In The News
White matter in the brains of children with dyslexia may be structured differently compared to typically developing readers, according to new research at Vanderbilt University.
For the study, published in the journals Brain Connectivity and Brain Research, researchers used neuroimaging to examine structural differences in connectivity in children with dyslexia as compared to typically developing readers.
The research involved 40 children ages eight to 17 years, 20 of whom had dyslexia and 20 of whom were typically developing readers. The researchers set out to visually map the structure of the brain in an effort to better understand the role of the thalamus in reading behavior.
Although many dyslexia studies focus on the cerebral cortex, the researchers of the new study targeted the thalamus region. The thalamus acts as the brain’s connector, relaying sensory and motor signals back to the cerebral cortex through nerve fibers that are part of the brain’s white matter. The thalamus also regulates alertness, consciousness, and sleep.
“A different pattern of thalamic connectivity was found in the dyslexic group in the sensorimotor and lateral prefrontal cortices,” said Dr. Laurie Cutting, professor of psychology and human development, radiology, and pediatrics at Vanderbilt.
“These results suggest that the thalamus may play a key role in reading behavior by mediating the functions of task-specific cortical regions. Such findings lay the foundation for future studies to investigate further neurobiological anomalies in the development of thalamo-cortical connectivity in individuals with dyslexia.”
In a related study, the team examined connectivity patterns in a cortical region known to be especially important for reading: the left occipito-temporal region, sometimes referred to as the visual word form area.
Cutting and her colleagues used diffusion MRI to study the structural connectivity patterns in the brains of 55 children.
“Findings suggest that the architecture of the left occipito-temporal region connectivity is fundamentally different between children who are typically developing readers and those with dyslexia,” Cutting said.
The typically developing readers showed greater connectivity in brain regions related to language than the dyslexic group. Those with dyslexia showed greater connectivity in regions related to visual word form and memory.
The researchers came from a variety of backgrounds, including faculty from pediatrics, engineering, radiology, psychology, special education, and other Vanderbilt departments and centers.
“This work also shows how collaborations between investigators with different expertise can lead to important discoveries and breakthroughs,” said Dr. John C. Gore, Hertha Ramsey Cress University Professor at Vanderbilt and director of the Vanderbilt Institute of Imaging Science.
“The interaction of developmental neuroscientists with imaging specialists was essential to produce these exciting results.”
Source: Vanderbilt University
Ketamine, recently the focus of research as a rapid-acting antidepressant that can ease symptoms within hours instead of weeks, is now being studied as a fast-acting mood-lifter to treat bipolar patients.
In a National Institutes of Health (NIH) trial, the drug – sometimes referred to as Special K and long used as an animal anesthetic and a party drug – restored pleasure-seeking behavior independent of its antidepressant effects, according to researchers.
In fact, researchers report that within 40 minutes after a single infusion of ketamine, treatment-resistant depressed bipolar disorder patients experienced a reversal of a key symptom — a loss of interest in pleasurable activities. What’s more, that reversal lasted up to 14 days, researchers reported.
Brain scans traced the drug’s action to boosted activity in areas at the front and deep in the right hemisphere of the brain, according to researchers.
“Our findings help to deconstruct what has traditionally been lumped together as depression,” explained Carlos Zarate, M.D., of the NIH’s National Institute of Mental Health (NIMH).
“We break out a component that responds uniquely to a treatment that works through different brain systems than conventional antidepressants — and link that response to different circuitry than other depression symptoms.”
Considered one of two prime symptoms of both depression and bipolar disorder, anhedonia is the loss of the ability to look forward to pleasurable activities. No effective treatments for anhedonia have been found to date.
Based on their previous studies, the NIMH researchers expected ketamine’s therapeutic action against anhedonia would be traceable — like that for other depression symptoms — to effects on a mid-brain area linked to reward-seeking and that it would follow a similar pattern and time course.
To test their theory, the researchers infused the drug or a placebo into 36 patients in the depressive phase of bipolar disorder. They then detected any mood changes using rating scales for anhedonia and depression.
By isolating scores on anhedonia from scores on other depression symptoms, the researchers discovered that ketamine was triggering a strong anti-anhedonia effect sooner — and independent of — the other effects, they report in the study, which was published in the journal Translational Psychiatry.
Levels of anhedonia plummeted within 40 minutes in patients who received ketamine, compared with those who received the placebo, according to the researchers, who add the effect was still detectable in some patients two weeks later.
Other depressive symptoms improved within two hours, the researchers noted. The anti-anhedonic effect remained significant even in the absence of other antidepressant effects, suggesting a unique role for the drug.
Next, the researchers scanned the brains of a subset of the ketamine-infused patients, using positron emission tomography (PET), which shows what parts of the brain are active by tracing the destinations of radioactively-tagged glucose — the brain’s fuel.
The scans showed that ketamine jump-started activity not in the middle brain area they had expected, but rather in the dorsal (upper) anterior cingulate cortex, near the front middle of the brain, and putamen, deep in the right hemisphere.
Boosted activity in these areas may reflect increased motivation towards or ability to anticipate pleasurable experiences, according to the researchers.
Depressed patients typically experience problems imagining positive, rewarding experiences, which would be consistent with impaired functioning of this dorsal anterior cingulate cortex circuitry, they said.
However, confirmation of these findings must await results of a similar NIMH ketamine trial nearing completion in patients with unipolar major depression, the researchers noted.
Other evidence suggests that ketamine’s action in this circuitry is mediated by its effects on the brain’s major excitatory neurotransmitter, glutamate, as well as downstream effects on a key reward-related chemical messenger, dopamine.
The findings add to mounting evidence in support of the antidepressant efficacy of targeting this neurochemical pathway, according to the researchers. Ongoing research is exploring, for example, potentially more practical delivery methods for ketamine and related experimental antidepressants, such as a nasal spray, they noted.
They add, however, that ketamine is not approved by the U.S. Food and Drug Administration as a treatment for depression. It is mostly used in veterinary practice, and its abuse can lead to hallucinations, delirium, and amnesia.
Having sex with two women is a common fantasy, but fantasizing about “golden showers” or sex with a prostitute is not, according to a new study.
Researchers at the Institut universitaire en santé mentale de Montréal and Institut Philippe-Pinel de Montréal, affiliated with the University of Montreal, state their new study scientifically defines sexual deviation for the first time.
Although many theories about deviant sexual fantasies incorporate the concept of atypical fantasies, the scientific literature does not describe what these types of fantasies actually are, the scientists said.
“Clinically, we know what pathological sexual fantasies are: They involve non-consenting partners, they induce pain, or they are absolutely necessary in deriving satisfaction,” said Christian Joyal, lead author of the study.
“But apart from that, what exactly are abnormal or atypical fantasies? To find out, we asked people in the general population, as simple as that. Our main objective was to specify norms in sexual fantasies, an essential step in defining pathologies.”
The researchers noted that the study required finding adults willing to describe their sexual fantasies. They eventually recruited 1,517 Quebec adults — 799 men and 718 women with a mean age of 30 — who filled out a questionnaire describing their sexual fantasies, as well as describing their favorite fantasy in detail.
According to the researchers, the results are “more than interesting.”
For example, the study found that sexual fantasies are varied among the general population. However, few fantasies can be considered statistically rare, such as sex with a child or animal.
Perhaps not surprisingly, the study confirms that men have more fantasies and they describe them more vividly than women.
The study also discovered that a significant proportion of women — 30 percent to 60 percent — have fantasies associated with submission, such as being tied up, spanked, or forced to have sex.
The researchers also found that women — unlike men — clearly distinguish between fantasy and desire.
Many women who express more extreme fantasies of submission, such as domination by a stranger, specify that they never want these fantasies to come true. The majority of men, however, would love their fantasies — for example, a threesome — to come true, the researchers report.
As expected, the presence of one’s significant other is considerably stronger in female fantasies than in male fantasies. In general, men in couples fantasize more about extramarital relationships compared to women, according to the study’s findings.
“One of the most intriguing findings has to do with the significant number of unique male fantasies, for example, regarding shemales, anal sex among heterosexuals, and the idea of watching their partner have sex with another man,” Joyal said.
“Evolutionary biological theories cannot explain these fantasies, which, among males, are typically desires.”
He added that the study’s findings help shed light on certain social phenomena, such as the popularity of the book “Fifty Shades of Grey” with women.
“The subject is fascinating,” he said. “ We are currently conducting statistical analyses with the same data to demonstrate the existence of homogeneous subgroups of individuals based on combinations of fantasies.
“For example, people who have submission fantasies also often report domination fantasies. These two themes are therefore not exclusive — quite the contrary. They also seem associated with a higher level of satisfaction.”
The study was published in the Journal of Sexual Medicine.
Source: University of Montreal
The ability to improve intelligence by environmental manipulation remains a subject of considerable debate.
New research explores if a parents interactions with their child can help boost the child’s intelligence.
For example, does reading bedtime stories, engaging in conversation, and eating nightly dinners influence a child’s intelligence later in life?
Although the interactions are important for normal development and socialization skills, researchers say that none of these actions have any detectable influence on children’s intelligence later in life.
In the study, Florida State University criminology professor Kevin Beaver examined a nationally representative sample of youth alongside a sample of adopted children from the National Longitudinal Study of Adolescent Health (Add Health).
Upon review he found evidence that suggests IQ is not the result of parental socialization.
The study analyzed parenting behaviors and whether they had an effect on verbal intelligence as measured by the Picture Vocabulary Test (PVT).
The IQ tests were administered to middle and high school students, and again when they were between the ages of 18 and 26.
“Previous research that has detected parenting-related behaviors affect intelligence is perhaps incorrect because it hasn’t taken into account genetic transmission,” Beaver said.
The findings were published in the article, “A closer look at the role of parenting-related influences on verbal intelligence over the life course: Results from an adoption-based research design,” in the journal Intelligence.
The subject of how much influence parents have on intelligence has long been debated.
Some research that shows parents who socialize their children in accordance with certain principles like reading with them often or having nightly family dinners, have children who are smarter than children whose parents do not do those things.
There is also an argument that it’s not a parental socialization effect, but that intelligence is passed down from parent to children genetically, not socially.
In order to test these two explanations, Beaver used an adoption-based research design.
“We thought this was a very interesting set up and when we tested these two competing hypotheses in this adoptive-based research design, we found there was no association between parenting and the child’s intelligence later in life once we accounted for genetic influences,” Beaver said.
Studying children who share no DNA with adoptive parents eliminates the possibility that parental socialization is really just a marker for genetic transmission.
“In previous research, it looks as though parenting is having an effect on child intelligence, but in reality the parents who are more intelligent are doing these things and it is masking the genetic transformation of intelligence to their children,” Beaver said.
Does this mean parents can neglect or traumatize their children and it won’t affect them?
“My response is no,” Beaver said, “but the way you parent a child is not going to have a detectable effect on their IQ as long as that parenting is within normal bounds.”
Source: Florida State University
As humans we all have emotional responses to change and transition.
New research helps to explain the emotion of sadness and why sadness seems to last longer than other emotions.
In the study, investigators discovered a person can feel sad up to 240 times longer than they feel ashamed, surprised, irritated, or even bored.
The reason for this extended response is complex although one reason is logical — sadness often goes hand in hand with events of greater impact such as death or accidents.
“The extended duration of sadness allows one more time to mull over and cope with what happened to fully comprehend it,” say researchers Philippe Verduyn and Saskia Lavrijsen of the University of Leuven in Belgium.
Their research, published in the journal Motivation and Emotion, is the first to provide clear evidence to explain why some emotions last a longer time than others.
The Belgian researchers asked 233 high school students to recollect recent emotional episodes and report their duration.
The participants also had to answer questions about the strategies they use to appraise and deal with these emotions.
Researchers discovered various emotions have different duration’s — that is, some last longer than others.
Out of a set of 27 emotions, sadness lasted the longest, whereas shame, surprise, fear, disgust, boredom, being touched, irritated, or feeling relief were often over quickly.
The finding that boredom was among the shorter emotions experienced was surprising.
Verduyn and Lavrijsen believe this means that even though time seems to pass slowly when one is bored, an episode of boredom typically doesn’t last that long.
A key finding of the research was that emotions that last a shorter time are typically prompted by events that have relatively low importance attached to them.
On the other hand, long-lasting emotions tend to be caused by events that have strong implications for a person’s major concerns.
Verduyn says some of these implications may only become apparent over time. This delayed reaction can cause the emotion to be maintained or strengthened. The feeling therefore endures while a person rethinks the events and consequences over and over again.
Duration was found to be a dimension that can differentiate between otherwise very similar emotions.
For instance, Verduyn and Lavrijsen found that guilt is an emotion that persists much longer than shame, while anxiety lingers longer than fear.
The feeling (either a positive or negative emotion) associated with an event one thinks about over and over or on a persistent basis, is more likely to persist.
“Rumination is the central determinant of why some emotions last longer than others. Emotions associated with high levels of rumination will last longest,” says Verduyn,
“Emotions of shorter duration are typically — but, of course, not always — elicited by events of relatively low importance.
“On the other hand, long-lasting emotions tend to be about something highly important,” Lavrijsen explains further.
New research suggests sleep apnea may disrupt the formation of new spatial memories.
Spatial memories are used every day and act as our internal compass to keep us from getting lost, remember where we left the keys, or parked the car.
Sleep apnea is characterized by abnormal pauses in breathing or instances of shallow or infrequent breathing during sleep.
In the new study, sleep specialists from New York University (NYU) used a unique technique to determine that sleep apnea may retard spatial memories.
As discussed online in the Journal of Neuroscience, study participants were evaluated as they played a specific video game that disrupts rapid eye movement (REM).
They found that sleep apnea can impair spatial memory in humans even when other sleep stages are intact.
This type of memory is particularly affected in Alzheimer disease, and often is the root cause of why afflicted individuals are often found wandering lost by caregivers.
The research, led by Andrew Varga, M.D., Ph.D., builds on earlier studies in rodents demonstrating that deprivation of REM sleep has detrimental effects on memory.
However, this is the first study to demonstrate the importance of REM sleep for spatial memory in humans, and to document the negative consequence of sleep apnea on spatial memory.
“We’ve shown for the first time that sleep apnea, an increasingly common medical condition, might negatively impact formation of certain memories, even when the apnea is limited to REM sleep,” said Dr. Varga.
“Our findings suggest memory loss might be an additional symptom for clinicians to screen for in their patients with sleep apnea.”
Although sleep apnea can occur during any stage of sleep, it is often worst during REM sleep because of reduced muscle tone in the upper airway that naturally occurs during REM sleep. Some individuals, in fact, have apnea that only occurs during REM sleep.
While the negative effects of sleep apnea on cardiovascular health have been more broadly studied, this work sheds light on important cognitive consequences of sleep apnea.
In order to assess cognitive impact of REM sleep apnea, Dr. Varga and colleagues recruited 18 subjects with severe sleep apnea who also are treated with nightly use of a continuous positive airway pressure (CPAP) machine.
Individuals spent two different nights in the NYU Sleep Disorders Center’s sleep lab, during which time they played video games before and after sleep.
Subjects were first given a baseline examination using the video games before any observation of their sleep patterns. They used a joystick to navigate through one of two unique, computer-generated 3D spatial mazes.
Then, during one night’s sleep, subjects used their therapeutic CPAP as they normally would at home. On the other night, their use of CPAP was reduced during REM sleep, thus allowing sleep apnea to occur. CPAP was maintained at the therapeutic level during all other stages of sleep.
When sleep was aided by therapeutic CPAP all night, researchers observed a 30 percent overnight improvement in maze completion time from their baseline examinations.
However, when REM sleep was disrupted by sleep apnea, there was not only no improvement from baseline testing, but, in fact, subjects took four percent longer to complete the maze tests.
Equally important, when sleep apnea occurred in REM sleep, subjects did not experience delayed reaction times on a separate test to measure attention, called a psychomotor vigilance test.
Dr. Varga says that this suggests that sleepiness or lack of attention were not reasons for the decline in spatial memory, as indicated by the maze performance after experiencing sleep apnea in REM sleep.
Sleep apnea is a common condition affecting four percent of Americans overall and as many as 25 percent of middle-aged men.
Sleep apnea is thought to have two main detrimental effects: First, it creates numerous repetitive dips in the blood’s oxygen levels. Second, sleep apnea creates numerous small arousals that interrupt sleep continuity.
Investigators say that future research will focus on determining the contributions of each of these mechanisms of sleep apnea toward its effect on disruption of spatial memory.
Source: NYU Langone Medical Center
A new study suggests the way a person’s brain responds to a single disgusting image can be used to predict whether he or she identifies as a liberal or conservative.
Still, investigators say that while a particular reaction or leaning may be instinctive, humans can exert control over what their brain may be telling them.
With Election Day rapidly approaching, researchers believe the study should remind us of an important point, that we should “think” and not just “react.”
“Disgusting images generate neural responses that are highly predictive of political orientation even when those neural responses don’t correspond with an individual’s conscious reaction to the images,” said Read Montague, a Virginia Tech Carilion Research Institute professor who led the study.
Images could be of maggot infestations, rotting carcasses, unidentifiable gunk in the kitchen sink — anything repulsive.
“Remarkably, we found that the brain’s response to a single disgusting image was enough to predict an individual’s political ideology.”
In a brain scanner, participants were shown disgusting images, such as dirty toilets or mutilated carcasses, mixed with neutral and pleasant images, such as landscapes and babies.
Afterward, the subjects took a standard political ideology inventory, answering questions about how often they discuss politics and whether they agreed or disagreed with hot-button topics such as school prayer and gay marriage.
Investigators from the Virginia Tech Carilion Research Institute — in collaboration with researchers from University College London, Rice University, the University of Nebraska at Lincoln, and Yale University — used functional magnetic resonance imaging to record brain activity of the subjects responding to the images.
Responses to disgusting images could predict, with 95 percent to 98 percent accuracy, how a person would answer questions on the political survey.
“The results suggest political ideologies are mapped onto established neural responses that may have served to protect our ancestors against environmental threats,” Montague said.
Those neural responses could be passed down family lines — it’s likely that disgust reactions are inherited.
“We pursued this research because previous work in a twin registry showed that political ideology — literally the degree to which someone is liberal or conservative — was highly heritable, almost as heritable as height,” said Montague.
“Conservatives tend to have more magnified responses to disgusting images, but scientists don’t know exactly why,” Montague said.
Investigators believe the responses could be a callback to the deep, adverse reactions primitive ancestors needed to avoid contamination and disease. The insights were critical to survival.
Montague points out that we’re not necessarily hardwired to respond on instinct alone. He uses height as an analogy.
“Genetics predetermines height — but not fully,” Montague said.
“Nutrition, sleep, and starvation can all change someone’s ultimate height. But tall people’s children tend to be tall, and that’s a kind of starting point. If we can begin to understand that some automatic reactions to political issues may be simply that — reactions — then we might take the temperature down a bit in the current boiler of political discourse.”
People are unique among animals in their degree of cognitive control. Montague calls it a behavioral superpower.
“People can deny their biological instincts for an idea — think of hunger strikes for political reasons,” Montague said.
“That requires a high degree of cognitive control, and that’s the point.”
Source: Virginia Tech
Chronic fatigue syndrome (CFS) is a perplexing condition characterized by extreme fatigue that can worsen with physical or mental activity, but doesn’t improve with rest.
While the cause remains unknown, a new imaging study has found distinct differences between the brains of CFS patients and those of healthy people.
Stanford University School of Medicine investigators believe the findings could lead to more definitive diagnoses of the syndrome and may also point to an underlying mechanism in the disease process.
The abnormalities identified in the study, published in the journal Radiology, may help to resolve those ambiguities, said lead author Michael Zeineh, M.D., Ph.D., assistant professor of radiology.
“Using a trio of sophisticated imaging methodologies, we found that CFS patients’ brains diverge from those of healthy subjects in at least three distinct ways,” Zeineh said.
CFS affects between one million and four million individuals in the United States and millions more worldwide. Coming up with a more precise number of cases is tough because it’s difficult to actually diagnose the disease.
It’s not uncommon for CFS patients to face several mischaracterizations of their condition, or even suspicions of hypochondria, before receiving a diagnosis of CFS.
While all CFS patients share a common symptom — crushing, unremitting fatigue that persists for six months or longer — the additional symptoms can vary from one patient to the next, and they often overlap with those of other conditions.
“CFS is one of the greatest scientific and medical challenges of our time,” said the study’s senior author, Jose Montoya, M.D., professor of infectious diseases and geographic medicine.
“Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure, and heart-rate events, and hypersensitivity to light, noise, or other sensations.”
“The combination of symptoms can devastate a patient’s life for 10, 20, or even 30 years,” said Montoya, who has been following 200 CFS patients for several years in an effort to identify the syndrome’s underlying mechanisms.
“In addition to potentially providing the CFS-specific diagnostic biomarker we’ve been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system,” Montoya said.
“If you don’t understand the disease, you’re throwing darts blindfolded,” said Zeineh. “We asked ourselves whether brain imaging could turn up something concrete that differs between CFS patients’ and healthy people’s brains. And, interestingly, it did.”
The Stanford investigators compared brain images of 15 CFS patients chosen from the group Montoya has been following to those of 14 age- and sex-matched healthy volunteers with no history of fatigue or other conditions causing symptoms similar to those of CFS.
The analysis yielded three noteworthy results, the researchers said. First, an MRI showed that overall white-matter content of CFS patients’ brains, compared with that of healthy subjects’ brains, was reduced. The term “white matter” largely denotes the long, cablelike nerve tracts carrying signals among broadly dispersed concentrations of “gray matter.”
White matter helps to transfer information from one part of the brain to another, while gray matter areas specialize in processing information.
“That finding wasn’t entirely unexpected,” Zeineh said. CFS is thought to involve chronic inflammation, quite possibly as a protracted immunological response to an as-yet unspecified viral infection. Inflammation, meanwhile, is known to take a particular toll on white matter.
But a second finding was entirely unexpected. Using an advanced imaging technique — diffusion-tensor imaging, which is especially suited to assessing the integrity of white matter — Zeineh and his colleagues identified a consistent abnormality in a particular part of a nerve tract in the right hemisphere of CFS patients’ brains.
This tract, which connects two parts of the brain called the frontal lobe and temporal lobe, is called the right arcuate fasciculus, and in CFS patients it appears abnormal.
Researchers also found a fairly strong correlation between the degree of abnormality in a CFS patient’s right arcuate fasciculus and the severity of the patient’s condition. This was determined by a person’s performance on a standard psychometric test used to evaluate fatigue.
Although the right arcuate fasciculus’s function is still somewhat mysterious, its counterpart in the brain’s left hemisphere has been extensively explored.
The left arcuate fasciculus connects two critical language areas of the left side of the brain termed Wernicke’s and Broca’s areas, which are gray-matter structures several centimeters apart. These two structures are important to understanding and generating speech, respectively.
Right-handed people almost always have language organized in this fashion exclusively in the left side of the brain, but the precise side (left or right) and location of speech production and comprehension are not so clear-cut in left-handed people. (It’s sometimes said that every left-hander’s brain is a natural experiment.)
Therefore, combining left- and right-handed people’s brain images can be misleading. And, sure enough, the finding of an abnormality in the right arcuate fasciculus, pronounced among right-handers, was murky until the two left-handed patients and four left-handed control subjects’ images were exempted from the analysis.
Strengthening these observations was the third finding: a thickening of the gray matter at the two areas of the brain connected by the right arcuate fasciculus in CFS patients, compared with controls.
“Its correspondence with the observed abnormality in the white matter joining them makes it unlikely that the two were chance findings,” Zeineh said.
Researchers admit that although these results appear promising, they will need to be confirmed. “This study was a start,” says Zeineh. “It shows us where to look.”
Use of a group setting to train parents on autistic therapy appears to be a beneficial method to improve language skills in their autistic children.
Researchers from the Stanford University School of Medicine and Lucile Packard Children’s Hospital Stanford found that parents can learn to use a scientifically validated autism therapy with their own children by taking a short series of group classes
The therapy helped children improve their language skills, an area of deficiency in autism, according to a study published in the Journal of Child Psychology and Psychiatry.
The study is the first randomized, controlled trial to test whether group classes are a good way to train parents on using an autism therapy.
“We’re teaching parents to become more than parents,” said the study’s lead author, Antonio Hardan, M.D., professor of psychiatry and behavioral sciences.
“What we’re most excited about is that parents are able to learn this intervention and implement it with their kids.”
The treatment is not intended to replace autism therapies administered by professionals, but rather to improve parents’ ability to help their children learn from everyday interactions.
“There are two benefits: The child can make progress, and the parents leave the treatment program better equipped to facilitate the child’s development over the course of their daily routines,” said study co-author Grace Gengoux, Ph.D.
“The ways that parents instinctually interact with children to guide language development may not work for a child with autism, which can frustrate parents. Other studies have shown that learning this treatment reduces parents’ stress and improves their happiness. Parents benefit from knowing how to help their children learn.”
Over the course of 12-weeks parents were trained in a technique called pivotal response training, a method that has been shown to help children with autism.
To use the treatment for building language skills, parents identify something the child wants and systematically reward the child for trying to talk about it.
For instance, if the child reaches for a ball, the parent says, “Do you want the ball? Say ‘ball.’”
“The child might say ‘ba,’ and you reward him by giving him the ball,” Hardan said. “Parents can create opportunities for this treatment to work at the dinner table, in the park, in the car, while they’re out for a walk.”
The method has roots in other behavioral therapies for autism, such as applied behavior analysis, but is more flexible than many such programs and makes greater use of the child’s own interests and motivations.
Parents can create opportunities for this treatment to work at the dinner table, in the park, in the car, while they’re out for a walk.
Fifty-three children with autism and their parents participated in the study. The children ranged in age from two to six. All had language delays.
The parents were randomly assigned to one of two groups: The experimental group attended 12 weeks of classes on pivotal response training, and the control group attended a 12-week program offering basic information about autism.
The children’s verbal skills were measured at the start of the study, at six weeks and at 12 weeks. At six and 12 weeks, the parents in the experimental group were video-recorded while using pivotal response training so that researchers could assess whether they were using the treatment correctly.
At the end of the study, 84 percent of parents who received instruction in pivotal response training were using the therapy correctly.
Their children showed greater gains in language skills — both in the number of things they said and in their functional use of words — than children in the control group.
The researchers were encouraged to see that the group-based approach to training parents was successful and produced results quickly for the children.
Rising rates of autism diagnosis have made it difficult for clinicians to meet the demand for their expertise, and groups are an efficient way to train parents. Parents also liked having the opportunity to learn from one another.
“Parents really do feel more empowered when they’re in a group setting,” said study co-author Kari Berquist, Ph.D., a clinical instructor in psychiatry and behavioral sciences and an autism clinician at the hospital.
“They’re talking, connecting, sharing their experiences. It gives them a sense of community.”
The study provided an early hint about which children on the autism spectrum might benefit most from pivotal response training: Children with the best visual problem-solving abilities improved most with the treatment.
In future studies, the researchers hope to identify good predictors of which autism therapies fit best for different children and families. They are also testing different lengths and intensities of pivotal response training to see what produces the best results.
Researchers believe strong attachments to animals may help military-connected children develop resiliency and other positive developmental traits.
Defined as the ability to recover from or adjust easily to misfortune or change, resiliency is acquired with practice, over time. But military children must adapt to parental deployment and frequent moves, events that could slow the learning of essential life skills.
New research published online in Applied Developmental Science supports the idea that, along with other key resources, strong attachments to animals may help military-connected children develop resiliency and other positive developmental traits.
“We were interested in seeing if the specific stressors faced by military-connected families could be mitigated by interacting with animals. We found that kids with deployed parents who had developed a deep bond with a family pet reported having better coping strategies in dealing with the stress than those without such ties to a companion animal,” said the paper’s author, Megan Mueller, Ph.D.
The online survey study, conducted with the assistance of the Military Child Education Coalition (MCEC) collected responses on measures of human-animal interaction (HAI), positive youth development, stress and adaptive coping strategies from nearly 300 children in grades six through 12.
The children reported being from military families and all participated in youth programs developed by MCEC.
Approximately 70 percent of the youth surveyed had family pets and most of them had some involvement in caretaking (for example, 50 percent reported being responsible for feedings).
Researchers discovered a greater attachment to companion animals was associated with higher positive youth development scores (which measured characteristics of competence, confidence, connection, character, and caring) for all military-connected children.
Children with at least one currently deployed family member had significantly higher perceived stress levels than those who didn’t.
The researchers also assessed the connection between children’s attachment to a companion animal and the strength of their copings skills by measuring how frequently children tried to develop social supports and self-reliance, and seek social activities such as investing in close friendships.
HAI didn’t appear to have a strong relationship with coping skills for children without a deployed family member but for youth dealing with deployment there was significant positive association between the two.
The finding was consistent with previous research that found the quality and strength of the attachment between children and their pets was an important aspect of that dynamic.
“It isn’t enough to be around animals — children need to be engaged in that relationship. Strong attachments to pets may foster a more proactive attitude about handling stressful problems and could serve as a bridge to developing and maintaining peer relationships during stressful circumstances,” Mueller said.
However, Mueller cautions that the study can’t determine causality and is a first step to better understanding whether the emotional attachment to a pet could be one way for children to develop positive coping strategies to emotional stressors.
Nevertheless, the results may point to a cost-effective way to help military families thrive and foster resiliency during challenging times.
“Through this work, we recognize the importance of establishing connections that help kids develop a sense of responsibility and outward focus. We now know that caring for a pet boosts self-confidence, establishes important routines, and provides a stabilizing force in the highly-mobile life of a military child,” said Sandy Franklin, Ph.D., of the Military Child Education Coalition.
“We strongly believe in the importance of the human-animal bond among families,” said Dr. Christine Jenkins, chief veterinary medical officer for Zoetis U.S.
Source: Tufts University
Going to work is often associated with high stress and low physical activity. For many, work is characterized by long hours of sitting, which is linked to poor health.
Emerging research has shown that sitting is very bad for our mental health, increases our chance of heart disease and ups our risk of being disabled.
Researchers have also found that the people who sit most are more likely to be obese.
With these concerns in mind Dr. Michael Sliter, an assistant professor of psychology at Indiana University-Purdue University Indianapolis (IUPUI), has developed a walking workstation that can be used to burn off stress and calories.
“We found that the walking workstations, regardless of a person’s exercise habits or body mass index (BMI), had significant benefits,” Sliter said.
“Even if you don’t exercise or if you are overweight, you’ll experience both short-term physical and psychological benefits.”
A sample of 180 participants were evaluated on boredom, task satisfaction, stress, arousal, and performance while completing work-related computer tasks across four randomly assigned workstations: seated, standing, cycling, or walking.
The researchers found walking workstation participants had higher satisfaction and arousal, while experiencing less boredom and stress than the standing and sitting workstation participants.
In comparison, the cycling workstation related to reduced satisfaction and performance.
The paper, which Sliter wrote entirely while using a walking workstation, appears online in the Journal of Occupational Health Psychology.
Sliter hopes the study encourages employers to examine methods to assist workers in healthy living.
While it might be expected that those on the short end of financial negotiations suffer stress, new research suggests that when people make very low offers they also experience emotional distress.
In the new study, Australian researchers examined the physiological reactions of participants in a financial bargaining game.
Their findings, published in scientific journal PLOS ONE, found that not only those receiving relatively low offers experienced stress but also those that make low offers, when compared to people who made more generous offers.
Participants were asked to play the Ultimatum Bargaining Game, in which players decide how to divide a sum of money given to them.
Player one (the proposer) proposes how to divide the money and player two (the responder) must accept or reject the offer. If player two rejects it, neither player receives any money.
Uwe Dulleck, Ph.D., a professor at Queensland University and lead author, said the study analyzed the emotional reactions of participants in ultimatum situations.
“We wanted to understand the physiological reactions people have in these situations so responders and proposers wore heart rate monitors to track Heart Rate Variability (HRV) — the variation in the time interval between heart beats.”
“We found low offers, typically below 40 percent of the total, increased HRV activity and stress levels in both the proposer and responder.”
Co-author Markus Schaffner, Ph.D., said “guilt” felt by the proposer about to make a low offer was one possible explanation for the increase in stress.
“This can be seen as evidence that we empathize with people and put ourselves in their shoes in these sorts of situations,” he said.
“The results indicate we have negative feelings when we treat someone unfairly, for example by offering below 40 percent of the total in the game. There is an emotional and physiological cost and we feel uncomfortable.
“The responder also feels stressed with low offers, first, because they have suffered from unfairness, and second, because they have an opportunity to punish the proposer by rejecting the offer and leaving them both without any money.
“Our preference is to be fair and it is likely proposers experience pleasure when making fair offers.”
“The QuBE group was one of the first to use HRV in economic experiments to measure mental stress in economic decision making,” Dulleck said.
“The question which remains without a clear answer is: do emotions dictate behavior or does behavior induce emotional response?” he said.
“Our results can give no definite answer to this question, but do clearly indicate a link between emotional state and the decision.”
Source: Queensland University
A person’s perspective appears to play a critical factor in the way we believe punishment should be used to restore justice.
New psychological research discovers third parties — such as a jury — are more likely to use punishment as a means to restore justice for a nonviolent offense.
Conversely, investigators discovered that for a nonviolent offense, victims want what they have lost to be restored.
The findings, which appear in the journal Nature Communications, may offer insights into how juries differ from plaintiffs in seeking to restore justice.
The study, conducted in the laboratory of New York University (NYU) cognitive neuroscientist Elizabeth Phelps, Ph.D., also shows that victims, rather than seeking to punish an offender, instead seek to restore what they’ve lost.
“In our legal system, individuals are presented with the option to punish the transgressor or not, but such a narrow choice set may fail to capture alternative preferences for restoring justice,” said Oriel Feldman Hall, Ph.D., the study’s lead author and a postdoctoral fellow.
“In this study we show that victims actually prefer other forms of justice restoration, such as compensation to the victim, rather than punishment of the transgressor.”
“These results differ from the majority of findings on social punishment,” said co-author Jay Van Bavel, Ph.D., a professor in NYU’s Department of Psychology. ”Notably, they show that third parties make decisions on justice that are at odds with the wishes of victims.”
The study was based on a series of experiments that employed a variation of “the Ultimatum Game,” a common method used in psychology and economic research that gauges how people respond to unfair monetary offers.
In the first set of experiments, composed of more than 100 subjects, Player A proposes a division of a $10 pie with Player B.
Player B can respond to the proposition in one of the following ways: accepting the proposal; punishing Player A by reducing that player’s amount in a counteroffer; equally splitting the pie so that both players get half; compensating Player B so that Player B’s payout matches Player A’s payout; or reversing the proposed split — the severest form of punishment if Player A has originally proposed an unfair division.
The results from this experiment showed that Player B was most likely to choose the “compensate” option — rather than either of the “punishment” choices (punish or reverse), even when Player A offered a highly unfair split of $9/$1.
These findings showed that when given a choice people actually prefer compensation to punishment when they think they have been wronged.
An additional experiment, however, yielded notably different outcomes.
In it, a third party, Player C, observed the game waged by Players A and B. These participants were asked to make decisions on behalf of another player such that payoffs would be paid to Players A and B and not to themselves.
In this experiment, Player C, when responding to unfair offers, selected “reverse”– the option that both compensates Player B and punishes Player A — significantly more often than Player Bs did for themselves.
In other words, participants did not show preferences for punishing Player A when directly affected by a fairness violation (i.e., as a second party), but when observing a fairness violation targeted at another (i.e., as a third party), participants significantly increased their retributive responding.
The researchers conducted a final series of experiments involving more than 500 participants who adopted, at various times, both the Player B role (personally affected) and the Player C role (acting on behalf of another player).
As before, when subjects were in the Player B role, they showed strong preferences to “compensate” — even when Player A’s offers became increasingly unfair (e.g., a 9/1 split).
Yet, when adopting the Player C role, participants changed their response, choosing to apply the harshest form of punishment to the transgressor, demonstrating that people respond differently depending on whether they have been directly affected by a fairness violation, or are observing another person.
Source: New York University
In a new study, researchers found “social host” laws that hold adults responsible for underage drinking on their property have reduced the number of teenage weekend drinking parties.
Over the years, a variety of such laws have been enacted in many U.S. states and local communities, but prior research has been mixed as to whether they actually keep kids from drinking.
In the new study, found in the Journal of Studies on Alcohol and Drugs, investigators focused on 50 communities in California, half of which had social host laws. California as a state has no law on the books, but local governments are free to devise their own.
The researchers found that teenagers were less likely to report drinking at parties when they lived in communities with particularly strong social host laws.
However, the findings indicate a correlation and not necessarily a direct effect of the laws, said lead researcher Mallie J. Paschall, Ph.D., a senior research scientist at the Prevention Research Center in Oakland.
“These findings are preliminary. We can’t say that social host laws definitely prevent kids from drinking at parties,” Paschall said.
Still, the results are encouraging, according to Paschall.
“Most kids get alcohol from social sources, not commercial ones,” he pointed out. So, in theory, laws aimed at those social sources – in this case, parents or other adults of legal drinking age – should help reduce underage drinking.
“It does look like there is less-frequent drinking among teenagers in cities with stringent social host laws, even when other city and youth characteristics that are related to underage drinking are controlled for,” Paschall said. ”So these laws might be an effective strategy for reducing hazardous drinking.”
“Strong” social host laws have some key provisions, according to Paschall:
- They specifically target underage drinking;
- There is a civil penalty (such as a hefty fine) that is swiftly administered;
- Property owners are held responsible, even if they claim they didn’t know about the underage drinking.
Paschall acknowledges that the laws are often controversial. Further, in some communities, police do not enforce the laws, sometimes because there is little support for the policies from the public or the local prosecutor’s office.
Enforcement is necessary for the laws to work although public knowledge of the laws may be a greater force to restrain underage drinking.
“If adults don’t know they could be held responsible for underage drinking, the policies won’t be much of a deterrent,” said Paschall.
In future studies, the researchers plan to look at rates of teen drinking before and after the passage of social host laws to get a better idea of whether the policies themselves have an impact.
Paschall said it will also be important to see whether the laws reduce problems related to teen drinking, including drunk driving.
New research suggests men with self-reported sleep disorders may be at higher risk of developing Alzheimer’s disease than men without them.
Swedish researchers followed more than 1,000 men, who were initially 50 year old, between the years 1970 and 2010.
They found that self-reported sleep disturbances were linked to an increased risk for Alzheimer’s disease during the 40-year follow-up period, particularly if they occurred late in life.
The data suggests that a regular good night’s sleep could support brain health in men.
The study is published in the journal Alzheimer’s & Dementia.
‘We demonstrate that men with self-reported sleep disturbances run a 1.5-fold higher risk to develop Alzheimer’s disease than those without reports of sleep disturbances during a 40-year follow-up period,” said study leader Christian Benedict, Ph.D., a sleep researcher at Uppsala University.
Researchers discovered self-reported sleep disturbance among older men increased the risk for developing Alzheimer’s disease.
These findings suggest that strategies aimed at improving sleep quality in late life may help reduce the risk to develop Alzheimer’s disease.
“Importantly, there are several lifestyle factors, such as exercise, that can influence your brain’s health. Thus, it must be borne in mind that a multifaceted lifestyle approach comprising good sleep habits is essential for maintaining brain health as you age,” Benedict said.
Source: Uppsala University/EurekAlert
Finding a setting that allows autistic kids to socialize with more normally developing peers is often a Catch-22 for parents.
For while autistic youth need significant practice to develop social skills, deficits in this skill set often make play, and associating with similar age kids challenging.
Research by Dr. Pamela Wolfberg, a professor of special education and communicative disorders at San Francisco State University, provides a solution by developing a different type of play group that focuses on collaborative rather than adult-directed activities.
A new report shows that such “Integrated Play Groups,” or IPGs, developed by Wolfberg over several years, are effective in teaching children with autism the skills they need to interact with their peers and engage in symbolic play such as pretending.
In IPGs, adults help children with autism and their typically developing peers engage in playful activities of mutual interest, but do not direct the play themselves.
That sets them apart from more traditional interventions, according to Wolfberg, a professor of special education and communicative disorders.
“Children learn much better how to play through interactions with peers than they do from adults, because adults are not like children anymore,” she said.
“We can definitely have wonderful interactions with kids through play, and we should. But this is qualitatively different.”
Wolfberg and her colleagues studied 48 children with autism during free-play activities, in which they did not know the other children, twice before and once after those same children participated in an Integrated Play Groups program with familiar peers.
They found that, following the IPG intervention, the children’s ability to interact with kids they did not know and to engage in pretend play had risen dramatically, indicating the IPGs were successful in providing them with transferable social and symbolic play skills.
Children with autism, according to Wolfberg, tend to have a “very restrictive play repertoire,” in which they may have unusual interests and repeat the same activity, most often by themselves.
The goal of Integrated Play Groups is to move children from engaging in lower levels of play, such as simply banging something, to engaging in more symbolic play that involves reciprocal interaction with peers.
“The earthquake-rescue theme is the most popular in San Francisco, and we had a little boy just like that, who had an affinity to bang things,” she said.
“So the kids came up with this idea of building cardboard blocks and having an earthquake, and he was the construction worker. He was able to participate in other kids’ interest, build something more elaborate and have a whole fantasy about it.”
The success of IPGs is an opportunity for parents, educators, and therapists seeking to help children with autism in socializing with their peers.
In addition, the IPG model also teaches typically developing children about autism and lets them learn how to form friendships with kids who might play, communicate, or relate differently.
“This is what families want for their kids,” added Wolfberg. “This flips around the idea that kids with autism are incapable of socializing or incapable of pretending.
“They have the same innate drive to participate with peers and to engage in playful experiences, but what has been happening is we have not been able to tap into their potential.”
Future research will involve collaboration with assistant professor Betty Yu, Ph.D., and graduate students to look more closely at how Integrated Play Groups can help children with autism better communicate with their typically developing peers, another challenge they face.
Source: San Francisco State University
Research suggests religiosity among African-Americans helps to keep suicidal rates low despite the psychological stress of racism.
“African-Americans experience an inordinate amount of psychological strain through racial discrimination, leading to depression, hopelessness, and other high risk factors for suicide, but demonstrate significantly lower rates of suicide relative to European-Americans,” said Rheeda Walker, Ph.D., associate professor at the University of Houston and principal researcher of a new study in the journal Suicide and Life-Threatening Behavior.
Investigators say the goal of the study is to assess suicide ideation (thinking about, considering or planning for suicide), depressive symptoms, intrinsic/extrinsic religiosity (religious orientation), and perceived racism.
Researchers studied a community sample of 236 African-American men and women.
Walker notes suicide does exist for African-Americans, but it’s rarely noticed and understudied. She cites suicide as one of the leading causes of death among African-Americans and that approximately, 1,900 African-American adults and youth die by suicide each year.
“There is a belief that if one creates psychological science and knowledge, such knowledge ought to apply universally to everyone. That is simply not the case,” said Walker. “We need to spend more time finding out what depression means for African-Americans and across ethnic groups.
“What does suicide look like for African Americans? Are there self-destructive behaviors that are suicidal, but not considered as suicide?”
The findings from Walker’s research provide evidence that perceived racism may play a role in suicide vulnerability.
The study’s contributions are important in the context of providing evidence that despite the harmful effects of racism, extrinsic religiosity (external motivation for being religious, such as meeting people, community conformity, cultural heritage, etc.) buffered these effects.
Moreover, previous research has discovered that people who experience high levels of stress experience relief in supportive religious settings.
In the current study, people who reported higher levels of more socially oriented, extrinsic religiosity did not report suicide ideation when experiencing symptoms of depression.
The study is the first to study the benefits of religiosity in an environment of perceived discrimination and depression.
“Although discrimination can have adverse emotional consequences, the findings suggest that the ‘use’ of religion perhaps to connect with others or to meet some other need can be emotionally helpful among individuals who experience racism,” said Walker.
In this context, Walker hopes religion might be used to obtain social cohesion and relief from emotional distress that might be experienced by others in similar circumstances.
Source: University of Houston
New research discovers that it is OK to make mistakes when learning as the errors can benefit memory and lead to the correct answer.
However, the premise is true only when the incorrect response is close or meaningful to the accurate response.
“Making random guesses does not appear to benefit later memory for the right answer, but near-miss guesses act as stepping stones for retrieval of the correct information — and this benefit is seen in younger and older adults,” says lead investigator Andrée-Ann Cyr, a graduate student with the Rotman Research Institute, part of the University of Toronto’s Baycrest Centre for Geriatric Care.
Cyr’s paper is found online in the Journal of Experimental Psychology: Learning, Memory, and Cognition (ahead of print publication).
The study expands upon a previous paper she published in Psychology and Aging that found that learning information the hard way by making mistakes (as opposed to just being told the correct answer) may be the best boot camp for older brains.
That paper was controversial since the scientific literature has traditionally recommended that older adults avoid making mistakes — unlike their younger peers who actually benefit from them.
But recent evidence from Cyr and other researchers is challenging this perspective and prompting professional educators and cognitive rehabilitation clinicians to take note.
The new research provides evidence that trial-and-error learning can benefit memory in both young and old when errors are meaningfully related to the right answer, and can actually harm memory when they are not.
In their latest study, researchers had 65 healthy younger adults (average age 22) and 64 healthy older adults (average age 72) learn target words (e.g., rose). The learning was based either on the semantic category the word belongs to (e.g., a flower) or its word stem (e.g., a word that begins with the letters ‘ro’).
For half of the words, participants were given the answer right away (e.g., “the answer is rose”) and for the other half, they were asked to guess at it before seeing the answer (e.g., a flower: “Is it tulip?” or ro___ : “is it rope?”).
On a later memory test, participants were shown the categories or word stems and had to come up with the right answer.
Investigators wanted to know if participants would be better at remembering rose if they had made wrong guesses prior to studying it rather than seeing it right away. They found that this was only true if participants learned based on the categories (e.g., a flower). Guessing actually made memory worse when words were learned based on word stems (e.g., ro___).
This was the case for both younger and older adults. Cyr and her colleagues suggest this is because our memory organizes information based on how it is conceptually rather than lexically related to other information.
For example, when you think of the word pear, your mind is more likely to jump to another fruit, such as apple, than to a word that looks similar, such as peer.
Wrong guesses only add value when they have something meaningful in common with right answers. The guess tulip may be wrong, but it is still conceptually close to the right answer rose (both are flowers).
Researchers believe that when a person guesses first, as opposed to just reading the answer, they are thinking harder about the information and making useful connections that can help memory.
This may explain why younger and older participants were more likely to remember the answer if they also remembered their wrong guesses — suggesting the incorrect responses were beneficial. By contrast, when guesses only have letters in common with answers, they clutter memory because one cannot link them meaningfully.
The word rope is nowhere close to rose in our memory. In these situations, where your guesses are likely to be out in left field, it is best to bypass mistakes altogether.
“The fact that this pattern was found for older adults as well shows that aging does not influence how we learn from mistakes,” said Cyr.
Experts believe the findings can positively influence memory training among elders.
“These results have profound clinical and practical implications. They turn traditional views of best practices in memory rehabilitation for healthy seniors on their head by demonstrating that making the right kind of errors can be beneficial.
“They also provide great hope for lifelong learning and guidance for how seniors should study,” said Dr. Nicole Anderson, senior scientist with Baycrest’s Rotman Research Institute and senior author on the study.
A new analysis suggests nearly one in five U.S. adults are in pain most every day for spells of three months or longer.
Researchers estimate the 39 million adults in persistent pain outnumber the residents of our most populous state, California.
According to previous studies, the costs of pain amount to hundreds of billions of dollars a year in lost productivity and health care.
Importantly, the detrimental impact in monetary terms may be dwarfed by the psychological burden associated with chronic pain.
“A sizeable portion of American adults are dealing with persistent pain and that’s affecting their lives profoundly,” said Jae Kennedy, Ph.D., professor of health policy and administration at Washington State University Spokane.
“Access to good pain management for this population is limited, and there’s a real risk that taking short-term pain medications for a long period of time will lead to dependency or addiction.”
The study, published in the Journal of Pain, analyzed findings from the first national survey to measure persistent pain defined as daily or nearly daily pain lasting three months. The National Center for Health Statistics survey questioned 35,000 households.
Kennedy was inspired to look at the data after seeing the 2011 national Institute of Medicine report, which found nearly half of Americans suffer what it called chronic pain.
The current report’s chronic pain definition is more inclusive and can include arthritis, joint pain, moderate or severe pain in the past four weeks, and any work or housework disability.
“I don’t think that half of the population is dealing with chronic pain in the sense that we would describe chronic pain as a risk factor for deteriorating mental health and substance abuse,” said Kennedy.
“So we wanted to come up with a subset of chronic pain that focused on something that we could look at across different chronic conditions rather than saying, ‘OK, if you’ve got arthritis, then you’ve got chronic pain.’”
“By focusing on persistent pain,” he said, “health policy makers and providers can get a clearer sense of pain’s economic and social costs.”
“Persistent pain is going to have the biggest impact on people’s daily lives,” he said. “If you’re dealing with pain constantly for a long period of time, that’s going to affect your work life, your family life, your social life. It also puts you at higher risk for things like mental illness and addiction.”
Researchers discovered pain extends across demographic and ethnic boundaries although some clustering does persist.
Naturally, older adults are more likely to report persistent pain, particularly between the ages of 60 and 69. Women are at a higher risk than men, as are those without high school degrees. Latino and African-American adults are less likely to report pain than whites.
Two-thirds of those with persistent pain said it is “constantly present.” Half said it is sometimes “unbearable and excruciating.”
People with persistent pain were also more likely to report daily feelings of anxiety, depression, and fatigue. This makes sense, said Kennedy.
“Being in pain is depressing,” he said. “Being in pain all the time is tiring. Being in pain all the time is anxiety-provoking. So it’s plausible that pain is triggering other kinds of more psychological distress.”
Kennedy believes questions regarding persistent pain should be included in future national health surveys. He believes this will allow a more consistent measure of pain and the associated burden it places across different groups of people.
And while pain is in some ways inherent in the human condition, he would like to see policies and practices that ease it.
“The rate of pain could be lowered,” he said, “with responsive health systems that look at the entire person and the range of therapeutic services that they may need.
“It may be more expensive in the short term but in the long term — if we can get those people back to work, paying taxes, supporting their families, engaged in the community — there will be all kinds of economic as well as social benefits.”
Source: Washington State University
A recent study of people who have been accidentally conscious while under a general anesthetic shows it can have a long-term impact.
The patient remains conscious in about one in every 19,000 general anesthetics, said researchers led by Dr. Jaideep Pandit of Oxford University, U.K. This is known as Accidental Awareness during General Anesthesia (AAGA).
Details were gathered on three million general anesthetics from every public hospital in UK and Ireland. This included over 300 reports of AAGA, in which patients experienced sensations such as tugging, stitching, pain, paralysis, and choking. Some of the episodes were of a short duration, either before or after the surgery, and were not reported as distressing.
However, 51 percent of episodes were felt to be distressing, with patients feeling dissociation, panic, extreme fear, suffocation, and even as though they were dying.
Among the total cases of AAGA, 41 percent caused long-term psychological harm similar to post-traumatic stress disorder. This was closely linked to distress at the time of the experience.
Every report of AAGA was studied in detail by a multidisciplinary panel including patients, anesthetists, psychologists, and other professionals.
Pandit said this study was “patient-focused, dealing entirely with patient reports of AAGA.” He said, “Risk factors were complex and varied, and included those related to drug type, patient characteristics, and organisational variables.
“We found that patients are at higher risk of experiencing AAGA during Caesarean section and cardiothoracic surgery, if they are obese or when there is difficulty managing the airway at the start of anesthesia. The use of some emergency drugs heightens risk, as does the use of certain anesthetic techniques.
“However, the most compelling risk factor is the use of muscle relaxants, which prevent the patient moving.”
The team presented their study at the Royal Society of Medicine conference in London on September 10, 2014.
One of the study participants, Sandra, shared her experience of AAGA during a routine orthodontic operation at the age of 12.
“Suddenly, I knew something had gone wrong, I could hear voices around me, and I realized with horror that I had woken up in the middle of the operation, but couldn’t move a muscle. While they fiddled, I frantically tried to decide whether I was about to die,” she said.
Sandra had nightmares for several years afterwards, which featured a monster that jumped on her and paralyzed her. After 15 years of such nightmares, she says she connected them back with her operation. “After that I was freed of the nightmare and finally liberated from the more stressful aspects of the event,” she said.
Sandra’s experience shares many similarities with other affected patients. Pandit said that longer-term effects like this are closely linked to the particular sensation of paralysis during AAGA. Paralysis is felt due to the muscle relaxants often needed for safe surgery.
He states, “Significantly, the study data also suggest that although brain monitors designed to reduce the risk of awareness have a role with certain types of anesthetic, the study provides little support for their widespread use.”
Co-author Dr. Tim Cook pointed out that the study was “uniquely large and broad” and described the low rate of AAGA as reassuring. “The project dramatically increases our understanding of anesthetic awareness and highlights the range and complexity of patient experiences,” he commented.
After the results were analyzed, the researchers outlined several recommendations to change clinical practice. The most important recommendations were: using a simple anesthesia checklist at the start of every operation, and having an ‘Awareness Support Pathway’ which is a structured approach for managing patients who report awareness.
Implementing these interventions will reduce the errors that cause awareness and minimize the psychological impact if it does occur, says the team.
They also call for better training and hospital support systems for anesthetists, both nationally and internationally.
Cook believes this study has defined the nature of the problem and its contributing factors more clearly than ever before.
“As well as adding to the understanding of the condition, we have also recommended changes in practice to minimize the incidence of awareness and, when it occurs, to ensure that it is recognized and managed in such a way as to mitigate longer-term effects on patients,” he said.
Pandit, J. J. et al. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods and analysis of data. The British Journal of Anaesthesia and Anaesthesia, 9 September 2014 doi: 10.1093/bja/aeu31 http://nap5.org.uk/NAP5report