in attention problems, speech problems, and other mental or developmental disorders that likely include autism, although that condition was not identified specifically.
“Declines in asthma-related problems and physical injuries accounted for much of the overall 12 percent drop in physical disabilities. Perhaps this is because of better treatments for asthma and more use of bike helmets, car seats, and seat-belts,” Houtrow said.
A new study shows that when asking for flexible work arrangements, especially for childcare-related reasons, men are more likely to have an advantage.
Researcher Dr. Christin Munsch, an assistant professor of sociology at Furman University, analyzed the reactions both men and women received when making flexible work requests to either work from home or to work non-traditional hours.
She found that men who asked to work from home two days a week in order to care for a child were “significantly advantaged” compared to women who made the same request.
Munsch, who presented her research at the 109th Annual Meeting of the American Sociological Association, also found that both men and women who made flexible work requests for childcare-related reasons were advantaged compared to those who made the same requests for other reasons.
For her study, Munsch asked 646 U.S. citizens who ranged in age from 18 to 65 to read a transcript of what they were told was an actual conversation between a human resources representative and an employee.
Some of the employees requested a flexible work arrangement, either asking to come in early and leave early three days a week, or to work from home two days a week. Munsch varied the gender of the employee and the reason for the request (involving childcare or not).
After reading their transcript, participants were asked how likely they would be to grant the request and also to evaluate the employee on several measures, including how likeable, committed, dependable, and dedicated they found him or her.
Among those who read the transcript in which a man requested to work from home for childcare-related reasons, 69.7 percent said they would be “likely” or “very likely” to approve the request, compared to 56.7 percent of those who read the scenario in which a woman made the request.
Almost a quarter — 24.3 percent — found the man to be “extremely likeable,” compared to only three percent who found the woman to be “extremely likeable.”
Only 2.7 percent found the man “not at all” or “not very” committed, yet 15.5 percent found the woman “not at all” or “not very” committed, Munsch reported.
“These results demonstrate how cultural notions of parenting influence perceptions of people who request flexible work,” Munsch said.
“Today, we think of women’s responsibilities as including paid labor and domestic obligations, but we still regard breadwinning as men’s primary responsibility and we feel grateful if men contribute in the realm of childcare or to other household tasks.”
Munsch said she fears this will be an issue as marriages become more egalitarian.
“For example, in an arrangement where both partners contribute equally at home and in terms of paid labor, men, but not women, would reap workplace advantages,” she said. “In this situation, a move towards gender equality at home would perpetuate gender inequality in the workplace.”
The study also found that “men and women who requested to work from home or to work atypical hours to take care of a child were viewed as more respectable, likable, committed, and worthy of a promotion, and their requests were more supported than those who requested flexible work for reasons unrelated to childcare,” Munsch said.
For example, among those who read a transcript in which an employee asked to work from home two days a week for childcare-related reasons, 63.5 percent said they would be “likely” or “very likely” to grant the request.
However, only 40.7 percent of those who read a scenario in which an employee asked to work from home two days a week to reduce his or her commute time and carbon footprint said they would be “likely” or “very likely” to grant the request.
Munsch said she was surprised by her findings.
“I was surprised because so much of the research talks about how parents — and mothers in particular — are discriminated against compared to their childless counterparts,” she said.
“When it comes to flexible work, it seems that engaging in childcare is seen as a more legitimate reason than other, non-childcare related reasons, like training for an endurance event or wanting to reduce your carbon footprint.”
While feminists and work-family scholars have championed flexible work options as a way to promote gender equality and as a remedy for work-family conflict, Munsch said that her research “shows that we should be hesitant in assuming this is effective.”
She added, however, that employers should not eliminate flexible work arrangements, but should be cognizant of their biases and the ways in which they “differentially assess people who use these policies, so as not to perpetuate inequality.”
A new study may explain why people with schizophrenia have difficulty achieving real-world goals, such as making friends, completing their education, and finding a job.
The study, from researchers at the University of Sydney in Australia, found that people with schizophrenia struggle to turn goals into action because the parts of the brain governing desire and emotion are less active, failing to pass along goal-oriented messages to other regions of the brain that affect decision-making.
“The apparent lack of motivation in schizophrenic patients isn’t because they lack goals or don’t enjoy rewards and pleasure,” said Richard Morris, Ph.D., the study’s lead author. “They enjoy as many experiences as other people, including food, movies, and scenes of natural beauty.
“What appears to block them are specific brain deficits that prevent them from converting their desires and goals into choices and behavior.”
The researchers used a two-prong approach to reveal how and why schizophrenics fail to convert their preferences into choices.
The first included a series of experiments involving different snack foods.
Through these, the researchers found that people with schizophrenia had the same liking for snack foods as those without. And when the researchers reduced the value of one of the snacks, people in both groups preferred different snacks.
The researchers found, however, that those with schizophrenia had a lot of difficulty choosing their preferred snack when provided with a choice between their preferred snack and the devalued snack.
Next, researchers used functional magnetic resonance imaging (fMRI) to measure brain activity while those in the study performed learning tasks involving snack foods. This technique relies on the fact that cerebral blood flow and neuronal activity are coupled, the researchers said.
When an area of the brain is in use, blood flow to that region increases, indicating neural activity, the researchers explained. This neural activity can be presented graphically by color-coding the strength of activation across the brain or in specific brain regions.
The functional MRI results revealed that those with schizophrenia had normal neural activity in the prefrontal cortex, the part of the brain responsible for decision-making, but in the part of the brain responsible for controlling actions and choice — the caudate — there was far lower neural activity than in healthy subjects.
This lower activity was correlated with the difficulty that the schizophrenic subjects had in applying their food preferences to getting future snack foods, according to the researchers.
“Pathology in the caudate and associated brain regions may prevent schizophrenic subjects from properly evaluating their desires then transmitting that information to guide their behavior,” said Morris.
“This means that desires and goals are intact in people with schizophrenia, however they have difficulty choosing the right course of action to achieve those goals. This failure to integrate desire with action means people with schizophrenia are stuck in limbo, wanting a normal life but unable to take the necessary steps to achieve it.”
The study was published in Biological Psychiatry.
Source: University of Sydney