By Rick Nauert PhD

Emerging research suggests the hormones that trigger the menstrual cycle influence the way a woman’s memory works. Practically, investigators discovered cognitive and spatial abilities were influenced by the time of the month.

Researchers from Concordia University designed the study to show that the female brain works differently. Drug development and treatment protocols are typically designed using male models.

In the current study, researchers investigated whether hormones associated with the menstrual cycle could change brain patterns and capabilities.

“Women have sometimes reported to doctors that their memory works differently depending on which phase of the menstrual cycle they are in — even during and following pregnancy, or following menopause.

This has led scientists to wonder whether estrogen and progesterone could affect memory and problem solving,” said psychology professor Dr. Wayne Brake, who co-authored the study.

“Our research shows that, rather than impairing memory in general, estrogen and progesterone may instead cause the brain to favor one memory system or strategy over another.”

For the study, researchers tested 45 women who had regular menstrual cycles. Participants were asked to complete a “hormonal profile” questionnaire that gathered detailed information on their periods, past pregnancies, contraceptive, and synthetic hormone intake history and general life habits.

The participants were then given a verbal memory task, such as remembering a list of words, as well as a virtual navigation task, such as finding their way through a maze in a video game, that could be solved in several ways.

At the end of the experiment, participants were debriefed on how they solved the tasks from beginning to end.

Results were clear: women who were ovulating performed better on the verbal memory task. On the other hand, women tested in their pre-menstrual phase were better at solving spatial navigation tasks.

Researchers said that proves that women tend to use different strategies to solve tasks — such as navigating a maze or remembering a list of words — depending on where they are in their menstrual cycle.

Essentially, the study shows that the hormonal changes women experience throughout their cycles have a broader impact than previously believed, and have significant effects on how women approach and solve problems.

“This is important scientifically. We and others have previously shown that the levels of estrogen and progesterone in rodents influence different brain regions, affecting various memory systems involved in task-solving,” says Brake.

“For example, when estrogen levels are high, female rats will use one type of memory system or strategy versus another to solve a maze. This is the first study to show that this is also true for women, who solve tasks in different ways based on their hormones.”

The findings clearly show that additional research is needed to deepen the understanding of the female brain.

For recent Ph.D. graduate Dema Hussain, the study’s lead author, these results point to an ongoing bias in scientific research.

“Traditionally, researchers and scientists have relied on using male participants — and male rats — in studies to develop drugs and treatments for the general population. But we now know that women respond differently than men,” she says.

“I hope that this study emphasizes that more research is needed to deepen our understanding of the female brain, and that efforts must be made to tailor future research to improve our understanding of the effects of female sex hormones on cognition and memory.”

By Rick Nauert PhD

Researchers from the University of Warwick Sleep and Pain Lab show in a new study that conditions like back pain, fibromyalgia, and arthritis are linked with negative thoughts about insomnia and pain — and this double whammy can be effectively managed by cognitive-behavioral therapy (CBT).

In the research, Esther Afolalu and colleagues developed a pioneering scale to measure beliefs about sleep and pain in long-term pain patients, alongside their quality of sleep. This method of quantification is the first of its type to combine both pain and sleep and investigate the vicious cycle between sleep and pain problems.

“Current psychological treatments for chronic pain have mostly focused on pain management and a lesser emphasis on sleep, but there is a recent interest in developing therapies to tackle both pain and sleep problems simultaneously,” Afolalu said. “This scale provides a useful clinical tool to assess and monitor treatment progress during these therapies.

The scale was tested on four groups of patients suffering from long-term pain and bad sleeping patterns, with the result showing that people who believe they won’t be able to sleep as a result of their pain are more likely to suffer from insomnia, thus causing worse pain.

The results show that the scale was vital in predicting patients’ level of insomnia and pain difficulties. With better sleep, pain problems are significantly reduced, especially after receiving a short course of CBT for both pain and insomnia.

The study has provided therapists the means with which to identify and monitor rigid thoughts about sleep and pain that are sleep-interfering, allowing the application of the proven effective CBT for insomnia in people with chronic pain.

“Thoughts can have a direct and/or indirect impact on our emotion, behavior and even physiology. The way how we think about sleep and its interaction with pain can influence the way how we cope with pain and manage sleeplessness,” said Dr. Nicole Tang, the senior author.

“Based on clinical experience, whilst some of these beliefs are healthy and useful, others are rigid and misinformed. The new scale, PBAS, is developed to help us pick up those beliefs that have a potential role in worsening the insomnia and pain experience,” Tang said.

The study appears in the Journal of Clinical Sleep Medicine.

By Rick Nauert PhD

Experts explain that although high-functioning children with an autism spectrum disorder often have above average intellectual capabilities, they often experience social difficulties.

The communication challenges and difficulty inhibiting thoughts and regulating emotions can lead to social isolation and low self-esteem.

A method to help these children appears on the near horizon as research from the Center for BrainHealth at the University of Texas at Dallas suggests a new virtual reality training program shows promise.

“Individuals with autism may become overwhelmed and anxious in social situations,” research clinician Dr. Nyaz Didehbani said.

“The virtual reality training platform creates a safe place for participants to practice social situations without the intense fear of consequence.”

Researchers found that participants who completed the training demonstrated improved social cognition skills and reported better relationships. Neurocognitive testing showed significant gains in emotional recognition, understanding the perspective of others and the ability to solve problems.

Study findings appear in the journal Computers in Human Behavior.

For the study, 30 young people ages seven to 16 with high-functioning autism were matched into groups of two. The teams completed 10, one-hour sessions of virtual reality training for five weeks.

Participants learned strategies and practiced social situations such as meeting a peer for the first time, confronting a bully and inviting someone to a party. Participants interacted with two clinicians through virtual avatars.

One clinician served as a coach, providing instructions and guidance, while the other was the conversational partner who played a classmate, bully, teacher or others, depending on the scenario in the world that’s similar to a video game.

“This research builds on past studies we conducted with adults on the autism spectrum and demonstrates that virtual reality may be a promising and motivating platform for both age groups,” said Tandra Allen, head of virtual training programs.

“This was the first study to pair participants together with the goal of enhancing social learning. We observed relationships in life grow from virtual world conversations. We saw a lot of growth in their ability to initiate and maintain a conversation, interpret emotions, and judge the quality of a friendship.”

“It’s exciting that we can observe changes in diverse domains including emotion recognition, making social attribution, and executive functions related to reasoning through this life-like intervention,” said Dr. Daniel C. Krawczyk.

“These results demonstrate that core social skills can be enhanced using a virtual training method.”

Source: University of Texas, Dallas

By Támara Hill, MS, LPC

Do you know someone who looks and appears depressed but denies it when confronted? Do you believe their rejection of your assessment of them? Could it be that they are”hiding,” covering their true emotions, or simply telling the truth? Even as a trained therapist I have seem my fair share of clients, primarily men and adolescent males, proclaim over and over that they are not depressed even when they appear that way. I ended up second guessing myself and desperately searching for a term, diagnosis, or phenomenon that could help me make sense out of what appeared to be depression. Little did I know, it was pretty simple.

We live in a nation that fervently seeks for answers for behaviors that we do not understand or that do not meet a certain set criteria. For example, mental health professionals will often engage families in learning about depression when a adolescent exhibits traits and behaviors that seem to be depression. Rarely, if ever, will a trained mental health professional ignore other reasons for behaviors that seem like depression. We are all susceptible to mistaking certain behaviors for something way more serious than it actually is.

When I was beginning in my field in an inpatient child and adolescent residential facility of very troubled and ill youngsters, I began to feel very tired. Every other day I felt more and more tired. I loved the work I did and I felt honored/humbled to be as close to troubled, yet wonderful youths who were mistaken to be “tarnished.” There wasn’t a day that went by that I did not have crippling fatigue or migraine headaches. I found myself developing, because of mild burn-out symptoms, a pessimistic view of today’s youths and their future. This pessimistic view most likely caused others to question whether I was depressed or not.

Trying to identify differences between depressed mood and normal temperament can be a very big challenge, especially for family and friends. It is important to learn the signs of depression so that you can decipher what may or may not be clinical depression. Unfortunately, because depression can be so very similar to other disorders or difficult temperaments, it is important to understand what is and is not a symptom of depression. Some of the following “symptoms” may be more temperament than depression:

Isolation: Believe it or not, some people prefer to be alone. Why? Well, a few reasons may be that they “rejuvenate” through isolation (introverts), they prefer thinking over socializing, or they are avoiding social settings because of a history of social ostracism, discrimination/racism, or bullying. Some people believe isolation is not a bad thing, especially if isolating will keep them from having to be disappointment and uncomfortable in the social arena. Have you ever heard of the saying “the quietest people have the loudest minds.”
Maturity or serious behavior(s): Some individuals grow up fast while others take a bit more time to become “real adults.” People who “act mature” are often regarded by their peer group as “depressed,” “old,” or “pessimistic.” Mature behaviors or serious thinking styles can cause others to regard the individual as depressed or sad. Many mental health professionals come across as more serious than others at times which can appear to be depression or pessimism. For example, while completing my counseling psychology program in graduate school I often had fellow-classmates make statements about me such as “why don’t you ever joke around in class” or “you do know that therapists can have fun…right?”
Not easily amused or “moved” by things: Some people are simply calm about almost every single thing in their lives. Nothing moves them. “Laid-back” people are sometimes underwhelmed and may not react to certain things like others would. For example, a wedding announcement or baby-announcement may not move the “laid-back” person like it would someone who is more reactive. For me, I tend to be “laid-back” and will only naturally respond to events that truly moves me to respond. Individuals who tend to be underwhelmed may or may not be depressed. It is important to consider the natural mood of the individual before assuming they are depressed.
Emotional or reactive behaviors: As stated above, some individuals are reticent and laid-back while others are not. Individuals who are reactive are often viewed by others as positive or optimistic. Individuals who are thoughtful and tend to react only when necessary, are often viewed as depressed or pessimistic. I’ve heard families of some of my laid-back teen client’s say “OMG. Just tell me already. Don’t you have any thoughts or feelings about this?”
Irritability: One of the hallmark features of depression for men and adolescent males is irritability. For women, depression is often characterized by tearfulness, depressed mood, or mood lability (i.e., changeable moods). But some irritability is temperamental and not based on mood. Temperament is personality and an irritable personality or temperament is not depression.
Substance abuse and use of alcohol: Self-medication with drugs and alcohol is often a “symptom” of depressed mood. But there are some individuals who will use drugs and alcohol for social purposes (i.e., engaging with others or interacting at parties) or because they are addicted/dependent. Substance abuse/dependency does not always = depression.
Anhedonia or lack of motivation: As difficult as it may be to believe, some individuals are born unmotivated. Individuals who seem to “take things in stride” or “does not care” may not be depressed. Again, temperament is often a major influence of personality. It is important to understand that individuals who have a positive temperament will most likely lose motivation if depressed. An individual who has always been unmotivated does not have to be depressed.
Interest in “dark” subjects such as death/dying, life challenges, tribulation, or sorrow: Individuals who like to listen to depressing or “dark” music (or read dark/depressing books/articles, etc.) does not have to be depressed. As you know, some people enjoy topics that speak about life challenges, death, or depressed moods/attitudes. This does not always insinuate a depressed mood. While many of us are drawn to things that “speak” to our challenges, primarily when struggling with some aspect of life, other individuals gravitate toward this kind of stuff all of the time.

By Lauren Walters

According to https://www.psychologytoday.com/blog/anxiety-zen/201605/depression-7-powerful-tips-help-you-overcome-bad-moods, “There is no health without mental health. In the past decade, depression rates have escalated, and one in four Americans will suffer from major depression at one time in their lives. While there is no quick fix or one-size-fits-all for overcoming depression, the following tips can help you manage depression so it does not manage you.” Mental health is an integral component of one’s daily routine. Therefore, how do you manage your mental health? In particular, how do you alleviate symptoms associated with depression? This article will provide the reader with strategies to alleviate symptoms associated with depression.

Beware Of Rumination

According to https://www.psychologytoday.com/blog/anxiety-zen/201605/depression-7-powerful-tips-help-you-overcome-bad-moods, “Many ruminators remain in a depressive rut because their negative outlook hinders their problem-solving ability.” In other words, rumination occurs when individuals constantly overanalyze situations. This can lead to depression. However, how do you overcome rumination and become less depressed. According to https://www.psychologytoday.com/blog/anxiety-zen/201605/depression-7-powerful-tips-help-you-overcome-bad-moods, the following can be stated:

· Remind yourself that rumination does not increase psychological insight.
· Take small actions toward problem-solving.
· Reframe negative perceptions of events and high expectations of others.
· Let go of unhealthy or unattainable goals and develop multiple sources of social supports.

Therefore, focus less on rumination but rather problem-solving to overcome depression.

Focus On What You’re Doing Right

It is easy to discount the positive and focus on the negative. When you focus on the negative, your self-esteem and confidence level can drastically decrease. This can result in depression. The question remains how do you focus on the positive as opposed to the negative. According to https://www.psychologytoday.com/blog/anxiety-zen/201605/depression-7-powerful-tips-help-you-overcome-bad-moods, the following can be noted:

At the end of the day, write down three things you did well. No need to over think this, and no act of taking the high road is too small. For example, “When my coworker emailed the budget proposal, he forgot to cite a source. Rather than get upset, I spent two minutes researching the answer and added the information myself.”

Therefore, it is always essential to look at a situation from a positive perspective as opposed to a negative perspective. As a result, you will become less depressed.

Conclusion

With that said, there are many ways to alleviate symptoms associated with depression. This article has provided the reader with two of them, including being aware of rumination, as well as focusing on what you’re doing right, as opposed to what you’re doing wrong in a situation or an event.

By Christine Hammond, MS, LMHC
A weakness of a narcissist is their extreme hatred of being embarrassed. There is nothing worse for them than having someone point out even the slightest fault. Ironically, they have no problem openly doing this to others.

This method of casting shame allows them to feel superior while minimizing any impact the other person might have. It also serves as a way of discounting any future comments the other person use to embarrass the narcissist. Basically, they are beating the other person to the first punch.

In order to avoid a first punch, a person needs to understand what it looks like. Here are eleven ways a narcissist uses shame to control others.

Historical Revisionism. A narcissist will retell another person’s story adding their own flare of additional shame. This can be done in front of others or privately. It usually happens after the other person has achieved some level of accomplishment. The narcissist will state that they are only trying to the keep the other person humble but in reality, they are trying to humiliate.
Confidence Breaking. Narcissists love to gather information about a person and store it away for later abuse. They use their charm to entice a person to share confidential details, especially ones that caused the other person embarrassment. Once gathered the narcissist uses the story to keep the other person in check and constantly worried about when the information will come out.
Exaggerating Faults. No one is perfect except for the narcissist. The narcissist is very good at identifying the faults of others and even better at passively aggressively commenting on them. This is a way of putting the other person ‘in their place.’ When confronted, they often say, “I was only joking,” or that person “can’t take a joke.”
Victim Card. Narcissists are talented at exasperating others and then using their reaction as justification for becoming the real victim. Regardless of how hard the narcissist incited the other person, the angry reaction to the provocation is viewed as shameful. The other person who usually feels bad by their reaction, allows the narcissist to play the victim card, and thereby surrenders control to the narcissist.
Blame Shifting. Whenever something goes wrong, the narcissist shifts all of the blame to the other person. The other person who may have done one thing wrong, allows the narcissist to dump more than their fair share of the responsibility.
Baby Talk. In any narcissistic relationship, the narcissist wants to be seen as the adult and the other person as the child. This belittlement is done in several condescending ways such as literally talking down, calling the other person immature, and saying the other person needs to grow up. The implication is that the narcissist is more mature and has developed beyond the level of the other person.
Religious Guilt. It doesn’t matter what the religion of the narcissist or the other person is. In every religion, there are a set of standards and expectations. The narcissist will use the other person’s religious beliefs to guilt them into acting a certain way. They might even go as far to say, “God told me you need to…”
Offensive Play. The narcissist will use personal attacks to put the other person on the defense. The other person will get so caught up in defending their name or character that they will miss the next attack. “Look how defensive you are, you must have done something wrong,” the narcissist will say. This is a checkmate position because the other person has nowhere to go.
Talking Above. Instead of talking down (baby talk), the narcissist will talk over the other person’s knowledge level. Even if the other person is more intelligent, the narcissist will talk in circles with an air of authority to force the other person into an inferior position. They will use sophisticated vocabulary, physical posturing such as looking down at the other person, and embellishment of details to disguise the real point of shaming the other person.
Comparing Accomplishments. It doesn’t matter what the other person has accomplished, the narcissist did it first, better, and more efficiently. By outperforming the other person, the narcissist minimizes the other person’s accomplishments in comparison to their own. This produces an ‘I can never be good enough,’ feeling in the other person.
First Impression. A narcissist is very aware of how they look and appear to others. Frequently they are dressed in designer clothing with immaculate grooming. Not a hair is ever out of place. This is not just for the narcissist; rather their perfectionistic appearance is used to demean others. Comments like, “They don’t take care of themselves,” or “It doesn’t take a lot of effort to look better” are typical.
When a person can see a punch coming, it is easier to dodge. Resist the temptation to attack first with a narcissist that will only intensify their reaction. Instead, deflect and distract to avoid become a target.

Christine Hammond is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

By Natasha Daniels

Parenting an introverted child can be confusing if you are not an introvert yourself. You may not even realize what you are doing wrong. Why is she so upset? What did I do? Introverts have some basic rules. If you understand what they are – parenting them will go much smoother!

If you are an extrovert – your introverted child might completely baffle you? I have worked with parents who have said things like, “We are so outgoing. How did we have such an introverted child?” and “What should we do to help her?”

For starters – she doesn’t need help. At least – not for being an introverted child. Being an introvert isn’t a problem in and of itself. We are all wired differently. Some of us get energized being around others and some of us get depleted. Many of us understand these type of kids because we are introverts ourselves.

The bigger problem emerges when an extroverted parent doesn’t understand their introverted child. When you birth a child who is wired completely differently than you – parenting can become a struggle.

To give you a quick cheat sheet – here are 15 things you should NEVER do to your introverted child.

Embarrass them on purpose.

Some parents have a jokey personality. They like to tease and poke fun at their kids. They aren’t doing it to be mean – they are doing it to be funny. Unfortunately, your introverted child will completely miss the humor in this type of interaction. Worse – it has the potential to make them resent you.

Force them to have discussions with others.

I get it – you want them to be social. You want them to talk. But, forcing them to talk with others isn’t going to work. An Introverted child needs to feel comfortable in order to open up. If they are pushed into talking too soon – they will withdrawal completely.

Orchestrating social interactions.

Maybe you see another quiet kid on the playground. You think this is your time to help your child make friends. You call the kid over. Introduce the child to your child. You wind up talking for your child and the conversation is going south quickly.

There is nothing wrong with helping your child jump start a social interaction – but know when to back off and let the conversation naturally flourish or die a quick death.

Make fun of them in front of others.

There is only one thing worse than making fun of an introverted child – and that is making fun of them in front of other people. Introverted kids can be highly self-conscious and they are more likely to get embarrassed over things you might think are no big deal.

Put them on the spot in front of others.

Did your child forget to do a chore? Did they say thank you too quietly or not at all. Putting your child on the spot and scolding them in front of others will just make them want to curl up and die. There will be no learning curve in those moments. If you want to correct their behavior – address it after the audience has left.

Ask them to perform in front of other people.

Maybe your daughter has the most beautiful voice or your son tells the funniest jokes. Introverts don’t want to be on stage and do not appreciate an unwanted spotlight on them. Avoid putting them on show and asking them to perform for others. You might think it is cute – but most likely they will not.

Talk for them – when they do not want you to.

People ask your child a question and you are quick to answer for them. He’s too quiet. He’s too shy. He won’t answer quickly enough. Give your child some space to talk for themselves.

Over schedule them.

Many kids are over scheduled – but some kids flourish with an abundance of activities. In general an introverted child needs more down time. They get overwhelmed with too much stimulation and need to recharge at home.

Plan back to back activities with no down time.

If you have a busy day – be sure to plan some down time in between. Think of your introvert’s social energy as a battery. Every time they are out their battery is getting depleted. Your home is the charging station. An introverted child needs to be recharged frequently.

Force them to go outside and play when they want to recharge inside.

A seven hour school day can be completely exhausting for an introverted child. They might want to come home and just collapse. You might feel uncomfortable with your child just sitting on the couch or lying on their bed reading. However, that might be just what your child needs after a long school day.

Belittle their quiet demeanor.

The worst thing a parent can do is demean their child for being an introvert. I witness this all the time and it makes me cringe. Telling your child, “stop being so quiet” or “just go up and talk to them!” doesn’t help and only makes them want to withdrawal even further.

Consider them rude when they have a hard time saying hi to acquaintances.

An introverted child may have a hard time saying hi to acquaintances. People might walk past them and they might ignore their hellos. They are not being rude. Introverts can have a hard time being friendly to acquaintances. Instead of scolding them – teach them that a nod or a smile would be the polite thing to do.

Be loud and draw attention to yourself when you are around their peers.

An introverted child can be acutely self-conscious around others. When you are loud and rambunctious around their peers – that might mortify them (just sayin’).

Ask their peers questions.

An introverted kid might be on high alert around peers. When you swoop in and start asking their friends questions – this can be unnerving for your child. They might worry about what you might say or do. You might be thinking – what could I possibly say that would be embarrassing? But remember – your idea of what is embarrassing and their idea of what is embarrassing are two completely different things entirely.

Disclose personal information in front of other people.

You might think it is no big deal to talk about silly things your child did as a baby or what cute mistakes they made when they were younger – but to the introverted child this can feel like ridicule. Even the most mundane facts about an introverted child can be perceived as personal and private information to them.

Not all extroverted parents do these things to their introverted kids. You don’t have to be an introvert to successfully parent an introverted child. Taking the time to read your child’s cues and respect their boundaries will go a long way. Even if you don’t understand why they get embarrassed so easily or why they don’t talk as freely – respecting their feelings is huge!

By Rick Nauert PhD

New research finds that people with developmental delays, learning disabilities, and other intellectual issues are vulnerable to online victimization.

In a first-of-its-kind study, researchers found that adults with Williams syndrome – and who use Facebook and other social networking sites frequently — are especially vulnerable to online victimization.

Williams syndrome is a condition characterized by an individual being extremely social and trusting.

Experts explain that people with intellectual disabilities are more susceptible to exploitation and abuse, and the rise of the Internet only increases their susceptibility to harm.

In the study, roughly a third of study participants said they would send their photo to an unknown person, arrange to go to the home of a person they met online, and keep online relationships from their parents.

“You have this very social group of people who are vulnerable in real life and now they are seeking a social outlet through the Internet, communicating with people they know and don’t know,” said Marisa Fisher, Michigan State University assistant professor of special education.

“They don’t have the training or the knowledge to know how to determine what is risky behavior.”

The study, co-authored by Fisher and Emma Lough, a doctoral student at Durham University in the United Kingdom, appears online in the Journal of Intellectual Disability Research.

Williams syndrome is a relatively rare genetic disorder characterized by developmental delays, learning disabilities, excessively social personalities, and an affinity for music. Many adults with the syndrome live with their parents or other caregivers.

A 2013 study led by Fisher found that people with Williams syndrome, autism and Down syndrome experienced extremely high rates of real-world teasing and bullying, theft and abuse. The current study is the first to investigate the online risk of victimization for adults with Williams syndrome.

Remarkably, nearly 86 percent of adults with Williams syndrome use social networking sites such as Facebook nearly every day, typically without supervision, the study found.

Participants also share a large amount of identifiable information on their social network profiles and are likely to agree to engage in socially risky behaviors.

Fisher is developing a social skills program for people with Williams syndrome that includes appropriate online behavior and safety.

Her research suggests people with the syndrome can learn to say no to strangers, refuting past studies that indicated sociability may be hard-wired in individuals with Williams syndrome.

Investigators note that while the Internet provides an opportunity to enhance the everyday lives of adults with Williams syndrome, it also poses threats that are arguably more dangerous than those they face in the real world.

“It’s time to start teaching individuals with Williams syndrome about safety, both in the real world and online,” Fisher said.

“This includes what personal information they should share, how to set privacy settings and how to decide whether an ‘online friend’ should become an ‘offline friend.’”

Source: Michigan State University

Cracking down on highly effective pain medications will make patients suffer for no good reason
By Maia Szalavitz on May 10, 2016

Both the FDA and the CDC have recently taken steps to address an epidemic of opioid overdose and addiction, which is now killing some 29,000 Americans each year. But these regulatory efforts will fail unless we acknowledge that the problem is actually driven by illicit—not medical—drug use.
You’ve probably read that 80 percent of heroin users started with prescription medications—and you may have seen billboards that compare giving pain medication to children to giving them heroin. You have probably also heard and seen media stories of people with addiction who blame their problem on medical use.
But the simple reality is this: According to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.
And 90 percent of all addictions—no matter what the drug—start in the adolescent and young adult years. Typically, young people who misuse prescription opioids are heavy users of alcohol and other drugs. This type of drug use, not medical treatment with opioids, is by far the greatest risk factor for opioid addiction, according to a study by Richard Miech of the University of Michigan and his colleagues. For this research, the authors analyzed data from the nationally representative Monitoring the Future survey, which includes thousands of students.
While medical use of opioids among students who were strongly opposed to alcohol and other drugs did raise later risk for misuse, the overall risk for this group remained small and their actual misuse occurred less than five times a year. In other words, it wasn’t actually addiction. Given that these teens had generally rejected experimenting with drugs, an increased risk of misuse associated with medical care makes sense since they’d otherwise have no source of exposure.
But for the majority of students, who weren’t morally opposed to recreational chemicals, medical use made no difference. Here, heavy recreational drug use was what mattered, and that was probably a sign that this group was was at highest risk of addiction in the first place.
In general, new addictions are uncommon among people who take opioids for pain in general. A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent.
Moreover, a study of nearly 136,000 opioid overdose victims treated in the emergency room in 2010, which was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition.
All of this this means that steps to limit prescribing opioids for chronic pain run a great risk of harming pain patients without doing much to stop addiction. The vast majority of people who are prescribed opioids use them responsibly—recent research on roughly one million insurance claims for opioid prescriptions showed that just less than five percent of patients misused the drugs by getting prescriptions for them from multiple doctors.
If we want to reduce opioid addiction, we have to target the real risk factors for it: child trauma, mental illness and unemployment. Two thirds of people with opioid addictions have had at least one severely traumatic childhood experience, and the greater your exposure to different types of trauma, the higher the risk becomes. We need to help abused, neglected and otherwise traumatized children before they turn to drugs for self-medicatation when they hit their teens.
Further, at least half of people with opioid addictions also have a mental illness or personality disorder. The precursors to these problems are often evident in childhood, too. For example, children who are extremely impulsive are at high risk—but on the opposite end of the scale, so, too are children who are highly cautious and anxious. To reach these kids, we don’t need to label them, but we do need to provide tools that are tailored to their specific issues to prevent them from using drugs to manage those issues.
The final major risk factor for addiction is economic insecurity and poverty, particularly unemployment and the hopelessness, social marginalization and lack of structure that often accompany it. For example, heroin addiction rates among people who make less than $20,000 a year are 3.4 times higher than in people who make over $50,000. To those who study the effects of inequality on health, it is no coincidence that the collapse of the white middle class has been accompanied by a rise in all types of addictions, but especially addiction to opioids.
Many people would prefer it if we could solve addiction problems by busting dealers and cracking down on doctors. The reality, however, is that as long as there is distress and despair, some people are going to seek chemical ways to feel better. Only when we can steer them towards healthier—or at least, less harmful—ways of self-medication, and only when we reach children before they develop this type of desperation, will we be able to reduce addiction and the problems that come with it.

By Rick Nauert PhD

New research finds significant benefit in the use of mindfulness-based cognitive therapy to reduce the risk of depression relapse.

The mindfulness-based cognitive therapy approach was compared to usual care with the results comparable to other active treatments, as measured over a five month period.

Recurrent depression is a serious issues as it causes significant disability. Interventions that prevent depressive relapse could help reduce the burden of this disease.

A growing body of research suggests mindfulness-based cognitive therapy (MBCT) is efficacious.

In the study, researchers reviewed the results of analyses of individual patient data from nine published randomized trials of MBCT. The analyses included 1,258 patients with available data on relapse and examined the efficacy of MBCT compared with usual care and other active treatments, including antidepressants.

From the review, Willem Kuyken, Ph.D., of the University of Oxford, England, and coauthors report MBCT was associated with reduced risk of depressive relapse/recurrence over 60 weeks compared with those who did not receive MBCT.

Investigators also discovered that the technique is robust as it is equally effective for a variety of groups regardless of sex, age, education, or relationship status.

The treatment effect of MBCT on the risk of depressive relapse/recurrence also may be larger in patients with higher levels of depression symptoms at baseline compared with non-MBCT treatments. This finding suggests that MBCT may be especially helpful to those patients who still have significant depressive symptoms.

Nevertheless, the authors acknowledge study limitations related to the availability of the data within the studies.

“We recommend that future trials consider an active control group, use comparable primary and secondary outcomes, use longer follow-ups, report treatment fidelity, collect key background variables (e.g., race/ethnicity and employment), take care to ensure generalizability, conduct cost-effectiveness analyses, put in place ethical and data management procedures that enable data sharing, consider mechanisms of action, and systematically record and report adverse events,” the authors conclude.

The study and accompanying editorial appear in JAMA Psychiatry.

Editorial: Mindfulness-Based Cognitive Therapy, Prevention of Depressive Relapse

“Mindfulness practices were not originally developed as therapeutic treatments. They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue. The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage.

“To my knowledge, the article by Kuyken et al is the most comprehensive meta-analysis to date to provide evidence for the effectiveness of MBCT in the prevention of depressive relapse.

“However, the article also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research,” writes Richard J. Davidson, Ph.D., of the University of Wisconsin-Madison.

Source: JAMA Psychiatry

By Rick Nauert PhD

In a study of newlywed couples, researchers found partners believe the frequency of sex does not influence relationship quality. This opinion, however, appears to lack validity as investigators discover partners’ autonomic behavioral responses suggest otherwise.

“We found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners,” said psychological scientist Lindsey L. Hicks of Florida State University, lead author on the research.

The study appears in Psychological Science, a journal of the Association for Psychological Science.

“This is important in light of research from my colleagues demonstrating that these automatic attitudes ultimately predict whether couples end up becoming dissatisfied with their relationship,” Hicks said.

From an evolutionary standpoint, frequent sex confers several benefits. Sex improves chances of conception and helps bond partners together in relationships that facilitate child-rearing. But when researchers explicitly ask couples about their relationship satisfaction, they typically don’t find any association between satisfaction and frequency of sex.

“We thought these inconsistencies may stem from the influence of deliberate reasoning and biased beliefs regarding the sometimes taboo topic of sex,” explains Hicks.

Because our gut-level, automatic attitudes don’t require conscious deliberation, Hicks and colleagues hypothesized, they might tap into implicit perceptions or associations that we aren’t aware of.

The researchers decided to tackle the question again, assessing partners’ relationship satisfaction using both standard self-report measures and automatic behavioral measures.

In the first study, 216 newlyweds completed survey-style measures of relationship satisfaction.

Participants rated various qualities of their marriage (e.g., bad-good, dissatisfied-satisfied, unpleasant-pleasant); the extent to which they agreed with different statements (e.g., “We have a good marriage”); and their overall feelings of satisfaction with their partner, their relationship with their partner, and their marriage.

Then, they completed a computer classification task: A word appeared on-screen and they had to press a specific key to indicate whether the word was positive or negative. Before the word appeared, a photo of their partners popped up for 300 ms.

The rationale behind this kind of implicit measure is that participants’ response times indicate how strongly two items are associated at an automatic level.

The faster the response time, the stronger the association between the partner and the word that appeared. Responding more slowly to negative words than to positive words that followed the picture of the partner would signify generally positive implicit attitudes toward the partner.

The researchers also asked each partner in the couple to estimate how many times they had had sex in the last four months.

Just as in previous studies, Hicks and colleagues found no association between frequency of sex and self-reported relationship satisfaction.

But when they looked at participants’ automatic behavioral responses, they saw a different pattern: Estimates of sexual frequency were correlated with participants’ automatic attitudes about their partners. That is, the more often couples had sex, the more strongly they associated their partners with positive attributes.

Importantly, this finding held for both men and women. And a longitudinal study that tracked 112 newlyweds indicated that frequency of sex was in fact linked with changes in participants’ automatic relationship attitudes over time.

“Our findings suggest that we’re capturing different types of evaluations when we measure explicit and automatic evaluations of a partner or relationship,” says Hicks.

“Deep down, some people feel unhappy with their partner but they don’t readily admit it to us, or perhaps even themselves.”

The researchers note that participants’ reports of how often they remember having sex may not be the most precise measure of sexual frequency. And it remains to be seen whether the findings are applicable to all couples or specific to newly married couples like those they studied.

Taken together, the findings drive home the point that asking someone about their feelings or attitudes isn’t the only way to measure how they feel.

“These studies illustrate that some of our experiences, which can be either positive or negative, affect our relationship evaluations whether we know it or not,” Hicks concludes.

Source: Association for Psychological Science

By Rick Nauert PhD

Provocative new research looks into the way that people think and talk about love.

Social psychologists observed that people talk and think about love in an incessant variety of ways but underlying such diversity are some common themes that frame how we think about relationships.

One popular perspective considers love as perfect unity (“made for each other,” “she’s my other half”); in another view, love is a journey (“look how far we’ve come,” “we’ve been through all these things together”).

These two ways of thinking about relationships are particularly interesting because, according to study authors Spike W. S. Lee and Norbert Schwarz, they have the power to highlight or downplay the damaging effect of conflicts on relationship evaluation.

Here’s the scoop. If two people were really made in heaven for each other, why should they have any conflicts?

“Our findings corroborate prior research showing that people who implicitly think of relationships as perfect unity between soulmates have worse relationships than people who implicitly think of relationships as a journey of growing and working things out,” says Lee.

“Apparently, different ways of talking and thinking about love relationship lead to different ways of evaluating it.”

In one experiment, Lee and Schwarz had people in long-term relationships complete a knowledge quiz that included expressions related to either unity or journey, then recall either conflicts or celebrations with their romantic partner, and finally evaluate their relationship.

As predicted, recalling conflicts leads people to feel less satisfied with their relationship — but only with the unity frame in mind, not with the journey frame in mind.

Recalling celebrations makes people satisfied with their relationship regardless of how they think about it.

In a two follow-up experiments, the study authors invoked the unity vs. journey frame in even subtler, more incidental ways.

For example, people were asked to identify pairs of geometric shapes to form a full circle (activating unity) or draw a line that gets from point A to point B through a maze (activating journey).

Such non-linguistic, merely pictorial cues were sufficient to change the way people evaluated relationships.

Again, conflicts hurt relationship satisfaction with the unity frame in mind, not with the journey frame in mind.

“Next time you and your partner have a conflict,” as Professors Lee and Schwarz would advise, think what you said at the altar, ‘I, ____, take you, ____, to be my husband/wife, to have and to hold from this day forward, for better, for worse, for richer, for poorer, in sickness or in health, to love and to cherish; from this day forward ‘till death do us part.’”

“It’s a journey,” they said. “You’ll feel better now, and you’ll do better down the road.”

The study was published in a recent issue of the Journal of Experimental Social Psychology.

By Natasha Daniels

Not all signs of anxiety are obvious. Here are 5 missed signs of child anxiety.
Anxiety in children is obvious, right? Kids would tell you their fears. They would be scared all the time. They might cling to you in new situations.

You would know if your child is anxious – wouldn’t you?

Unfortunately, anxiety isn’t always that obvious. Some children don’t vocalize their worries. They don’t show their fears. And anxiety isn’t on their parents’ radar.

In my child therapy practice parents often bring their children in for other reasons, only to discover that the problem is actually anxiety.

Here are five missed signs of child anxiety:

PHYSICAL SYMPTOMS:

Anxiety isn’t just in our minds, it is in our body as well. Here are just a few examples-

Your child won’t poop. They have been constipated for weeks. You’ve been to the doctor and there is no medical origin.

Your child’s stomach hurts. They feel like throwing up. They are having gastrointestinal problems. You brought them to the pediatrician. You went to the gastrointestinal specialist. Your child has been poked, prodded and maybe even scoped. No medical origin has been found.

Anxiety isn’t just in the mind, it can be felt in the body as well.

SCHOOL REFUSAL:

Your child used to love school. They’ve always had friends and they have always gotten good grades. Now it is a battle just to get them in the car. They tell you they don’t feel well. Their stomach hurts. They say they are going to throw up. You keep them home – only to feel bamboozled because they seem fine shortly thereafter.

You talk to the teacher and the counselor. Everyone swears up and down that your child has friends. That they are not being bullied. That they enjoy school.

Weekends are pain-free. Your child seems completely healthy – and then Sunday rolls around. The cycle begins again.

ANGER:

Anger can be tricky. Kids can be angry for so many reasons. They might have difficulty self-regulating. They might have a mood issue. They might have a hard time accepting no. But along with the usual contenders, anxiety can be the underlining cause of anger too.

If your child stuffs their worries way down deep – the only thing to bubble to the surface might be their anger.

They come home from school ready to explode. Bedtime brings with it rage and resistance. New situations cause unusual hostility and defiance.

Pay attention to when and why your child gets angry – as it could be the key to unearthing the true cause.

AVOIDANCE OF ACTIVITIES:

Your child used to love soccer practice and now they are refusing to go. Your child said they wanted to take swim lessons, but after the first lesson you can’t get them back to class. Your child always wants to stay home and refuses to go to restaurants and stores with you.

When a child starts avoiding situations they used to enjoy – it is time to take a second look at why. It might be that they simply no longer like soccer or swim class – but it might be something more significant.

The #1 unhealthiest, go-to coping mechanism for anxiety is AVOIDANCE. Avoid at all costs.

If I don’t go to soccer, then I won’t have to worry about the ball hitting my face.

If I say I don’t want to go to swim, then I won’t have to worry about sinking to the bottom of the pool.

If I put up a big fight – then I won’t have to go to the restaurant and worry about throwing up in public.

ROUTINES VERSUS RITUALS:

Your child has to line up all their stuffed animals in a perfect row before they go to bed. You have to say “I love you” in a certain way – for a certain number of times – before your child will go to bed.

Parents often mistake ritualistic behavior for routines. Routines are comforting and predicable. Rituals are rigid and need to be redone if not done “correctly.” Routines are a healthy part of childhood – rituals are an indication of anxiety.

Anxiety is a very treatable condition. The earlier children get help – the better the prognosis in the long run. If you feel like your child is having some signs of anxiety, seek out the advice of a mental health professional. It can never hurt to get some professional input and guidance.

By Natasha Daniels

You can’t parent an anxious kid the way you would your other kids. Here are the top 9 things to NOT do when parenting an anxious child. That is of course unless you like meltdowns!
Anxious kids are a different breed. If you parent one – you know what I am talking about. Perhaps this realization dawned on you when you watched your friends interact with their children. What seemed to work for them – completely backfired for you.

In my child therapy practice I will often hear things such as, “I don’t get it. Everything that worked with our other kids won’t work with our anxious kid.”

You can throw your regular parenting book out the window – you need a completely different playbook for an anxious child.

Let’s countdown the 9 most ineffective parenting approaches for anxious kids

Each child is unique – even anxious kids. Some of these might actually work with your anxious kiddos – but in general these approaches are much less likely to work on an anxious mind.

RUSHING YOUR CHILD

You want to see anxious children have a complete meltdown – tell them to hurry up. Most anxious kids completely implode when we tell them to speed up. I can bark at two of my kids to hurry up and they’ll get moving. If I did that to my third child – we’d have to tack on 30 more minutes to allow for the meltdown that will ensue.

SINK OR SWIM

Many parents feel they just need to throw their kids into a feared situation and the kids will do fine. The sink or swim approach. Anxious kids will sink. They will plummet to the deepest darkest depths and will not come up for air.

SET A TIMER

A great parenting approach for time management might include a timer. Such as, “when the timer goes off it is time for you to stop playing your video game.” A timer is a ticking time bomb for anxious children. Instead of speeding them up – they will ruminate over the clock and will probably explode into tears or screams long before the buzzer sounds.

MAKE A RACE OF IT

Similar to the timer – any type of time-limiting approach is most likely not going to work. Anxious kids get overwhelmed with time limits. Timed tests. Timed activities. None go down well. Trying to make things fun with comments such as, “who can get there first?” can turn an anxious child into a puddle of a tears.

TELL THEM ABOUT THE FUN THEY’LL MISS

Your anxious child doesn’t want to go to a party. They don’t like crowds or new social situations. You tell them they are going to miss out on all the fun.

Telling your anxious child what fun they’ll miss if they don’t go won’t work. They know they are missing the fun. It upsets them more than maybe you know. Reminding them of what they’ll miss out on will just increase their anxiety. Instead, address the fear that is driving the behavior. Talk about how they can handle the new social situation and give them tools to get through it.

FOOD BATTLES

You want to see an anxious child throw up? Have a food battle with him or her. Drawing a line in the sand will result in a loss for both of you. You’ll be frustrated and your children will never again touch whatever food you are trying to metaphorically (hopefully) shove down their throat.

My twelve year old still won’t touch broccoli due to a food battle when she was three. The tongue never forgets!

Anxious kids can be picky eaters due to oral sensitivities and the fear of new foods. Encourage your children to eat new things. Place new foods on their plate. But, don’t make mealtime a battle zone.

PUNISHING YOUR CHILD FOR TOILETING ISSUES

Some anxious kids are slow to potty train. Older kids might fear pooping (yes, that is a thing) and may avoid pooping at all costs. This can cause constipation and conversely accidents. I know this can be a gross and frustrating parenting issue. But shaming, blaming or punishing this behavior will not fix it. Address the fear – not the behavior.

SCARE THEM INTO BEHAVING

Parents will use facts to help their children do things they would otherwise not do. Brush your teeth or they’ll fall out! Hold my hand or you’ll get hit by a car! Put a helmet on or you’ll crack your head open. I know these things have flown out of my mouth at times. I also know that sometimes I say the wrong scary thing and I have to do damage control for weeks afterwards.

Try to focus on more positive statements. Brush your teeth and make them sparkly clean. Hold my hand so I can make sure to keep you safe.

ALL OR NOTHING RESPONSES

Anxious behavior can sometimes be mislabeled as oppositional. Anxious kids might completely freak out when told no. This can be misconstrued as spoiled and entitled behavior – but in reality anxious kids can’t handle the concept of no. They can’t handle the finality of no.

Speaking in absolute terms typically doesn’t go down well with anxious kids. When possible, focus on when they can do it or when they can have it – even if it is far away. Tell them things such as, “You can have that for your birthday” or “you can have that after dinner.” You can even motivate them with comments like, “You can save up your money and get it.”

Now having said that – sometimes “no” will just be “no.” Just like other kids, anxious kids need to learn how to handle not always getting what they want. In reality, sometimes there is no future “yes” to their answer.

Parenting any child can be a struggle. Parenting an anxious child can make your head swirl.
Now that you know what doesn’t work, click here to read about what does work!

By Margarita Tartakovsky, M.S.
Sadness. Hopelessness. Loss of interest. Loss of energy. Difficulty sleeping. Difficulty concentrating. Low self-esteem. Weight gain. Weight loss. Suicidal thoughts.

These are some of the symptoms listed for a depressive episode (also called bipolar depression) in bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders. But these clear-cut signs don’t exactly capture the complicated course of bipolar disorder or the palpable anguish that people with bipolar depression really feel. They don’t capture the angst or fear or confusion.

“The unpredictable nature of cycling through mood states, being unsure of what symptoms may envelop you next, typically creates underlying anxiety,” said Colleen King, LMFT, a psychotherapist who specializes in treating individuals with bipolar disorder, depression and anxiety. People with bipolar disorder can experience mixed states or dysphoric mania, she said. This is when you feel agitated and angry — furious at everyone and everything.

You might be especially curt with others and feel like no one understands your experience, said Louisa Sylvia, Ph.D, associate director of psychology at the Bipolar Clinic and Research Program at Massachusetts General Hospital and author of The Wellness Workbook for Bipolar Disorder: Your Guide to Getting Healthy and Improving Your Mood. You might lash out and not want to interact with anyone, she said.

During a depressive episode, King’s clients tell her that they feel broken or don’t care about anything anymore. They don’t have the motivation or passion for anything except sleep. They cry all the time. They feel frustrated and helpless. They fear they’ll never feel normal again.

“For me, depression feels like I have been robbed of my cognitive, emotional and physical abilities,” said King, who also has bipolar disorder. She feels as though she’s walking through a river of waist-high molasses while fog surrounds her. “There is minimal visibility and it’s challenging to move around.”

It takes King a lot of cognitive energy to pay attention to and understand what others are saying or what she’s reading or writing. It’s hard to create cohesive sentences during conversations. Sometimes, she says the opposite of what she’s thinking. Sometimes, she can’t remember the words for common objects. Sometimes, multi-step tasks take days to complete.

Depressive episodes are physically exhausting. “I feel as though I’m moving against all the forces of nature, fighting as hard as I can, to keep functioning,” King said. Episodes go beyond feelings of sadness to guilt, shame, anxiety and fear. They shatter a person’s self-identity. “Self-worth rattles like glassware in an earthquake, swaying with the shifting earth that is my mood state,” King said.

Of course, everyone is different and will experience different symptoms during their depressive episode. But whatever the specific symptoms, bipolar depression tends to have one thing in common: It’s overwhelming.

Because the depression may come after a manic or hypomanic episode, it can feel like a big crash, Sylvia said. It can feel especially devastating, because when your energy and mood are so high, you naturally have further to fall. For instance, during a manic or hypomanic episode, you might not need much sleep and perceive yourself as more productive, Sylvia said. When depression strikes, and you may feel like you want to cancel all your plans and need 16 hours of sleep, you might feel utterly worthless, she said.

Navigating Bipolar Depression

Sylvia works with clients on creating separate plans for preventing or minimizing manic and depressive episodes. The first step is to become aware of what you’re experiencing, she said. Pay attention to your own unique warning signs and symptoms. As Sylvia said, what does tired mean to you? What does loss of energy look like for you? How many hours do you typically sleep when you’re starting to feel depressed? What are the first signs of a depressive episode for you?

Sylvia also stressed the importance of prioritizing a healthy lifestyle, which can be summarized with the acronym MEDS: medication, exercise, diet and sleep. Similarly, she emphasized building a routine — and adapting it when new situations arise. (For more, check out The Wellness Workbook for Bipolar Disorder and The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania and Anxiety, which is co-authored by Sylvia).

For instance, Sylvia worked with a woman who became a caretaker for her sick friend. Because her friend lived several hours away, the client’s routine was completely disrupted, triggering a whole lot of stress and feeling overwhelmed. In response, Sylvia and her client created new morning and evening habits. Instead of getting up and getting right into her car, the client started waking up earlier. She’d eat breakfast at home and walk her dog. To make her drive more enjoyable, she’d listen to books on tape and to her favorite music. She found an activity — gardening — that she enjoyed at her friend’s house. Sylvia also helped the client rethink her trips: As a caretaker, she was actually doing wonderful work.

When King experiences a depressive episode, she also has a plan in place. This includes: making sure her psychiatrist and therapist know what’s going on; turning to loved ones for support; regulating her sleep; eating nutritious foods; meditating; and moving her body. It also means: reducing obligations; focusing on immediate priorities; and practicing nourishing activities, such as being in nature, creating art and spending time with her wife.

King uses coping skills that she teaches to her own clients, including mindfulness and cognitive-behavioral techniques. She socializes less but doesn’t completely withdraw from others, and she practices self-compassion. “Acknowledging the enormity of energy it takes to manage a depressive episode helps me to be gentle and kind to myself. When the self-doubts assault my identity and worth, I repeat self-compassionate mantras.”

This plan isn’t easy or linear. It takes hard work. It’s very likely that you’ll have to force yourself to eat something nutritious, to take a walk, to talk to a friend and to grieve your old expectations, King said. This is when turning to a support team—of loved ones and professionals — is so powerful.

“Depression tricks us into believing that it’s going to last forever. It seems like it does when you’re in it.” King reminds herself that she’s endured depressive episodes and cycling before — and she’s regained her health and stability. Sylvia also reminds her clients that these episodes end. “It won’t last forever, and it won’t last at its highest peak forever.”

King tells herself that she’ll remember joy and feel whole, again. And, with treatment, you will, too. “Do not give up.”

By Traci Pedersen

Scientists have identified 43 genes associated with risk for both autism and cancer. This discovery could lead to the development of treatments for both conditions if the underlying mechanisms behind these genes are the same, according to a new study by the University of California (UC) Davis MIND Institute and Comprehensive Cancer Center.

“This striking coincidence of a remarkably large number of genes implicated in both autism spectrum disorder and cancers has not been previously highlighted in the scientific literature,” said Jacqueline Crawley, MIND Institute distinguished professor and endowed chair.

“Potentially common biological mechanisms suggest that it may be possible to repurpose drug treatments for cancer as potential therapeutics for neurodevelopmental disorders.”

Crawley collaborated on the work with professor and chair of the UC Davis Department of Microbiology and Molecular Genetics Wolf-Dietrich Heyer, who is affiliated with the Cancer Center and Janine LaSalle, professor of medical microbiology and immunology, who is associated with the MIND Institute.

“It may be possible to repurpose available cancer drugs with reasonable safety profiles as targeted treatments for ASD,” the authors write in the journal Trends in Genetics.

“Stratifying individuals with ASD who harbor a risk gene for autism that is also a risk gene for cancer may enable therapeutic development of personalized medicines based on the specific causal mutation.”

Included in the dozens of genes implicated in both cancer and autism are genes for relatively rare syndromes, such as Rett syndrome and tuberous sclerosis, in which patients experience a wide variety of physical and neurological symptoms, including intellectual disability, as well as some of the communication deficits often found in autism.

So what does tumor cell growth have in common with synapse formation and brain development?

“Errors associated with genome maintenance during fetal life may occur at critical time periods for [brain development] resulting in neurodevelopmental disorders,” said Heyer, “whereas errors more commonly occur during adult life in cell types susceptible to tumors.”

Considerable value can be gained from a new focus on understanding the genetic commonalities of autisms and cancers. The authors note that since autism encompasses a broad range of causes, symptoms, and outcomes — similar to different types of cancers — it is also referred to in the plural, as “autisms.”

The study, titled “Autism and Cancer Shared Risk Genes, Pathways and Drug Targets,” is published online in Trends in Genetics, a Cell Symposia publication.

Source: UC Davis Health System

TBy Rick Nauert PhD
Research looking at how the timing of sexual initiation in adolescence impacts adult romantic ties finds that having sex later may lead to better relationships.
iming of First Sex Has Far-Reaching Relationship Effects
In a new study, Dr. Paige Harden, a psychological scientist, investigated how the timing of sexual initiation in adolescence influences romantic outcomes — such as whether people get married or live with their partners, how many romantic partners they’ve had, and whether they’re satisfied with their relationship — later in adulthood.

To answer this question, Harden and colleagues from the University of Texas at Austin used data from the National Longitudinal Study on Adolescent Health to look at 1659 same-sex sibling pairs who were followed from adolescence (around 16) to young adulthood (around 29).

Each sibling was classified as having an Early (younger than 15), On-Time (age 15-19), or Late (older than 19) first experience with sexual intercourse.

Harden’s findings are reported in a new research article published in Psychological Science, a journal of the Association for Psychological Science.

As expected, later timing of first sexual experience was associated with higher educational attainment and higher household income in adulthood when compared with the Early and On-Time groups.

Individuals who had a later first sexual experience were also less likely to be married and they had fewer romantic partners in adulthood.

Among the participants who were married or living with a partner, later sexual initiation was associated with significantly lower levels of relationship dissatisfaction in adulthood.

Researchers found that these associations with a later sex experience were not changed when genetic and environmental factors were taken into account. Furthermore, the associations could not be explained by differences in adult educational attainment, income, or religiousness, or by adolescent differences in dating involvement, body mass index, or attractiveness.

Experts believe the results suggest that the timing of first experience with sexual intercourse predicts the quality and stability of romantic relationships in young adulthood.

Although investigators have often focused on the consequences of early sexual activity, the Early and On-Time participants in this study were largely indistinguishable.

Researchers say the data suggests early initiation is not a “risk” factor so much as late initiation is a “protective” factor in shaping romantic outcomes.

According to Harden, there are several possible mechanisms that might explain this relationship.

It’s possible, for example, that people who have their first sexual encounter later also have certain characteristics (e.g., secure attachment style) that have downstream effects on both sexual delay and on relationship quality.

They could be pickier in choosing romantic and sexual partners, resulting in a reluctance to enter into intimate relationships unless they are very satisfying.

It’s also possible, however, that people who have their first sexual encounter later have different experiences, avoiding early encounters with relational aggression or victimization that would otherwise have detrimental effects on later romantic outcomes.

Finally, Harden said that it’s possible that “individuals who first navigate intimate relationships in young adulthood, after they have accrued cognitive and emotional maturity, may learn more effective relationship skills than individuals who first learn scripts for intimate relationships while they are still teenagers.”

Experts say that additional research is needed to help to tease apart which of these mechanisms may actually be at work in driving the association between timing of first sexual intercourse and later romantic outcomes.

Prior studies by Harden and her colleagues have provided evidence that earlier sexual intercourse isn’t always associated with negative outcomes.

For example, using the same sample from the National Longitudinal Study of Adolescent Health, she found that teenagers who experienced their first sexual intercourse earlier, particularly those who had sex in a romantic dating relationship, had lower levels of delinquent behavior problems.

She said, “We are just beginning to understand how adolescents’ sexual experiences influence their future development and relationships.”

By Lauren Walters

Introduction

You may have heard of Major Depressive Disorder. However, individuals who experience depression may not necessarily have a diagnosis of Major Depressive Disorder. Instead, they may have a diagnosis of Dysthymic Disorder. You may be wondering what Dysthymic Disorder is. This article will explain this. In addition to explaining the criteria for a diagnosis of Dysthymic Disorder, this article will also describe the specifiers of Dysthymic Disorder.

What Is The Criteria For Dysthymic Disorder?

According to http://www.allaboutdepression.com/dia_04.html#1, the following is the criteria for a diagnosis of Dysthymic Disorder:

A person has depressed mood for most the time almost every day for at least two years. Children and adolescents may have irritable mood, and the time frame is at least one year.
While depressed, a person experiences at least two of the following symptoms:
Either overeating or lack of appetite.
Sleeping to much or having difficulty sleeping.
Fatigue, lack of energy.
Poor self-esteem.
Difficulty with concentration or decision making.
Feeling hopeless.
A person has not been free of the symptoms during the two-year time period (one-year for children and adolescents).
During the two-year time period (one-year for children and adolescents) there has not been a major depressive episode.
A person has not had a manic, mixed, or hypomanic episode.
The symptoms are not present only during the presence of another chronic disorder.
A medical condition or the use of substances (i.e., alcohol, drugs, medication, toxins) do not cause the symptoms.
The person’s symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.
What Are The Specifiers For Dysthymic Disorder?

According to http://www.allaboutdepression.com/dia_04.html#1, there are three specifiers for Dysthymic Disorder, including early onset, late onset, and with atypical features. According to http://www.allaboutdepression.com/dia_04.html#1, on the basis of the early onset specifier, “Dysthymic symptoms begin before the age of 21. This may increase the likelihood of developing later major depressive episodes.” According to http://www.allaboutdepression.com/dia_04.html#1, on the basis of the late onset specifier, “Dysthymic symptoms begin after the age of 21.” According to http://www.allaboutdepression.com/dia_04.html#1, on the basis of the atypical features specifier, “symptoms are experienced during the last two years.”

Conclusion

This article has provided the reader with the criteria of Dysthymic Disorder and the specifiers for Dysthymic Disorder. On a final note, to have a diagnosis of Dysthymic Disorder, as oppose to a diagnosis of Major Depressive Disorder, symptoms must be present for an extended period of time, specifically for at least two years or more.

By Gabe Howard

Teenagers have a tendency to be dramatic. Many of us don’t like to admit it, but we were dramatic at that age, too, at least to some extent. Now that we’re parents (or other relatives, mentors, caregivers, or friends) to a teenager, the universe is giving us a taste of it from the other side. Most teenage angst is typical. I remember the first time my mom insulted my favorite band. What she said was, “I don’t like this band.”

What I heard was, “You’re stupid for listening to them and you have awful taste in music.”

When teenagers get angry, watch out. We’ve all said things we regret when angry and the minds of teenagers aren’t fully formed. Many life lessons that we adults take for granted have not yet been experienced by the average teen. When angry, they lash out and will say whatever it is they feel will hurt you.

Threatening to “commit suicide” is a fairly typical escalation point for an upset teenager looking to lash out.

Don’t Ignore Any Suicide Threat, Even If You’re “Sure” They’re Lying

Our society is deficient in mental health education and suicide prevention. The fact is that many adults don’t know what to do when anyone threatens to commit suicide, let alone a kid. Our natural tendency is to ignore things that make us feel uncomfortable or that we don’t understand. However, ignoring teenagers when they threaten suicide is a bad idea – even if you are sure they are just being dramatic. There are only two reasons for individuals to say they are contemplating suicide:

They are considering ending their life and in need of medical care.
They are trying to manipulate you and, in doing so, (unintentionally) making it harder for people who aren’t lying to be taken seriously.
Either reason needs to be taken seriously. Addressing the first reason is obvious; addressing the second ensures that your teen doesn’t minimize the experiences of people who truly need help. Crying wolf doesn’t just hurt them; it causes a ripple effect that prevents people who need care from getting it.

That’s not okay.

What Do You Do When Someone Says He or She Is Considering Suicide?

If someone says that he or she is considering suicide, you immediately get the person medical help. Call 9-1-1, take them to the emergency room, take them to the doctor’s office or local health department. Do not ignore the comment and do not try to handle it on your own. Mental illness, mental health crises, and thoughts of suicide are medical issues that need medical intervention.

Suicide PreventionEven if you are sure the teen is “just being dramatic,” seek medical help anyway. Suicidal threats are not something to take lightly. Many people don’t want to “waste their time” or “waste a doctor’s time” with something that they believe is just a adolescent being manipulative.

And they would be wrong to think that. Suicide is permanent. Would you want to take that risk if there is even a 1% chance that you’re wrong? Also, a teen learning the lesson that threatening suicide isn’t a weapon to be wielded in a disagreement or a tool for manipulation is a very valuable lesson.

So, your teen gets life-saving medical care or a life-changing experience that will make him or her a better person. There is no downside.

For all the manipulation, teenage angst, and dramatic rantings out there, I still take all threats seriously. I’m 99% positive my six-year-old nephew can’t get, and doesn’t have, a gun. But, if he walked up to me and said he had a loaded gun under his bed, I’d still go look.

Wouldn’t you?

Gabe Howard is a professional speaker, writer, and advocate who lives with bipolar and anxiety disorders. He has made it his mission to change the way society reacts to mental illness. He is an award-winning blogger and the creator of the official bipolar shirt. (Get yours now!) Interested in working with Gabe or learning more? He can be reached on Facebook, via email, or on his website, www.GabeHoward.com. Don’t be shy — he’s not.

By Rick Nauert PhD

Need help in remembering a difficult concept? A solution may literally be at your fingertips as new research suggests drawing pictures of information that needs to be remembered enhances memory.

“We pitted drawing against a number of other known encoding strategies, but drawing always came out on top,” said the study’s lead author, Jeffrey Wammes, a Ph.D. candidate in the Department of Psychology at the University of Waterloo.

“We believe that the benefit arises because drawing helps to create a more cohesive memory trace that better integrates visual, motor, and semantic information.”

In the study, researchers presented student participants with a list of simple, easily drawn words, such as “apple.” The students were given 40 seconds to either draw the word, or write it out repeatedly. They were then given a filler task of classifying musical tones to facilitate the retention process.

Finally, the researchers asked students to freely recall as many words as possible from the initial list in just 60 seconds.

“We discovered a significant recall advantage for words that were drawn as compared to those that were written,” said Wammes.

“Participants often recalled more than twice as many drawn than written words. We labelled this benefit ‘the drawing effect,’ which refers to this distinct advantage of drawing words relative to writing them out.”

Drawing the words or concepts, however crudely appears to be the best method for retention.

In variations of the experiment in which students drew the words repeatedly, or added visual details to the written letters, such as shading or other doodles, the results remained unchanged.

Memory for drawn words was superior to all other alternatives. Drawing led to better later memory performance than listing physical characteristics, creating mental images, and viewing pictures of the objects depicted by the words.

“Importantly, the quality of the drawings people made did not seem to matter, suggesting that everyone could benefit from this memory strategy, regardless of their artistic talent. In line with this, we showed that people still gained a huge advantage in later memory, even when they had just four seconds to draw their picture,” said Wammes.

While the drawing effect proved reliable in testing, the experiments were conducted with single words only. Wammes and his team are currently trying to determine why this memory benefit is so potent, and how widely it can be applied to other types of information.

By Janice Wood

A new study shows that the age at which an adolescent starts using marijuana affects which parts of the brain will be affected.

Researchers at the Center for BrainHealth at the University of Texas at Dallas found that study participants who began using marijuana when they were 16 or younger had brain variations that indicate arrested brain development in the prefrontal cortex, the part of the brain responsible for judgment, reasoning, and complex thinking.

Those who started using after age 16 showed the opposite effect, demonstrating signs of accelerated brain aging, according to the study, which was published in Developmental Cognitive Neuroscience.

“Science has shown us that changes in the brain occurring during adolescence are complex. Our findings suggest that the timing of cannabis use can result in very disparate patterns of effects,” said Francesca Filbey, Ph.D., principal investigator. “Not only did age of use impact the brain changes, but the amount of cannabis used also influenced the extent of altered brain maturation.”

For the study, the researchers analyzed MRI scans of 42 heavy marijuana users; 20 participants were categorized as early onset users with a mean age of 13.18, while 22 were labeled as late onset users with a mean age of 16.9.

According to self-reports, all the participants, who ranged in age from 21 to 50, began using marijuana during adolescence and continued throughout adulthood, using at least once a week.

According to Filbey, in typical adolescent brain development, the brain prunes neurons, which results in reduced cortical thickness and greater gray and white matter contrast. Typical pruning also leads to increased gyrification, which is the addition of wrinkles or folds on the brain’s surface.

However, in this study, MRI results reveal that the more marijuana early onset users consumed, the greater their cortical thickness, the less gray and white matter contrast, and the less intricate the gyrification, as compared to late onset users.

This indicates that when participants began using marijuana before age 16, the extent of brain alteration was directly proportionate to the number of weekly marijuana use in years and grams consumed.

In contrast, those who began using marijuana after age 16 showed brain changes that would normally manifest later in life: Thinner cortical thickness, and stronger gray and white matter contrast.

“In the early onset group, we found that how many times an individual uses and the amount of marijuana used strongly relates to the degree to which brain development does not follow the normal pruning pattern,” she said.

“The effects observed were above and beyond effects related to alcohol use and age. These findings are in line with the current literature that suggest that cannabis use during adolescence can have long-term consequences.”

Source: Center for BrainHealth at The University of Texas at Dallas

By Rick Nauert PhD

New research suggests the more time young adults use social media, the more likely they are to be depressed.

Investigators from the University of Pittsburgh School of Medicine believe the findings could help clinical and public health entities better care for depression. The study does not, however, establish causation.

Depression is expected to become the leading cause of disability in high-income countries by 2030. The research, funded by the National Institutes of Health, is available online and is forthcoming in the journal Depression and Anxiety.

Researchers explain that this was the first large, nationally representative study to examine associations between use of a broad range of social media outlets and depression.

Previous studies on the subject have yielded mixed results, been limited by small or localized samples, and focused primarily on one specific social media platform, rather than the broad range often used by young adults.

“Because social media has become such an integrated component of human interaction, it is important for clinicians interacting with young adults to recognize the balance to be struck in encouraging potential positive use, while redirecting from problematic use,” said senior author Brian A. Primack, M.D., Ph.D.

In 2014, Dr. Primack and his colleagues sampled 1,787 U.S. adults ages 19 through 32, using questionnaires to determine social media use and an established depression assessment tool.

The questionnaires asked about the 11 most popular social media platforms at the time: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine, and LinkedIn.

On average the participants used social media a total of 61 minutes per day and visited various social media accounts 30 times per week. More than a quarter of the participants were classified as having “high” indicators of depression.

Investigators discovered a significant link between social media use and depression whether social media use was measured in terms of total time spent or frequency of visits.

For example, compared with those who checked least frequently, participants who reported most frequently checking social media throughout the week had 2.7 times the likelihood of depression.

Similarly, compared to peers who spent less time on social media, participants who spent the most total time on social media throughout the day had 1.7 times the risk of depression.

In the study, researchers were careful to control for other factors that may contribute to depression including age, sex, race, ethnicity, relationship status, living situation, household income, and education level.

Lead author Lui yi Lin, B.A., emphasized that, because this was a cross-sectional study, it does not disentangle cause and effect.

“It may be that people who already are depressed are turning to social media to fill a void,” she said.

Conversely, Ms. Lin explains that exposure to social media also may cause depression, which could then in turn fuel more use of social media. For example:

Exposure to highly idealized representations of peers on social media elicits feelings of envy and the distorted belief that others lead happier, more successful lives;
Engaging in activities of little meaning on social media may give a feeling of “time wasted” that negatively influences mood;
Social media use could be fueling “Internet addiction,” a proposed psychiatric condition closely associated with depression;
Spending more time on social media may increase the risk of exposure to cyber-bullying or other similar negative interactions, which can cause feelings of depression.
The findings will encourage clinicians to ask about social media use among people who are depressed. Moreover, the knowledge of the relationship could be used as a basis for public health interventions leveraging social media.

Some social media platforms already have made forays into such preventative measures. For example, when a person searches the blog site Tumblr for tags indicative of a mental health crisis — such as “depressed,” “suicidal,” or “hopeless” — they are redirected to a message that begins with “Everything OK?” and provided with links to resources.

Similarly, a year ago Facebook tested a feature that allows friends to anonymously report worrisome posts. The posters would then receive pop-up messages voicing concern and encouraging them to speak with a friend or helpline.

“Our hope is that continued research will allow such efforts to be refined so that they better reach those in need,” said Dr. Primack, who also is assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences and professor of medicine.

“All social media exposures are not the same. Future studies should examine whether there may be different risks for depression depending on whether the social media interactions people have tend to be more active vs. passive or whether they tend to be more confrontational vs. supportive. This would help us develop more fine-grained recommendations around social media use.”

Source: University of Pittsburgh/EurekAlert

By Traci Pedersen

A new Dutch survey found that college students with a chronic lack of sleep experience great difficulty concentrating on their schoolwork and in turn have lower grades. Many of these students are “evening types,” those who gain more energy later in the day and into the night.

The study involved nearly 1,400 healthy students at Dutch universities and is based on a national survey by the Netherlands Association for Sleep Wake Research, Leiden University and the Netherlands Brain Foundation.

Young people require eight to nine hours of sleep in order to function properly, according to research at the National Sleep Foundation. Of the students surveyed, more than one-third reported not feeling rested enough to study properly. In fact, students who suffer from a chronic lack of sleep scored significantly lower on their final exam in the current academic year and had a significantly lower average grade than those who got enough sleep.

Of the respondents, 32 percent say they are evening types and seven percent say they are morning types (61 percent say they are neither). The evening types have more energy in the evenings than the other types and tend to go to bed later. Therefore, evening types have shorter sleeping times (eight hours and six minutes) than the average (eight hours and 20 minutes) and the morning types (eight hours and 28 minutes).

The evening types find it harder to keep their eyes open if they are sitting for a prolonged period of time in a lecture or working group and are less interested in studying because they feel too sleepy.

“’As the evening types sleep for less time every day than the average and morning types, they build up a sleep deficit over time. Evening types are more likely to have to get up in the morning while their biological clock hasn’t yet given them a signal to wake up. This can have a negative effect on the rest of the day,” says lead researcher Dr. Kristiaan van der Heijden from Leiden University.

“Regular bedtimes are extra important for these people and sleeping through to the afternoon in order to make up for lost sleep is disastrous for their sleep rhythm.”

Nearly all students agree that drinking coffee or other caffeine-containing drinks after dinner can cause sleeping problems. But there some negative habits and behaviors that many students believe are positive.

For example, 52 percent of students believe that participating in an intensive sport just before going to bed can have a positive influence on their sleep, while in fact this is not the case, as exercise raises body temperature and keeps one feeling wired and energetic. Drinking alcohol is another common misconception, as 30 percent of students believe that it affects sleep positively, while research has shown that the opposite is the case.

By Rick Nauert PhD

New research suggests that for at least some groups of “emerging adults,” sleep problems are a predictor of chronic pain and worsening pain severity over time.

Investigators say, however, that the presence of pain generally doesn’t predict worsening sleep problems during the transition between adolescence and young adulthood.

Drs. Irma J. Bonvanie and colleagues of University of Groningen, the Netherlands, believe early identification and treatment of sleep problems might help reduce later problems with pain in some groups of emerging adults.

Results of the study appear in suggests a study in PAIN®, the official publication of the International Association for the Study of Pain® (IASP).

In attempting to discover which come first — sleep problems or pain — Drs. Bonvanie and colleagues performed a “bidirectional” relationship assessment between sleep problems and pain among young adults, ages 19-22.

The study focused on overall chronic pain as well as specific types of pain: musculoskeletal, headache, and abdominal pain.

The long-term associations between sleep problems and three pain types were compared between the sexes, and the combined effects of anxiety and depression, fatigue, and physical activity were explored.

The study included approximately 1,750 young Dutch men and women who were followed for three years.

About half of young people who had sleep problems at the initial evaluation still had them three years later. At baseline, subjects with sleep problems were more likely to have chronic pain and had more severe musculoskeletal, headache, and abdominal pain.

Three years later, those with sleep problems were more likely to have new or persistent chronic pain. Overall, 38 percent of emerging adults with severe sleep problems at initial evaluation had chronic pain at follow-up, compared with 14 percent of those without initial sleep problems.

The relationship between sleep problems and pain was stronger in women than men — a difference that may start around older adolescence/emerging adulthood.

Fatigue appeared to be a modest intervening factor, while anxiety/depression and lack of physical activity were not significant contributors.

Sleep problems predicted increased severity of abdominal pain in women only. Sleep problems, however, did not predict headache severity in either sex. Abdominal pain was the only type of pain associated with a long-term increase in sleep problems, and the effect was small.

“Emerging adulthood…is characterized by psychosocial and behavioral changes, such as altered sleep patterns,” Drs. Bonvanie and coauthors write.

Chronic pain is also common in this age group, especially among women. Sleep problems might be an important risk factor for increased pain, acting through altered pain thresholds, emotional disturbances, or behavioral changes.

The new study suggests that sleep problems are significantly associated with chronic pain and specific types of pain problems in emerging adults.

“Our findings indicate the sleep problems are not only a precursor for pain, but actually predict the persistence of chronic pain and an increase in pain levels,” say the researchers.

In addition, they conclude, “Our findings suggest that sleep problems may be an additional target for treatment and prevention strategies in female emerging adults with chronic pain and musculoskeletal pain.”

WatchMinder3

(WatchMinder.com)
Reviewer: Nancy, mom of Jason, 14
The Challenge: My son’s teachers have told me that he “spaces out” in class, and I’m worried that he will fall behind. Cell phones are prohibited in class, and a beeping alarm would be disruptive to everyone.
The Solution: The WatchMinder3 looks like a sports watch, so Jason didn’t mind wearing it to school. You can set a silent, vibrating alarm–he programmed it to go off every 20 minutes during class–as well as pre-programmed messages. He chose PYATTN (“pay attention”). The vibrating alarm nudges him out of his daydreams–at least for a few minutes. There’s also a mode for 30 daily reminders, and we set one for taking medication. The watch is rechargeable and you can create your own personal messages.

VibraLITE 3 Watch

(VibraLITE.com)
Reviewer: Cynthia, mom of Chas, 15, and Katy, 13
The Challenge: My kids lose their watches or won’t wear them–maybe because they see them as annoying reminders from me! I want them to remember to do things on their own.
The Solution: We were mainly interested in the stopwatch function of the VibraLITE, with a silent, vibrating buzzer to notify you of the time. Katy was excited to try it, but she found it too complicated to set up. Chas figured it out easily, but the watch wasn’t his style–so Katy wore it. Katy had trouble setting the watch with one hand while wearing it on the other. Larger buttons or an easier set-up process would help. The vibrating buzzer does alert Katy to the time and helps her stay on track–when she remembers to set it.

Cadex 12-Alarm Watch

(Cadexwatch.com)
Reviewer: Stephen, dad of Jeanne, 13
The Challenge: My daughter forgets to do simple chores–taking out the garbage–and to take medication. I am tired of reminding her to do things.
The Solution: I needed something (besides me) to nag Jeanne to get things done. What I like about Cadex is the alarm, which rings every three minutes (for up to four hours), reinforced by a text message, up to 36 characters long, that appears on the face. Jeanne, even at her most distracted, can’t ignore both the auditory and visual prompts. When she finally takes out the garbage, she presses the FORWARD button on the watch to stop the alarm and text messages. At school, she takes her meds quickly when the alarm goes off, to avoid being embarrassed in front of classmates. Jeanne still doesn’t do all of her chores, but, thanks to the watch, I get an occasional reprieve from being a 24/7 nag.

By Neil Petersen

Today I’m an ADHD blogger. But before that I was just a guy with an ADHD diagnosis. And before that I was a guy who didn’t know much about ADHD at all.

When I finally did get diagnosed, I wondered how it took me so long to find out something that made so much sense. Part of the reason many people with ADHD get diagnosed late or not at all is that they think they know what ADHD is, and based on what they think they know they think they can’t have it.

ADHD MisconceptionsIn my case, thereare a few assumptions I made that influenced my view of ADHD before I started learning about ADHD. For anyone out there who has these misconceptions or knows other people who have them, I wanted to share them. They are:

1. Having ADHD means you can’t focus on anything

Based on the fact that ADHD is an “attention deficit” disorder, I assumed the essence of ADHD was a lack of focus and an inability to concentrate on anything.

However, more than being a simple deficit of attention, ADHD is an inability to regulate attention. When you have ADHD, you have less control over where your attention goes, so your focus will be naturally drawn towards things that are interesting/stimulating and away from things that aren’t.

In practice, what this means is that there will be some things you struggle to focus on, but there will also be some things that grab your attention. In fact, there might be somethings you can’t stop paying attention to.

That’s not to downplay the importance of inattention: in inability to sustain attention that interferes with your life is a big clue to the possibility of ADHD. But that doesn’t mean you don’t have ADHD if you can concentrate on some things, especially things you enjoy.

So having ADHD doesn’t mean you can’t focus on anything, but it does mean there will be a bigger gap between the activities you can focus on and the ones you can’t.

2. If you had ADHD, someone would have noticed by now

By the time you become an adult, it’s easy to assume that if you don’t have an ADHD diagnosis you don’t have ADHD. After all, if you did have it, a teacher, parent or doctor would have caught it when you were growing up, right?

Not necessarily!

There are many reasons ADHD can go unrecognized. Not everyone with ADHD has hyperactive symptoms, and ADHD without hyperactivity can be harder to spot from the outside. If you’re able to do alright in school despite ADHD, your parents or teachers might not have reason to suspect anything. Many people simply don’t know enough to recognize the signs of ADHD, and your doctor might not know you well enough personally to connect the dots.

You don’t know something until you know it, so you should never assume that not having an ADHD diagnosis precludes having ADHD. If you think you might have ADHD, you have nothing to lose and a lot to gain by making an appointment to talk it over with a professional.

3. ADHD is no big deal

By the time I was in high school, I was regularly hearing people use “ADD” as a cute shorthand for being scattered, disorganized or unfocused. “I’m so ADD,” “that’s so ADD,” “stop being so ADD,” you know how it goes.

The problem with trivializing ADHD this way isn’t just that it comes across as dismissive to people who really do have the disorder. It’s that for people don’t have the disorder or don’t know they have the disorder, it skews their perspective of what ADHD is.

Before I got diagnosed, I recognized I had some “quirks” in my ability to control my attention, impulses and so on (although I don’t think I would have articulated it in those terms at the time). If you’d asked me, I probably wouldn’t have even denied that I met the colloquial description of “so ADD.”

However, because I’d mostly heard traits like inattention and impulsivity discussed as trivial things, I wasn’t able to connect the dots to really see how these were symptoms that had a far-reaching impact on my life.

That said, even if I’d had a better objective understanding of ADHD, I doubt I would have been able to spontaneously acknowledge the full extent of how these symptoms were affecting my life. Denial is a powerful way of thinking, and we get used to how are lives are even when they’re not working that well.

We think of ADHD as a thing that’s different, but it doesn’t feel like a thing that’s different when you’ve had it all your life because it’s all you know – it’s like being the fish in water who doesn’t know what water is.

So if you do recognize possible ADHD symptoms in your life, don’t dismiss them and say “oh, I guess I’m just kind of ADD.” Research has shown that having ADHD profoundly alters the courses of people’s lives in terms of work, health and relationships just to name a few areas.

Learning more about ADHD and getting rid of my misconceptions has been a gradual process. Probably the biggest step forward I took in building more awareness was talking to a professional and stumbling into a diagnosis, which is why I always recommend this to other people (the talking to a professional part; the stumbling part is optional). And hopefully reading ADHD blogs can help too.

By Amy Bellows, PhD
When a remarriage occurs with children, it is a safe assumption that there will be some level of difficulty with their adjustment. The intensity of this adjustment period can vary greatly based on the child’s personality, divorce/custody circumstances and also the child’s age.

Here are a few things to consider about their age when you remarry with children:

Preschoolers (Ages 2-5)

Changes at this young age can be simpler for many families due to the fact that they may not remember the previous family structure and they may be more open to new people entering their life. It’s important to understand that the changes for kids this age may cause confusion. Lifelong changes such as divorce and remarriage be difficult to grasp since most young children have a hard time understanding permanent change. They may struggle with the idea that their parents will not be getting back together and they may internalize guilt, such as believing that their parent left because they did something ‘bad’.

Keeping an eye on their behavior and maintaining a sensitivity to their thoughts and feelings will help them to adjust to the new household. You may find yourself repeating the same reassurances many times with preschoolers who have fears of abandonment or guilt. Children at this age can also benefit from giving verbal assurance that they are allowed to love their step-parent and step-siblings.

Elementary School (Ages 6-10)

Just like with preschoolers, many elementary school children will carry thoughts and feelings of guilt over the divorce or creating relationships with their new step-relatives. Repeated verbal reassurance is key to helping them work through these emotions. Behavior changes may be seen such as poor grades or arguments with friends. These changes can signal emotions that they are trying to work through such as sadness over the divorce, coming to terms with the new family structure or guilt. Giving these children choices during a time when they may feel powerless can help them in their adjustment. Age appropriate choices such as hairstyle, clothes or room décor can give them areas of freedom to express themselves.

It’s important to maintain boundaries and rules during these choices – such as following school dress codes and maintaining healthy parent / child boundaries. It’s also important to remember that even if children do not verbally acknowledge the grieving process, they may be dealing with the lost illusion that their parents will someday reunite or from other areas of loss such as a reduced amount of attention from the parent. To help your children cope with these wide range of emotions it’s important to keep lines of communication open and to be understanding of their sense of loss.

Preteens (Ages 11-12)

This is the time period that generally has the highest potential for conflict in step-families. Research has shown that the hardest time period for children to adjust to remarriage is between the ages of 10-14. This is due to all of the changes a child is already working through emotionally and physically. Major adjustments to their home life can cause them to feel that they do not have a safe and consistent place to turn.

Children in the preteen years are starting to pull away in order to gain independence and to identify themselves in a new light. Preteen resentment towards authority figures is a normal occurrence in families, but this resentment can be intensified in stepfamilies. The stepparent will be the easiest target for this resentment because the child is less likely to fear rejection from them and there usually isn’t an underlining layer of unconditional love or a long relationship to lean on.

While children in this age group do need freedom to begin exploring their independence, they also need assurance of support and understanding. Forcing kids this age into situations they are uncomfortable with can cause push back so it is recommended to give them freedom of choice in safe areas. As a stepparent it can initially feel that you should back away at this time to get out of the line of fire, but Psychologist Carl Pickhardt advises the opposite reaction. He suggests that the stepparent/stepchild relationship needs more contact and time alone to grow and enforce the existing relationship. Additional time to communicate and to create positive memories can help to reduce overall conflict.

Teens (Ages 13-18)

With teens starting to understand and becoming more aware of their own sexuality and independence, seeing their parent form a romantic relationships can cause then to feel uncomfortable. Simple acts of affection may conflicts with the views they have held about their parents.

The act of bringing in a new partner and adjusting roles in the home may also result in the teenagers responsibilities or freedoms changing. New rules and adjusted boundaries can cause resentment. The level of discomfort with the roles changes will vary based on the closeness of the relationship they previously had with their parent, changes in parenting strategies and whether or not step-siblings are present. Decisions that teens may have previously been involved in now may change to include only the parent and step-parent. This can cause the child to hold anger towards their step-parent and it may cause resentment over the marriage as a whole.

Some children may choose to spend more time with the non-custodial parent during this time of transition so that they can adjust to the changes in a slower manner. Having flexibility with your teenager while they adjust to their new role and surroundings is important and can help reduce tension. Recent studies have shown that children over the age of 15 are generally not as involved with the step-family due to the lower level of active parenting they require and their likelihood of being more externally focused towards their peers. This can result in the relationship with the step-parent being more distant.

While each age has it’s own potential for conflict, understanding the unique challenges and the strengths of each age can help you to plan for the road ahead.

By Rick Nauert PhD

New research suggests the ability to ignore distraction is often associated with a better working memory.

Specifically, investigators from Simon Fraser University discovered differences in an individual’s working memory capacity correlate with the brain’s ability to actively ignore distraction.

A research team led by psychology professor Dr. John McDonald and doctoral student John Gaspar used EEG technology to determine that “high-capacity” individuals (those who perform well on memory tasks) are able to suppress distractors.

Conversely, “low-capacity” individuals are unable to suppress distractors in time to prevent them from grabbing their attention.

The suppressed memory capabilities has implications for individuals challenged with attention deficit disorders. Academic performance and individual safety concerns may be influenced by the attention deficits.

The research has been published in the journal PNAS.

“Distraction is a leading cause of injury and death in driving and other high-stakes environments, and has been associated with attentional deficits, so these results have important implications,” said McDonald, who holds a Canada Research Chair in Cognitive Neuroscience.

The study is linked to two previous papers in 2009 and 2014 in which McDonald’s research team showed that when people search the visual world for a particular object, the brain has distinct mechanisms for both locking attention onto relevant information and for suppressing irrelevant information.

The study is the first to relate these specific visual-search mechanisms to memory and show that the suppression mechanism is absent in individuals with low memory capacity.

Source: Simon Fraser University

By Rick Nauert PhD

New research suggests people suffering from anxiety perceive the world in a fundamentally different way than others. Investigators believe this finding may help to explain why certain people are more prone to anxiety.

The new study, published in the journal Current Biology, shows that people diagnosed with anxiety are less able to distinguish between a neutral, “safe” stimulus.

Researchers tested their hypothesis using the sound of a tone — a stimuli that had earlier been associated with gaining or losing money.

Investigators found that when some people have emotionally-charged experiences, they show a behavioral phenomenon known as “over-generalization.”

“We show that in patients with anxiety, emotional experience induces plasticity in brain circuits that lasts after the experience is over,” says Prof. Rony Paz of the Weizmann Institute of Science in Israel.

“Such plastic changes occur in primary circuits, and these later mediate the response to new stimuli. The result is an inability to discriminate between the experience of the original stimulus and that of a new, similar stimulus.

Therefore anxiety patients respond emotionally to the new stimuli as well and exhibit anxiety symptoms even in apparently irrelevant situations. They cannot control this response: it is a perceptual inability to discriminate.”

The study was a collaboration between psychiatrist Dr. David Israeli and Paz, and it was led by Dr. Offir Laufer, then a Ph.D. student in Paz’s group.

Paz and his colleagues recruited anxiety patients to participate in the study. They trained the patients to associate three distinct tones with one of three outcomes: money loss, money gain, or no consequence.

In the next phase, the participants were presented with one of several new tones and were asked whether the tone was one they had heard before while in training. If they were right, they were rewarded with money.

The best strategy would be to take care not to mistake (or over-generalize) a new tone for one they had heard in the training phase. But people with anxiety were more likely than healthy controls to think that a new tone was one they had heard earlier.

That is, they were more likely to mistakenly associate a new tone with the earlier experience of money loss or gain. Those differences were not explained by differences in participants’ hearing or learning abilities.

Investigators explain that the participants simply perceived sounds that were earlier linked to an emotional experience differently.

Functional magnetic resonance images (fMRIs) of the brains of people with anxiety and those of healthy controls revealed differences in the activity of several brain regions. These differences were mainly found in the amygdala, a region related to fear and anxiety, as well as in the primary sensory regions of the brain.

Researchers believe these results strengthen the idea that emotional experiences induce long-term changes in sensory representations in anxiety patients’ brains.

The findings might help explain why some people are more prone to anxiety than others.

The underlying brain plasticity that leads to anxiety isn’t in itself bad, Paz says.

“Anxiety traits can be completely normal; there is evidence that they benefitted us in our evolutionary past. Yet an emotional event, sometimes even a minor one, can induce brain changes that can potentially lead to full-blown anxiety,” he says.

Therefore, understanding how the process of perception operates in anxiety patients may help lead to better treatments for the disorder.

Source: Weizmann Institute of Science

By Matt McMillen , Reviewed by Arefa Cassoobhoy, MD, MPH
If a test could tell whether you’ll get Alzheimer’s disease someday, would you want to know? And if so, what would you do with that knowledge?

These questions are becoming more and more important as researchers close in on tools to predict your risk of Alzheimer’s disease decades before symptoms start to appear.

“Primary care physicians, in the disease’s early stages, [eventually] could be able to say, ‘It looks like there’s a problem here’ through a blood test, a saliva test, or by looking at the retina,” says Dean Hartley, PhD, director of science initiatives for the Alzheimer’s Association. “But there’s no medical test now. It’s all in the research stage.”

For now, only genetic tests are available to the general public. They can spot genes linked to a higher risk of Alzheimer’s, such as the ApoE4 gene. But genetic tests aren’t conclusive. Not everyone whose test result says they have ApoE4 will get Alzheimer’s, and many people who don’t have that gene will get the disease.

And if you have the gene, there isn’t much you can do yet, aside from making lifestyle changes that may be preventive. “You can get the ApoE4 test at your doctor’s office, but I and many of my colleagues rarely offer it, because we don’t have any treatments to offer if we determine that patients are at higher risk,” says Alzheimer’s researcher Liana Apostolova, MD, a professor at the Indiana University School of Medicine.

Also, knowing your risk could come with a price. Seven years ago, Jamie Tyrone learned unexpectedly that she had two copies of the ApoE4 gene.

“I went into a deep, dark hole,” says Tyrone, 55, a former nurse who lives in San Diego. “This information was very anxiety-provoking, to the point that I was diagnosed with PTSD [post-traumatic stress disorder]. Knowing has done me harm.”

Tyrone says Alzheimer’s was not on her radar when she was tested for a variety of genetic disorders as part of a research study. Being unprepared for the news, she says, made her anxiety worse.
Eventually she learned to cope. She started to take better care of herself, exercising and improving her diet, meditating and doing brain-twisting puzzles purported to strengthen memory and focus. And she became involved with research into the disease. She founded B.A.B.E.S., Beating Alzheimer’s By Embracing Science, a non-profit that supports research into the disease and encourages people to get involved.

Tyrone wants others to learn from her experience.

“I’m choosing to heal by talking about it,” she says. “I don’t want people to go through what I went through.”

New Ways to Detect Alzheimer’s Disease
The biggest advance toward the early prediction of Alzheimer’s, Hartley says, is using PET scans to show the buildup of beta amyloid plaques in the brain. The plaques are a risk factor for the disease, and in the past they could be seen only during an autopsy.

“This is an opportunity to see into the live brain,” Hartley says.

The FDA has approved PET amyloid imaging for use in some clinical trials and to help diagnose dementia patients, but not to predict the development of the disease — at least not yet.

“PET imaging with amyloid will be the first way of approaching prediction,” Apostolova says. MRI will also be useful, she says, as will PET imaging for tau proteins, another sign of disease.

But, she continues, amyloid PET scans are expensive, not readily available, and they expose patients to radiation.

“What if there’s another way to get at the answer of who’s at risk?” she asks.

Research Apostolova led while at UCLA resulted in a simple blood test that picks up biomarkers — or proteins in the blood — linked to Alzheimer’s. Along with other tests, it one day may help predict the disease. She published her early findings in January in the journal Neurology.

Researchers are studying several other new tests:

A saliva test that identifies biomarkers linked to Alzheimer’s disease.
A combination of cognitive tests, MRI scans, and analysis of proteins found in cerebrospinal fluid — fluid in the brain and spinal cord that can predict mild cognitive impairment, or thinking problems, 5 years before symptoms become apparent.
Measurements of the protein neurogranin, a potential Alzheimer’s biomarker found in fluid in the brain and spinal cord.
Tests that uncover the deterioration of your sense of smell may indicate Alzheimer’s.
Eye exams that can measure beta amyloid buildup.
All of these tests remain experimental, and their effectiveness remains to be seen.

“Saliva tests, blood tests, and things like that are not ready for prime time,” Hartley says.
Knowing Your Risk
If you do learn your risk of Alzheimer’s — through a genetic test or, eventually, through one of these still-experimental tests — what can you do with that knowledge? And how would it affect you? After all, with no viable treatments available to slow, stop, or prevent the disease — only drugs that may improve symptoms in some people for a short time — there’s little doctors can offer you.

“Some people would want to know so they can plan things out, such as long-term care insurance and end-of-life decisions, while others would not want to know,” says David Salmon, PhD, of the Shiley-Marcos Alzheimer’s Disease Research Center at the University of California, San Diego. “It’s a personal decision. It’s hard to say what the best advice would be.”

Salmon’s research suggests that knowing you’re at risk can have bad consequences. You’re more likely to rate your memory worse and do worse on a memory test than someone with the same risk who is unaware.

“We don’t think it’s depression, but we didn’t measure anxiety and stress, so we don’t know if the disclosure increased anxiety and that it’s the anxiety that causes you to have memory problems,” Salmon says.

But other research suggests that knowing your genetic risk does not up your chances of depression, anxiety, or distress. Jason Karlawish, MD, an Alzheimer’s expert and medical ethicist at the University of Pennsylvania, has studied middle-age adults with a family history of Alzheimer’s.

If people get their mood and well-being assessed before they get tested, “they have minimal problems with mood and well-being after learning the results,” Karlawish says. “We don’t have data from persons who are older and plausibly closer in age of onset to AD.”

Karlawish is involved in a study of an experimental Alzheimer’s drug known as solanezumab. The drug, made by Eli Lilly, targets amyloid plaques and may delay the onset of cognitive decline. It is now being tested on people who don’t have Alzheimer’s symptoms but whose PET scans have shown the presence of such plaques, a potential early warning sign of the disease.
It’s among several meds that may prevent or slow Alzheimer’s from getting worse that are being studied in people long before they show symptoms.

Karlawish’s previous research suggests that that knowledge may motivate people to change their lifestyles. That’s what Tyrone eventually began to do. She has improved her diet and her exercise habits, she’s at work on a book about her experiences, and she’s become involved in Alzheimer’s research, such as studies into new medication. That’s something she highly recommends — as does Karlawish — for people who know they’re at risk.

“Yes, it’s partially selfish, because you’re getting something as well as giving something,” she says. “You’re at the forefront of cutting-edge research.”

But if you don’t yet know? “I would ask them, why do you really want to know this information? And can you make changes without knowing that information?” Tyrone asks. “It may be anxiety provoking. Is it really healthy to know this information or is not healthy? What are you going to do with it?”

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