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Dec 27

5 Tools of Emotional Intelligence

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by Lisa Brookes Kift, MFT What is emotional intelligence?

Emotional intelligence is a set of skills that helps us recognize, contain and communicate our emotions. Many people who struggle with keeping relationships have low levels of “emotional intelligence.”

What does attachment have to do with it?

The ways we have experienced connection or disconnection with others, going as far back as early parental relationships, shapes our expectations and way we relate to others.

Attachment relationships play a large role in the development of the brain. The security – or insecurity – of a child’s early attachment relationship shapes their view of themselves, others and the world around them.

If you didn’t have early (and later) relationships where you felt nurtured and satisfactory levels of emotional safety, here are some of the ways your adult relationships may be impacted:

* You don’t know how to work through differences without getting mad or tuning out.

* You often feel betrayed by others.

* You’re in a pattern of unsatisfying relationships.

Five tools of emotional intelligence:

According to Jeanne Segal, Ph.D. and author of The Language of Emotional Intelligence, there are a number of ways to communicate in an emotionally intelligent manner. She calls them:

* The Elastic

* The Glue

* The Pulley

* The Ladder

* The Velvet Hammer

Let’s take a closer look at Tool #1: The Elastic (Stress Busting):

According to Dr. Segal, “Our capacity to regulate our own stress is the elastic that provides us with a feeling of safety, giving us the ability to be emotionally available and engaged with other people, as well as to resolve relationship difficulties by returning communications to relaxed, energized states of awareness.”

The first step in managing relationship stress is to identify what your triggers are. The next step is to learn how to manage the physiological reaction (think, “fight or flight”). Ways to decrease stress in the moment are deep breathing or taking a “time-out.” A properly executed “time-out” allows the partner to get their stress response under control.

Couples who learn how to make use of the “elastic” tool will find they argue less. And if conflict arises, as it always will at some point, it will be managed in a much more productive way.

Let’s explore Tool #2: The Glue (Emotional Communication):

“The glue that holds the communication process together is the emotional exchange triggered by primary biological emotions which include anger, sadness, fear, joy and disgust,” she says. “These emotions, essential for communication that engages others, have often been numbed or distorted by misattuned early relationships, but they can and must be reclaimed and restored to attract and preserve relationships.”

This facet really gets into the area of my work that I love the most – how people react to each other based on earlier important relationships. Our emotional responses to our partner can be less about what’s going on in front of us and more about old wounds being triggered. It’s not to say that our partners might be behaving in an unhelpful way – but the experience may be magnified to us.

People who get in touch with their family of origin wounds (if they exist) will be better able to identify when “old stuff” is getting triggered in their relationship and be able to think more clearly about it.

Now for Tool #3: The Pulley (Nonverbal Communication):

“It takes more than words to create and secure productive, exciting, safe and fulfilling relationships,” says Dr. Segal. “Nonverbal communication is the pulley that attracts and holds the attention of others.”

Examples include eye contact, facial expression, tone of voice and intensity. What messages do you send to your partner? Do you accurately read the nonverbal communication of others or do you misinterpret signals?

Couples who are good at nonverbal emotional communication can better manage and avoid conflict. Additionally, poor stress management (as discussed in part 1) can negatively impact the use of nonverbal communication.

Let’s briefly explore Tool #4: The Ladder (Playfulness and Humor):

“Playfulness and humor, the naturally high ladder, enable us to navigate awkward, difficult and embarrassing issues,” she says.

Couples who can use humor in times of conflict are much better getting through it. It reduces stress, wards off depression, creates a shared experience and generally improves relationships. However, be aware that not all “humor” is helpful. Sarcasm can be experienced as thinly veiled criticism.

And the final tool, #5: The Velvet Hammer (Conflict Resolution):

The ability to manage conflict and forgive is referred to as the velvet hammer. Couples who are able to hear each other, assist in problem solving, and avoid harsh, critical language are more adept at building trust between each other. Additionally, people have different needs regarding feeling emotionally safe. “Everyone needs to feel understood, nurtured and supported but the ways these needs are met can vary widely,” she says.

In my couples therapy practice, the issues that people present often times end up being less about the “issues” and more about a lack of emotional safety and ability to manage that (emotional intelligence). The good news is that emotional intelligence can be learned and couples can have a closer and more loving relationship.

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Lisa Brookes Kift, MFT is the creator of The Toolbox at LisaKiftTherapy.com, with tools for marriage, relationship and emotional health. She is the author of The Premarital Counseling Workbook for Couples – and The Marriage Refresher Course Workbook for Couples.

By Christine S. Moyer, Three in four adults 65 and older say they would tell their primary care physicians about feelings of anxiety or depression. But doctors don’t always provide appropriate care to older patients with those conditions, says a survey of more than 1,300 seniors issued Dec. 13 by the John A. Hartford Foundation.

Appropriate, evidence-based care for anxiety and depression includes educating patients about their condition, engaging them in medical care and following up to ensure they’re responding properly to treatment, said Christopher Langston, PhD. He is program director at the foundation, which works to improve the well-being of seniors.

“Depression is one of the most common and burdensome issues in older individuals,” Langston said. It’s unfortunate “that so many older people are still receiving mental health care that does not measure up.”

Forty-six percent of older adults who received mental health treatment said their primary care physician didn’t follow up after prescribing treatment. Thirty-eight percent reported not being told about possible treatment side effects of any medications, and 34% received no information on what to do if they felt worse.

Contributing to the problem is that physicians have limited time to attend to mounting demands, said Indiana internist Christopher Callahan, MD. Another challenge for doctors is that seniors often have multiple health problems and various medications that need to be addressed and adjusted during an office visit, he said.

Primary care physicians “are feeling a little burdened by the magnitude of their responsibility for a whole range of conditions, and sometimes it’s hard to get the [physician’s] attention for this very serious condition,” said Dr. Callahan, director of the Indiana University Center for Aging Research.

He encourages doctors to pay the same kind of attention to mental health problems as they do to chronic diseases such as diabetes. And he recommends that physicians involve older patients in decisions about their health.

“There has been a notion in geriatrics that older adults are less demanding of their care than baby boomers” and that they prefer to leave health care decisions to the physician, Dr. Callahan said. “Those days are fading fast.”

Researchers conducted a survey between Nov. 16 and Nov. 26 on a nationally representative sample of 1,318 adults 65 and older. Survey questions focused on participants’ attitudes toward and experiences with mental health issues.

Researchers found that 20% of respondents had been diagnosed with a mental health problem at some time. Of those individuals, 14% were told they had depression, and 11% were diagnosed with anxiety (jhartfound.org/file/MjQ2/Hartford_MH_Poll_Memo_FINAL_121211%20%282%29.pdf).

More than one in four incorrectly believed that depression is a natural part of aging, and 56% didn’t know that depression doubles the risk of developing dementia.

Among the encouraging findings is that most older adults seem comfortable talking about depression and anxiety, Dr. Callahan said. Two decades ago, that wasn’t the case, he added.

“This survey shows us that older adults are asking for help, and it shows that a lot of primary care physicians and other doctors are initiating treatment,” Dr. Callahan said.

Published on December 27, 2012 by David Rock in Your Brain at Work The science of self-improvement never ceases. Every year brings dozens of new quirky findings about how to be more effective, whether in managing our time, being more creative or just getting things done. Here are some of the highlights for me from 2012.

1. You don’t know yourself as well as you think

We think we know ourselves best, but more and more evidence is surfacing to the contrary. This raises an interesting challenge for employers who solely base their hiring decisions on self-reported questionnaires. Psychologist Timothy Wilson proposes that to really know someone, you have to ask others to evaluate you. It turns out that how you see yourself and how other people see you are only very modestly correlated.

In his book, Strangers to Ourselves, Wilson talks a lot about the adaptive unconscious. He tells us that much of what we do lives in the unconscious and therefore we cannot detect it ourselves. Things like what we think, feel, and want become unnoticeable. Now of course, if you’ve ever practiced mindfulness, or have ever self-reflected, some of the unnoticed start to surface and we gain insights, but more often than not, a lot of information goes unnoticed.

This is why one might have a hard time understanding why things go wrong. Given that we aren’t completely conscious of what we were doing, we tend to blame others for our mistakes. In order to gain better insight into ourselves, we need help getting the right answers. It turns out that other people’s assessment of your personality predicts your behavior better than your own assessment would. So instead of thinking you already know everything about yourself, stop for a minute, and ask someone else.

2. Have a problem? Distract yourself from it

It’s already known that in order to gain an insight, your brain has to be in a quiet state, but new research by Neuroscientist David Creswell from Carnegie Mellon sheds light on the phenomenon of how and why it can be valuable to come back to a problem, after a brief moment of distraction.

Creswell explored what happens in the brain when people tackle problems that are too big for their conscious mind to solve. He made three groups of people think about purchasing an imaginary car based on multiple wants and needs. One group had to choose immediately—this group didn’t do so well at optimizing their decision. The second group had time to try to consciously pick the best car— yet their choices weren’t much better. The last group was given the task, then given a distracter task—something that didn’t require lots of mental energy, but still held their conscious attention, allowing for their non-conscious to keep working on the problem. Results showed this group did significantly better than the others at optimizing their decision.

FMRI scans also showed something interesting happening with the third group. According to Creswell, the brain regions that were active during the initial learning of the problem, continued to be active (we call this unconscious neural reactivation) even while the brain was distracted with another task.

In short, when trying to solve a complex task, people who were distracted after first tackling the problem did better than people who put in conscious effort. (More information can be found in my previous blog.)

3. We’re more creativity when thinking about others

Creativity in the business world is increasingly important. Creativity often involves viewing things from different perspectives. New findings show that we are more creative when we think of others solving problems instead of ourselves.

To test this, professors Evan Polman and Kyle Emich presented 137 undergraduates with this riddle: “A prisoner was attempting to escape from a tower. He found a rope in his cell that was half as long enough to permit him to reach the ground safely. He divided the rope in half, tied the two parts together, and escaped. How could he have done this?”

Half the participants were asked to imagine themselves as the prisoner locked inside the tower (we’ll call them the “prisoner group”) and the other half were asked to imagine someone else trapped in the prison (“imaginary group”). In the prisoner group, 48% of participants solved the riddle, but in the imaginary group, 66% were able to solve the riddle. In a second experiment, the same professors asked participants to draw an alien that someone else might use to write about in a short story. In a third, participants had to come up with gift ideas for themselves, someone close to them, and someone they barely knew.

In the results across all three experiments, Polman and Emich found that participants were more creative or had better solutions when thinking for someone else. This is an intriguing finding with many implications and applications for creative problem solving. Just try to imagine someone else coming up with good ideas for using this finding…

4. It’s not napping, it’s constructive rest

We live in a time when where more people are staying connected on vacations. People have forgotten how important it is for your mind to rejuvenate. Research shows that naps improve productivity—a growing body of evidence shows that taking regular breaks from mental tasks improves productivity and creativity — and that skipping breaks can lead to stress and exhaustion.

(I’ll be right back…zZz)

John P. Trougakos, an assistant management professor at the University of Toronto Scarborough and the Rotman School of Management, compares the brain to any other muscle in the body. Similarly to how muscles become fatigued after repeated and sustained use, so does the brain after sustained mental exertion. The brain needs a rest period before it can recover he explains.

There is no need to take a break if you’re on a roll though, Trougakos advises. For some people, working over an extended period can be revitalizing—you get into a zone. It is only when you’re forcing yourself to go on that you should stop.

Research from the University of Notre Dame even shows that sleeping shortly after learning new information is the most beneficial for recallNotre Dame Psychologist Jessica Payne and colleagues studied 207 students who habitually slept for at least six hours per night. Payne randomly gave each student information to study at either 9am, or 9pm, allowing for the 9am team to be awake for the rest of the day, while the 9pm, went to sleep. She tested these students on their recall after 30 minutes, 12 hours, and 24 hours. She found that after 12 hours, those students who slept shortly after studying had a better overall memory. After 24 hours, when both teams were well-rested, all students had superior memory recall.

“Our study confirms that sleeping directly after learning something new is beneficial for memory” Payne says. In a world where we believe to be more successful you have to work longer hours, perhaps its time for a change, or even time for a break. Jessica will be presenting these and other findings at the 2013 NeuroLeadership Summits.
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5. Optimize your peak time

What if you aligned everything in your schedule according to your body’s biological clock? New research is showing there’s a peak time for all activities, from when you should think critically to the best time for a tweet.

People run on circadian rhythms that are patterns of brain wave activity, hormone production, cell regeneration and other biological activities linked to our 24-hour daily cycle. Disruption of these rhythms can be quite harmful. Steve Kay, a professor of molecular and computational biology at the University of Southern California, says problems such as diabetes, depression, dementia and obesity, can develop from not listening to our body’s clock.

If you get paid to think critically, try to get most of your work done in the late morning, right after a warm shower. This will motivate your body’s clock by raising its temperature and preparing your working memory, alertness and concentration for getting things done. Anytime before noon is the best for when it comes to focusing because the afternoon (12pm-4pm) is prime time for distractions according to recent research led by Robert Matchock, an associate professor of psychology at Pennsylvania State University. (Tips on how to manage these distractions can be found in my previous blog.)

If you get paid to think creativity, most adults perform their best right as they begin to slump in terms of wakefulness. Martin Moore-Ede, chairman and chief executive of Circadian, a training and consulting firm, says at around 2pm, sleepiness tends to peak. This can boost creativity. When you’re fatigued, your mind can’t stay focused and you drift in and out of all these different avenues in your mind, which allows for you to free associate and be open to new ideas.

In summary, it turns out that if you want to be most effective, letting go of the need for your own conscious mind to do all the problem solving might be the key. Let your unconscious do more work, whether through napping or distractions, and try seeing things through the eyes of others. Finally, quite counter-intuitively, perhaps others know more about us than we do ourselves.

Dec 25

By John M. Grohol, Psy.D.
Bipolar disorder, which is also known by its older name “manic depression,” is a serious mental disorder that responds to treatment with both medication and psychotherapy.

Not everyone who has bipolar disorder (manic depression) experiences every symptom. Some people experience a few symptoms, some many. The severity of symptoms varies with individuals and also varies over time. The top 10 signs of mania, one part of bipolar disorder, are:

Abnormal or excessive elation
Unusual irritability
Decreased need for sleep
Grandiose notions
Increased talking
Racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
People with bipolar disorder must not only meet the criteria for the signs and symptoms listed above, but also for an episode of depression.

Dec 21

It seems as if the whole nation is walking around in a state of stunned shock, following the shooting at Sandy Hook school in Newtown, Connecticut that left 20 children, 6 adults, and the shooter dead. Schools across the country have been bombarded by calls from worried parents. President Obama, himself a father of two beautiful girls, had to pause his speech to wipe away tears. This event raises large and important questions for our leaders to answer. What do we, as a society do to keep ourselves safe from the disturbed among us? How can we provide more support and education to families so as to reduce child abuse and family violence that provide breeding grounds for psychopathy? Do we need to take another look at our gun control policies, or lack of them? These are longer-term questions. In the short-term, we all seek to restore a sense of safety, meaning, and predictability to our individual and family lives. With the holidays approaching, we want to be able to celebrate without being overwhelmed by guilt or sadness.

Below are some things you can do to help yourself cope with this tragedy. It is important to spend time and energy strengthening your internal resources, so you can feel safer and more competent in dealing with difficult or traumatic personal and societal events.

(1) Accept Your Feelings

Realize that events of this magnitude take time to process. Even if you were not directly affected, exposure to constant media coverage can be traumatizing. Give yourself time to feel sad or introspective. These are normal reactions.

(2) Re-establish Your Usual Routines.

Don’t spend all day watching news coverage. Sleep, exercise, healthy eating, pleasant activities, time with friends and family, yoga or meditation can strengthen your internal resources to cope.

(3) Create a Mental Safe Place

Mentally create a peaceful and relaxing setting in your mind to help you de-stress. Deliberately focus on each sense at a time. What do you see, hear, smell, and feel in this real or imaginary haven of peace?

(4) Find Self-Compassion

Treat yourself and your own feelings with tenderness and compassion. Do not push feelings away. Rather find or create a comforting environment in which to feel them. This may be with a friend or family member, while taking a bath, or while listening to soothing music. Mindfulness meditation, with its dual focus on observing the breath and letting sensations come up, provides an excellent way of looking at feelings while remaining anchored in the present.

(5) Create a Narrative

Write a narrative of how you found out about the event, the details that upset you, and your thoughts and feelings. Writing helps you to organize your reactions into a narrative that makes your reactions clearer and more understandable. “When we name it, we can tame it.”

(6) Seek Support and Connection

Reach out to others who can provide support and comfort. If you need to talk about your feelings, choose a person who can listen and be with you as you struggle with anxiety. Stay away from people who minimize your feelings and tell you to “Get over it.” Research shows social support is one of the most important predictive factors in preventing post-traumatic stress disorder, following a trauma.

(7) Turn to the Positive

Remind yourself that although the world contains much suffering and cruelty, it also contains much that is good. Deliberately think about the positive and uplifting things in your own life and community.Think about the freedoms and opportunities you have that many in the world have not. Focus on the strengths and coping strategies you have developed and the people you can turn to for help if you need it.

(8) Recommit to Your Most Important Values

Think about your most important personal or spiritual values, including love for family, nonviolence, compassion, integrity, hard work, and so on. How does your current life reflect these values? Make a list of your values and some concrete things you can do in the next week or month to make them an even more important part of your life. If you have a family, arrange a time to sit and talk about your family’s most important values. Make a poster, list, or vision board reflecting these and post it in an area your family regularly uses. When a family member makes a contribution or has an achievement that reflects these values, celebrate it!

(9) Feel Gratitude

Focus on the people in your life, past and present, that have provided you with protection, nurturance, or love. Bring to mind an image of yourself with that person. Focus on how you feel in that person’s presence. Then think about the gratitude you feel for what that person has given you. Find a concrete way to express that gratitude, through demonstrations of affection, a letter, a gift, or just telling them you appreciate them.

(10) Do Something Constructive

Channel your anger and outrage into constructive activities to help improve the situation. This may include sending letters of support to the victims, volunteering at local shelters, writing letters to the editors of local papers, or lobbying politicians for the needed changes on a societal level. Taking action can combat feelings of helplessness or guilt and can contribute to iincreasing safety or goodness in the world.

About The Author

Melanie Greenberg, Ph.D. is a Clinical Psychologist, and expert on Mindfulness and Positive Psychology. Dr Greenberg provides workshops and speaking engagements for organizations and coaching and psychotherapy for individuals and couples in person or via telephone.

Visit my website:

http://melaniegreenbergphd.com/marin-psychologist/

Follow me on twitter @drmelanieg

Like me on Facebook www.fb.com/mindfulselfexpress

Read my Psychology Today blog & personal blog

http://www.psychologytoday.com/blog/the-mindful-self-express

http://marinpsychologist.blogspot.com/

Dec 21

Here’s a joke from one of our fans:

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Here’s a joke from one of our fans:

An old man in Miami calls up his son in New York and says, “Listen, your mother and I are getting divorced. Forty-five years of misery is enough.”

“Dad, what are you talking about?” the son screams.

“We can’t stand the sight of each other any longer,” he says. “I’m sick of her face, and I’m sick of talking about this, so call your sister in Chicago and tell her,” and he hangs up.

Now, the son is worried. So he calls up his sister. She says, “Like hell they’re getting divorced!” and calls her father immediately. “You’re not getting divorced! Don’t do another thing, the two of us are flying home tomorrow to talk about this. Until then, don’t call a lawyer, don’t file a paper, DO YOU HEAR ME?” and she hangs up.

The old man turns to his wife and says “Okay, they’re coming for Christmas and paying their own airfare…..”

But those who live alone not at increased risk, study shows Feeling lonely, as distinct from being/living alone, is linked to an increased risk of developing dementia in later life, indicates research published online in the Journal of Neurology Neurosurgery and Psychiatry. Various factors are known to be linked to the development of Alzheimer’s disease, including older age, underlying medical conditions, genes, impaired cognition, and depression, say the authors.

But the potential impacts of loneliness and social isolation – defined as living alone, not having a partner/spouse, and having few friends and social interactions – have not been studied to any great extent, they say. This is potentially important, given the ageing population and the increasing number of single households, they suggest. They therefore tracked the long term health and wellbeing of more than 2000 people with no signs of dementia and living independently for three years. All the participants were taking part in the Amsterdam Study of the Elderly (AMSTEL), which is looking at the risk factors for depression, dementia, and higher than expected death rates among the elderly.

At the end of this period, the mental health and wellbeing of all participants was assessed using a series of validated tests. They were also quizzed about their physical health, their ability to carry out routine daily tasks, and specifically asked if they felt lonely. Finally, they were formally tested for signs of dementia.
At the start of the monitoring period, around half (46%; 1002) the participants were living alone and half were single or no longer married. Around three out of four said they had no social support. Around one in five (just under 20%; 433) said they felt lonely.

Among those who lived alone, around one in 10 (9.3%) had developed dementia after three years compared with one in 20 (5.6%) of those who lived with others. Among those who had never married or were no longer married, similar proportions developed dementia and remained free of the condition. But among those without social support, one in 20 had developed dementia compared with around one in 10 (11.4%) of those who did have this to fall back on. And when it came to those who said they felt lonely, more than twice as many of them had developed dementia after three years compared with those who did not feel this way (13.4% compared with 5.7%).

Further analysis showed that those who lived alone or who were no longer married were between 70% and 80% more likely to develop dementia than those who lived with others or who were married. And those who said they felt lonely were more than 2.5 times as likely to develop the disease. And this applied equally to both sexes. When other influential factors were taken into account, those who said they were lonely were still 64% more likely to develop the disease, while other aspects of social isolation had no impact. “These results suggest that feelings of loneliness independently contribute to the risk of dementia in later life,” write the authors.

“Interestingly, the fact that ‘feeling lonely’ rather than ‘being alone’ was associated with dementia onset suggests that it is not the objective situation, but, rather, the perceived absence of social attachments that increases the risk of cognitive decline,” they add. They suggest that loneliness may affect cognition and memory as a result of loss of regular use, or that loneliness could itself be a sign of emerging dementia, and either be a behavioural reaction to impaired cognition or a marker of undetected cellular changes in the brain.

Almost one-fifth of youngsters with bipolar disorder will make a suicide attempt. Two red flags at intake are a family history of depression and depression severity; three causes for concern over the short term are persistent depression, substance abuse, and mixed bipolar episodes. These findings, obtained in a five-year prospective study, are reported in the November Archives of General Psychiatry. The lead scientist was Tina Goldstein, Ph.D., of the University of Pittsburgh.

“I think it’s an excellent study,” Paula Clayton, M.D., medical director of the American Foundation for Suicide Prevention, said in an interview with Psychiatric News. Another valuable finding to emerge from the study, she believes, is that more than half the subjects were on psychotropic medications when they made their suicide attempts. The implication is thus “that treatment wasn’t enough to prevent them from making an attempt. It was maybe too much, too little, or the wrong treatment…. [So if a child with bipolar disorder] makes a suicide attempt, then I think we should reexamine the medications.”

Information about managing the care of children with bipolar disorder can be found in American Psychiatric Publishing’s Clinical Manual for Management of Bipolar Disorder in Children and Adolescents and in the just-published Clinical Manual of Child and Adolescent Psychopharmacology, Second Edition.
http://alert.psychiatricnews.org/2012/11/many-youth-with-bipolar-illness-will.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+PsychiatricNewsAlert+%28Psychiatric+News+Alert%29

Dec 21

Dec. 3, 2012 By Brenda Goodman, MA — Most teens with mental illnesses don’t take medications for their conditions, a new survey finds.

The study contradicts reports of widespread and indiscriminate pill-popping in high schoolers. If anything, researchers say, many kids may not be getting enough help for real problems that are affecting their lives.

“The one thing that we heard over and over when we started this study was that parents are getting their kids prescriptions for stimulants so they can do better on the SATs,” says researcher Kathleen Merikangas, PhD, chief of the genetic epidemiology branch in the intramural research program at the National Institute of Mental Health in Bethesda, Md.

But researchers, who questioned teens for the study, say they found no evidence of that trend.

“I was surprised that the rates were as low as they were. I thought the frequency of medication use was lower than we would have expected,” Merikangas says.

She points out that not treating mental health problems in teens can often lead to serious problems. They include failing grades, disruptive or criminal behavior, substance abuse, and suicide.

“As a society, we need to think about access to care before all of these bad outcomes occur,” Merikangas says.

Psychiatric Medications in Teens

Previous studies have relied on insurance claims to estimate rates of medication use in children and teens. Those studies have found sharp rises with psychiatrists prescribing to kids, especially poor children.

One 2006 study found that prescriptions of psychotropic drugs written to teens had shot up 250% between 1994 and 2001. It’s not always clear from claims data why the drugs are prescribed or even if they’re taken.

The new study, published in the Archives of Pediatric and Adolescent Medicine, took a different approach.

Researchers surveyed more than 10,000 teens in the U.S. who were between the ages of 13 and 18. The teens were carefully selected to reflect the makeup of the general population.

Researchers interviewed the teens at home and asked about any symptoms of mental problems in the past year that had been severe enough to affect their day-to-day functioning. When they reported taking medications, researchers had them produce the pill bottle so they could write down the drug name.

About half the teens in the study met the criteria for a mental disorder, and 22% were classified as being severely affected by their problems.

Despite that, only 14.1% of kids had taken any kind of psychotropic drug. The highest rates of medication use were in kids who met the criteria for attention deficit hyperactivity disorder (ADHD). Nearly 1 in 3 kids with ADHD reported taking a psychotropic medication. About 1 in 5 had been prescribed stimulants to help manage their condition.

In contrast, teens who were anxious, depressed, or bipolar were less likely to be prescribed a drug that could help. About 11% of teens diagnosed with an anxiety disorder were prescribed medications. About 20% of kids with depression or bipolar disorder were taking a mood-altering medication.

The study also found that the majority of kids who had been prescribed a psychotropic drug had a mental disorder severe enough to disrupt their day-to-day lives.
Many Kids Need Better Mental Health Care

“Not only were they not overprescribed, one could say that this group was inadequately treated,” says Victor Fornari, MD, director of the division of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y.

Fornari, who wasn’t involved in the research, praised the study for its careful methods. He says it reflects attitudes he often sees in his own practice.

“There’s enormous resistance. Many families, maybe 50%, refuse treatment, even when they are told their child has a psychiatric disorder,” Fornari tells WebMD.

Health coverage may be another factor behind the lower-than-expected rates of medication use seen in teens.

In an editorial on the study, David Rubin, MD, a pediatrician at the Children’s Hospital of Philadelphia, points out that many middle-class families simply can’t afford mental health care. These teens are often covered on their parents’ private insurance plans, which rarely cover mental health visits.

“The take-home message is that as a country it should bother us that many children do not have access to the appropriate services they need, and that rates of medication use (whether high or low) are really a symptom of a mental health system that does not meet the standard of what any parent — whether rich or poor — would hope for their children if they were in crisis,” Rubin says.

On the surface, obsessive compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD) appear very similar, with impaired attention, memory, or behavioral control. But Prof. Reuven Dar of Tel Aviv University’s School of Psychological Sciences argues that these two neuropsychological disorders have very different roots – and there are enormous consequences if they are mistaken for each other.

Prof. Dar and fellow researcher Dr. Amitai Abramovitch, who completed his PhD under Prof. Dar’s supervision, have determined that despite appearances, OCD and ACHD are far more different than alike. While groups of both OCD and ADHD patients were found to have difficulty controlling their abnormal impulses in a laboratory setting, only the ADHD group had significant problems with these impulses in the real world.

According to Prof. Dar, this shows that while OCD and ADHD may appear similar on a behavioral level, the mechanism behind the two disorders differs greatly. People with ADHD are impulsive risk-takers, rarely reflecting on the consequences of their actions. In contrast, people with OCD are all too concerned with consequences, causing hesitancy, difficulty in decision-making, and the tendency to over-control and over-plan.

Their findings, published in the Journal of Neuropsychology, draw a clear distinction between OCD and ADHD and provide more accurate guidelines for correct diagnosis. Confusing the two threatens successful patient care, warns Prof. Dar, noting that treatment plans for the two disorders can differ dramatically. Ritalin, a psychostimulant commonly prescribed to ADHD patients, can actually exacerbate OCD behaviors, for example. Prescribed to an OCD patient, it will only worsen symptoms.

Separating cause from effect

To determine the relationship between OCD and ADHD, the researchers studied three groups of subjects: 30 diagnosed with OCD, 30 diagnosed with ADHD, and 30 with no psychiatric diagnosis. All subjects were male with a mean age of 30. Comprehensive neuropsychological tests and questionnaires were used to study cognitive functions that control memory, attention, and problem-solving, as well as those that inhibit the arbitrary impulses that OCD and ADHD patients seem to have difficulty controlling.

As Prof. Dar and Dr. Abramovitch predicted, both the OCD and ADHD groups performed less than a comparison group in terms of memory, reaction time, attention and other cognitive tests. Both groups were also found to have abnormalities in their ability to inhibit or control impulses, but in very different ways. In real-world situations, the ADHD group had far more difficulty controlling their impulses, while the OCD group was better able to control these impulses than even the control group.

When people with OCD describe themselves as being impulsive, this is a subjective description and can mean that they haven’t planned to the usual high degree, explains Prof. Dar.

Offering the right treatment

It’s understandable why OCD symptoms can be mistaken for ADHD, Prof. Dar says. For example, a student in a classroom could be inattentive and restless, and assumed to have ADHD. In reality, the student could be distracted by obsessive thoughts or acting out compulsive behaviors that look like fidgeting.

“It’s more likely that a young student will be diagnosed with ADHD instead of OCD because teachers see so many people with attention problems and not many with OCD. If you don’t look carefully enough, you could make a mistake,” cautions Prof. Dar. Currently, 5.2 million children in the US between the ages of 3 and 17 are diagnosed with ADHD, according to the Centers for Disease Control and Prevention, making it one of the most commonly diagnosed neuro-developmental disorders in children.

The correct diagnosis is crucial for the well-being and future trajectory of the patient, not just for the choice of medication, but also for psychological and behavioral treatment, and awareness and education for families and teachers.

By Traci Pedersen Associate News Editor
Reviewed by John M. Grohol, Psy.D. on December 19, 2012

Mindfulness Cognitive Therapy Reduces Anxiety in Bipolar PatientsIn patients with bipolar disorder, mindfulness-based cognitive therapy (MBCT) has been shown to significantly reduce anxiety, according to researchers at the University of New South Wales.

MBCT involves traditional cognitive behavioral therapy (CBT) methods, while also incorporating newer psychological strategies, such as mindfulness meditation. The goal is to become aware of and accept all incoming thoughts and feelings, but not to attach or react to them.

The newer therapy, however, seemed to have no effect on symptoms of depression or mania; nor did it reduce episodes, found the researchers during 12 months of follow up.

For the study, the team recruited 95 patients with bipolar disorder, who were at least 18 years old. They were either assigned to MBCT or typical therapy.

Those in the MBCT group received weekly mindfulness meditation practice, cognitive therapy regarding depression, and psychoeducation.

All of the participants were assessed at baseline and follow up using the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), the Depression Anxiety Stress Scales, and the State Trait Anxiety Inventory (STAI). They were also evaluated for mood episode recurrences over the study period.

Overall, 34 participants assigned to the MBCT group finished the program and were assessed at followup.

The findings revealed that there were no significant differences between the two groups regarding improvements in MADRS and YMRS scores over the 12-month study period. There were also no significant differences regarding either time to a first mood episode recurrence or the total number of recurrences over the study period.

However, patients assigned to MBCT had significantly lower anxiety scores on the STAI over the study period.

“These findings suggest that MBCT may offer some assistance in managing anxiety for those with bipolar disorder,” said researcher Tania Perich and team in Acta Psychiatrica Scandinavica.

But they add that “MBCT did not reduce time to recurrence of depressive or hypomanic episodes over a 12-month follow-up period, nor was it associated with a reduction in mood symptom severity scores.”

Dec 18

Divorce Causes: 5 Ways To Destroy Your Marriage

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By Francesca Escoto for YourTango.com

A good friend of mine says that love is blind, but marriage restores your 20/20 vision. Regardless of romance, all marriages — at some point or another — will go through at least one major crisis.

If the relationship survives past the first few years, after the endorphins have subsided, couples will have to deal with the 12-to-20 season: the time between years 12 and 20 when couples typically work out the last major kinks and differences. If they are unable to reach this point, years 12-20 will typically result in divorce.

Here are five signs you might be the reason why your marriage has not worked out its kinks:

1. You can’t handle the in-laws. Research shows that how spouses relate to the in-laws is a strong predictor of marriage longevity. A man who gets along with his wife’s parents is wise — his chances of a strong marriage increases by about 20 percent. Women who get along with their in-laws actually have an increased probability of divorce, by about 20 percent.

If you are the husband who does not invest in knowing or liking the in-laws, or if you are a wife who can’t say no to the mom-in-law’s constant, last-minute demands, you are probably driving your spouse to divorce.

2. You are always the victim. You never do anything wrong, and your spouse is always doing things on purpose, obviously. He/she is completely insensitive, never takes you into consideration and probably even forgets that you exist. In return, you never ask for anything, you allow your spouse to over-indulge and underestimate.

Perhaps your spouse has been unfaithful but you will forgive every single time. If you truly cannot see any of your own faults or imperfections and blame the other person for all that goes wrong, you are probably driving your spouse to divorce.

3. You can’t handle pain or anger. No, this does not mean that you explode in anger every two minutes. This could very well mean you pretend to never get angry in an effort to avoid confrontations. You cannot be fully honest about how you feel because you don’t want to be the bearer of bad news.

The idea of pain is overwhelming, and it is something you avoid because it is “bad.” You always wait until you cool off, which takes about six months and by then you don’t even remember what happened. It must not have been that important…

The idea of anger makes you angry at yourself for even thinking it, because you believe you should never feel angry. When your spouse gets angry, you feel a lot of pain and you work hard to get rid of the pain. Instead of dealing with your hyper-sensitivities, you pretend to not be angry, give silent treatments and fake orgasms, or better yet, you fake headaches to avoid sex altogether. If you are more concerned with keeping the peace than you are with making peace, you are probably driving your spouse to divorce.

4. You know you’re right. Negotiating typically means that your spouse will think it over until they agree with, well — you. There is nothing more frustrating than trying to reason with someone who already knows how the problem will be resolved. Its not that you are being unreasonable, you actually make a lot of sense, which makes everything more difficult.

Since you make sense, you assume that you are right, and that your point of view is therefore the only “right” one. Your spouse never gets it. Ever. Or hardly ever. Because you really are willing to negotiate, just not this time because this time you are right. As usual. If your spouse can’t make decisions without you having a great “suggestion,” as you typically do, you are probably driving your spouse to divorce.

5. You constantly belittle your partner’s needs. Men need words of affirmation and sexual intimacy. Women need time to be heard and appreciated, as well as random acts of kindness. Minimizing how important these are is like denying water to a rose garden and expecting roses.

The bond that holds couples together will never bloom unless you give it what it needs: validation. When couples start to hold their needs against each other, they vanish any possibility of real intimacy. After all, your spouse should be the one person on this planet who wants your needs to be met, even if they can’t meet all of them.

If you withold sex as punishment because you know how important it is for him, or you skip intellectual foreplay consistently because you are too tired to romance her, you are probably driving your spouse to divorce.

Francesca is a speaker, author, and life coach. Join the conversation on Facebook at Living Latina. For speaking information, visit francescaescoto.com.

Dec 18

Don’t Blame Autism for Newtown

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By PRISCILLA GILMAN LAST Wednesday night I listened to Andrew Solomon, the author of the extraordinary new book “Far From the Tree,” talk about the frequency of filicide in families affected by autism. Two days later, I watched the news media attempt to explain a matricide and a horrific mass murder in terms of the killer’s supposed autism.

It began as insinuation, but quickly flowered into outright declaration. Words used to describe the killer, Adam Lanza, began with “odd,” “aloof” and “a loner,” shaded into “lacked empathy,” and finally slipped into “on the autism spectrum” and suffering from “a mental illness like Asperger’s.” By Sunday, it had snowballed into a veritable storm of accusation and stigmatization.

Whether reporters were directly attributing Mr. Lanza’s shooting rampage to his autism or merely shoddily lumping together very different conditions, the false and harmful messages were abundant.

Let me clear up a few misconceptions. For one thing, Asperger’s and autism are not forms of mental illness; they are neurodevelopmental disorders or disabilities. Autism is a lifelong condition that manifests before the age of 3; most mental illnesses do not appear until the teen or young adult years. Medications rarely work to curb the symptoms of autism, but they can be indispensable in treating mental illness like obsessive-compulsive disorder, schizophrenia and bipolar disorder.

Underlying much of this misreporting is the pernicious and outdated stereotype that people with autism lack empathy. Children with autism may have trouble understanding the motivations and nonverbal cues of others, be socially naïve and have difficulty expressing their emotions in words, but they are typically more truthful and less manipulative than neurotypical children and are often people of great integrity. They can also have a strong desire to connect with others and they can be intensely empathetic — they just attempt those connections and express that empathy in unconventional ways. My child with autism, in fact, is the most empathetic and honorable of my three wonderful children.

Additionally, a psychopathic, sociopathic or homicidal tendency must be separated out from both autism and from mental illness more generally. While autistic children can sometimes be aggressive, this is usually because of their frustration at being unable to express themselves verbally, or their extreme sensory sensitivities. Moreover, the form their aggression takes is typically harmful only to themselves. In the very rare cases where their aggression is externally directed, it does not take the form of systematic, meticulously planned, intentional acts of violence against a community.

And if study after study has definitively established that a person with autism is no more likely to be violent or engage in criminal behavior than a neurotypical person, it is just as clear that autistic people are far more likely to be the victims of bullying and emotional and physical abuse by parents and caregivers than other children. So there is a sad irony in making autism the agent or the cause rather than regarding it as the target of violence.

In the wake of coverage like this, I worry, in line with concerns raised by the author Susan Cain in her groundbreaking book on introverts, “Quiet”: will shy, socially inhibited students be looked at with increasing suspicion as potentially dangerous? Will a quiet, reserved, thoughtful child be pegged as having antisocial personality disorder? Will children with autism or mental illness be shunned even more than they already are?

This country needs to develop a better understanding of the complexities of various conditions and respect for the profound individuality of its children. We need to emphasize that being introverted doesn’t mean one has a developmental disorder, that a developmental disorder is not the same thing as a mental illness, and that most mental illnesses do not increase a person’s tendency toward outward-directed violence.

We should encourage greater compassion for all parents facing an extreme challenge, whether they have children with autism or mental illness or have lost their children to acts of horrific violence (and that includes the parents of killers).

Consider this, posted on Facebook yesterday by a friend of mine from high school who has an 8-year-old, nonverbal child with severe autism:

“Today Timmy was having a first class melt down in Barnes and Nobles and he rarely melts down like this. He was throwing his boots, rolling on the floor, screaming and sobbing. Everyone was staring as I tried to pick him up and [his brother Xander] scrambled to pick up his boots. I was worried people were looking at him and wondering if he would be a killer when he grows up because people on the news keep saying this Adam Lanza might have some spectrum diagnosis … My son is the kindest soul you could ever meet. Yesterday, a stranger looked at Timmy and said he could see in my son’s eyes and smile that he was a kind soul; I am thankful that he saw that.”

Rather than averting his eyes or staring, this stranger took the time to look, to notice and to share his appreciation of a child’s soul with his mother. The quality of that attention is what needs to be cultivated more generally in this country.

It could take the form of our taking the time to look at, learn about and celebrate each of the tiny victims of this terrible shooting. It could manifest itself in attempts to dismantle harmful, obfuscating stereotypes or to clarify and hone our understanding of each distinct condition, while remembering that no category can ever explain an individual. Let’s try to look in the eyes of every child we encounter, treat, teach or parent, whatever their diagnosis or label, and recognize each child’s uniqueness, each child’s inimitable soul.

Priscilla Gilman is the author of “The Anti-Romantic Child: A Memoir of Unexpected Joy.”

By Kaitlin Bell Barnett

I’ve argued before that declaring American kids and teens to be “overmedicated” is something of a cop-out.

How can people say what constitutes overmedication when they can’t – or won’t – specify what would constitute an acceptable number or percentage of kids taking psychiatric meds?

Still, I do care about the numbers, because they can give us clues as to which kids and how many are getting appropriate treatment for emotional and behavioral problems.

A recent and widely publicized study by researchers from The National Institute of Mental Health provides data on some -but not all – key measurements of youth medication use.

Its main finding: Just one in seven teens with a diagnosable psychiatric conditions have recently taken medications to treat it.

Among Kids With Diagnosable Disorders, Low Rates of Recent Medication Use

The study, which was published online in the Archives of Pediatrics and Adolescent Medicine, surveyed a large, nationally representative sample of more than 10,000 teens ages 13 to 18.

It found that about 14 percent of kids with DSM-IV psychiatric diagnoses had been treated with medication in the past year.

The percentage ranged widely, however, depending on the condition. Thirty-one percent of teens with diagnosable ADHD reported having taken medication for that condition in the past 12 months, compared to just 11 percent of those with anxiety disorders.

Researchers Find ‘No Compelling Evidence’ For Overmedication

The research team – which includes several major figures in this field – considered these percentages to be reasonable, especially considering the amount of distress and dysfunction involved in the kids they surveyed. “There was no compelling evidence for either misuse or overuse of psychotropic medications,” they wrote.

“The majority who had been prescribed medications, particularly those who received treatment in specialty mental health settings,” they added, “had a mental disorder with severe consequences… functional impairment, suicidality, or associated behavioral and developmental difficulties.”

The study also found that most kids were taking a medication commonly prescribed for their diagnosis, such as antidepressants for depression, or stimulants for ADHD.

Antipsychotic use, which has been growing dramatically in recent years and is the subject of much debate about alleged overprescribing, was very low overall, ranging from 0.1 percent of those with anxiety as their primary diagnosis to 2 percent of those with developmental disorders as their primary problem.

Moreover, just 2.5 percent of kids who didn’t qualify for a psychiatric diagnosis reported having taken meds in the past year.

But even this small percentage of kids who didn’t meet the formal criteria sufficient for a diagnosis at the time they were surveyed weren’t necessarily inappropriately mediated: 78 percent reported having a prior mental or developmental disorder (like autism) that caused distress or impairment.

What’s Missing From The Study

It’s important to note that this study collected data between 2001 and 2004, so it’s possible medication use in teens – or at least the use of certain medications, like antipsychotics – has expanded since then.

And an important measurement was missing from the article that would provide key context about under- or over-treatment. Although researchers queried teens and families about where they received mental health services (in school, from a general practitioner, a mental health specialist, etc.), the text of the article didn’t indicate what percentage of the medicated kids were also receiving other services, such as psychotherapy. It also didn’t indicate what percentage of the unmedicated kids were receiving other services.

That’s crucial, because medication isn’t the only treatment out there. Other therapies have been shown to be effective, and a number of studies have found combined therapy and medication to be superior to either treatment alone.

Therefore, the issue isn’t so much what percentage of kids are taking medications – or even what percentage of kids with a bona fide diagnosis are taking them, the focus of this study.

Rather, the more salient questions are whether kids with troubling emotional and behavioral problems have appropriate and sufficient access to treatment, and whether they and their families consider that treatment – and those who administer it – adequate and effective.

An editorial accompanying the article made that point convincingly.

The editorial also pointed out that this study included a relatively high percentage of well-off kids with private insurance, which might account for the low rates of medication use. Previous studies have shown that kids with public insurance, especially foster children, are far more likely to be medicated at higher rates.

So What Do We Still Need To Know?

Although this study provides valuable information showing that relatively few teens take medication for their psychiatric disorders, we need a study that examines how common psychiatric diagnoses, medication use and other treatment modalities are in youngsters from diverse backgrounds.

And that same study should also measure kids and families’ opinions about access to and effectiveness of different kinds of treatment, as well as their level of satisfaction with the medical and with mental health professionals who administer it.

Dec 14

Is Depression an Emotional Mush?

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By Wray Herbert I have a vivid memory of dropping my oldest son off at college, the first day of his freshman year, many years ago. He stood outside his dorm, waving as I drove away, and I was overcome by a complex mix of emotions. I was unquestionably sad — the tears testified to that — but I wasn’t morose or agitated, and I kind of knew that this sadness would pass. In fact, I was in the same moment keenly aware of a range of powerful and positive emotions — pride that my son had earned his way into a fine university, relief that he seemed well-adjusted and untroubled and had solid friends. He seemed to be landing OK, and the moment was bittersweet.

Bittersweet. It seems like a contradiction, but in truth our emotional states are rarely simple or tidy. We don’t feel good this moment, bad the next. More discrete feelings like pride and excitement and frustration and shame spill over one another and mix, and it’s up to us to differentiate the nuances. What I was doing in those minutes as I drove away from campus — sorting out my welter of feelings and making sense of them — is what most people do in some way every day.

If they’re lucky, that is. Research has shown that people vary greatly in their ability to do this fine-grain emotional sorting, and the inability to do such emotional calibration may take a toll. Emotions are information to the human mind, and when we experience a discrete emotion like sadness, we try to process that emotion and conceptualize it in a meaningful way. In that way we can explain the feeling to ourselves in a reasonable way, and act appropriately. If on the other hand we experience an undifferentiated emotional mush, we’re likely to misconstrue the causes, and act in ways that don’t make sense and may indeed be harmful.

At least that’s the theory, which has been pieced together in several labs over many years. It’s also the departure point for new work by Emre Demiralp of the University of Michigan, who with several colleagues decided to investigate whether people who suffer from serious depression might experience a disability in this kind of emotional parsing. The idea makes sense theoretically, because depression has long been associated with impoverished perception and memory and thinking. The scientists wanted to see if depressed people’s emotional states are also less rich and textured.

The problem with studying emotions is that they are very difficult to tap and measure. Feelings are subjective, so scientists can’t simply ask people what they are feeling and expect an accurate and meaningful answer. To circumvent this problem, the scientists used what’s called “experience sampling.” They recruited a group of volunteers — half healthy, half clinically depressed — and gave them Palm Pilots to carry with them for a week. Over this time, the scientists beeped the volunteers at random times, and asked them to stop what they were doing and rate how much — on a scale of zero to four — they were experiencing eleven different emotions at the moment — anxiety, disgust, guilt, alertness, happiness and so forth.

Demiralp and his colleagues wanted to assess the richness of the volunteers’ emotional lives, and to do this they looked for patterns of correlation. For example, if a volunteer experienced fluctuations in anger over the week, and those fluctuations correspond closely with that volunteer’s fluctuations in sadness, this would suggest that this person does not differentiate much between anger and sadness. They are linked together into a vague sense of feeling bad. The scientists predicted that the depressed volunteers would show such a pattern, while the healthy volunteers’ emotions would not correlate closely. What’s more, because depressed people have a bias toward negativity, the scientists expected that depressed volunteers would parse their positive emotions just as finely as healthy volunteers.

And that’s exactly what they found. As reported in-line in the journal Psychological Science, the volunteers suffering from serious depression tended — much more than healthy controls — to lump all their bad feelings together; shame and frustration and sadness were all parts of a vague sense of feeling bad. They did not do this with positive feelings. Importantly, this inability to parse negative emotion works independently of emotional intensity or instability. In other words, it’s a fundamental characteristic of the depressed mind.

The scientists believe that finely discriminated emotions are more adaptive for mental health, because they are less likely to be attributed to the wrong cause. People suffering from clinical depression often have distorted thinking, blaming themselves for situations they can’t control, and it could be that mushy emotional states contribute to that harmful thinking. A vague undifferentiated unpleasantness is much harder to explain, and therefore much harder to regulate.

Dec 14

App lets seniors rate ‘age-friendly’ places

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— With a new app, seniors can rate the “age-friendliness” of restaurants, libraries, crosswalks, shopping centers, and public transit—and share their ratings with others.

“It empowers older adults to evaluate what’s senior-friendly and what’s not,” says one of the app’s creators, Alex Mihailidis, an associate professor of occupational science and occupational therapy at the University of Toronto.

Users rate locations on things like general accessibility, availability of seating, lighting levels, staff attitudes, and background music levels. Age-CAP (Age-friendly Communities Assessment ApP) then produces an overall rating, based on the World Health Organization’s age-friendly cities guidelines.

The app uses GPS to pinpoint the user’s location, no matter which city they live in worldwide and is available for iPhone, iPad, and Android devices. People can simply browse the database to see which locations and services in a neighborhood are considered “age-friendly” and why.

“This is a new way for seniors to create a crowd-sourced database of age-friendly locations,” says Mihailidis, who is also a core faculty member of the Institute of Biomaterials and Biomedical Engineering and the Department of Computer Science.

The team hopes the app will promote “active” aging and encourage seniors to get out and about in the community. Social isolation in the elderly can lead to depression and physical problems, such as loss of appetite and difficulty sleeping.

There’s also a safety dimension.

“Already, people are using the app to warn others about dangerous crosswalks, and subway stops that don’t have elevators,” says Mihailidis.

Some of the features users can rate, by indicating agreement or disagreement on a scale of one to five, include:
•Restaurants: “The menu and bill were written in a legible font and size.”
•Community centers: “A senior’s discount is offered on classes and memberships.”
•Libraries: “Advertisements for seniors programming were readily displayed.”
•Crosswalks: “I had enough time to cross at the crosswalk during the allotted time.”
•Shopping centers: “There were areas to sit and rest.”
•Public transit: “There was appropriate shade available during my wait.”

People can also offer general comments, and create new categories for locations or services they wish to rate.

Will seniors embrace the app? Mihailidis points to an upward trend in mobile technology use among seniors, citing statistics that suggest between 30 and 70 percent are using smartphone devices.

As the app’s database grows, it can be used to advocate for improvements that make cities more senior-friendly, says Mihailidis. He hopes businesses, including restaurants, and municipal politicians will take note of the ratings.

The app was developed by researchers at University of Toronto and Toronto Rehabilitation Institute with funding from Toronto Rehab, and is owned by Toronto Rehab-UHN.
http://www.futurity.org/society-culture/app-lets-seniors-rate-‘age-friendly’-places/

Dec 8

Meditation: Children and Teens as Mindful Warriors

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Can meditation positively change a young person’s life?

Absolutely it can!

Research in neuroscience and attention provides evidence that meditation strengthens the neural systems of the brain that are responsible for concentration and generating empathy. Becoming more mindful helps children and adolescents better regulate how life circumstances impact their mental health.

Last week, I posted an article at Psychology Today, Happiness or Harvard? — about high school valedictorian Carolyn Milander who discovered her own values about success through her meditation practice. If you haven’t read her compelling story of why she chose a community college over an Ivy-League school, don’t miss it!

All young people cope with stress in one form or another.

In schools, we teach reading, science, and math. Yet most communities miss one of the most important aspects of learning – how to care for and nurture the mind.

A new book, Get Out of Your Mind and Into Your Life For Teens: A Guide to Living an Extraordinary Life, provides excellent insights for young people. Written by psychology professionals Joseph Ciarrochi PhD, Louise Hayes PhD, and Ann Bailey, it introduces teens to the concept of becoming mindful warriors.

Mindful warriors are BOLD. This is an acronym used in the book to describe the skills required to help young people deal with their emotions and stay committed to the kind of life they want to create. The BOLD skills coincide with Carolyn Milander’s story to a tee!

B – Breathing deeply and slowing down.
O – Observing.
L – Listening to your values.
D – Deciding on actions and doing them.
Meditation takes regular practice. While this book is designed to be a resource and road map for teens, I believe it will be best utilized when combined with a face-to-face meditation class. For those who teach meditation to adolescents, this workbook may be a great companion to your classes as it is well-designed so that teens can complete home exercises and record their reflections.

Children of all ages can benefit from meditation, even elementary-school-age. Numerous books are available to help younger children develop the art of mindfulness, including Planting Seeds: Practicing Mindfulness with Children by Thich Nhat Hanh and Buddha at Bedtime by Dharmachari Nagaraia.

Improving Schools through Meditation and Quiet Time
It is very clear that the culture of schools must change in ways that reduce stress on children and teens. Whether students feel pressured to score high on standardized tests or burdened by poverty and violence, their mental health is similarly at risk.

One school in San Francisco took a BOLD approach to reducing student stress.

In a compelling video produced at the Visitacion Valley Middle School, meditation improved student’s well-being. And, by the way, it significantly lowered truancy and suspensions too!

Watch this and be inspired! Then introduce the young people you parent or teach to meditation!

A Postscript on Meditation and Happiness
Most of us are not exposed to meditation before adulthood.

Yet we know that meditation creates more contentment, less anxiety, and the ability to better overcome challenging life problems. Longitudinal research shows that today’s youth experience more stress than previous generations. Meditation and mindfulness practices can help.

Carolyn Milander referred to her meditation class as “Happy Class.” She said, “Happy Class prompted me to turn my life around. The meditation I did inside and outside of Happy Class was the impetus that caused me to start making healthy changes in my life.”

“I will always live in the skin I was born with,” asserted Carolyn, “so the sooner I learn to accept myself for who I am and the differences I may have, the better. Meditation was a step forward in which I acknowledged to myself that I needed help dealing with my stress.”

These are wise words from a young woman who learned how to meditate in ninth grade. In fact, they should speak to all of us who experience the stresses of everyday life.

If we create cultures where young people can quiet themselves from the busy world, observe their thoughts and feelings, listen to their values, and decide with intentionality on their actions, we will surely nurture healthier and happier children.

Let’s help kids be BOLD and mindful warriors!

Breath.

Observe.

Listen.

Decide.
http://rootsofaction.com/blog/meditation-children-teens-mindful-warriors/#more-1515

Dec 7

Casual sex linked to teen depression

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Casual sex increases a teenager’s odds for clinical-level depression nearly threefold. The effects are the same for boys and girls, though younger teens (13-15 years old) who had so-called “nonromantic sex” faced substantially greater risks for depression. Dating alone was not linked to depressive symptoms.

Published in the Journal of Abnormal Psychology, the the study provides evidence that “context is key” when trying to understand how teen relationships and sex affect their well-being.

“Many historical and media perspectives have presented adolescent sexuality as an indicator of problematic or even socially deviant behavior,” says Jane Mendle, assistant professor of human development in Cornell University’s College of Human Ecology. “But this study and other recent findings are showing that’s not the case, and adolescent dating and sexuality can be viewed as normal developmental behavior.”

Using a novel behavioral genetics approach that compares siblings growing up in the same home, Mendle and her co-authors analyzed responses from 1,551 sibling pairs ages 13-18 from the National Longitudinal Study of Adolescent Health, a nationally representative sample of US high school students initiated in the mid-1990s. Among other topics, teens answered questions about their mental health and dating and sexual history. Nearly two-thirds of the sample’s youth had dated, and two-thirds were virgins.

By comparing siblings in their study, the authors could control for family and environmental influences that might also raise one’s risk for depression.

“We designed the study to give us a purer way to isolate many of the factors that could be contributing to depression,” Mendle says. “It allows us to compare specific types of social activities—in this case, dating and romantic and nonromantic sex—to see their overall effect.”

The paper notes that not all the associations at play can be unraveled, however. For instance, some teens who have depressive symptoms or clinical depression may be more likely to engage in casual sexual behaviors.

Mendle, a licensed clinical psychologist who studies how such developmental processes as puberty and sexual maturation influence teens’ emotional growth, believes adolescent sexuality is important to study because it is closely tied to how well people transition into adulthood.

“One of the hallmarks of adolescence is the formation of romantic relationships, and we know that what happens in adolescence is strongly related to your psychological, physical and financial well-being for years to come,” Mendle says. “Findings like this can help shape the dialogue and public debate about how to best support teen sexual health, psychological development and other areas.”

Benzodiazepines were associated with an increased risk of, and mortality from, community acquired pneumonia (CAP), according to a report published online in the journal Thorax. British researchers looked at 29,697 controls and 4,964 cases of CAP from The Health Improvement Network, a U.K. primary care patient database, to investigate a reported link between benzodiazepines and pneumonia.

They found that diazepam, lorazepam, and temazepam, but not chlordiazepoxide, were associated with an increased incidence of CAP. As a class, benzodiazepines were associated with increased 30-day and long-term mortality in patients with a prior diagnosis of CAP. Individually diazepam, chlordiazepoxide, lorazepam, and temazepam affected long-term mortality in these patients.

“Benzodiazepines and zopiclone are commonly prescribed medications that have significant immune effects, the researchers said. “Our data…suggest that they may increase both the risk of and mortality from pneumonia. This is consistent with data from clinical trials and concerns expressed over the intensive care unit effects of these drugs leading to movement away from benzodiazepine sedation. Nonetheless, given the widespread use of benzodiazepine drugs, further studies are required to evaluate their safety in the context of infection.”

Cognitive behavioural therapy (CBT) can reduce symptoms of depression in people who fail to respond to drug treatment, says a study in the Lancet.

CBT, a type of psychotherapy, was found to benefit nearly half of the 234 patients who received it combined with normal care from their GP. Up to two-thirds of people with depression do not respond to anti-depressants. Patients should have access to a range of treatments, the charity Mind said.

CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behaviour. The study followed 469 patients with treatment-resistant depression picked from GP practices in Bristol, Exeter and Glasgow over 12 months.

One group of patients continued with their usual care from their GP, which could include anti-depressant medication, while the second group was also treated with CBT. After six months, researchers found 46% of those who had received CBT reported at least a 50% reduction in their symptoms.

Continue reading the main story
“The research confirms how these approaches – the psychological and physical – can complement each other. ”
Prof Chris Williams
University of Glasgow

This compared with 22% experiencing the same reduction in the other group. The study concluded CBT was effective in reducing symptoms and improving patients’ quality of life. The improvements had been maintained for a period of 12 months, it added.

Other options

Dr Nicola Wiles, from the Centre for Mental Health, Addiction and Suicide Research at the University of Bristol, said: “While the addition of CBT was effective for patients who had not responded to anti-depressants, not everyone who received CBT got better. These patients had severe and chronic depression so it is unlikely that one treatment would be effective for everyone.”

“We need to invest in other research to find alternative treatments for patients whose symptoms have not responded to treatment with anti-depressants.” Cognitive behavioural therapy is:
a way of talking about how you think about yourself, the world and other people
how what you do affects your thoughts and feelings
CBT can help you to change how you think (cognitive) and what you do (behaviour).

Unlike some other talking treatments, it focuses on the “here and now” instead of the causes of distress or past symptoms. The patients who did benefit from cognitive behavioural therapy spent one hour a week with a clinical psychologist learning skills to help change the way they think.

Chris Williams, professor of psychosocial psychiatry at the University of Glasgow, and part of the research team, said: “The research used a CBT intervention alongside treatment with anti-depressants. It confirms how these approaches – the psychological and physical – can complement each other.

“It was also encouraging because we found the approach worked to good effect across a wide range of people of different ages and living in a variety of settings.”

Paul Farmer, chief executive at the mental health charity Mind, said there was no “one size fits all” treatment for people with mental health problems.

“We welcome this research because it recognises that patients should have the right to a wide range of treatment options based on individual needs,” he said.

“Initiatives such as the Improving Access to Psychological Therapies (IAPT) programme has helped to ensure that more treatment options are available for conditions such as depression, however, we know that there still is a huge difference between what treatment people want and what they actually get.”

Have you benefited from cognitive behavioural therapy? Send your comments and experiences

Thorin Klosowski
With holiday shopping in full swing, you might have noticed yourself acting a little strangely when you’re out shopping. Over on Psychology Today, they break down the sensory campaigns of most stores to show why you might find yourself out of sorts when shopping during the holidays.

A holiday shopping campaign is a multi-pronged approach from an advertising point of view, and as Psychology Today points out, marketers are going after each of your senses to convince you to buy more. This works in different ways depending on which senses they’re going for. For instance, certain colors might change your spending habits:

Red stimulates and energizes—even our spending. Waitresses wearing red receive 14 to 26% higher tips than waitresses wearing any other color uniform. Another study found that shoppers on eBay bid more aggressively for products shown against red backgrounds than blue backgrounds.

Of course, it’s not just what you see that matters, it’s also what you hear. In the case of the December, that means holiday music:

More importantly, classic holiday music evokes nostalgia. Recent research shows that nostalgia elevates positive moods and helps people feel better about themselves… Feeling more connected to others, positive and loaded with holiday spirit is a recipe of on the spot bumps in gift budgets.

All of your senses play a role in your shopping experience, from the sensation of touching a product, to the smells that waft out from the shopping floor. Unfortunately, much like how advertising manipulates your choices, you can’t do much to counter the experience except recognize what’s going on. When you’re aware of the manipulation at retailers, you’re less likely to succumb to their effects.

by Aaron Levin
The association of posttraumatic stress disorder (PTSD) with substance dependence is no random pairing.
As many as 65 percent of patients with PTSD have a comorbid substance use disorder, and up to 62 percent of people with substance dependence have PTSD, according to sources cited by Katherine Mills, Ph.D., in a new study of combined PTSD/substance dependence therapy. Mills is a senior lecturer in the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney, Australia.

“Substance abuse may follow PTSD as a way of coping with stress or as an avoidance strategy,” noted Paula Schnurr, Ph.D. “Or it can predate and lead to PTSD by encouraging risky behavior that results in trauma.”
However, many clinicians have worried that exposure-based therapy could increase those stresses and cause patients to revert to primary coping strategies such as substance abuse, said Schnurr, deputy executive director of the Department of Veterans Affairs’ National Center for PTSD in White River Junction, Vt., and a research professor of psychiatry at Dartmouth Medical School, in an interview with Psychiatric News.

Nevertheless, exposure-based therapies are the standard for treating PTSD, and conventional wisdom has held that prolonged exposure should be used only with patients who have been off substances for some time. The truth of that belief was unknown, however, since substance-dependent subjects have usually been excluded from other than pilot studies of combined therapies.

Now Mills and colleagues have presented evidence indicating that such fears may be misplaced. The researchers randomized 103 patients to receive either “usual treatment” for substance dependence—that is, anything available in the community, or usual treatment plus a modified version of COPE—Concurrent Treatment of PTSD and Cocaine Dependence.

The participants were 34 years old on average; 62 percent were women and 80 percent had a history of injection drug use. Most had experienced noncombat trauma exposure, such as sexual or physical assault, or accidents or disasters. The COPE protocol included 13 individual sessions with a therapist, cognitive-behavioral therapy for substance use, psychoeducation, and in-vivo and imaginal exposure.

After nine months of treatment, symptom severity had decreased in both groups. “However, the treatment group demonstrated a significantly greater reduction in PTSD symptom severity,” said the researchers in the August 15 Journal of the American Medical Association. There was also no significant difference in changes in substance use or in depression, or anxiety symptoms, but those symptoms did not worsen either.

“The complex trauma, substance use, and psychiatric presentations commonly found among individuals with PTSD and substance dependence should not be a deterrent to providing trauma-focused treatment,” concluded Mills and colleagues. “This study may minimize potential benefits of combined therapy,” said Schnurr. “It provides evidence that such treatment doesn’t create other problems, although I’m surprised and a little disappointed that the treatment didn’t help with substance dependence symptoms.”

While the COPE treatment protocol called for 13 sessions, participants attended a median number of only five sessions. Perhaps a greater number of therapy sessions attended or a different type of treatment might have made a difference, she said. However, the fact that the study report appears in a journal of wide general circulation will help communicate the importance of the topic, said Schnurr.

“My hope is that people pay attention to this study,” she said. “Opinions have changed over time about whether people who have PTSD and substance abuse can engage in PTSD care. Many people still believe that these people were fragile and that treating PTSD would increase substance abuse. I hope that this paper changes some minds in that regard, because I worry that people have not received the treatment that they need and that they could benefit from.”

“Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence” is posted at http://jama.jamanetwork.com/article.aspx?articleid=1346186#Abstract.

Dec 6

By ALice Boyes, Ph.D.
Cognitive Behavioral Therapy techniques come in many shapes and sizes, offering a wide variety to choose from to suit your preferences.

You and your therapist can mix and match techniques depending on what you’re most interested in trying and what works for you. You can also try the following Cognitive Behavioral Therapy techniques as self-help.

Behavioral Experiments

In Cognitive Behavioral Therapy, behavioral experiments are designed to test thoughts. Example: You might do a behavioral experiment to test the thought “If I criticize myself after overeating, I’ll overeat less” vs. “If I talk to myself kindly after overeating, I’ll overeat less.”
To do this you would try each approach on different occasions and monitor your subsequent overeating. This would give you objective feedback about whether self-criticism or self-kindness was more effective in reducing future overeating. This type of behavioral experiment might also help counteract a thought like “If I’m kind to myself, it’s like giving myself a free pass to overeat and I’ll lose all self-control.” (CBT Behavioral experiment example)

Thought Records

Like behavioral experiments, thought records are also designed to test the validity of thoughts. For example, a clinical psychology student who gets negative feedback from a supervisor might jump to the conclusion “My supervisor thinks I’m useless.” The student could do a thought record evaluating the evidence for and against that thought. Evidence against the thought might be things like “My supervisor gave me positive feedback yesterday” or “My supervisor is allowing me to run assessments and give feedback to clients. If she thought I was useless, she probably wouldn’t be allowing me to feedback to clients.”

Once you’ve looked at the objective evidence for and against a thought side by side, the idea is to come up with several more balanced thoughts. An example of a balanced thought might be “I made a mistake in doing… Making mistakes is normal. I can learn from this. My supervisor will be impressed to see me learning from my mistakes and incorporating her feedback.”
Thought records tend to help change beliefs on a logical level, whereas behavioral experiments may be more helpful in also changing beliefs on a gut or felt level i.e., what you emotionally feel is true, regardless of the objective evidence. (CBT Thought record example)

Pleasant Activity Scheduling

Pleasant activity scheduling is a surprisingly effective Cognitive Behavioral Therapy technique. It’s particularly helpful for depression.
Try this: write the next seven days down on a piece of paper, starting with today (e.g., Thurs, Fri, Sat…). For each day, schedule one pleasant activity (anything you enjoy that’s not unhealthy) that you wouldn’t normally do. It could be as simple as reading a chapter of a novel or eating your lunch away from your desk without rushing.
An alternative version of this technique is to also schedule an activity a day that gives you a sense of mastery, competence, or accomplishment. Again, choose something small that you wouldn’t usually do. Aim for something that will take you less than ten minutes.
An advanced version of this technique would be to schedule three pleasant activities per day – one for sometime during your morning, one for the afternoon, and one for evening.
Doing activities that produce higher levels of positive emotions in your daily life will help make your thinking less negative, narrow, rigid, and self-focused.

Situation Exposure Hierarchies

Situation exposure hierarchies involve putting things you would normally avoid on a list. For example, a client with an eating disorder might make a list of forbidden foods, with ice cream at the top of the list and full fat yogurt near the bottom. A client with social anxiety might put asking someone on a date at the top of her list and asking a woman for directions near the bottom of her list. For each item on your list, rate how distressed you think you’d be if you did it. Use a scale from 0-10. For example, ice-cream = 10, full fat yogurt = 2. Order your list from highest to lowest. The theme of the list should reflect your problem.

Try to have several items at each distress number so there are no big jumps. The idea is to work your way through the list from lowest to highest. You would likely experiment with each item several times over a period of a few days until the distress you feel about being in that situation is about half of what it was the first time you tried it (e.g., you can eat full fat yogurt with only 1/10 distress instead of 2/10). Then move to the next item up the list.

Imagery Based Exposure

One version of imagery exposure involves bringing to mind a recent memory that provoked strong negative emotions. For example, let’s take the earlier example of a clinical psychology student being given critical feedback by a supervisor. In imagery exposure, the person would bring the situation of being given the feedback to mind and remember it in lots of sensory detail (e.g., the supervisor’s tone of voice, what the room looked like). They would also attempt to accurately label the emotions and thoughts they experienced during the interaction, and what their behavioral urges were (e.g., to run out of the room and cry, or to get angry). In prolonged imagery exposure, the person would keep visualizing the image in detail until their level of distress reduced to about half its initial level (say from 8/10 to 4/10).

Imagery based exposure can help counteract rumination because it helps make intrusive painful memories less likely to trigger rumination. Because of this, it also tends to help reduce avoidance coping. When a person is less distressed by intrusive memories they’re able to choose healthier coping actions.

Summary

This list of Cognitive Behavioral Therapy techniques is far from exhaustive but will give you a good idea of the variety of techniques that are used in Cognitive Behavioral Therapy. If you’re working with a therapist and you’ve been doing your own reading about CBT, you can let your therapist know what techniques you’re excited to try.

by Kyle. J. Norton
Serotonin or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter derived from tryptophan, primarily found in the gastrointestinal (GI) tract, platelets, and in the central nervous system (CNS). In Gut, serotonin regulates intestinal movements, in CNS, it regulates mood, appetite, sleep, memory and learning, etc.

Brain serotonin, carbohydrate-craving, obesity and depression

Serotonin-releasing brain neurons are unique in that the amount of neurotransmitter they release is normally controlled by food intake, according to the study by Massachusetts Institute of Technology, Cambridge serotonin release is also involved in such functions as sleep onset, pain sensitivity, blood pressure regulation, and control of the mood. Hence many patients learn to overeat carbohydrates (particularly snack foods, like potato chips or pastries, which are rich in carbohydrates and fats) to make themselves feel better. This tendency to use certain foods as though they were drugs is a frequent cause of weight gain, and can also be seen in patients who become fat when exposed to stress, or in women with premenstrual syndrome, or in patients with “winter depression,” or in people who are attempting to give up smoking. (Nicotine, like dietary carbohydrates, increases brain serotonin secretion; nicotine withdrawal has the opposite effect.) It also occurs in patients with normal-weight bulimia. Dexfenfluramine constitutes a highly effective treatment for such patients. In addition to producing its general satiety-promoting effect, it specifically reduces their overconsumption of carbohydrate-rich (or carbohydrate-and fat-rich) foods(1).

Dec 5

Listen Up! Listening When You Have ADHD

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By Laura Rolands, ADHD Coach
Why Active Listening?

Listening is a core competency of coach training programs and coaching organizations, so, you would expect me to find it valuable. Active listening provides many benefits beyond coaching in our relationships and in daily conversations. ADHD can make active listening more difficult for individuals which is why, as an ADHD Coach, I often work with my clients to improve their listening skills. By actively listening, you will better understand what is being discussed and be better equipped to provide valuable input at the appropriate time. Sometimes when someone else is speaking, you might spend time figuring out what you will say next and that can interfere with your understanding of the situation. Or you might simply struggle to pay attention to what is being said. You will gain more insight into discussions and have more meaningful input if you actively listen while the other person is speaking.

If you have ADHD, listening can be a challenge since ADHD can naturally interfere with your listening skills. Impulsiveness may drive you to unintentionally interrupt someone while speaking. Inattentiveness might cause your mind to wander during conversations, meetings or presentations. Both of these situations can be frustrating for you if they apply. You may personally have other listening challenges that come into play. There are steps you can take, however, to improve your listening skills. Review the ideas below and give one of them a try to help improve your listening skills.
Practice Listening

Talk to a friend or co-worker whom you know and trust. Perhaps they have concerns about listening as well. Take turns telling each other something about a recent event that happened in the past week. Make it brief, but long enough to stretch your listening skills. Two to four minutes is a good time length to start. When your friend is done talking, reflect the story back to him or her and ask for feedback. Discuss with your friend what got in the way of your listening and brainstorm ways you can listen more actively in the future. Then reverse roles and tell your friend something of interest. Practice this a few times each week and keep track of your listening skills to see if you notice any improvements.
Try Fidgeting

If your ADHD is largely inattentive you might drift off and lose focus while struggling to listen while someone is talking during a conversation or meeting. Another activity to try is to fidget. One of my coaching colleagues, Sarah Wright and her co-author, Roland Rotz, wrote a book called Fidget to Focus. Outwit Your Boredom: Sensory Strategies for Living With ADD (2005). Their website is http://FidgetToFocus.com and explains that fidgeting means “any simultaneous sensory-motor stimulation strategy”. The authors encourage using the active of fidgeting to keep your brain activated which will help you pay attention to what you need to pay attention to. Examples of fidgeting include squeezing a stress ball, chewing gum, playing with pipe cleaners and even listening to music. My favorite fidget is to tear paper into small pieces and roll them up – sounds strange to many people, but it kept me focused during many long corporate meetings! For more ideas, I encourage you to check out the Fidget to Focus website or book.
Notice When You Listen (or don’t)

Sometimes the first step to improving your listening skills is to notice when you listen well and actively. By noticing when you listen, you can focus on recreating the positives of those situations in the future. What is the environment? How is the speaker speaking? What did you eat for breakfast? How much sleep did you get last night? By noticing the positive listening experiences that you have, you can be more mindful of creating those experiences again in the future. After you notice the positive of when you listen well, you might also want to take notice of when you do not listen so well. How can you use the strengths you identified above to make the situations where you don’t listen well better?

Dec 1

ADHD and Social-Emotional Abilities

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Children with ADHD often have more social and emotional problems than other children. This is true for all subtypes of ADHD and for both boys and girls. Children with ADHD often have trouble making and keeping friends, for a variety of reasons:

They may have difficulty reading social cues; for example, they may interrupt or have trouble taking turns.

They may have problems learning social skills, such as conversation skills and problem-solving. They may have trouble controlling their behaviour and emotions. Other children may find their hyperactive or impulsive behaviour irritating.
They may be very physical or aggressive.

They may react angrily or inappropriately when they are upset.

They may have trouble cooperating with friends.
Signs of social problems
Children with ADHD may:

behave aggressively

be rejected by peers

have poor conversational skills

have trouble using conversational skills in social situations

become frustrated or angry more easily than other children

be anxious or depressed

seem quiet and withdrawn

be shunned or bullied by peers
These “problem” behaviours are not intentional; they are part and parcel of the disorder. Children with ADHD often have trouble regulating their emotions, or controlling emotional reactions. Many children with ADHD also have a psychiatric disorder such as anxiety disorder, oppositional defiant disorder, or conduct disorder. These too can affect children’s social and emotional skills.

Helping children with ADHD and social and emotional problems
There are many programs available to help children develop social skills. Research shows that the most effective programs take place in the environment where the child is having trouble.

It is important for parents and teachers to:

Teach, model, and support appropriate behaviour.

Provide lots of positive feedback to reinforce appropriate behaviour.
Teachers can make a difference in the classroom:

Children who feel connected to their school and classroom are more likely to engage in pro-social behaviour. They are also more likely to achieve academically. Teachers can make children feel connected by creating a positive learning environment.

Teachers need to become aware of which students are at risk, and then recognize and support their skills.
Parents can help their children with ADHD by:

Playing games with them that require following rules, concentration, and cooperation.

Talking about difficult situations your child encounters with other children. Encouraging him or her to be empathetic by thinking how the other person might have felt.

Noticing when they handle a situation successfully and pointing out what they did and why it worked.

Talking about and imagining the consequences of actions or behaviour, such as “What do you think might happen if you did that?” or “What might the other person feel like if you said that?”

Helping them to understand the importance of personal space and boundaries. For example, not interrupting when someone else is talking and not speaking too loudly.
Social skills training is usually provided by a trained counsellor. It can help children with:

communication

anger management

problem-solving and conflict resolution

improving interpersonal skills

making and keeping friends

http://www.aboutkidshealth.ca/En/ResourceCentres/ADHD/TreatmentofADHD/Behavioural%20Therapy%20for%20ADHD/Pages/ADHDandSocial-EmotionalAbilities.aspx

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