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Brain Training App Improves Memory of People With Schizophrenia

Sun, 08/02/2015 - 6:38pm

A new brain training iPad game developed by researchers at the University of Cambridge may improve the memory of patients with schizophrenia, according to new research.

While the psychotic symptoms of schizophrenia are reasonably treated by current medications, patients are still left with debilitating cognitive impairments, including in their memory, and so are frequently unable to return to school or work, the researchers said.

They added that while there are no medications to improve cognitive function for people with schizophrenia, there is increasing evidence that computer-assisted training can help them overcome some of their symptoms, with better outcomes in daily functioning and their lives.

In a study published in the Philosophical Transactions of the Royal Society B, a team of researchers led by Professor Barbara Sahakian from the Department of Psychiatry at Cambridge describe how they developed and tested Wizard, an iPad game aimed at improving episodic memory.

Episodic memory is the type of memory required when you have to remember where you parked your car in a multi-story parking garage after going shopping for several hours or where you left your keys several hours ago, for example. It is one of the facets of cognitive functioning affected in patients with schizophrenia, the researchers said.

The game is the result of a nine-month collaboration between psychologists, neuroscientists, a professional game developer, and people with schizophrenia. It is intended to be fun, attention-grabbing, motivating and easy to understand, while at the same time improving the player’s episodic memory.

The memory task was woven into a narrative in which the player is allowed to choose their own character and name. The game rewards progress with additional in-game activities to provide the user with a sense of progression independent of the cognitive training process, the researchers explain.

For the study, the researchers recruited 22 people diagnosed with schizophrenia. They were then randomly assigned to either the cognitive training group or a control group.

Those in the training group played the memory game for a total of eight hours over a four-week period, while those in the control group continued their treatment as usual.

At the end of the four weeks, the researchers tested all participants’ episodic memory using the Cambridge Neuropsychological Test Automated Battery (CANTAB) PAL, as well as their level of enjoyment and motivation, and their score on the Global Assessment of Functioning (GAF) scale, which doctors use to rate the social, occupational, and psychological functioning of adults.

The researchers found that the patients who had played the memory game made significantly fewer errors and needed significantly fewer attempts to remember the location of different patterns in the CANTAB PAL test relative to the control group. In addition, patients in the cognitive training group saw an increase in their score on the GAF scale.

Those in the training group indicated that they enjoyed the game and were motivated to continue playing across the eight hours of cognitive training. In fact, the researchers found that those who were most motivated also performed best at the game. This is important, as lack of motivation is another common facet of schizophrenia.

“We need a way of treating the cognitive symptoms of schizophrenia, such as problems with episodic memory, but slow progress is being made towards developing a drug treatment,” Sahakian said. “So this proof-of-concept study is important because it demonstrates that the memory game can help where drugs have so far failed. Because the game is interesting, even those patients with a general lack of motivation are spurred on to continue the training.”

In April 2015, the researchers began a collaboration with the team behind the brain training app Peak to produce scientifically-tested cognitive training modules. The collaboration has resulted in the launch of the Cambridge University & Peak Advanced Training Plan, a memory game available within Peak’s iOS app, designed to train visual and episodic memory while promoting learning.

The training module is based on the Wizard memory game, developed by Sahakian and colleague Tom Piercy at the Department of Psychiatry at the University of Cambridge. Rights to the game were licensed to Peak by Cambridge Enterprise, the university’s commercialization company.

“This new app will allow the Wizard memory game to become widely available, inexpensively,” Sahakian said. “State-of-the-art neuroscience at the University of Cambridge, combined with the innovative approach at Peak, will help bring the games industry to a new level and promote the benefits of cognitive enhancement.”

The game is built for four weeks of training and is priced at $14.99/£10.99.

Source: University of Cambridge

Perfectionism Linked to Burnout

Sun, 08/02/2015 - 4:44pm

Being a perfectionist may lead you to unwittingly sabotage success at work, school or in sports, leading to stress, burnout and health problems, according to new research.

In a meta-analysis of the relationship between perfectionism and burnout, researchers at York St. John University in England analyzed the findings from 43 previous studies conducted over the past 20 years.

What they found is that perfectionism isn’t all bad.

One aspect of perfectionism called “perfectionistic strivings” involves setting high personal standards and working toward those goals in a proactive manner. These efforts may help maintain a sense of accomplishment and delay the debilitating effects of burnout, according to the study’s findings.

The dark side of perfectionism, called “perfectionistic concerns,” can be more detrimental when people constantly worry about making mistakes, letting others down, or not measuring up to their own impossibly high standards, said lead researcher Dr. Andrew Hill, an associate professor of sport psychology.

Previous research has shown that perfectionistic concerns and the stress they generate can contribute to serious health problems, including depression, anxiety, eating disorders, fatigue and even early death.

“Perfectionistic concerns capture fears and doubts about personal performance, which creates stress that can lead to burnout when people become cynical and stop caring,” Hill said. “It also can interfere with relationships and make it difficult to cope with setbacks because every mistake is viewed as a disaster.”

The study, published in the Personality and Social Psychology Review, also found that perfectionistic concerns had the strongest negative effects in contributing to burnout in the workplace.

This may be because people have more social support and clearly defined objectives in education and sports, according to the researchers. A student can be rewarded for hard work with a high grade, or a tennis player can win the big match, but a stellar performance in the workplace may not be recognized or rewarded, which may contribute to cynicism and burnout, researchers explained.

“People need to learn to challenge the irrational beliefs that underlie perfectionistic concerns by setting realistic goals, accepting failure as a learning opportunity, and forgiving themselves when they fail,” Hill said. “Creating environments where creativity, effort and perseverance are valued also would help.”

Source: Society for Personality and Social Psychology

Man with job burnout photo by shutterstock.

Overactive Glutamate Receptor Gene Tied to Depression in Women

Sun, 08/02/2015 - 3:44pm

A new study has found depressed women have an abnormally high expression of the genes that regulate the glutamate system.

Glutamate is the major excitatory neurotransmitter in the brain, according to a researcher at the University of Illinois at Chicago. Schizophrenia, epilepsy, autism and Alzheimer’s disease have all been linked to abnormalities of the glutamate system.

This overabundance may be an underlying cause of the higher incidence of suicide among women, said Monsheel Sodhi, Ph.D., an assistant professor of pharmacy practice at the university.

Gender plays a role in depression and suicide, according to Sodhi. While women are two to three times more likely to attempt suicide, men are four times more likely to die by suicide.

Sodhi noted she and her colleagues were intrigued by recent studies that found that a low dose of the drug ketamine, which alters glutamate system activity, can rapidly eliminate depression in two-thirds of patients who do not respond to conventional antidepressants. Conventional antidepressants target the monoamine systems, which secrete the neurotransmitters dopamine, serotonin or norepinephrine.

In the new study, published in the journal Molecular Psychiatry, Sodhi and her research team analyzed post-mortem brain tissue from people who had suffered from depression. Both females and males were compared to subjects who had never experienced psychiatric illness. Many of the depressed patients, she said, died by suicide.

Females with depression had the highest levels of expression of several glutamate receptor genes, perhaps making them more prone to depression, according to the study’s findings. In addition, three of these genes were found to be elevated in both male and female patients who had died by suicide, Sodhi noted.

“Our data indicate that females with major depression who are at high risk of suicide may have the greatest antidepressant benefit from drugs that act on the glutamate system, such as ketamine,” Sodhi said.

Source: University of Illinois at Chicago

Woman with depression photo by shutterstock.

Socially Integrated Women at Lower Risk for Suicide

Sun, 08/02/2015 - 2:43pm

Women with a thriving social life have a lower risk for suicide, according to a new analysis of data from the Nurses’ Health Study.

Using data from 72,607 nurse respondents, Alexander C. Tsai, M.D., Ph.D., of Massachusetts General Hospital, Boston, and coauthors studied the connection between social integration and suicide. The nurses (ages 46 to 71 years) were surveyed about their social relationships beginning in 1992 and were followed until death or until June 2010.

The researchers measured levels of social integration based on an index of seven items that included questions about marital status, social network size, frequency of contact with social ties, and participation in religious or other social groups.

The majority of study participants were found to be in the highest (31,071 of 72,607) category of social integration. The findings showed that suicide risk was lowest among women in the highest and second-highest categories of social integration. Increasing or consistently high levels of social integration also were associated with a lower risk for suicide.

Socially isolated women were at greater risk of suicide and were more likely to be employed full time, were less physically active, consumed more alcohol and caffeine, and were more likely to smoke than socially integrated women.

Overall, there were 43 suicides from 1992 to 2010 and the most frequent means of suicide were poisoning by solid or liquid substances (21 suicides), followed by firearms and explosives (eight suicides) and strangulation and suffocation (six suicides).

“Interventions aimed at strengthening existing social network structures, or creating new ones, may be valuable programmatic tools in the primary prevention of suicide,” write the researchers.

So far, there has been minimal research on the social factors of suicide risk. Instead, most of the work in this field has emphasized the psychiatric, psychological or biological determinants of suicide.

“The social part has always been the weakest link of this paradigm and needs invigoration. Just as important, we already know, in broad terms, the positive and deleterious effects of social forces and factors in the development and evolution of conditions that are behaviorally and emotionally based,” writes Eric D. Caine, M.D., of the University of Rochester Medical Center, Rochester, N.Y in a related editorial.

“Like heart disease 50 years ago, we do not need to have absolute certainty about the mechanism of action to begin to test and implement essential, broadly targeted preventive interventions.”

The findings are published online in the journal JAMA Psychiatry.

Source: JAMA Network Journals

Women in conversation photo by shutterstock.

New Study Shows Parents Misjudge Children’s Happiness

Sun, 08/02/2015 - 1:36pm

A new study shows that parents of 10- and 11-year-olds consistently overestimate their child’s happiness, while those with 15- and 16-year-olds are inclined to underestimate their teen’s unhappiness.

Researchers at the University of Plymouth in England attribute the discrepancies to an “egocentric bias” through which parents rely too heavily on their own feelings in assessing the happiness of the family as a whole.

Children’s and adolescents’ happiness has gained considerable attention in recent research, however the potential problems of relying on parental reports to assess children’s happiness have been overlooked, according to the researchers.

Published in the Journal of Experimental Child Psychology, the latest study could provide valuable information, not only for advancing knowledge about well-being, but also for improving parent-child relationships and paving the way for carrying out improved interventions, the researchers noted.

For the study, Dr. Belén López-Pérez, a postdoctoral research fellow in developmental and social psychology, and Ellie Wilson, a recent graduate of the BSc (Hons) Psychology course, questioned 357 children and adolescents from two different schools in Spain, along with their parents. Happiness was assessed using a range of self-reporting measures and ratings.

The results showed that parents were inclined to score a child or adolescents’ happiness closely in line with their own emotional feelings while, in fact, there were notable differences in the child’s reports, according to the researchers.

While children and adolescents reported very similar levels of happiness, parents reported different levels depending on the age of their child, the researchers said. While the study found the discrepancies between the parents and children, it also found a drop in the level of happiness in parents of adolescents, they noted.

“Studying informants’ discrepancies and the relationship between parents’ and children’s self-reports on happiness is vital to determine whether parental report is valid,” Lopez- Perez said. “Being unable to read children’s happiness appropriately may increase misunderstanding between parents and children/adolescents, which has been shown to have negative consequences for parent-child relationships. Furthermore, parents might not be able to provide the appropriate emotional support or attend to their children’s needs accurately.”

Source: University of Plymouth

Child with hands clasped over ears photo by shutterstock.

Mindfulness May Help Smokers Quit by Increasing Self-Control

Sun, 08/02/2015 - 10:36am

Exercises that help increase self-control, such as mindfulness meditation, can decrease the unconscious influences that motivate a person to smoke, according to a new review published in the journal Trends in Cognitive Sciences.

In fact, the researchers say that the desire to quit smoking, often considered a requirement for enrolling in treatment programs, may not even be necessary to reduce cigarette cravings.

According to recent neuroimaging studies, smokers have been shown to exhibit less activity in the brain regions associated with self-control. This raises questions around whether targeting these neurobiological circuits could be a way to treat addiction.

“We are interested in trying to probe how repeated use of drugs ultimately influences our ability to control our desires,” said senior study author Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse.

“We are starting to work through how drugs affect areas of the brain that normally enable us to self-regulate, to create goals and to be able to achieve them, and how those changes influence the behavior of the person addicted.”

One study, for example, explored how improving self-control can help smokers with their cravings. Texas Tech University and University of Oregon researchers recruited 60 undergraduate students (27 cigarette smokers and 33 nonsmokers) to participate in an integrative body-mind training program that included relaxation training techniques.

Each participant came into the program expecting to learn meditation and relaxation techniques for stress reduction and cognitive improvement.

They were divided into two groups so that half received mindfulness meditation training (becoming self-aware of one’s experience) and half received relaxation technique (relaxing muscle groups).

For two weeks, the students participated in their assigned class for a total of five hours divided into 30-minute sessions. They received brain scans before the study and again at the end of the study period. They also filled out self-report questionnaires, and received objective measure of carbon monoxide on their smoking amounts and habits.

Although many of the students reported smoking the same number of cigarettes before and after the training, for those who received mindfulness meditation, an objective measure of carbon dioxide percentage in their lungs showed a 60 percent reduction in smoking over 2 weeks after the study.

“The students changed their smoking behavior but were not aware of it,” said lead study author Dr. Yi-Yuan Tang, a professor of psychological sciences at Texas Tech.

“When we showed the data to a participant who said they had smoked 20 cigarettes, this person checked their pocket immediately and was shocked to find 10 left.”

“We then measured intention to see if it correlated with smoking changes and found there was no correlation,” he said. “But if you improve the self-control network in the brain and moderate stress-reactivity, then it’s possible to reduce smoking.”

Other studies showed how integrative body-mind training can lower levels of the stress hormone cortisol, as well as increase immune reactivity. Specific changes in the brain have also been identified, showing stronger connectivity between regions linked to self-control.

More research is needed as there are still some unanswered questions about how often mindfulness therapy would need to be conducted, how long the benefits last, and whether some individuals benefit more than others. The researchers also want to know whether such treatments can be applied to other forms of addiction, such as over-eating or drinking.

“Even though one therapy works on something, you cannot say this therapy is better than others,” Tang said. “We can only get a full picture through systematic research and practice but I think this is a field with a lot of promise and that we should be open minded.”

“Mindfulness meditation, as well as other strategies that are aimed at strengthening self-control, are likely to be useful for the management of addiction, but not necessarily for everybody,” Volkow added.

“However, understanding how our brain works when we do interventions that strengthen self-control can also have multiple implications that relate to behaviors that are necessary for health and well-being.”

Source: Cell Press


Man breaking his smoking addiction photo by shutterstock.

New Blood Test May Detect Traumatic Brain Injury

Sun, 08/02/2015 - 10:00am

A new quick blood test may be able to diagnose traumatic brain injury (TBI) and even determine its severity, according to a new study published in the Journal of Neurotrauma. The test could help determine the best type of treatment for each TBI patient.

Millions of Americans develop TBIs each year. These can range from mild concussions, causing only a headache or temporary blurred vision, to much more severe injuries leading to seizures, confusion, memory and attention problems, muscle weakness, or coma for many months. These symptoms, whether mild or more severe, are generally caused by damaged brain cells.

Until now, most doctors have relied on CT scans and patients’ symptoms to determine whether to send them home and have them resume their usual activities or take extra precautions. However, CT scans can only detect bleeding in the brain, not damage to brain cells, which can occur without bleeding.

“A typical situation is that someone comes to the emergency department with a suspected TBI, we get a CT scan, and if the scan shows no bleeding, we send the patient home,” said first author Frederick Korley, M.D., Ph.D., an assistant professor of emergency medicine at the Johns Hopkins University School of Medicine.

“However, these patients go home and continue having headaches, difficulty concentrating and memory problems, and they can’t figure out why they are having these symptoms after doctors told them everything was fine.”

The researchers wanted to know if a blood test could better predict which patients would have ongoing brain injury-related problems. So they measured the levels of three proteins that they suspected play a role in brain cell activity in more than 300 patients with a TBI and 150 patients without brain injuries. Then, they followed those with a TBI for the next six months.

The found that levels of one particular protein, called brain-derived neurotrophic factor (BDNF), taken within 24 hours of someone’s head injury, could predict the severity of a TBI and how a patient would fare.

While healthy people averaged 60 nanograms per milliliter (ml) of BDNF in their blood, patients with brain injuries had less than one-third of that amount, averaging less than 20 nanograms per ml. Those with the most severe TBIs had even lower levels, around 4 nanograms per ml.

Furthermore, patients with high levels of BDNF had mostly recovered from their injuries six months later. But in patients with the lowest levels of BDNF, symptoms still lingered at follow-up. The findings strongly suggest that a test for BDNF levels, administered in the emergency room, could help stratify patients.

“Compared to other proteins that have been measured in traumatic brain injury, BDNF does a much better job of predicting outcomes,” said Korley.

“The advantage of being able to predict prognosis early on is that you can advise patients on what to do, recommend whether they need to take time off work or school, and decide whether they need to follow up with a rehab doctor or neurologist,” Korley said.

In addition, it could help decide which patients to enroll in clinical trials for new drugs or therapies targeting severe TBIs.

More research is needed to determine why, at a molecular level, brain injuries decrease levels of BDNF in the blood and whether things known to increase BDNF levels — including exercise and omega-3 fatty acids— could help treat TBIs. Korley also wants to know whether changes in BDNF levels over time can be a proxy for recovery and if they could be used to gauge the effectiveness of a particular treatment.

“We looked at that very first blood sample obtained within 24 hours of an injury,” he said. “But for BDNF to be used as a surrogate outcome, we’ll have to see what happens to BDNF blood levels down the line, at one, three or six months after the injury.”

Source: Johns Hopkins Medicine

Blood samples for testing photo by shutterstock.

Mental Distress Can Linger Long After Hurricane

Sun, 08/02/2015 - 9:32am

Not only do major hurricanes create devastation in their immediate wake, but they also cause lingering damage, both materially and emotionally, that can remain for years to come.

These after-effects are still haunting New Jersey residents impacted by Superstorm Sandy, a category 3 hurricane that came ashore in October 2012. Nearly three years later, affected residents are still at an increased risk of experiencing poor mental health, post-traumatic stress disorder (PTSD), and depression.

In a new study, researchers  found that among the approximately 100,000 New Jersey residents whose homes suffered extensive damage, 27 percent are still experiencing moderate or severe mental health distress, and 14 percent report the signs and symptoms of PTSD —even 2-1/2 years after the storm.

In fact, the health effects connected with catastrophic hurricane damage to one’s home are similar to those felt by people living in deep poverty.

The findings from this study, conducted by researchers from Rutgers University and New York University (NYU), in collaboration with Columbia University and Colorado State University, are based on face-to-face surveys with 1,000 randomly sampled New Jersey residents living in the state’s nine most-affected counties.

“Recovery, or stalled recovery, is not as dramatic as the storm and the initial response,” said Dr. David Abramson, the study’s principal investigator.

“But it is what exacts the greatest toll both financially and psychologically. Sandy may have occurred nearly three years ago, but it has had an enduring impact on those individuals and communities exposed to it,” he said.

The study was developed to help the state identify the health and well-being of residents exposed to the storm and to begin to identify unmet needs.

“It was striking to us and to our field team of over 30 interviewers how Sandy still dominated the lives of so many New Jersey residents,” added Dr. Donna Van Alst of Rutgers, the study’s co-principal investigator, “even 2-1/2 years after the event. People across the economic spectrum were affected.”

The findings showed that children in hurricane-damaged homes are at higher risk for mental health problems compared to children whose homes suffered no damage.

For example, children living in homes with minor damage were over 5 times as likely to feel sad or depressed as were children in homes that were not damaged, over 8 times as likely to have difficulty sleeping, and 5 times as likely to feel nervous or afraid.

Furthermore, the health effects connected with catastrophic damage to one’s home are similar to those felt by people living in deep poverty. Many residents whose homes suffered major damage said that they often did not have enough money for rent or mortgage, to pay for utilities, to pay for transportation, or to pay for all the food that they or their family needed.

Mold was strongly linked to both asthma and mental health distress.

“The similarities between hurricanes Katrina and Sandy are quite disturbing,” noted NYU’s Abramson. “Many adults and children are still experiencing emotional and psychological effects, so long after the storm passed. In a significant number of cases housing damage is at the heart of the problem, and it’s very concerning to hear that so many of the federally financed programs have ended even though the needs still clearly persist.”

Source: New York University



Chronic GI Conditions Up Risk of Generalized Anxiety Disorder

Fri, 07/31/2015 - 8:30am

Canadian researchers have discovered that generalized anxiety disorder is much more common among individuals with inflammatory bowel disease (IBD).

Specifically, people who have conditions such as Crohn’s disease or ulcerative colitis, have twice the odds of having a generalized anxiety disorder at some point in their lives when compared to peers without IBD.

Researchers believe the findings unmistakably characterize the relationship between physical and mental health.

“Patients with IBD face substantial chronic physical problems associated with the disease,” said lead-author Professor Esme Fuller-Thomson, from the University of Toronto’s Factor-Inwentash Faculty of Social Work.

“The additional burden of anxiety disorders makes life much more challenging so this ‘double jeopardy’ must be addressed.

Investigators reported that female IBD sufferers were particularly vulnerable to anxiety disorders. Women with IBD had four times the odds of anxiety when compared to men with IBD, said Fuller-Thomson.

Researchers analyzed data drawn from a representative sample of more than 22,000 Canadians from the 2012 Canadian Community Health Study: Mental Health.

A total of 269 respondents reported that they had been diagnosed by a health professional with Crohn’s disease or ulcerative colitis.

“The study draws attention to the need for routine screening and targeted interventions for anxiety disorders,” said co-author and adjunct lecturer Joanne Sulman.

“Particularly among the most vulnerable patients with IBD: women, individuals who are in chronic pain, and those with a history of childhood sexual abuse.”

Co-author and former graduate student, Rusan Lateef, noted two other factors that were associated with anxiety disorders among those with IBD.

“Of particular interest was the six-fold odds of anxiety disorders we found among those with IBD who had a history of childhood sexual abuse. Not surprisingly, we also found that those who reported moderate or severe chronic pain had twice the odds of anxiety disorders in comparison to those with only mild or no chronic pain.”

Patrick McGowan, an assistant professor of biological sciences at the University of Toronto Scarborough, says one of the reasons this study is so significant is because it underlines the important link between physical and mental health.

“We sometimes think of the two as if they are entirely separate entities but the reality is they are intimately linked,” said McGowan. “Both involve genuine physical changes in the body and affect each other.” McGowan was not directly involved with the study.

McGowan notes that although the study was not designed to determine the biological mechanisms of anxiety disorders or inflammatory bowel diseases, adverse life experiences and chronic anxiety can hijack the stress response system, potentially affecting a whole host of bodily processes, including chronic inflammation.

“This study asks about the association between these processes, so we don’t know cause-and-effect, but treatment options are likely to expand if the options are broader than physical or mental health alone.”

The study appears online in the journal Inflammatory Bowel Diseases.

Source: University of Toronto/EurekAlert
Man with inflammatory bowel disease photo by shutterstock.

Computer Training Program Relieves PTSD Symptoms in Vets

Fri, 07/31/2015 - 7:45am

In our 21st century environment, approximately 10-15 percent of combat veterans struggle with invisible wounds related to post-traumatic stress.

For these veterans debilitating symptoms such as insomnia, flashbacks, depression, anxiety, guilt, and tension are often a part of everyday life.

While there is no cure-all for post-traumatic stress disorder (PTSD), cognitive behavioral therapy — which actively reprocesses traumatic events to reduce symptoms — has seen some success.

Now, a new study from researchers at Tel Aviv University, Creighton University in Omaha, Nebraska, and the National Institute of Mental Health suggests an entirely new approach to treating PTSD.

This research incorporates a cutting-edge computer program that is capable of alleviating PTSD symptoms by reducing fluctuations in attention toward and away from perceived threats.

Dr. Yair Bar Haim, head of Tel Aviv University’s School of Psychological Sciences and director of Tel Aviv University’s Laboratory for Research on Anxiety and Trauma, Dr. Daniel Pine of the NIMH Emotion and Development Branch, and Dr. Amy Badura-Black of the Department of Psychology at Creighton University, led the research. Their findings appear in the American Journal of Psychiatry.

“This approach is entirely different from existing treatments,” said Dr. Bar Haim. “Our approach is bottom-up. Our targets are basic, attention-level cognitive processes. We try to normalize and regulate this behavioral system by providing very simple computer tasks, retraining the neural network to better balance threat vigilance and avoidance.

“Our results were promising,” Dr. Bar Haim reported. “The program produced a significant reduction in severe PTSD symptoms, with a similar success rate as cognitive behavioral therapy.”

According to Dr. Bar Haim, humans have a “threat monitoring system” which fluctuates all the time, generating responses to potential threats in the environment and nullifying reactions to non-threatening stimuli.

In the computer training program, two stimuli (threatening or neutral) appear on the screen, followed by a target (an arrow) pointing left or right. The researchers hope to retrain the participant’s neural network to regain the balance between threat avoidance and threat vigilance. The treatment entailed four to eight sessions of computerized training, each of which lasted 10-15 minutes.

“In PTSD, the system is in disarray, with high fluctuations — between vigilance to threats on one hand and threat avoidance on the other,” said Dr. Bar Haim.

“Our promising new treatment for PTSD targets a neurocognitive mechanism to mediate that system, and change attention patterns that go in disarray. If you can influence this pattern, maybe you can affect other symptoms of PTSD.”

The training implicitly teaches participants that threatening stimuli are irrelevant to performing a specific task, requiring them to attend equally to threatening and neutral stimuli. The study determined that the training program reduced symptoms by reducing this variability in attention.

For the purpose of the study, teams of researchers from TAU and Creighton University conducted parallel trials testing the program on US and Israeli combat veterans — the results in both groups were the same.

“Our cost-effective treatment could even one day be available over the Internet,” said Dr. Bar Haim.

“You would need a psychologist to diagnose you and monitor your treatment, but the therapy itself could be administered over the Internet or through short visits to the clinic.”

Source: American Friends of Tel Aviv University

Military veteran photo by shutterstock.

Older Adults Take Mental Health Meds at Twice the Rate of Younger People

Fri, 07/31/2015 - 7:00am

Older adults are given drug prescriptions for mental health issues at twice the rate of younger adults, according to a new study published in the Journal of the American Geriatrics Society. Yet this group is significantly less likely to receive mental health care from a psychiatrist.

This raises the question of whether primary care doctors may need more support to care for older people with depression, anxiety, and other mental health issues. The researchers are also concerned about whether older adults could be at greater risk for bad drug combinations and negative side effects.

“We need to pay special attention to polypharmacy, or multiple drugs taken at once, when prescribing psychotropic drugs in this population, because so many older adults are already on multiple medications,” says Maust, an assistant professor in the University of Michigan Department of Psychiatry.

The study, conducted by a team of researchers at the University of Michigan Medical School and VA Ann Arbor Healthcare System, is the first to compare overall outpatient mental health treatment in adults over age 65 with that of patients between ages of 18 and 64.

The concern of previous decades — that the nation’s seniors weren’t receiving attention for mental health problems — may now need to shift, says Donovan Maust, M.D., M.S., the geriatric psychiatrist who led the analysis.

“Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients,” he says.

“In many cases, especially for milder depression and anxiety, the safer treatment for older adults who are already taking multiple medications for other conditions might be more therapy-oriented, but very few older adults receive this sort of care.”

Medication use is particularly concerning for seniors, because the risk/benefit balance can shift as they become more likely to experience side effects or other adverse events.

For example, anti-anxiety benzodiazepine drugs such as Valium, Xanax, Klonopin, and Ativan (and their generic counterparts) may be relatively safe for younger adults, but carry a higher risk of car accidents, falls, fractures, and a decline of thinking ability or memory for seniors.

Antidepressants can interact with blood thinners and painkillers and can raise blood pressure, all of which are more likely to be problems for older adults, who are generally on more medications than their younger counterparts.

The researchers looked at more than 100,000 outpatient doctor visits between 2007 and 2010 collected by the National Ambulatory Medical Care Survey.

They observed four types of visits: ones where patients received a mental health diagnosis; saw a psychiatrist; received psychotherapy; and/or received a prescription or renewal of a psychotropic medication (including antidepressants, anxiety-calming drugs called anxiolytics, mood stabilizers, antipsychotics, or stimulant drugs).

Visits related to antidepressant and anti-anxiety drug use among older adults occurred at nearly double the rates of such visits by younger adults. In contrast, older adults see psychiatrists at about half the rate of younger adults.

“While it’s still true that we have patients who are not getting treated for mental health concerns, these data suggest that we also need to be mindful of the possibility of overtreatment, especially given the changing balance of risk and benefit as patients age,” says Maust.

“Collaborative care efforts in primary care that seek to create structure and support for these patients, along with appropriate reimbursement for this type of service, could be key.”

Source: University of Michigan Health System
Older woman looking at her medication information with concern photo by shutterstock.

Words of Praise Provide Special Benefit to ADHD Kids

Fri, 07/31/2015 - 6:15am

Interesting new research finds that positive reinforcement is especially beneficial for children with Attention Deficit/Hyperactivity Disorder (ADHD).

Although it was known that praise improves the performance of children with ADHD on certain cognitive tasks, experts were unsure if the results were due to enhanced motivation or because ADHD kids had greater room for improvement.

University of Buffalo (UB) researchers discovered a little recognition for a job well done means a lot to children with ADHD, more so than it would for typically developing kids.

And the reason behind the improvement appears to be related to motivational factors, rather than innate intellect.

“Our results suggest that the motivation piece is critical,” says Whitney Fosco, a graduate student in the Department of Psychology in the UB College of Arts and Sciences.

“Kids with ADHD showed more improvement because they are more motivated by the opportunity to gain rewards, not because they simply did worse from the beginning.”

The findings come out of a novel study published in the journal Behavioral and Brain Functions that collectively examined two leading theories on ADHD, combining what previous work had mostly looked at separately.

One of those theories suggests that lower-than-average cognitive abilities contribute to symptoms associated with ADHD, such as inattentiveness. The other theory favors motivation over ability, focusing on whether kids with ADHD have an increased sensitivity to reward.

“When asking whether the performance difference we see is the result of ability or motivation, this research has more of an answer than any study that comes before it,” says UB psychologist Larry Hawk, the paper’s principle investigator.

The results of the research conducted by Hawk, Fosco, UB graduate student Michelle Bubnik and Keri Rosch of the Kennedy Krieger Institute in Baltimore, Maryland, have clinical parallels as well.

Behavioral therapy, which uses positive consequences to increase the likelihood of achieving certain behaviors, is among the leading psychosocial interventions for children with an ADHD diagnosis.

The authors point out that the benefits of reward are not specific to children with ADHD.

“The major difference is that typically developing kids usually perform well even when simply asked to do their best,” says Fosco. “But kids with ADHD typically need an external or an additional reinforcement to perform their best.”

It’s a tricky area of research area, according to Hawk, since some of the subjects are being tested on tasks on which they have a demonstrated history of poor performance.

There is also a degree of variability between the two groups.

The authors say that having a diagnosis of ADHD doesn’t necessarily mean that a child will perform poorly on any given task, and neither does the absence of a diagnosis mean that the child will perform well on any given task.

“You can’t say kids with ADHD respond more to reinforcement because they were doing poorly to begin with,” says Hawk.

“We showed that was not true. It was greater motivation to obtain external rewards that drove the effects we observed.”

Source: University of Buffalo
Young student needing help with motivation photo by shutterstock.

Personality Influences Financial Savings

Fri, 07/31/2015 - 5:30am

A new study suggests extroverted populations should be vigilant toward managing their bank accounts because extroverts tend to have lower savings rates.

Jacob Hirsh, a University of Toronto management professor, says the research topic stemmed from his interest in how personality affects decision-making. In the study, Hirsh shifted his focus from studying individuals to looking at personality effects across entire populations.

“Many of the choices that people make are influenced by their personality characteristics,” Hirsh said. “I started to think about how that affect might play out across larger groups.”

In his previous work, Hirsh has shown that more extroverted individuals tend to choose smaller but immediate rewards instead of larger but delayed ones.

“Extroverts are far more sensitive to rewards, which makes it harder for them to overcome their desire for immediate gratification,” said Hirsh. “When making financial decisions, this can contribute to impulsive spending, higher credit card debts, and reduced savings.”

Therefore, if personality traits are related to individual saving behavior, what would happen when entire populations differ in their personality characteristics? As found in a paper that appears in the journal Personality and Individual Differences, Hirsh examined this question using three different data sets.

In the first study, Hirsh found a correlation between United States extroversion levels and changes in the personal savings rate over time. During the same period that U.S. savings rates underwent a sharp decline, there was a corresponding increase in U.S. extroversion levels.

In a second study, Hirsh found that U.S. states with higher average extroversion levels tended to allocate more of their income toward immediate consumption, rather than setting money aside for saving.

A final study examined how the average extroversion levels of different countries were related to gross national savings as a percentage of GDP (gross domestic product).

“Across all three different analyses, the same pattern emerged,” Hirsh said.

“The more extroverted the population, the lower the savings rates tended to be, even when controlling for population differences in age, life expectancy, and wealth.”

Although the pattern was consistent across studies, Hirsh cautions that correlation does not guarantee causation.

“We can’t be certain about the direction of causality here,” he said, “but to the extent that aggregate savings reflect individual choices, there is reason to think that personality traits can indeed have a causal influence.”

Experts believe this knowledge is profound as personality psychology can contribute to an understanding of financial decision-making and economic behavior.

“We know that personality traits have a powerful influence on an individual’s life outcomes,” said Hirsh.

“We are only beginning to understand the broader social and economic consequences of these personality differences.”

Source: University of Toronto
Woman excited about shopping at the mall photo by shutterstock.

Teens with Insomnia at Greater Risk for Self-Harm

Thu, 07/30/2015 - 8:30am

A new study has found that teens who suffer from sleep difficulties, such as insomnia and short sleep duration, are significantly more likely to engage in self-harm compared to teens with healthy sleep patterns.

The findings suggest that sleep interventions be included in treatments for teens with self-harming behaviors.

“Both health care professionals and other people should be aware of the fact that good sleep routines can prevent both stress and negative emotions. Sleep regulation is one of the factors one should consider to use in preventing and treating self-harm among young people,” said lead researcher and psychology specialist Mari Hysing, Ph.D., from Uni Research in Bergen, Norway.

The researchers conducted a large population-based study using data from the youth@hordaland survey. The data included self-reports from 10,220 teenagers who were 16-19 years of age in Western Norway. They answered questions on mental health and completed a comprehensive assessment of sleep and self-harm.

A total of 702 (7.2 percent) teen respondents met the criteria for self-harm, and more than half (55 percent) of those reported harming themselves on two or more occasions.

The risk of self-harming was four times higher among the 16-19 years old adolescents who fulfilled the diagnostic criteria for insomnia. The researchers also found that self-harming was more common in girls than boys, and that cutting was the most prevalent type of self-harm behavior, Hysing said.

Several types of sleeping problems were found to be linked consistently to self-harming behavior.

“Insomnia, short sleep duration, long sleep onset latency, wake after sleep onset as well as large differences between weekdays versus weekends, yielded higher odds of self-harm consistent with a dose-response relationship,” said the researchers.

Teens who had engaged in self-harm behaviors also showed higher levels of depression, perfectionism, and symptoms of ADHD. The researchers add that depressive symptoms accounted for some, but not all, of the connection to self-harming.

However, having symptoms of ADHD remained significant even in the fully adjusted analyses, the researchers emphasize.

To help prevent teens from engaging in self-harming behaviors, the researchers suggest interventions that incorporate healthy sleeping habits as a part of the treatment.

The research findings are published in the British Journal of Psychiatry.

Source: Uni Research

Teenager with insomnia photo by shutterstock.

Prosocial Skills at 5 Can Predict Adult Success

Thu, 07/30/2015 - 7:45am

New research suggests the prosocial aptitude of five year-olds is a significant predictor of their future education, employment, and criminal activity, among other outcomes.

The study included 20 years of input collected by surveys administered to kindergarten teachers on their students’ social competence.

Once the kindergartners reached their 20s, researchers followed up to see how the students were faring socially and occupationally.

Students demonstrating better prosocial behavior were more likely to have graduated college, to be gainfully employed, and to not have been arrested than students with lesser prosocial skills.

“This research by itself doesn’t prove that higher social competence can lead to better outcomes later on,” said Damon Jones, Ph.D., a senior research associate at Pennsylvania State University. “But when combined with other research, it is clear that helping children develop these skills increases their chances of success in school, work and life.”

Jones and colleagues analyzed data collected from more than 700 students who were participating in the Fast Track Project, a study conducted by four universities: Pennsylvania State, Duke University, Vanderbilt University, and the University of Washington.

The Fast Track Project is a prevention program for children at high risk for long-term behavioral problems. The individuals studied for this research were part of the control group and did not receive any preventive services. Overall, the sample was representative of children living in lower socio-economic status neighborhoods.

Kindergarten teachers rated students on eight items using a five-point scale assessing how each child interacted socially with other children. Items included statements such as “is helpful to others,” “shares materials,” and “resolves peer problems on own.”

The researchers compared the teachers’ assessments to the students’ outcomes in five areas during late adolescence through age 25 — including education and employment, public assistance, criminal activity, substance abuse, and mental health. Jones and colleagues report their results online and in a future issue of the American Journal of Public Health.

Social competency, even at such a young age, appears to play a significant role in future success.

Specifically, the researchers found that a higher rating for social competency as a kindergartner was significantly associated with all five of the outcome domains studied. For every one-point increase in a student’s social competency score, he or she was twice as likely to graduate from college and 46 percent more likely to have a full-time job by the age of 25.

For every one-point decrease in the child’s score, he or she had a 67 percent higher chance of having been arrested and an 82 percent higher chance of being in or on a waiting list for public housing at age 25. The study controlled for the effects of poverty, race, having teenage parents, family stress, and neighborhood crime, and for the children’s aggression and reading levels in kindergarten.

Nevertheless, all is not lost for children who do not possess strong prosocial skills at a young age.

“The good news is that social and emotional skills can improve, and this shows that we can inexpensively and efficiently measure these competencies at an early age,” said Jones. Evidence from numerous intervention studies indicate that social and emotional learning skills can be improved throughout childhood and adolescence.

Jones and colleagues plan to continue this work in order to further understand how social competency can predict future life outcomes, and further understand intermediary developmental processes whereby early social-emotional skills influence long-term adult outcomes.

Source: Pennsylvania State

Kindergarten children playing doctor photo by shutterstock.

Cardiovascular Risk Factors Tied to Alzheimer’s

Thu, 07/30/2015 - 7:00am

New research suggests that some cardiovascular risk factors are associated with smaller regional brain volumes that may be early indicators of Alzheimer’s disease and dementia.

Investigators discovered the specific risk factors linked to Alzheimer’s and dementia include alcohol consumption, smoking, obesity, and diabetes.

“We already know that vascular risk factors damage the brain and can result in cognitive impairment,” said Kevin S. King, M.D., assistant professor of radiology at the Keck School of Medicine of the University of Southern California in Los Angeles.

“But our findings give us a more concrete idea about the relationship between specific vascular risk factors and brain health.”

The new findings suggest alcohol consumption and diabetes are associated with a decrease in total brain volume while smoking and obesity were linked to a reduction in size, or volume of a particular area of the brain.

Study results are published online in the journal Radiology.

Prior studies have linked cardiovascular risk factors and cognitive decline, but the new study focused on specific risk factors and examined three main brain regions, including the hippocampus, precuneus, and posterior cingulate cortex.

Because of each region’s connection to memory retrieval, gray matter volume loss in these areas may be a predictor of Alzheimer’s disease and dementia.

In the new study, King and colleagues analyzed results from 1,629 individuals in the Dallas Heart Study (DHS) and divided the participants into two age groups. There were 805 participants under age 50, and 824 age 50 and older.

The researchers evaluated the participants’ data from the initial baseline visit, which included laboratory and clinical analysis, and the follow-up visit seven years later consisting of a brain MRI and cognitive test, measuring mild cognitive impairment and preclinical Alzheimer’s disease.

By comparing the initial visit in which cardiovascular risk factors were identified to the MRI results and cognitive scores, the team was able to distinguish the specific risk factors of alcohol consumption, smoking, diabetes, and obesity and their relationship to smaller volumes in the three targeted regions of the brain. The results confirmed that lower cognitive test scores correlated with lower brain volumes in each area.

The study found that risk factors of alcohol use and diabetes were associated with smaller total brain volume, while smoking and obesity were linked with reduced volumes of the posterior cingulate cortex, the area of the brain connected with memory retrieval as well as emotional and social behavior.

In addition, lower hippocampal mass was linked to both alcohol consumption and smoking whereas alcohol use, obesity, and high fasting blood glucose numbers correlated with reduced precuneus size.

The findings also suggest that in patients age 50 and older, diminished hippocampal and precuneus volumes may be early risk indicators for cognitive decline, while smaller posterior cingulate volumes are better predictors in patients under age 50.

King believes that additional studies can provide the ability to better identify the impact of specific cardiovascular risk factors on the brain and improve patient understanding of brain diseases.

“We currently do not have effective treatments for Alzheimer’s disease, so the focus is on prevention,” he said.

“In the future, we may be able to provide patients with useful and actionable information about the impact different risk factors may be having on their brain health during routine clinical imaging. And since no special imaging equipment is needed, there is a great potential to provide this service at many centers across the country.”

Source: Radiological Society of North America/EurekAlert

Connection of the heart and brain photo by shutterstock.

Autism Costs May Reach $1 Trillion By 2025

Thu, 07/30/2015 - 6:15am

A new projection by health economists predicts the total costs of caring for all people with autism spectrum disorder (ASD) in the U.S. for the current calendar year will approach $500 billion.

Furthermore, the costs may escalate to $1 trillion by 2025 if effective interventions and preventive treatments for the condition are not identified and widely available.

University of California, Davis heath economists say ASD-related medical, nonmedical and productivity losses are $268 billion for 2015 and $461 billion for 2025. The researchers noted that these estimates are conservative and, if ASD prevalence continues to increase as it has in recent years, the costs could reach $1 trillion by 2025.

Experts believe these staggering health costs and projections show the need for aggressive governmental research and public involvement.

The study is published online in the Journal of Autism and Developmental Disorders.

“The current costs of ASD are more than double the combined costs of stroke and hypertension and on a par with the costs of diabetes,” said study senior author Paul Leigh, Ph.D.

“There should be at least as much public, research, and government attention to finding the causes and best treatments for ASD as there is for these other major diseases.”

Leigh hopes his findings inspire policy changes that emphasize early intervention to reduce ASD symptoms, along with employment, and other programs that support the independence of adults with the disorder.

“This approach would ultimately save money that otherwise would be spent on expensive custodial care,” Leigh said.

Leigh worked with co-author Juan Du, Ph.D., who received her doctoral degree at University of California, Davis, to determine the per-person and then total costs of ASD using data on medical services, residential care, special education, in-home care, transportation, employment support, and lost productivity.

Their information came from a variety of sources, including research literature, the U.S. Centers for Disease Control and Prevention, and the Bureau of Labor Statistics.

The evaluations included cost ranges that accounted for age, because services for people with ASD change throughout their lifespans, and the presence or lack of intellectual disability (formerly called “mental retardation”), which affects the intensity of services, along with varied estimates of population changes and ASD prevalence.

The team found that the comprehensive costs of ASD will range from $162 to $367 billion for 2015 (with the researchers’ best estimate of $268 billion) and from $276 to $1 trillion (with the researchers’ best estimate of $461 billion) for 2025.

The 2015 figures are on a par with recent cost estimates for diabetes and exceed the combined costs of stroke and hypertension. If the prevalence of ASD continues to grow as it has in recent years, the costs likely will far exceed those of diabetes by 2025.

To reduce these multi-billion dollar totals, Leigh and Du recommend a research investment in ASD equal to that for diabetes, which is funded by the National Institutes of Health at more than five times the level of research on ASD.

“The staggering costs identified in this study should serve as a call to action,” said Leonard Abbeduto, Ph.D., director of the University of California, Davis MIND Institute, an internationally recognized autism treatment, and research center.

“We need more funding for research to understand the causes of, and develop treatments for, ASD,” Abbeduto added.

“We also need to ensure that all children have access to intensive early intervention; that school-based interventions to support academics, as well as social and language skills, are adequately funded; and that supports are put in place to ensure better post-secondary and vocational options for adults. Investing in these areas, I believe, will actually reduce the costs to society.”

Source: University of California, Davis/EurekAlert
Rising healthcare costs photo by shutterstock.

Mixed Evidence on Benefit of Deep Brain Stimulation for Depression

Thu, 07/30/2015 - 5:30am

Those suffering from depression do not always respond to medication and/or psychotherapy. Recently, deep brain stimulation (DBS) has become an intervention option for cases of treatment-resistant depression.

New research suggests, however, that current techniques used for DBS may be no more effective than a placebo.

Depression can have a terrible personal and societal cost. The illness can devastate lives, careers, and families. Some severely ill patients may be unable to attend to even the basic elements of self-care, while others attempt or complete suicide.

Because of the clinical urgency, deep brain stimulation (DBS) treatments for depression have been developed over the past 15 years. These treatments require surgery to make a small hole in the skull through which an electrode is passed into a specific brain region.

Once positioned, a standard electrical stimulation procedure is initiated, which is modeled after highly effective DBS treatments that are used for Parkinson’s disease, essential tremor, and other neurologic conditions.

DBS does not damage healthy brain tissue. It works by using electrical pulses to “block” neural signals from the targeted brain area that is the known or suspected source of the symptoms.

A large number of relatively small studies have supported the effectiveness of various forms of DBS for both depression and obsessive-compulsive disorder.

In the current issue of the journal Biological Psychiatry, Dr. Darin Dougherty and his colleagues report the results of the first large-scale, randomized, sham-controlled trial of deep brain stimulation treatment for treatment-resistant symptoms of depression.

Thirty patients received active DBS or sham placebo stimulation for 16 weeks, targeted at the ventral capsule and ventral striatum, brain regions implicated in reward and motivation. A two-year open-label continuation phase followed.

This study, conducted at five medical centers across the U.S., found that DBS failed to reduce depression symptoms better than sham stimulation.

“While initial open-label trials of DBS at the ventral capsule/ventral striatum target were promising, the results of this first controlled trial were negative,” said Dougherty, director of neurotherapeutics at Massachusetts General Hospital and associate professor at Harvard Medical School.

Dr. Thomas Schlaepfer, an expert on DBS treatment unaffiliated with this study, from Johns Hopkins University and University Hospital Bonn in Germany, wrote a companion piece to this article and commented, “On first sight, this might be seen as a crisis for the whole field of neurostimulation therapies for depression… [but we] believe that these are examples of failed studies and not failed treatments.”

“This study raises serious questions about the advisability of continuing to stimulate these reward regions in the manner employed in this study,” said Dr. John Krystal, Editor of Biological Psychiatry.

“It is critical to understand that this study is not a universal indictment of DBS as a strategy for depression. It may turn out that stimulating other brain regions or stimulating these regions in different ways could provide important benefit.”

“Given the degree of response that we have seen in some of the most treatment refractory patients, we agree with Dr. Schlaepfer and Dr. Krystal. Alternative study designs will have to be considered as we conduct future clinical trials in this critical area,” Dougherty said.

Source: Elsevier/EurekAlert
Brain surgery photo by shutterstock.

How Cocaine Can Prime the Brain for Relapse

Wed, 07/29/2015 - 9:15am

Recent findings on the effects of cocaine on the brain show that the drug causes major changes that influence the risk of relapse under stress.

A new molecular mechanism in the reward center of the brain has been discovered by Dr. Peter McCormick and colleagues at the University of East Anglia, U.K. This influences how recovering cocaine addicts might relapse after stressful events and also points to a potential basis for treatment to protect against relapses.

“Relapse among cocaine addicts is a major problem. We wanted to find out what causes it,” said McCormick.

They focused on the interaction between two neuropeptides, corticotropin-releasing factor (CRF) and orexin-A in the ventral tegmental area of the brain.

These are messenger molecules that carry information between neurons, in the part of the brain that controls reward, motivation, and drug addiction. Tests were carried out on the effects of cocaine on rat brain cells (in vitro) and on live rats.

“We had speculated that there might be a direct communication between neuroreceptors controlling stress and reward,” McCormick said. “When we tested this, we found this to indeed be the case. Our research showed that the release of neuropeptides influences activity in this part of the brain and that profound changes occur at the neuroreceptor level due to exposure to cocaine.”

In The Journal of Neuroscience, the team reported that they found evidence for “pharmacologically significant interactions between CRF and orexin-A.” Cocaine binds to these neuroreceptors and “promotes long-term disruption” through which the drug “sensitizes cells to the excitatory effects of both CRF and orexin-A, thus providing a mechanism by which stress induces cocaine-seeking.

“We showed that cocaine disrupts the interaction between receptors and these changes could increase the risk of relapse under stressful conditions,” McCormick added. 

“Importantly, we identify a potential mechanism for protection against such relapse. By restoring the broken interaction, we may be able to minimize stress-driven relapse in addicts. This research lays the groundwork for the development of such approaches.

“Although our study is in rodents, the same receptors have been shown to impact human stress and drug addiction. Cocaine has a relatively unique effect on the brain. However, the reward center is crucial for addictive behaviors.

“Studies on post-traumatic stress disorder have shown traumatic events can have profound influences on receptors in this region of the brain, perhaps rendering soldiers more prone to addiction. Although speculative, it would not surprise me to see similar results in other situations, whether drug- or stress-related.”

Commenting on the study, journal editor Teresa Esch, Ph.D, of Harvard Medical School,  writes that the neuropeptide orexin “is best known for its roles in arousal and feeding.”

Orexin neurons are activated by hunger and by the presence of food or food-related stimuli, she said. In addition, “cues associated with other rewards, including addictive drugs, also activate orexin neurons, leading animals to seek these rewards.”

Orexin also plays a role in stress-induced reward-seeking, Esch said. One set of neurons where this occurs is dopaminergic neurons in the ventral tegmental area. These neurons express the CRF receptor. CRF does not normally trigger dopamine release, but it can do so after exposure to cocaine.

These results suggest that exposure to cocaine disrupts the regulation of reward-seeking, Esch writes. “This may explain stress-induced relapse in former cocaine users.”

Further research should investigate which signal-triggering molecules in the brain contribute to stress-induced pursuit of rewards such as cocaine, she concludes.

A team of experts led by John R. Mantsch, Ph.D, of Marquette University has also examined this issue. In the Journal of Neuroscience, they state, “Cocaine addiction is associated with a persistent susceptibility to drug relapse that emerges in an intake-dependent manner with repeated use.”

Understanding the neurobiological mechanisms that underlie relapse in cocaine addicts “is critical to the development of effective treatment,” they believe.

Much evidence suggests that stress contributes to relapse, they report. For example, stress promotes craving in abstinent cocaine addicts, and triggers relapse in experiments on rodents. In their tests on rodents, they show that repeated cocaine use alters the way stress affects brain neurons, and that this is intake-dependent, i.e., linked to the amount of prior use of the drug.

As with the McCormick study, this work showed that risk of relapse is determined in the ventral tegmental area, and linked to heightened CRF responsiveness in this area. But “the precise mechanism of CRF regulation of dopaminergic cells in the ventral tegmental area is unclear,” they write.

Nevertheless, it appears that repeated cocaine exposure raises CRF responsiveness, and lowers any inhibitory effects, “likely resulting in a net shift toward greater CRF regulation of dopaminergic cells.”

“The ability of stressful life events to precipitate drug use through actions involving CRF may be a consequence of excessive cocaine use,” they write. “Identification of the precise mechanisms through which CRF activation produces cocaine-seeking should provide important insights,” they conclude.


McCormick, P. et al. Orexin-CRF Receptor Heteromers in the Ventral Tegmental Area as Targets for Cocaine. The Journal of Neuroscience, 29 April 2015, 35(17), 6639-53. doi: 10.1523/JNEUROSCI.4364-14.2015

Esch, T. This Week in the Journal: Orexin and CRF Receptors Form Heteromers. The Journal of Neuroscience, 29 April 2015, 35(17).

Blacktop, J. M. et al. Augmented Cocaine Seeking in Response to Stress or CRF Delivered into the Ventral Tegmental Area Following Long-Access Self-Administration Is Mediated by CRF Receptor Type 1 But Not CRF Receptor Type 2. The Journal of Neuroscience, 3 August 2011, Vol. 31, pp. 11396-403. doi: 10.1523/JNEUROSCI.1393-11.2011

Abstract of brain photo by shutterstock.

Kids Prove Flexible Social Learners

Wed, 07/29/2015 - 8:30am

A new study finds that children are amazingly flexible in deciding whether to copy the behavior of others, or to go beyond the behavior of others.

Psychologists say this ability shows that children are precocious social learners.

“There’s nothing children are more interested in than other people,” said University of Texas at Austin psychologist Dr. Cristine Legare. “Acquiring the skills and practices of their social groups is the fundamental task of childhood.”

Experts explain that in order to function within their social groups, children have to learn both technical skills with instrumental goals and social conventions with goals based on social conformity.

As an example, technical skills with instrumental goals are learning tasks such as using a fork and knife to cut food. Social conventions are actions based upon socially accepted behaviors such as shaking hands, kissing, and bowing, as a form of greeting.

The new research demonstrates that children are sensitive to the distinction between instrumental and conventional goals and flexibly adapt their behavior accordingly.

“The more carefully you imitate a social convention, the better, more reliable group member you are. Tasks with instrumental goals allow for more innovation,” Legare said. “Young children adjust how carefully they imitate and when they innovate, depending on the perceived goal of the behavior or reason for action.”

Legare and her colleagues examined imitative and innovative behavior in children between the ages of four and six after watching one of two videos that illustrated conventional and instrumental uses of various geometric objects and a box.

Both videos showed an experimenter performing a pattern of arbitrary but intentional tasks with the objects. In the conventional video, the start- and end-state of the objects was identical. But in the instrumental video, the experimenter used the final object in the pattern to open the box and place the object inside. After the video, children were given the same group of objects.

The children imitated the conventional behavior with higher fidelity. Those who observed an instrumental behavior engaged in more innovative behavior.

In a second study, children were also more accurate in detecting variation in conventional than instrumental behavior, suggesting that conventional behavior is driven by expectations for social conformity.

“We are socially oriented in ways that other species are not, and we are very well equipped to acquire and adapt to the culture and skills of previous generations,” Legare said.

“The core insight here is that children adapt their imitative and innovative behavior to different goals, even at very young ages, demonstrating that humans as a species are flexible, social learners,” Legare said.

“Our research demonstrates that the early-developing distinction between instrumental and conventional behavior is fundamental to cultural learning in our species.”

Source: University of Texas, Austin/EurekAlert

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