In The News
In a new report, experts assert that electronic cigarettes are able to significantly lower the chances of death and illness caused by Britain’s biggest killer — tobacco. Professor John Britton at the University of Nottingham and his colleagues point out that nicotine causes little if any harm on its own and that it is the carcinogens, carbon monoxide, and thousands of other toxins in tobacco smoke that kill. Their findings are published in the journal The BMJ.
Reviewing a new report by the Royal College of Physicians (RCP) on the role of e-cigarettes in tobacco harm reduction, the authors write that e-cigs and other non-tobacco nicotine products “offer the potential to radically reduce harm from smoking in our society. This is an opportunity that should be managed, and taken.”
The authors explain that, although cigarette smoking has declined in recent decades, there are still nearly nine million smokers in the UK, a high percentage of whom are among the most disadvantaged in society. Smoking remains the largest avoidable cause of premature death, disability, and social inequalities in health in the UK.
The emergence of e-cigarettes has revolutionized the choice of nicotine products available to smokers, say the authors. Currently, an estimated 2.6 million people use e-cigarettes in the UK, almost all of whom are or have been smokers. And most importantly, one-third of these no longer smoke cigarettes.
The RCP report states that, while not absolutely safe, the harm arising from long term vapor inhalation from the e-cigarettes available today is unlikely to exceed 5 percent of the harm from smoking tobacco.
The report also lays to rest many of the concerns about the use of e-cigarettes, for example that e-cigs will attract young people to become new smokers or that they will re-establish the act of inhaling nicotine as something that is acceptable in public. On the contrary, the paper states that e-cigarette use is almost entirely limited to those who are or have been smokers, in most cases as a means to cut back or quit smoking entirely.
It also finds no evidence to support the idea that e-cigarette use re-normalizes smoking, or that using e-cigs in places where smoking is prohibited poses a hazard to health. It also finds that the availability of e-cigarettes is unlikely to account for the recent decline in the numbers of smokers using smoking cessation services.
One cause for concern, however, is that the tobacco industry might acquire many formerly independent e-cigarette producers and importers, but the report says that advertising restrictions due to be implemented in May 2016 “go some way towards alleviating these concerns.”
In conclusion, the report finds that e-cigarettes have so far been beneficial to UK public health, both at individual and population level, by providing smokers with a good alternative to tobacco smoking, write the authors.
“E-cigarettes represent an important means to reduce the harm to individuals and society from tobacco use,” they conclude. “They should continue to be supported by government and promoted as a tobacco harm reduction strategy.”
Motor vehicle accidents are the leading cause of death and injury among people under the age of 35 accounting for around five million casualties every year. Sadly, repeat offenders are common and are often minimally responsive to education and prevention efforts.
As such, McGill University researchers believe a better understanding of the subconscious and emotional processes of high-risk drivers could make a difference.
In a study focusing on repeat drunk driving and speeding offenders, researchers discovered each of these forms of risky drivers have a distinct behavioral, personality, and neurobiological profiles.
“Surprisingly, these drivers usually don’t consider themselves as risk takers,” says lead author Thomas G. Brown, an assistant professor of psychiatry at McGill and researcher at the Douglas Mental Health University Institute in Montreal.
“If drivers don’t believe they are risky, they will not accept the need to change. On the other hand, if we and they don’t understand their behavior, how can they be expected to change it effectively?”
The study, published in the journal PLOS ONE, looked at four groups of men in Quebec aged between 19 and 39. The groups included those with a history of two or more convictions for drunk driving; those who had been caught speeding or committing another moving traffic violation three or more times in the past two years; those with a driving history that included both these types of offence; and a control group of low-risk drivers.
The researchers gathered background information on the participants’ propensity for drug or alcohol abuse, and on their levels of inhibition and impulsivity. Personal characteristics such as their tendency to seek rewards or thrills in their decision-making, and their capacity to learn from past experience and make better decisions in the future were also assessed.
The study also involved observing participants’ driving on a simulator and measuring their levels of the stress hormone cortisol before and after they completed a stressful task.
The results revealed each group had a distinct emotional and behavioral profiles, leading the research team to speculate that high-risk drivers are more likely to respond to prevention strategies that take their particular characteristics into account.
A technique for thrill- and reward-seeking speeding offenders, for instance, might be to have them spend more time engaging in stimulating activities in a safe environment.
Drunk drivers, because of their greater sensitivity to the effects of alcohol as a cause of their risk taking, might be more responsive to exercises aimed at improving their ability to recall the negative consequences of any amount of drinking whenever they plan to drive.
“This might involve a strategy in which the driver mentally rehearses his plan for a night out when drinking is likely, specifically targeting how to avoid any decision-making about driving once under the influence of alcohol,” Professor. Brown said.
Meanwhile, the group engaging in both forms of dangerous driving was characterized by a lack of concern for others, extending to criminal behavior in some cases.
Past research has shown techniques focusing on a person’s individual motivations — rather than external authoritarian or moral principles — are more likely to succeed in changing behavior in these offenders.
Maybe owning some ocean-front property is not such a bad idea. Actually, property with a view of the ocean will suffice as new research suggests an ocean view relieves stress.
The Michigan State study is the first to find a link between health and the visibility of water, which the researchers call blue space.
“Increased views of blue space is significantly associated with lower levels of psychological distress,” said Amber L. Pearson, assistant professor of health geography. “However, we did not find that with green space.”
Using various topography data, the researchers studied the visibility of blue and green spaces from residential locations in Wellington, New Zealand, an urban capital city surrounded by the Tasman Sea on the north and the Pacific Ocean on the south.
Green space includes forests and grassy parks.
To gauge psychological distress, the researchers analyzed data from the New Zealand Health Survey. The national survey used the Kessler Psychological Distress Scale, or K10, which has proven to be an accurate predictor of anxiety and mood disorders.
The research is important as mental health disorders are the leading cause of disability worldwide, according to the World Health Organization.
Even after taking into account residents’ wealth, age, sex, and other neighborhood factors, the study found that having a view of the ocean was associated with improved mental health.
Interestingly, the visibility of green space did not show the same calming effect. That could be because the study did not distinguish between types of green space, says Pearson.
“It could be because the blue space was all natural, while the green space included human-made areas, such as sports fields and playgrounds, as well as natural areas such as native forests. Perhaps if we only looked at native forests we might find something different.”
Like most wealthy countries, New Zealand is highly urbanized, meaning effective city planning is increasingly important, Pearson said.
Therefore, environment design is important for public health. Designating a proportion of high-rise buildings or affordable homes in locations with ocean views could potentially promote mental health, suggests the research.
Pearson said future research could also investigate whether the findings hold true for large fresh bodies of water such as the Great Lakes.
The study appears in the academic journal Health & Place.
Source: Michigan State University
PHOTO: Ocean sunrise Credit: Dawn Carter
A new UK investigation of online troublemakers discovers the perpetrators are often socially well connected. As a result, some Facebook users remain friends online with troublemakers because they are worried about the repercussions if they “unfriend” them.
Sarah Buglass, a Ph.D. student in the School of Social Sciences at Nottingham Trent University will presented her research this week at the British Psychological Society’s Annual Conference in Nottingham.
The issue of online troublemaking is a growing concern as more people use online social networks as a focal point for social relationships.
“People are spending more and more time online making them more vulnerable to potentially damaging social tension and disagreements. Our study explored the characteristics of people who might be more likely to cause this sort of trouble in an online social network,” explains Buglass.
The researchers analyzed the online relationship characteristics of 5,113 network contacts from 52 Facebook users (13 to 45 years).
The participants were asked to rate 100 randomly sampled Facebook “friends” from their networks in terms of online disagreement (with self and others), relational closeness, and communication frequency (online and offline).
Analysis of the results revealed that online troublemakers tended to be socially popular contacts who were known and in regular communication with the participants offline but not online (i.e. the participants were Facebook friends with the troublemakers but had very limited online contact).
This implied that Facebook users might be keeping an eye on provocative friends in a bid to avoid confrontation themselves. Online disagreements could be attributed to immaturity as they were more frequent in the 19 to 21 year old group.
“Facebook users appear to be harboring known online troublemakers on their Facebook networks. While some were not averse to reporting the online indiscretions of others to the service provider, many more choose to merely ignore them. It appears that they don’t want to communicate with the troublemakers online for risk of damaging their own reputation, but at the same time they don’t appear to want to unfriend them either,” explains Buglass.
Therefore, the social risk and emotional toil of unfriending may be greater than accepting the inappropriateness.
Buglass summarizes, “The social repercussions of unfriending someone reach far beyond the boundaries of the online network. People don’t want to risk causing offline tension with their friends, family members, or colleagues by disconnecting them from their online lives. Remaining online friends with troublemakers appears to be a social necessity for some.”
New research finds significant benefit in the use of mindfulness-based cognitive therapy to reduce the risk of depression relapse.
The mindfulness-based cognitive therapy approach was compared to usual care with the results comparable to other active treatments, as measured over a five month period.
Recurrent depression is a serious issues as it causes significant disability. Interventions that prevent depressive relapse could help reduce the burden of this disease.
A growing body of research suggests mindfulness-based cognitive therapy (MBCT) is efficacious.
In the study, researchers reviewed the results of analyses of individual patient data from nine published randomized trials of MBCT. The analyses included 1,258 patients with available data on relapse and examined the efficacy of MBCT compared with usual care and other active treatments, including antidepressants.
From the review, Willem Kuyken, Ph.D., of the University of Oxford, England, and coauthors report MBCT was associated with reduced risk of depressive relapse/recurrence over 60 weeks compared with those who did not receive MBCT.
Investigators also discovered that the technique is robust as it is equally effective for a variety of groups regardless of sex, age, education, or relationship status.
The treatment effect of MBCT on the risk of depressive relapse/recurrence also may be larger in patients with higher levels of depression symptoms at baseline compared with non-MBCT treatments. This finding suggests that MBCT may be especially helpful to those patients who still have significant depressive symptoms.
Nevertheless, the authors acknowledge study limitations related to the availability of the data within the studies.
“We recommend that future trials consider an active control group, use comparable primary and secondary outcomes, use longer follow-ups, report treatment fidelity, collect key background variables (e.g., race/ethnicity and employment), take care to ensure generalizability, conduct cost-effectiveness analyses, put in place ethical and data management procedures that enable data sharing, consider mechanisms of action, and systematically record and report adverse events,” the authors conclude.
The study and accompanying editorial appear in JAMA Psychiatry.
Editorial: Mindfulness-Based Cognitive Therapy, Prevention of Depressive Relapse
“Mindfulness practices were not originally developed as therapeutic treatments. They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue. The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage.
“To my knowledge, the article by Kuyken et al is the most comprehensive meta-analysis to date to provide evidence for the effectiveness of MBCT in the prevention of depressive relapse.
“However, the article also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research,” writes Richard J. Davidson, Ph.D., of the University of Wisconsin-Madison.
For some people with depression, an exercise prescription may one day take the place of a pharmacological remedy, suggests a new research study.
University of Florida Health researchers have found that exercise provides significant relief from depression in people with certain genetic traits. Moreover, investigators discovered specific genetic markers that put people at risk for depression also predict who might benefit from exercise.
The benefit of exercise toward relieving depression symptoms was especially apparent in some men.
Specifically, the researchers found that men who were carriers of two specific genes had the most significant response to exercise. The results suggest physical activity as part of a treatment plan — exercise as moderate as walking — could help the carriers of these genes.
“I want to better understand who could benefit most from physical activity. I’d like to take the same approach to exercise that we take to medication, which is to have a personalized medicine approach,” said Vonetta Dotson, Ph.D. Dotson is the study’s first author and an assistant professor in the College of Public Health and Health Profession’s department of clinical and health psychology.
“If we show through systematic research that exercise has a good chance of helping a patient because of their particular characteristics, I think that might help with patients’ motivation to exercise.”
The results, published in The Journal of Frailty & Aging, came from a small pilot study. Therefore, more research is necessary before this work can be translated into clinical practice. But in the future, it’s possible that blood or saliva could be tested to determine if a person could benefit from physical activity to lower depressive symptoms.
The study used data gathered in the Lifestyle Interventions and Independence for Elders, or LIFE, pilot study. During the LIFE pilot study, 396 sedentary older adults were separated into two groups: those who received health education classes and those who were given moderate physical activity classes for 12 months.
A subsequent paper published from the LIFE pilot study found that exercise did not significantly affect depression symptoms across the whole group, but that changed when the research team tunneled down into the data.
“When we looked at subgroups, we ended up finding significant response to exercise in men who were carriers of a specific gene.” Dotson said.
Participants’ response to exercise was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), a screening test for depression and depressive disorders, at the beginning of the LIFE study’s intervention.
They took the test again after the interventions ended, at 12 months. The scale assesses four factors, including symptoms of sadness and fearfulness, symptoms such as loss of appetite and concentration difficulties, and a diminished capacity to experience pleasure or perceived difficulties in social relationships.
The participants also underwent genetic testing before the intervention, and the researchers tested three genes: the brain-derived neurotrophic, or BDNF, gene, a serotonin transporter gene, and a gene called apolipoprotein E.
The researchers found the greatest decrease in symptoms such as loss of appetite and concentration difficulties in men who carried the BDNF genetic variation that predisposed them to depression. They also saw an increase in the capacity to experience pleasure in men who exercised regularly who carried specific variations of the serotonin transporter gene.
Co-author Taimour Langaee, Ph.D., M.S.P.H., a research associate professor in the UF College of Pharmacy’s department of pharmacotherapy and translational research and Center for Pharmacogenomics, is interested in research studies on the effect of antipsychotic drugs on depression.
When patients are treated with antidepressants, the level of BDNF expression normalizes, helping them overcome depression, Langaee said. This study was different because it was designed to investigate the effect of physical activity in relation to genetic variations in these genes on changes in depressive symptoms.
“We already know that physical activity increases neurotransmitters and endorphins level,” he said. “So, we speculated that physical activity increased the expression of BDNF, leading to a decrease in somatic symptoms.”
Langaee said the study’s results were significant, but a larger sample size and more genetic testing is needed to better determine the effect of physical activity on these genes.
Dotson said the study provides evidence that physical activity could be explored as an intervention for depression, but warns that this study was not done in people whose symptoms were severe enough to be formally diagnosed with clinical depression. She said it’s also important to understand the benefits of exercise because of the impact medications may have on the brains of older adults.
“I’m trying to understand how exercise versus antidepressants affect the brain,” Dotson said. “The next step for me is to understand from a brain standpoint who is going to benefit and how exercise is going to be beneficial in addition to or as an alternative to medication.”
New research suggests it is important for leaders to maintain good relationships when workers exit the organization.
“When we, as researchers, study organizations, or even when we study how managers look at employees, we see that businesses often assume that the relationship terminates when a person leaves the organization,” said Dr. Sumita Raghuram, associate professor of human resource management at Pennsylvania State University.
“However, in our research, we extend the employment boundary outside of the organization. We believe that the relationship does not end there and you have to be mindful of the people who actually left the organization.”
The researchers collected data from employees of a global information technology firm headquartered in India. A total of 128 employees were tracked over an 18-month period, which included time that they were employed and after they quit the company.
During the interviews, the former employees were asked their opinion of their former employers, whether there were efforts to retain them, their experiences when they left and details about their new jobs.
Goodwill and word-of-mouth positive referral still make a difference as departed workers may help in replacement recruiting and could even come back to the organization in the future.
In a study, workers who had good relationships with their bosses carried that goodwill into their new jobs, which could lead to important benefits for their former workplaces, according to the researchers.
“These ex-employees, who we call organizational alumni, can be very important for you,” said Raghuram. “They are the ones who can be your ambassadors.”
She added that workers who felt good about their former employers could become future customers and could also relay new business knowledge and insights back to their old employers.
“They can also come back to work for you as boomerang employees,” Raghuram said. “They are a very powerful force and we cannot ignore that.”
One way to increase this alumni goodwill is to make a good effort to retain employees when they announce a pending departure, according to the researchers.
“When an employee quits they are sensitive to how they were treated when they left the organization. For example, did anyone care to tell them that they will be missed, or try to stop them from leaving by offering genuine inducements?” Raghuram said.
“What we find, once again, is that a strong retention effort can reinforce the effect between relationships with bosses and alumni goodwill.”
In many cases an employee develops new skills while working for the organization, often with the assistance of supervisor mentoring. Those improved skills can help them land better jobs with higher salaries than the positions they quit.
The study results appear in the journal Personnel Psychology.
Military veterans returning from combat situations face a substantial risk of developing posttraumatic stress disorder (PTSD). Previous studies have also shown a significant association between PTSD and intimate relationship problems.
To address these issues, family studies researchers at the University of Illinois developed an intensive retreat model for veterans and their romantic partners. The retreat includes therapeutic group and couple counseling, as well as relaxation activities. A pilot of the model was successful in helping to reduce symptoms and distress for the participants.
Kale Monk, a graduate research assistant in the Department of Human Development and Family Studies at the University of Illinois and lead author of the study, said many veterans with PTSD may not seek help because of the stigma associated with mental illness.
“After veterans complete their service, they may be reluctant to report some of these symptoms because they feel a sense of shame or that others would think less of them if they sought therapy,” he said.
“Many service members fear that seeking treatment will have negative consequences for their career or that their security clearance will even be revoked.”
He said another important reason veterans may not seek treatment is that they don’t want to take time away from their families for long-term counseling and most services don’t incorporate the partner or family.
“Therapy could take anywhere from eight sessions to months of treatment and that takes time away from service members reuniting with their families, and most people just want to go back to their lives after a long deployment. Service members and veterans indicate that they would be more willing to engage in treatment if it was brief and family focused.”
Monk says this has prompted service providers to seek out brief workshops or retreats for veterans that also include their support systems.
In the recent study, Monk and colleagues assessed what they call the Veteran Couples Integrative Retreat (VCIIR) model; seeking to evaluate a specific, inclusive treatment for those who had served and may still suffer from trauma, and their partners.
The model uses a holistic treatment approach including traditional therapeutic couple sessions and group psychoeducation, as well as yoga, massage, hiking, equine-assisted therapy, and other recreational wellness activities to promote relaxation.
For the current study, veterans must have had a diagnosis of PTSD or be experiencing PTSD symptoms, as well as a referral from a physician or VA clinic staff member in order to participate in the retreat.
During the weeklong retreat, participants engage in general psychoeducation, where they are given information about trauma, how it manifests, and what it looks like. Facilitators also share coping strategies for the veteran and the partner, such as how to handle stressors or identify triggers.
“In addition to the couple sessions, participants learn as a group about these different symptoms and ways of managing stress. They break into groups and talk about issues that are really salient to them with others who will understand their situation because they are coming from similar experiences.
“This experience sharing and sense of camaraderie seems to be really important, validating, and normalizing. When participants are not in session, they are involved in different relaxation activities and things to get them back into nature to hopefully induce a relaxing state.”
The model intentionally includes veterans from a variety of generations or combat eras to allow for interaction between older and younger veterans.
For the study, researchers used data collected from the National Veterans Wellness and Healing Center, as a total of 149 veteran couples (298 individuals) completed assessments before and immediately after the retreat. They also were assessed after six months to determine the effectiveness of the model. Assessments included military and civilian versions of the PTSD checklist.
The results showed a significant reduction in trauma symptoms for veterans and a significant decrease in distress for partners after the retreat.
“Obviously we wanted trauma symptoms to decline for veterans, but what’s additionally encouraging is that we also saw a reduction in distress for partners,” Monk said. “Many times you see an initial boost or benefit from a treatment and then people go back to where they started at baseline.
“But this was really encouraging because at six months out, we noticed that these benefits seemed to be maintained for both couple members. That’s one of the strengths of this retreat.”
Monk stressed that not all veterans returning from combat experience PTSD symptoms and not all veteran couples experience relational difficulties. However, in the United States, the lifetime risk for all people of experiencing PTSD is 8.7 percent.
Scholars estimate that the risk for veterans is 18 to 54 percent for Vietnam veterans and 16 to 30 percent for veterans of the recent conflicts in Iraq and Afghanistan, which illustrates that a significant proportion struggle even if most are doing well.
Sometimes partners may notice changes right away, but not all changes are indicators of PTSD.
“Flat affect and a service member wanting to sleep right when they get home might be more indicative of exhaustion after a long deployment,” he adds.
“It can also take some time to notice some of the effects of combat. For some in our study, they struggled with symptoms for years. One Vietnam veteran indicated that he had been struggling for 40 years, but these retreats helped him identify where the distress was coming from.”
Because of the model’s potential success, the researchers are now replicating the study as four-day retreats. “We are still finding similar outcomes as we did in the weeklong retreat study,” Monk says.
“In the new project we are also assessing relationship functioning in those that attend. Looking at the preliminary data, we’re finding that the retreats may also improve relationship quality.”
The retreats are currently free to veterans through grant funding and the contributions of communities where the retreats are held.
A new study finds that angry, competitive, and aggressive driving is becoming a worldwide phenomenon of almost epidemic proportions and appears to be a reflection of the surrounding culture, both on the road and in society.
The findings offer us a greater understanding of the underlying human psychological behaviors that come as a response to the increasingly crowded and congested road networks around the world.
Aggressive driving is viewed as competitive behavior that manifests as speeding, crowding, or lane-hopping on the road. “Road rage” is aggressive driving at its very worst, often leading to serious or fatal accidents.
In all its variations, aggressive driving is a problem that appears to be increasing. The American Automobile Association estimates that 56 percent of accidents involve aggressive driving.
The study, conducted by researchers at Oregon State University (OSU), the Beijing University of Technology and the Ministry of Transport of the People’s Republic of China, took place in China where aggressive driving has become very common.
“China is a good place to study competitive driving because it’s very common there,” said Haizhong Wang, Ph.D., an assistant professor of transportation engineering at the OSU College of Engineering.
“Roads are overcrowded, there’s less traffic control, and many drivers are younger or have little training or experience.”
China’s rising problem of aggressive driving reflects similar concerns at varying levels around the world, Wang said. The study results suggest that aggressive behavior on the road is more pronounced in men than in women and is partly a reaction to overcrowded road networks. In fact, the study implies that different social conditions might ultimately translate into better driving.
The researchers found that drivers in congested roadways shared the general belief that the chaotic traffic state was responsible for their competitive behavior and that they had no other choice than to compete for space, fight for the right-of-way, and gain advantages through speed and spacing.
In other words, the drivers believed it was completely acceptable that they should try to keep up with or get ahead of traffic; that was the example being set for them, and they drove that way because everyone else did.
The findings also suggest that an individual’s “personality traits draw on and are influenced by aspects of one’s social environment.” The researchers note that some countries and cultures may be more prone to aggressive driving due to their social environment, and that improvements in that arena would also translate into better driving behavior.
“The choice to be competitive versus cooperative always starts with culture, by the influences around us, and the way other people behave,” Wang said. “And it’s clear there’s a role for education and experience, where studies have shown the value of young drivers participating in driver education programs and receiving positive guidance from their parents and peers.”
China is unique in that many new drivers have come onto the scene just within the last two decades, and this explosion of growth is creating a very challenging driving environment. China doesn’t have generations of experience and support systems to draw upon, and this seems to be leading to a high level of accidents, injuries and fatalities.
As more countries around the world experience increasing traffic congestion, Wang said, part of the mental challenge will be for drivers to maintain a sense of personal responsibility, avoid copying the dangerous behaviors of other drivers, and exhibit tolerance, courtesy, and personal cooperation — all qualities necessary for safe driving.
The findings are published in the journal Procedia Engineering.
In a study of newlywed couples, researchers found partners believe the frequency of sex does not influence relationship quality. This opinion, however, appears to lack validity as investigators discover partners’ autonomic behavioral responses suggest otherwise.
“We found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners,” said psychological scientist Lindsey L. Hicks of Florida State University, lead author on the research.
The study appears in Psychological Science, a journal of the Association for Psychological Science.
“This is important in light of research from my colleagues demonstrating that these automatic attitudes ultimately predict whether couples end up becoming dissatisfied with their relationship,” Hicks said.
From an evolutionary standpoint, frequent sex confers several benefits. Sex improves chances of conception and helps bond partners together in relationships that facilitate child-rearing. But when researchers explicitly ask couples about their relationship satisfaction, they typically don’t find any association between satisfaction and frequency of sex.
“We thought these inconsistencies may stem from the influence of deliberate reasoning and biased beliefs regarding the sometimes taboo topic of sex,” explains Hicks.
Because our gut-level, automatic attitudes don’t require conscious deliberation, Hicks and colleagues hypothesized, they might tap into implicit perceptions or associations that we aren’t aware of.
The researchers decided to tackle the question again, assessing partners’ relationship satisfaction using both standard self-report measures and automatic behavioral measures.
In the first study, 216 newlyweds completed survey-style measures of relationship satisfaction.
Participants rated various qualities of their marriage (e.g., bad-good, dissatisfied-satisfied, unpleasant-pleasant); the extent to which they agreed with different statements (e.g., “We have a good marriage”); and their overall feelings of satisfaction with their partner, their relationship with their partner, and their marriage.
Then, they completed a computer classification task: A word appeared on-screen and they had to press a specific key to indicate whether the word was positive or negative. Before the word appeared, a photo of their partners popped up for 300 ms.
The rationale behind this kind of implicit measure is that participants’ response times indicate how strongly two items are associated at an automatic level.
The faster the response time, the stronger the association between the partner and the word that appeared. Responding more slowly to negative words than to positive words that followed the picture of the partner would signify generally positive implicit attitudes toward the partner.
The researchers also asked each partner in the couple to estimate how many times they had had sex in the last four months.
Just as in previous studies, Hicks and colleagues found no association between frequency of sex and self-reported relationship satisfaction.
But when they looked at participants’ automatic behavioral responses, they saw a different pattern: Estimates of sexual frequency were correlated with participants’ automatic attitudes about their partners. That is, the more often couples had sex, the more strongly they associated their partners with positive attributes.
Importantly, this finding held for both men and women. And a longitudinal study that tracked 112 newlyweds indicated that frequency of sex was in fact linked with changes in participants’ automatic relationship attitudes over time.
“Our findings suggest that we’re capturing different types of evaluations when we measure explicit and automatic evaluations of a partner or relationship,” says Hicks.
“Deep down, some people feel unhappy with their partner but they don’t readily admit it to us, or perhaps even themselves.”
The researchers note that participants’ reports of how often they remember having sex may not be the most precise measure of sexual frequency. And it remains to be seen whether the findings are applicable to all couples or specific to newly married couples like those they studied.
Taken together, the findings drive home the point that asking someone about their feelings or attitudes isn’t the only way to measure how they feel.
“These studies illustrate that some of our experiences, which can be either positive or negative, affect our relationship evaluations whether we know it or not,” Hicks concludes.
A new study finds that women who have been cheated on and left behind by a mate are often better off in the long run as they tend to gain a strong system of inner guidance regarding dating and life in general.
The “other” woman, however, often has a long tough road ahead of her as she attempts to work with a partner who has already shown a dishonest and unfaithful side.
Previous research on the effects of mate-loss has typically focused on a breakup’s short-term consequences, such as emotional pain and distress. In the new study, however, researchers from Binghamton University and University College London observed the long-term consequences of losing a mate as it relates to one’s personal development.
The findings show that there are consequences of female intrasexual mate competition that may be both evolutionarily adaptive and also beneficial in terms of personal growth. In fact, the lessons learned tend to expand beyond mating and into other realms of personal development.
“Our thesis is that the woman who ‘loses’ her mate to another woman will go through a period of post-relationship grief and betrayal, but come out of the experience with higher mating intelligence that allows her to better detect cues in future mates that may indicate low mate value. Hence, in the long term, she ‘wins,'” said lead author Dr. Craig Morris, a biocultural anthropologist, evolutionist and research associate at Binghamton University.
“The ‘other woman,’ conversely, is now in a relationship with a partner who has a demonstrated history of deception and, likely, infidelity. Thus, in the long-term, she ‘loses.'”
For the study, the researchers conducted an anonymous online survey of 5,705 participants in 96 countries. It was the largest-ever study on relationship dissolution, particularly in regards to cross-cultural experiences and age variation.
In his previous research, Morris highlighted how emotionally difficult breakups can be. His new study, however, highlights the ways in which humans — women, in particular — have adapted to cope with breakups.
“If we have evolved to seek out and maintain relationships, then it seems logical that there would be evolved mechanisms and responses to relationship termination, as over 85 percent of individuals will experience at least one in their lifetime,” said Morris.
So what can women take away from the experience of an unfaithful partner?
“They can learn that they are not alone — that virtually everyone goes through this, that it’s okay to seek help if needed, and that they will get through it,” Morris added.
In future research, the team will investigate how people of different life experience, age and relationship history process breakups, as well as how non-exclusively heterosexual respondents process breakups.
The study is published in The Oxford Handbook of Women and Competition.
A new Canadian study discovers that psychedelic drugs may help curb domestic violence committed by men with substance abuse problems.
In the observational study, researchers followed inmates with histories of substance abuse after they were released from prisons.
Investigators found that 42 percent of U.S. adult male inmates who did not take psychedelic drugs were arrested within six years for domestic battery after their release. However, only 27 percent of inmates who had taken drugs such as LSD, psilocybin (commonly known as magic mushrooms) and MDMA (ecstasy) were charged with battery.
In the study, researchers followed 302 inmates for an average of six years after they were released. All those observed had histories of substance use disorders.
“While not a clinical trial, this study, in stark contrast to prevailing attitudes that views these drugs as harmful, speaks to the public health potential of psychedelic medicine,” said Dr. Zach Walsh, the co-director for University of British Columbia Okanagan’s Centre for the Advancement of Psychological Science and Law.
“As existing treatments for intimate partner violence are insufficient, we need to take new perspectives such as this seriously.”
“Intimate partner violence is a major public health problem and existing treatments to reduce reoffending are insufficient,” he says. “With proper dosage, set, and setting we might see even more profound effects. This definitely warrants further research.”
The study, published in the Journal of Psychopharmacology, was co-authored by University of Alabama’s Dr. Peter Hendricks. Hendricks predicts that psilocybin and related compounds could revolutionize the mental health field.
“Although we’re attempting to better understand how or why these substances may be beneficial, one explanation is that they can transform people’s lives by providing profoundly meaningful spiritual experiences that highlight what matters most,” Hendricks said.
“Often, people are struck by the realization that behaving with compassion and kindness toward others is high on the list of what matters.”
While research on the benefits of psychedelic drugs took place in the 1950 to the 1970s, primarily to treat mental illness, it was stopped due to the reclassification of the drugs to a controlled substance in the mid-1970s. Recent years have seen a resurgence of interest in psychedelic medicine.
“The experiences of unity, positivity, and transcendence that characterize the psychedelic experience may be particularly beneficial to groups that are frequently marginalized and isolated, such as the incarcerated men who participated in this study,” said Walsh.
Experts say that there are more than 165,000 mobile applications available for health care, with the largest category for people with mental health disorders. The mobile software platforms manage or track everything from addiction to depression and schizophrenia.
Consumers should be cautious, however, as despite their wide use, the efficacy of most of these programs has not undergone rigorous scientific review, said Dr. Peter Yellowlees, a University of California, Davis professor of psychiatry and expert in using technology in clinical settings.
“While patients have access to an exponentially increasing number of apps, the research literature has not kept pace,” Yellowlees said. “But this lack of data has not held back the high level of industry and consumer interest.”
Only 14 apps for bipolar or major depressive disorder were examined in a recent literature review. And only seven apps had been reviewed for people with psychosis. Those studies found that there was little efficacy, safety, or clinical outcome data in the published literature.
Thus, despite little scientific literature on the reliability and validity of the software, demand is strong and growing.
The American Psychiatric Association is considering how to provide guidance to psychiatric providers, while the U.S. Food and Drug Administration has stated that it will not approach the monumental task.
A commentary published in the Journal of Clinical Psychiatry identifies two options for psychiatrists to choose from when considering apps and other consumer devices for clinical care.
They can decide to not use apps and counsel their patients against using them, because of the limited evidence regarding their utility and efficacy. But a more real-world approach would be to accept that patients already are using mobile psychiatry apps, and that they are here to stay.
Patients already are bringing apps, sleep-tracking devices, and activity-monitoring devices to psychiatrists to ask for a professional opinion on their use, in the same way that many patients bring Internet resources and Google searches to physicians for second opinions.
The commentary recommends a framework that psychiatrists should consider when evaluating all “ASPECTS” of an app. The acronym challenges a psychiatrist to review an app based on whether it is: Actionable, Secure, Professional, Evidence-Based, Customizable, and TranSparent.
“The framework presented here is important, as it offers a flexible tool that clinicians and patients can use together to make more informed decisions about whether to use or not use a smartphone app or other mobile health technology,” said Dr. John Torous, commentary first author and clinical fellow in psychiatry at Beth Israel Deaconess Medical Center and the Harvard Medical School.
“While both patients and clinicians know the right questions to ask about a new medication or pill, sometimes they may not be aware of all the best questions to ask about an app. With this framework we hope to guide them towards a more informed discussion,” said Torous.
- Actionable — To be actionable, an app should collect data, but it must be data that can be valuable and clinically useful. A psychiatrist should consider how app data will be incorporated into clinical decision-making and how the data will inform care. He noted that in the future, it will be increasingly valuable for some categories of apps to seamlessly integrate with electronic health records and complement clinical practices.
- Secure — Laws mandate that health information be secure, among them the Health Insurance Portability and Accountability Act (HIPAA). Psychiatrists should examine whether apps are password protected or biometrically authenticated. Patient data should be encrypted in case the mobile device is stolen or hacked.
- Professional — Apps should be in line with professional standards for clinical use, including legal and ethical standards. HIPAA is a federal law and in part requires strict protection and confidential handling of protected health information, and severe penalties for violation. Other laws protecting privacy may vary state to state.
- Evidence-Based — Apps with little or limited data may be risky to use. There are already documented cases in which apps designed for reduction in alcohol intake led to increased alcohol use. Caveat emptor — let the buyer beware.
- Customizable — One size does not fit all where apps are concerned. When considering an app for clinical use, psychiatrists should look for those that offer more customizable and flexible features. Patients and clinicians are more likely to be invested in and adhere to something they created together.
- TranSparent — Apps should openly report how data is collected, stored, analyzed, used and shared. This is critical in selecting an app for clinical care. If there is uncertainty about how an app is using a patient’s health care data, then there is uncertainty in any conclusions or recommendation that app may offer.
Patients will increasingly bring apps into the clinical visit with them, the authors said. Understanding the complexity of evaluating apps is important to allow physicians lead an informed discussion with patients regarding app use.
Source: University of California, Davis
Although we all strive for happiness, how do we measure if we are happy? Do we live in a happy community? Or, a happy country? How can we take stock of our satisfaction with life?
Researchers at the University of Iowa (UI) are turning to social media to answer these questions and more.
In a this new study, computer scientists used two years of Twitter data to measure users’ life satisfaction, a component of happiness.
Chao Yang, Ph.D., lead author on the study and a graduate of the UI Department of Computer Science, said this study is different from most social media research on happiness because it looks at how users feel about their lives over time, instead of how they feel in the moment.
“In countries like Bhutan, they are not satisfied with current measures of success like GDP, so they are measuring the Gross National Happiness Index,” Yang says. “They want to know how well their people are living; we saw an opportunity there.”
The study appears in the journal PLOS One.
Yang, along with faculty adviser Padmini Srinivasan, Ph.D., mined data from about three billion tweets from October 2012 to October 2014. They limited their data set to only first-person tweets with the words “I,” “me,” or “mine” in them to increase the likelihood of getting messages that conveyed self-reflection.
With assistance from two students in the UI Department of Linguistics, Yang and Srinivasan developed algorithms to capture the basic ways of expressing satisfaction or dissatisfaction with one’s life.
Then, they used these statements to build retrieval templates to find expressions of life satisfaction and their synonyms on Twitter. For example, the template for the statement “my life is great” also would include statements such as “my life is wonderful,” “my life is fabulous,” etc.
The UI researchers found that people’s feelings of long-term happiness and satisfaction with their lives remained steady over time, unaffected by external events such as an election, a sports game, or an earthquake in another country.
Srinivasan says these findings contrast with previous social media research on happiness, which typically has looked at short-term happiness (called “affect”) and found that people’s daily moods were heavily influenced by external events.
However, the UI findings are consistent with traditional social science research on subjective well-being (the scientific term for “happiness”), which she says lends credibility to their research.
“The traditional methods of studying happiness have been through surveys and observations and that takes a lot of effort,” Srinivasan said.
“But if you can actually tap into social media and get observations, I think it would be unwise to ignore that opportunity. So let the traditional methods continue, but let’s also look at social media, if it indeed gives you sensible results, and this study shows that it does.”
Yang and Srinivasan were able to group Twitter users by those who expressed satisfaction or dissatisfaction with their lives, with key differences found between the two.
They found satisfied users were active on Twitter for a longer period of time and used more hashtags and exclamation marks, but included fewer URLs in their tweets. Dissatisfied users were more likely to use personal pronouns, conjunctions, and profanity in their tweets.
In addition, the UI researchers found differences in satisfied and dissatisfied users’ psychological processes.
Dissatisfied users were at least 10 percent more likely than satisfied users to express negative emotion, anger, and sadness and to use words such as “should,” “would,” “expect,” “hope,” and “need” that may express determination and aspirations for the future.
They also were more likely to use sexual words and to use them in a negative context. Satisfied users were more likely to express positive emotion, especially related to health and sexuality, and were at least 10 percent more likely to use words related to money and religion.
Another finding was that dissatisfied users were at least 10 percent more likely to use words related to death, depression, and anxiety.
The researchers also studied users who changed their assessments of their life satisfaction. They found users who changed from expressing satisfaction to dissatisfaction over time posted more about anger, anxiety, sadness, death, and depression compared to those who continued to express satisfaction.
Srinivasan says research like this is significant because life satisfaction is a big component of happiness.
“To be happy is what everyone strives for, ultimately, so it’s important,” she says. “With this research, we can get a better understanding of the differences between those who express satisfaction and those who express dissatisfaction with their life. Possibly in the future, with more such studies, one might design suitable interventions.”
New research suggests intestinal bacteria can influence the way the brain responds to stressful situations.
Dr. John Bienenstock and Dr. Paul Forsythe — who work in the Brain-Body Institute at McMaster University in Ontario, Canada believe gut bacteria could be used to cure or prevent neurological conditions such as post-traumatic stress disorder (PTSD), anxiety and depression.
The study is sponsored by the Office of Naval research (ONR).
“This is extremely important work for U.S. warfighters because it suggests that gut microbes play a strong role in the body’s response to stressful situations, as well as in who might be susceptible to conditions like PTSD,” said Dr. Linda Chrisey, a program officer in ONR’s Warfighter Performance Department.
Researchers explain that the trillions of microbes in the intestinal tract, collectively known as the gut microbiome, profoundly impact human biology. The bacteria play an active role in digesting food, regulating the immune system and even transmitting signals to the brain that alter mood and behavior.
ONR believes the research will increase warfighters’ mental and physical resilience in situations involving dietary changes, sleep loss, or disrupted circadian rhythms (from shifting time zones or living in submarines).
Through research on laboratory mice, Bienenstock and Forsythe have shown that gut bacteria seriously affect mood and demeanor. They also were able to control the moods of anxious mice by feeding them healthy microbes from fecal material collected from calm mice.
Bienenstock and Forsythe used a “social defeat” scenario in which smaller mice were exposed to larger, more aggressive ones for a couple of minutes daily for 10 consecutive days.
The smaller mice showed signs of heightened anxiety and stress — nervous shaking, diminished appetite, and less social interaction with other mice. The researchers then collected fecal samples from the stressed mice and compared them to those from calm mice.
“What we found was an imbalance in the gut microbiota of the stressed mice,” said Forsythe.
“There was less diversity in the types of bacteria present. The gut and bowels are a very complex ecology. The less diversity, the greater disruption to the body.”
Bienenstock and Forsythe then fed the stressed mice the same probiotics (live bacteria) found in the calm mice and examined the new fecal samples. Through magnetic resonance spectroscopy (MRS), a non-invasive analytical technique using powerful MRI technology, they also studied changes in brain chemistry.
“Not only did the behavior of the mice improve dramatically with the probiotic treatment,” said Bienenstock, “but it continued to get better for several weeks afterward. Also, the MRS technology enabled us to see certain chemical biomarkers in the brain when the mice were stressed and when they were taking the probiotics.”
The biomarkers may be a key to detecting risk and suggesting proactive therapy.
Both researchers said stress biomarkers could potentially indicate if someone is suffering from PTSD or risks developing it, allowing for treatment or prevention with probiotics and antibiotics.
Later this year, Bienenstock and Forsythe hope to secure funding to conduct clinical trials to administer probiotics to human volunteers and use MRS to monitor brain reactions to different stress levels.
ONR explains that the analysis of gut microbiology is part of a program in warfighter performance. Researchers are also looking at the use of synthetic biology to enhance the gut microbiome.
Synthetic biology creates or re-engineers microbes or other organisms to perform specific tasks like improving health and physical performance. The field was identified as a top ONR priority because of its potential far-ranging impact on warfighter performance and fleet capabilities.
New research suggests an “addiction” to video games is often associated with attention deficit/hyperactivity disorder, obsessive-compulsive disorder, and depression.
Dr. Cecilie Schou Andreassen, a clinical psychologist specialist at Department of Psychosocial Science, University of Bergen (UiB), surveyed more than 20,000 participants on videogame addiction.
“Video game addiction is more prevalent among younger men, and among those not being in a current relationship, than others,” said Andreassen.
“Excessively engaging in gaming may function as an escape mechanism for, or coping with, underlying psychiatric disorders in attempt to alleviate unpleasant feelings, and to calm restless bodies.”
According to Andreassen, the large study shows some clear tendencies as to which people develop addictive use of social media.
“The study implies that younger with some of these characteristics could be targeted regarding preventing development of an unhealthy gaming pattern.”
The research, published in the journal Psychology of Addictive Behaviors, also showed that addiction related to videogames and computer activities shows sex differences.
“Men seem generally more likely to become addicted to online gaming, gambling, and cyber-pornography, while women to social media, texting, and online shopping,” Schou Andreassen says.
The study uses seven criteria to identify video game addiction where gaming experiences last six months. Responses were scored on a scale from Never to Very often:
- you think about playing a game all day;
- you spend increasing amounts of time on games;
- you play games to forget about real life;
- others have unsuccessfully tried to reduce your game use;
- you feel bad when you are unable to play;
- you have fights with others (e.g., family, friends) over your time spent on games;
- you neglect other important activities (e.g., school, work, sports) to play games
Scoring high on at least four of the seven items may suggest that you are addicted to video gaming associated with impaired health, work, school, and/or social relations.
Video game addiction is not the norm, as Andreassen explains, “most people have a relaxed relationship to video games and fairly good control.”
A new review of 50 years of research on the topic of spanking children determines spanking is linked to detrimental child outcomes.
In the meta-review, experts found that the more children are spanked, the more likely they are to defy their parents and to experience increased antisocial behavior, aggression, mental health problems, and cognitive difficulties.
The study, published in the Journal of Family Psychology, looks at five decades of research involving over 160,000 children. The researchers say it is the most complete analysis to date of the outcomes associated with spanking.
Notably, the review was more specific as to the effects of spanking alone, as previous papers often included other types of physical punishment in their analyses.
“Our analysis focuses on what most Americans would recognize as spanking and not on potentially abusive behaviors,” said Dr. Elizabeth Gershoff, an associate professor of human development and family sciences at the University of Texas at Austin.
“We found that spanking was associated with unintended detrimental outcomes and was not associated with more immediate or long-term compliance, which are parents’ intended outcomes when they discipline their children.”
Gershoff and co-author Dr. Andrew Grogan-Kaylor, an associate professor at the University of Michigan School of Social Work, found that spanking (defined as an open-handed hit on the behind or extremities) was significantly linked with 13 of the 17 outcomes they examined, all in the direction of detrimental outcomes.
“The upshot of the study is that spanking increases the likelihood of a wide variety of undesired outcomes for children. Spanking thus does the opposite of what parents usually want it to do,” Grogan-Kaylor said.
Gershoff and Grogan-Kaylor tested for some long-term effects among adults who were spanked as children. The more they were spanked, the more likely they were to exhibit anti-social behavior and to experience mental health problems.
Researchers found that adults who were spanked as kids were also more likely to support physical punishment for their own children.
Investigators looked at a wide range of studies and noted that spanking was associated with negative outcomes consistently and across all types of studies, including those that used robust methodologies such as longitudinal or experimental designs.
Amazingly, as many as 80 percent of parents around the world spank their children, according to a 2014 UNICEF report. Gershoff notes that this persistence of spanking is in spite of the fact that there is no clear evidence of positive effects from spanking and ample evidence that it poses a risk of harm to children’s behavior and development.
Both spanking and physical abuse were associated with the same detrimental child outcomes in the same direction and nearly the same strength.
“We as a society think of spanking and physical abuse as distinct behaviors,” she said.
“Yet our research shows that spanking is linked with the same negative child outcomes as abuse, just to a slightly lesser degree.”
Gershoff also noted that the study results are consistent with a report released recently by the Centers for Disease Control and Prevention that called for “public engagement and education campaigns and legislative approaches to reduce corporal punishment,” including spanking, as a means of reducing physical child abuse.
“We hope that our study can help educate parents about the potential harms of spanking and prompt them to try positive and non-punitive forms of discipline.”
Efforts to improve political rights for lesbian, gay, and bisexual (LGB) individuals often hinge on questions about the prevalence, causes, and consequences of non-heterosexual orientations.
The battle for equal rights has spanned more than 50 years and remains a contentious issue with social differences in opinion found across countries, states, and cities.
A new study provides an update on what is known, and what still remains to be discovered on issues related to sexual orientation.
“We wanted to write a comprehensive review that was ‘state of the art’ — in doing so, we also wanted to correct important misconceptions about the link between scientific findings and political agendas,” said psychology researcher and lead author Dr. J. Michael Bailey of Northwestern University.
Study results appear in in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, and is accompanied by a commentary by psychological scientist Dr. Ritch Savin-Williams of Cornell University.
Based on on review of the latest science, the researchers draw several conclusions about the nature of sexual orientation.
- Across cultures, a “small but nontrivial” percentage of people have non-heterosexual feelings. The specific expression of sexual orientation varies widely according to cultural norms and traditions, but research suggests that individuals’ sexual feelings are likely to develop in similar ways around the world.
- Men’s and women’s sexual orientations manifest in different ways: Men’s sexual orientation is more closely linked to their patterns of sexual arousal than women’s sexual orientation is.
- Various biological factors, including prenatal hormones and specific genetic profiles, are likely to contribute to sexual orientation, though they are not the sole cause. Scientific evidence suggests that biological and non-social environmental factors jointly influence sexual orientation.
- Scientific findings do not support the notion that sexual orientation can be taught or learned through social means. And there is little evidence to suggest that non-heterosexual orientations become more common with increased social tolerance.
Nevertheless, despite these points of consensus, some aspects of sexual orientation are not as clear-cut.
While Bailey and colleagues describe sexual orientation as primarily falling into categories — lesbian, gay, or bisexual — Savin-Williams said onsiderable evidence supports a sexual continuum.
He noted that the label “bisexual” serves as a catchall for diverse sexual orientations that fall in-between heterosexual and homosexual. As a result, his estimate of the prevalence of the nonheterosexual population is double that of Bailey and colleagues.
From their review, the authors also conclude that gender nonconformity in childhood — behaving in ways that do not align with gender stereotypes — predicts non-heterosexuality in adulthood.
According to Savin-Williams, the degree to which this is true could be a consequence of how study participants are typically recruited and may not be accurate among more representative samples of nonheterosexual individuals.
The report authors and Savin-Williams agree on most issues, including that a major limitation of existing research relates to how sexual orientation is measured.
For example, most researchers view sexual orientation as having several components — including sexual behavior, sexual identity, sexual attraction, and physiological sexual arousal — and yet, the majority of scientific studies focus solely on self-reported sexual attraction.
The decision to use these self-report measures is typically made for pragmatic reasons, but it necessarily limits the conclusions that can be drawn about how different aspects of sexual orientation vary by individual, by culture, or by time.
Additionally, individual and cultural stigma likely results in underreporting of non-heterosexual behaviors and orientations across the board.
The authors believe the fundamental question pertaining to whether people can “choose” to have non-heterosexual orientations, is not a relevant query. The authors contend that because sexual orientation is based on desire and we do not “choose” our desires, this question is illogical.
Ultimately, these kinds of debates come down to moral issues, not scientific ones: “People have often thought unclearly about sexual orientation and the political consequences of research,” Bailey said.
“The question of whether sexual orientation is ‘chosen’ has divided pro- and anti-gay forces for decades, but the question of causation is mostly irrelevant to the culture wars.”
The fact that issues related to sexual orientation continue to be hotly debated in the public arena underscores the need for more and better research.
“Sexual orientation is an important human trait, and we should study it without fear, and without political constraint,” Bailey said.
“The more controversial a topic, the more we should invest in acquiring unbiased knowledge and science is the best way to acquire unbiased knowledge.”
New research reduces concern that non-nicotine medications could cause neuropsychiatric issues.
An international team of investigators compared the smoking cessation aids varenicline (marketed as Chantix in the U.S.) and bupropion (Zyban) to the nicotine patch and a placebo.
As reported in the journal The Lancet, researchers discovered the medications were not associated with a significant increase in neuropsychiatric adverse events.
“There are one billion smokers in the world and nearly six million smoking-related deaths each year, but there are only three approved medication treatments for quitting: nicotine replacement therapies like the patch and the two non-nicotine medications, bupropion, and varenicline,” said Robert Anthenelli, M.D., professor of psychiatry, at University of California San Diego School of Medicine and first author of the study.
Anthenelli said the so-called EAGLES study is important because it prospectively examined the neuropsychiatric safety risks and quit-enhancing potential of the three medication classes versus placebo in a rigorous, adequately-sized, randomized controlled trial.
It is the result of a Food and Drug Administration (FDA) mandate following post-marketing reports suggesting varenicline and bupropion might cause adverse neuropsychiatric events, such as increased agitation, depression, hostility, or suicidal behavior.
The FDA requested that both medications carry boxed warnings in their labeling. This has resulted in limitation in use. The EAGLES study was funded by Pfizer and GlaxoSmithKline, makers of varenicline and bupropion, respectively, and designed in consultation with the FDA.
Authors sought to directly assess the safety and efficacy of varenicline and bupropion compared to the nicotine patch and to a placebo in smokers with and without psychiatric disorders.
Investigators conducted a randomized, controlled, double-blind trial in an examination of more than 8,000 smokers seeking to quit in 16 countries over a period from November 2011 to January 2015.
Trial participants, investigators and research personnel were blinded to who received which treatment.
“This is the first study to compare the safety and efficacy of the three first-line smoking cessation aids on the market, head-to-head, in smokers. It’s the largest double-blind smoking cessation medication trial to date,” said Anthenelli.
“And no study has done so in smokers with current or past psychiatric disorders who consume roughly 45 percent of the cigarettes sold in the U.S.”
In terms of safety, approximately two percent of non-psychiatric participants reported moderate or severe adverse neuropsychiatric events for any of the treatments. Specifically, 1.3 percent for varenicline, 2.2 percent for bupropion, 2.5 percent for the nicotine patch, and 2.4 percent for placebo.
In the cohort of participants with psychiatric disorders, moderate and severe adverse neuropsychiatric events were slightly higher across the board: 6.5 percent for varenicline, 6.7 percent for bupropion, 5.3 percent for the nicotine patch, and 4.9 percent for placebo.
Anthenelli said the risk difference in the incidence of serious neuropsychiatric adverse events for varenicline and bupropion was not significantly higher than placebo. However, psychiatric patients trying to stop smoking are likely to have more confounding or complicating factors in treatment and appear to have a harder time quitting.
The efficacy or success rate, measured as biochemically-confirmed continuous abstinence for weeks nine to 12 after treatment began, was broadly consistent with past research and predictions.
Regardless of participants’ psychiatric status, varenicline was found to be more effective at helping smokers achieve abstinence than bupropion, the patch or placebo; bupropion and patch were more effective than the placebo.
For all of the treatment groups, the most frequent adverse events were nausea, insomnia, abnormal dreams, and headache.
A new study has found that domestic violence tends to occur more often when a couple is experiencing financial stress. And while the findings don’t prove a specific cause-and-effect relationship, they do confirm that extreme stressors such as unstable housing and food insecurity should be addressed more often in health care settings.
“What we don’t know yet is whether financial stress makes a violent couple more violent, or is financial stress enough of a disruption in a relationship that violence begins?” saod Corinne Peek-Asa, Ph.D., a corresponding author and director of the Injury Prevention Research Center at the University of Iowa (UI) College of Health. “Both are plausible.”
Though researchers aren’t ready to identify specific interventions for couples that are struggling with finances and domestic abuse, they are beginning to see that stressors beyond health, such as financial strain or unstable housing, may be at the root of some health-related problems.
For the study, researchers looked at data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adolescents that began in 1994, when participants were in grades seven through 12.
Researchers analyzed the connection between financial stressors and three levels of violence, as reported by 11,499 participants. The researchers gathered data for the UI study in 2008, when participants in the initial study were between the ages of 24 and 32.
Participants reported how often they had committed any level of violence on a scale ranging from “never” to “more than 20 times in the last year.” The three levels of violence were “making threats/minor physical abuse,” “severe physical abuse,” and “physical abuse causing injury.”
They also reported whether they had experienced six types of financial stressors at least once in the past 12 months: nonpayment of utilities, nonpayment of housing, fears of food unavailability, utilities turned off, and eviction.
One significant finding was that more women than men reported feeling stressed financially. More women than men also reported lashing out verbally and physically at their partners. This doesn’t mean, however, that women are more likely than men to react to financial stress with violence, assert the researchers.
Specifically, 27.7 percent of women and 22.9 percent of men experienced at least one type of financial stressor. A higher percentage of women than men also reported experiencing three of the six types of financial stressors.
Furthermore, a greater percent of women than men were unable to pay their utilities (17.6 percent vs. 12.7 percent), reported food insecurity (14 percent vs. 9.9 percent), and experienced disconnected phone service (10.4 percent vs. 7.8 percent).
A similar proportion of both men and women experienced the stressors of housing nonpayment, having utilities turned off, and eviction.
Regarding domestic violence, more women than men reported perpetrating threats/minor physical abuse (11.4 percent vs. 6.7 percent) and severe physical abuse (8.8 percent vs. 3.4 percent). But more men who did commit violence reported causing injury to their partner (32 percent vs. 21 percent). Overall, 92.9 percent of men and 86.7 percent of women reported they had committed no form of violence to their partner in the previous year.
Lead author Laura Schwab-Reese, Ph.D., of the Department of Community & Behavioral Health at the UI College of Public Health, said the data is helpful, but it isn’t conclusive enough to develop interventions.
“So, we know violence happened in the last year, and we know that financial stressors happened in the last year,” she says. “But what we haven’t been able to tease apart with this data is whether the financial stressor happened immediately before a violent episode, or did it exacerbate an already violent relationship? That is a really important point in terms of developing interventions.”
Getting down to the root cause will be key to creating helpful interventions, said Peek-Asa.
“When we are developing interventions, do we need to focus on reducing the event, such as reducing the financial stressor, or do we need to help people manage the stress that happens as a result of the financial stressor?” she said.
Peek-Asa said it’s good timing for these findings, just as more people than ever have access to health care because of the Affordable Care Act. This ruling requires all hospitals to perform a community needs assessment and increase efforts to refer patients to community resources.
The findings could help doctors expand their ideas of what they typically consider health-related stress, from factors such as being overweight, smoking, and drinking, to include such stressors as food insecurity, unpaid bills, and eviction.
“Although hospitals aren’t quite there yet, some of the most important health needs of patients are things like housing, employment services, and financial consulting — things that could reduce financial stress and potentially reduce intimate partner violence,” Peek-Asa said.
The study is published in the journal Injury Epidemiology.
Source: University of Iowa