Overcome negative thinking and emotional barriers to life success
Published on May 1, 2013 by Melanie A. Greenberg, Ph.D. in The Mindful Self-Express

Have you spent a lot of time and money on psychotherapy or self-help books, yet you still feel stuck in unhealthy habits?. Unfortunately, verbal insight and understanding do not always lead to changing self-destructive behaviors (e.g. addictions, procrastination, angry outbursts) or removing distress. Knowing why you are depressed, anxious, or feeling pain doesn’t necessarily make you feel any better. However, if you get up and get active – walking, reaching out to friends, pursuing a hobby or creative activity, doing your yoga stretches, or even getting errands done, you will focus less on the negative feelings and they won’t last as long. Understanding what is most meaningful to you in life (such as your health, family, or work) and committing to taking specific, manageable actions to achieve your goals in these areas can put you back in the driver’s seat of your life.

Acceptance And Commitment Training

Acceptance and Commitment Therapy/Training (or ACT) is a short-term intervention used in psychotherapy or workplace settings. It combines principles of Mindfulness with techniques of motivation and behavior change. ACT can help you to break out of negative thought cycles, accept what you can’t control, stop running away from pain, and be more able to tolerate risk, failure, and uncertainty to reap the rewards of a meaningful, engaged life. It can help your career and health by teaching you how to handle negative emotions and overcome procrastination.

Some core principles of ACT are:

(1) Experiencing the Present Moment Directly

Similar to Mindfulness, ACT therapists use exercises to help you remain present and focused on the breath or your present thoughts and feelings, rather than trying to avoid them. Feelings are momentary, changing experiences in our bodies and minds. However, because of childhood learning experiences, we often develop judgments about them and what it means about us that we have them – such as “You’re depressed again – You’re such a loser!” When you focus on and describe the direct physical sensations of pain or anxiety (e.g., my chest feels tight), rather than feeling helpless or trying to distract yourself, you may realize that they are not going to kill you and that they will eventually pass. Watching feelings rise and fall in your body, gives you a sense of them as transient experiences, rather than as who you are in essence.

(2) Being Willing to Be Where You Are

Acceptance is often confused with passivity. In ACT terms, acceptance means “being willing to experience the present moment, even if it’s not what we would have chosen.” This also means accepting your life experiences and history, realizing you can never completely get rid of or make up for experiences of suffering. At the same time, you have a choice about what you do with your life now. You do not have to be so limited by old ways of thinking. Like any habit, change takes time and effort. Therefore, you will likely be uncomfortable for a while. It takes time to change your brain pathways and to have other people notice you are different and behave differently towards you. Like losing a lot of weight, you have to work hard for a long time before seeing noticeable results. Being willing means you no longer avoid uncomfortable thoughts, feelings, or situations by zoning out, not showing up, addictions, anger, or procrastinating. If you want to be healthier, you first need to be able to look at and experience how unhealthy you are right now. At the same time, you can commit to doing what you need to do in small bits, each day, to be a little bit healthier. Lifting the veil of self-deception can go a long way towards getting you focused on the right track.

(3) Separating Your Self From Your Thoughts
Your thoughts, feelings, and sensations are not who you are. ACT Training includes mindfulness, imagery, and language-based exercises to help you connect with your “observing ego” so you can observe your thoughts and experiences from a more objective vantage point.. Although your thoughts feel true, they are not necessarily the whole truth, because they are biased by your expectations from past experiences and self-definition. You do not need to let your thoughts and feelings determine your behavior. You can choose how to behave, based on your direct experience (what you see, hear, feel – independent of your judgments about these events) and your core values. You may think about a thought: “Is it kind? Is it truthful?,..” and so on. Based on the answer, you may choose to take the thought seriously or let it pass on by. Rather than changing the content of your thoughts, you can choose to change how you interact with them Thinking you are stupid or fat does not make you stupid or fat – it is just a passing thought in your head.

(4) Defining Your Core Values

Core values are the things in life that are most meaningful to us and that enrich our lives. They include such things as “Being healthy,” “Taking care of our families,” “Being honest and accountable,” or “Contributing to society.” When people come to therapy, they are often so overwhelmed with distress, feelings of self-pity or anger, or struggles with pain or addiction, that they have lost touch with what really makes them fulfilled. Even if they know “I want to be a good parent,” their day-to-day behavior may not reflect this because they are preoccupied with seeking escape from daily stress, thoughts about past, painful events, or trying to prevent an anticipated future threat. ACT therapists/trainers use imagery and writing exercises to help clients define their individual core values and gain motivation to reconnect with activities and people that enhance these values in our lives.

(5) Committing to Motivated Action
To live a meaningful, authentic life, you need to take risks, get out into the world, and tolerate uncertainty and anxiety. Exercises focus on setting manageable, attainable, meaningful goals – committing to taking specific, small steps that get you closer to your larger goals. The focus is on taking action, not expecting a particular result, since outcomes may be at least partially out of our control. To be successful is not necessarily to always feel happy or pain-free, but to live a full life despite the anxiety or pain. By facing what you fear, the fear will eventually lessen, and, even if it doesn’t, you will know you have done your best with what you have. This takes you out of the cycle of self-doubt, regret, and second-guessing yourself.

Who Can Benefit From ACT?

ACT, also known as Acceptance and Commitment Therapy/Training, when used in workplace settings, is a short-term intervention approach that has been used with substance abusers, people suffering from chronic pain and illness, patients with obsessive thoughts, anxiety, or depression. ACT works well with clients or employees who are tired of letting uncontrollable symptoms rule and want to take a more active role in defining and directing their own lives. I use ACT principles and interventions with almost every client to help them tolerate uncontrollable, stressful situations and focus on what they can change. ACT can create a basis for hope and help you tolerate the pain of changing.

According to SAMHSA’s Registry of Effective Programs,

“ACT has been shown to increase effective action; reduce dysfunctional thoughts, feelings, and behaviors; and alleviate psychological distress for individuals with a broad range of mental health issues (including DSM-IV diagnoses, coping with chronic illness, and workplace stress).”

For more information about ACT, go to this link

http://contextualscience.org

Or watch this YouTube video by Dr Russ Harris:

About The Author

Melanie Greenberg, Ph.D. is a Clinical Psychologist, and expert on Mindfulness, Managing Anxiety, and Depression, Succeeding at Work,, and Mind-Body Health. Dr Greenberg provides workshops and speaking engagements for your organization and coaching and psychotherapy for individuals and couples

Visit her website:

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

Follow her on twitter @drmelanieg
Like her on Facebook www.fb.com/mindfulselfexpress
Read her Psychology Today blog & personal blog

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

http://marinpsychologist.blogspot.com

By Lisa A. Miles
Families Could Help More in Treatment, If HIPAA Allowed ItWhy is it that families are kept so far out of the loop when it comes to a loved one’s health?

The quick, easy answer, of course, is the nation’s health insurance portability and accountability act (HIPAA). Physicians are able to share only certain information with the family unless the patient agrees to more. The problem is that the patient might be too elderly, addicted or mentally ill to cooperate or even understand what they are agreeing to (or simply stubborn).

Certainly individual civil liberties must be taken into consideration. This writer, in fact, is more than moderately liberal.

But there is a blurry but significant line that puts human wisdom to the test, as we evaluate true need for family assistance.

Beyond HIPAA’s ramifications, there are doctors who frankly don’t care to communicate with anyone other than the patient, no matter who they are allowed to talk to. As well, many estranged families may not be interested in the health of their kin.

But for those families of the mentally ill, alcoholic or addicted who want to help their loved one, they need to be able to communicate with clinicians, doctors, and therapists. Rather than just informing the treatment team of a loved one’s behaviors at home and not receiving a treatment team response, the family must be brought into the fold of treatment teams. In the wake of the school shooting in Newtown, Conn. in December 2012, nothing less is required.

HIPAA needs to be reworked. There needs to be an out clause granted to family members who obviously 1) are intelligently trying to work on their own coping strategies in a troubled family dynamic; 2) care about their ill family member; and 3) can offer the most significant information about the patient because of a shared living situation or close interaction.

Lloyd Sederer, MD, medical director of the New York State Office of Mental Health and adjunct professor at Columbia University Mailman School of Public Health, wrote a few weeks after the Newtown tragedy of families being the true first responders of psychiatric illness. How very true. And yet how shabbily they have been treated.

Anyone who has been around the block with a relative suffering from mental illness or related concerns — even those empowered with the great help of the National Alliance on Mental Illness and other advocacy organizations — knows how hard it still is dealing with treatment providers.

Who, after all, knows a patient’s symptoms better than the family who lives with someone exhibiting psychosis, neurosis, manipulative behaviors, or obsessive-compulsive mannerisms? Who directly witnesses what the patient may cleverly hide in a therapeutic session?

Should not symptoms drive treatment more than diagnosis? Symptoms, after all, are what delineate an individual as being functional, or not, in various scenarios. And should not families be given information on how to respond in ways that may actually help the patient?

Though there are so many more, these alone are perhaps the two most critical, simple means of understanding that families must demand to be brought into the fold, respected as harbingers of the most significant information about mentally ill and addicted loved ones who are suffering, for the most part, needlessly.

A simple questionnaire can help differentiate individuals experiencing normal age-related memory loss from those at risk for developing dementia, most notably by their orientation to time and patterns of repetitive speech, researchers found.

On the 21-item Alzheimer’s Questionnaire, patients having trouble remembering the day, month, year, and time of day were almost 18 times more likely to have amnestic mild cognitive impairment, a precursor to dementia, according to Michael Malek-Ahmadi, MSPH, and colleagues from the Banner Sun Health Research Institute in Sun City, Ariz.

Those who often repeated questions, statements, and stories on the same day also were at very high risk, the researchers reported online in BMC Geriatrics.

Distinguishing mild cognitive impairment, particularly when associated with memory loss rather than loss of other functional domains, can be clinically challenging and time consuming, and brief screening tools are sorely needed as the aging population expands, according to the researchers.

“Additionally, as new therapies for Alzheimer’s disease transition from being symptomatic to disease-modifying, identifying individuals who are at risk or in the earliest stages of the disease will be crucial in determining and improving disease outcome,” they wrote.

A pilot study by these researchers recently showed good sensitivity and specificity for the Alzheimer’s Questionnaire, with responses about various aspects of memory and related cognitive concerns being provided by caregivers or other informants.

To see if certain components of the questionnaire were particularly accurate in pinpointing these types of impairments, Malek-Ahmadi’s group compared responses among 47 patients who had been diagnosed with amnestic mild cognitive impairment and 51 controls who were participants in a program involving posthumous brain and body donation.

The diagnosis of cognitive impairment had been made clinically and with neuropsychological testing, with scores on verbal memory recall measures falling 1.5 standard deviations below normal ranges for age and educational attainment.

Cognitively normal participants all scored higher than 1.5 standard deviations on the neuropsychological tests.

The Alzheimer’s Questionnaire assesses memory, language, orientation, visuospatial competence, and functional capacity by a series of yes/no questions such as, “Does the patient have trouble remembering to take medications?”

On almost all questions, significantly more “yes” responses were seen for the cognitive impairment group.

Regression analysis determined that, along with repetitive speech and disorientation as to time, two other questions were highly predictive.

One was whether the patient has trouble dealing with financial matters such as paying bills, and the second was if the patient showed an impaired sense of direction, according to the researchers.

“These data indicate that problems with orientation to time, repeating statements and questions, difficulty managing finances, and trouble with visuospatial orientation may accompany memory deficits in amnestic mild cognitive impairment,” the researchers stated.

Empowering yourself to challenge your inner critic.
Published on April 18, 2012 by Melanie A. Greenberg, Ph.D. in The Mindful Self-Express
“Loser!”

“You messed up again! “

“You should have known better!”

Sound familiar?

Of course it does! It’s that know-it-all, bullying, mean-spirited committee in your head. Don’t you wish they would just shut up already? I know I do!

The Committees in Our Heads

We all have voices inside our heads commenting on our moment-to-moment experiences, the quality of our past decisions, mistakes we could have avoided, and what we should have done differently. For some people, these voices are really mean and make a bad situation infinitely worse. Rather than empathize with our suffering, they criticize, disparage, and beat us down at every opportunity! The voices are often very salient, have a familiar ring to them and convey an emotional urgency that demands our attention. These voices are automatic, fear-based “rules for living” that act like inner bullies, keeping us stuck in the same old cycles and hampering our spontaneous enjoyment of life and our abilities to live and love freely.

Where Do the Voices Come From?

Psychologists believe these voices are residues of childhood experiences—automatic patterns of neural firing stored in our brains and dissociated from the memory of the events they are trying to protect us from. While having fear-based self-protective and self-disciplining rules probably made sense and helped us to survive when we were helpless kids, at the mercy of our parents’ moods, whims, and psychological conflicts, they may no longer be appropriate to our lives as adults. As adults, we have more ability to walk away from unhealthy situations and make conscious choices about our lives and relationships based on our own feelings, needs and interests. Yet, in many cases, we’re so used to living by these unwritten internal rules that we don’t even notice or question them. And we unconsciously distort our view of things so they seem to be necessary and true. Like prisoners with “Stockholm Syndrome,” we have bonded with our captors!

What Happens When the Committee Takes Charge of Our Lives?

If left unchecked, the committees in our heads will take charge of our lives and keep us stuck in mental and behavioral prisons of our own making. Like typical abusers, they scare us into believing that the outside world is dangerous, and that we need to obey their rules for living in order to survive and avoid pain. By following (or rigidly disobeying) these rules, we don’t allow ourselves to adapt our responses to experiences as they naturally unfold. Our behaviors and emotional responses become more a reflection of yesterday’s reality than what is happening today. And we never seem to escape our dysfunctional childhoods.

The Schema Therapy Approach
Psychologist Jeffrey Young and his colleagues call these rigid rules of living and views of the world “schemas.” Based on our earliest experiences with caregivers, schemas contain information about our own abilities to survive independently, how others will treat us, what outcomes we deserve in life, and how safe or dangerous the world is. They can also get in the way of our having healthy relationships in life, work, and love.

How Negative Schemas Affect Our Lives & Relationships

Young suggests that negative schemas limit our lives and relationships in several ways:

(1) We behave in ways that maintain them.

(2) We interpret our experiences in ways that make them seem true, even if they really aren’t.

(3) In efforts to avoid pain, we restrict our lives so we never get to test them out

(4) We sometimes overcompensate and act in just as rigid, oppositional ways that interfere with our relationships.

The Abandonment Schema – Diana’s Story

A woman who we will call Diana has a schema of “Abandonment.” When she was five years old, her father ran off with his secretary and disappeared from her life, not returning until she was a teenager. The pain of being abandoned was so devastating for young Diana that some part of her brain determined that she would never again allow herself to experience this amount of pain. Also, as many children do, she felt deep down that she was to blame; she wasn’t lovable enough, or else her father would have stuck around; a type of ‘Defectiveness” schema.

Once Diana developed this schema, she became very sensitive to rejection, seeing the normal ups and downs of children’s friendships and teenage dating as further proof that she was unlovable and destined to be abandoned. She also tried desperately to cover up for her perceived inadequacies by focusing on pleasing her romantic partners, and making them need her so much that they would never leave her. She felt a special chemistry for distant, commitment-phobic men. When she attracted a partner who was open and authentic, she became so controlling, insecure and needy that, tired of not being believed or trusted, he eventually gave up on the relationship.

Diana’s unspoken rule is that it is not safe to trust people and let relationships naturally unfold; if she relaxes her vigilance for even a moment, the other person may leave. In an effort to rebel against her schema, she also acted in ways that were opposite to how she felt; encouraging her partner to stay after work to hang out with his friends, in an attempt to convince herself (and him) that she was ultra-independent. This led to chronic anger and feelings of dissatisfaction with her partner’s lack of understanding of her needs; she neither understood nor acknowledged her own role in the cycle.

What Can We Do?

Schema Therapy can help Diana (and her partner) understand how their schemas result in ways of relating to self and others that are repetitive, automatic, rigid, and dysfunctional. By acknowledging and empathically connecting with her unresolved fears and unmet needs, Diana can become more flexible and free. These new theories and therapies can help to heal couples conflict and individual problems such as anxiety, depression, personality disorders, grief, and childhood trauma. The schema concept helps us understand how early childhood events continue to influence adult relationships and mental health issues. We need to recognize their influence, pay attention to what our automatic inner voices are saying, and (with professional help, if necessary), begin to free ourselves from their grip.

Resources
Schema Therapy Website: http://www.schematherapy.com/

About The Author

Melanie Greenberg, Ph.D. is a licensed Clinical Psychologist, and expert on Mindfulness, Positive Psychology, Emotion Regulation, and Relationships. Dr Greenberg provides workshops and speaking engagements for organizations, life, weight loss, or career coaching, and psychotherapy for individuals and couples.

Visit my website:

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

Follow me on twitter @drmelanieg
Like me on Facebook www.fb.com/mindfulselfexpress
Read my Psychology Today blog & personal blog

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

http://marinpsychologist.blogspot.com/

May 21, 2013 — Children who have suffered maltreatment are 36% more likely to be obese in adulthood compared to non-maltreated children, according to a new study by King’s College London. The authors estimate that the prevention or effective treatment of 7 cases of child maltreatment could avoid 1 case of adult obesity.

The findings come from the combined analysis of data from 190,285 individuals from 41 studies worldwide, published this week in Molecular Psychiatry.

Severe childhood maltreatment (physical, sexual or emotional abuse or neglect) affects approximately 1 in 5 children (under 18) in the UK. In addition to the long-term mental health consequences of maltreatment, there is increasing evidence that child maltreatment may affect physical health.

Dr Andrea Danese, child and adolescent psychiatrist from King’s College London’s Institute of Psychiatry and lead author of the study says: “We found that being maltreated as a child significantly increased the risk of obesity in adult life. Prevention of child maltreatment remains paramount and our findings highlight the serious long-term health effects of these experiences.”

Although experimental studies in animal models have previously suggested that early life stress is associated with an increased risk of obesity, evidence from population studies has been inconsistent. This new study comprehensively assessed the evidence from all existing population studies to explore the potential sources of inconsistency.

In their meta-analysis, the authors were able to rule out specific factors which might explain the link — they found that childhood maltreatment was associated with adult obesity independently of the measures or definitions used for maltreatment or obesity, childhood or adult socio-economic status, current smoking, alcohol intake, or physical activity. Additionally, childhood maltreatment was not linked to obesity in children and adolescents, making it unlikely that the link was explained by reverse causality (i.e. children are maltreated because they were obese).

However, the analysis showed that when current depression was taken into account, the link between childhood maltreatment and adult obesity was no longer significant, suggesting that depression might help explain why some maltreated individuals become obese.

Previous studies offer possible biological explanations for this link. Maltreated individuals may eat more because of the effects of early life stress on areas of the developing brain linked to inhibition of feeding, or on hormones regulating appetite. Alternatively, maltreated individuals may burn fewer calories because of the effects of early life stress on the immune system leading to fatigue and reduced activity. The authors add that these hypotheses will need to be directly tested in future studies.

Dr Danese adds: “If the association is causal as suggested by animal studies, childhood maltreatment could be seen as a potentially modifiable risk factor for obesity — a health concern affecting one third of the population and often resistant to interventions.

He concludes: “Additional research is needed to clarify if and how the effects of child maltreatment on obesity could be alleviated through interventions after maltreatment has occurred. Our next step will be to explore the mechanisms behind this link.”

By Therese Borchard
“There is no question that the most common destructive behavior affecting depressed patients, barring suicide, is alcoholic or any substance abuse,” writes J. Raymond De Paulo Jr., M.D., of the Johns Hopkins School of Medicine in his book “Understanding Depression.” He does not mince words on the seriousness of alcoholism and drug addiction to the recovery of depression:

Nothing makes the job of a psychiatrist treating depression and manic depression harder than alcohol and drugs. The most difficult treatment situations that I have ever seen patients and families confront, since I started my training in psychiatry twenty-seven years ago, occur when the patients’ illnesses are complicated by what we call addictive behaviors. While I have seen many successful outcomes, none were easy to achieve.

Here are some important facts you need to know about the relationship between depression and substance abuse: why addiction impedes recovery from depression and why depression sustains drug dependence.
1.Depressive illness makes people prone to destructive behaviors.
2.Destructive behaviors make depression and mood disorders worse.
3.Depressed people drink and use drugs to self-medicate.
4.There is a greater risk of abusing alcohol or drugs by people who have moderate depression than those who have depression that is severe.
5.There is a high relapse rate with drugs and alcohol when it occurs along with depression and mania. Depressed people who drink or abuse drugs are far more likely to suffer a relapse.
6.Approximately one-third of people with all mental illnesses and approximately one-half of people with severe mental illnesses also experience substance abuse.
7.More than one-third of all alcohol abusers and more than one-half of all drug abusers are also battling mental illness.
8.People with manic depression are particularly at risk. One study suggests that as many as 60 percent of people with Bipolar I have substance abuse problems at some point in their life.
9.The likelihood of developing alcoholism or substance is abuse is far greater in people with bipolar disorder than in those with unipolar depression or the general population.

A new study in the Archives of General Psychiatry found that alcohol abuse may actually cause major depression. The research results showed that alcohol use could trigger genetic markers that increase the risk of depression. In other words, the depressant effect of alcohol could lead to depression itself.

NEW YORK, May 20 (UPI) U.S. men who had attention-deficit/hyperactivity disorder as children weighed 19 pounds more at age 41 than those with no ADHD, researchers say.

Study co-author F. Xavier Castellanos, a psychiatrist at the Child Study Center at New York University Langone Medical Center in New York, and colleagues at Verona University in Italy; the Institute for Psychiatric Research in Orangeburg, N.Y.; and the Neuroingenia Clinical and Research Center in Mexico said ADHD might affect up to 11 percent of U.S. children, the majority boys.

The study involved 207 white boys with childhood ADHD — mean age of 8.3 — interviewed at ages 18-25 and age 41. At age 18, 178 boys without ADHD were recruited.

At 41, 111 men with childhood ADHD and 111 men without childhood ADHD self-reported their weight and height.

The study, published in the journal Pediatrics, found at age 41, the men who had ADHD weighed an average of 213 pounds, and 41 percent of them were obese, while the men who hadn’t had ADHD weighed 194 pounds on average, and 22 percent were obese.

The study didn’t figure out why boyhood ADHD might be causing weight problems in adulthood — the weight gain could be caused by psychological factors or neurobiology, Castellanos told NPR.

Differences in the pathways for dopamine, a neurotransmitter in the brain, have been found in both people who are obese and people with ADHD, Castellanos said.

“It makes sense, because they’re self-medicating with carbohydrates,” Dr. Edward Hallowell, a psychiatrist in Sudbury, Mass., who has ADHD and treats adults with ADHD but wasn’t involved with the study, told NPR. “Carbs do the same thing that stimulant medications do — promote dopamine.”

Read more: http://www.upi.com/Health_News/2013/05/20/ADHD-in-childhood-may-be-linked-to-obesity-in-adults/UPI-34151369093137/#ixzz2TwJL5KU5

By Margarita Tartakovsky, M.S.
Associate Editor

How to Support an Anxious PartnerHaving a partner who struggles with anxiety or has an anxiety disorder can be difficult.

“Partners may find themselves in roles they do not want, such as the compromiser, the protector, or the comforter,” says Kate Thieda, MS, LPCA, NCC, a therapist and author of the excellent book Loving Someone with Anxiety.

They might have to bear the brunt of extra responsibilities and avoid certain places or activities that trigger their partner’s anxiety, she said. This can be very stressful for partners and their relationship.

“Partners of loved ones with anxiety may find themselves angry, frustrated, sad, or disappointed that their dreams for what the relationship was going to be have been limited by anxiety.”

Thieda’s book helps partners better understand anxiety and implement strategies that truly support their spouses, without feeding into or enabling their fears.

Below, she shared five ways to do just that, along with what to do when your partner refuses treatment.

1. Educate yourself about anxiety.

It’s important to learn as much as you can about anxiety, such as the different types of anxiety disorders and their treatment. This will help you better understand what your partner is going through.

Keep in mind that your partner might not fit any of these categories. As Thieda writes in Loving Someone with Anxiety, “The truth is, it doesn’t matter whether your partner’s anxiety is ‘diagnosable.’ If it’s impairing your relationship or diminishing your partner’s quality of life or your own quality of life, it will be worthwhile to make changes.”

2. Avoid accommodating your partner’s anxiety.

“Partners often end up making accommodations for their partner’s anxiety, whether it is intentional [such as] playing the part of the superhero, or because it just makes life easier, as in, doing all the errands because their partner is anxious about driving,” said Thieda, who also created the popular blog “Partners in Wellness” on Psych Central.

However, making accommodations actually exacerbates your partner’s anxiety. For one, she said, it gives your partner zero incentive to overcome their anxiety. And, secondly, it sends the message that there really is something to fear, which only fuels their anxiety.

3. Set boundaries.

Your partner might continue asking for accommodations, such as having you drive everywhere or regularly stay home with them, Thieda said. “You have the right to have a life, too, and this may mean telling your partner on occasion, and in a loving way, that you are going to do what you want and need to do.”

In her book Thieda devotes an entire chapter to effectively communicating this to your partner. Essentially, she suggests being empathetic, using “I” statements and giving specific requests.

For instance, she gives the following examples: Instead of saying, “You worry too much about what other people think of you,” you might say, “I’m concerned that your fears about what others think of you are holding you back at work.”

Instead of saying, “Don’t call me at work so much,” you might say, “It would be helpful if you would try some of the techniques you’ve learned for calming yourself down before calling me at the office.”

Also, “always consider whether a compromise is possible, but also recognize that you have the right to do things independently,” she said.

4. Relax together.

There are many techniques you can try together to alleviate anxiety. According to Thieda, “The body scan is a great couples mindfulness technique because one person can guide the other through the process.”

This promotes mindfulness for both partners. The partner giving instructions needs to pay attention to timing and the specific directions, she said. And the partner receiving the instructions needs to pay attention to each body part and releasing its tension, she said. (Here’s a sample body scan.)

5. Focus on your own care.

According to Thieda in her book, “When you live with an anxious partner, there can be a lot of tension in your relationship and in your home. Having self-care routines and plans in place can help you neutralize the static.”

Consider what you’re already “doing to promote physical, spiritual, mental, emotional, professional, and relationship health,” Thieda said. Assessing where you are helps you better understand where you need to go. For instance, you might want to set goals about improving your health or seek support from others, she said. You might want to work with a therapist or attend support groups.

What to Do When Your Partner Refuses Treatment

Anxiety is highly treatable. But your partner might not want to seek professional help. Thieda suggested considering the reasons behind their refusal.

For instance, they might’ve tried treatment before but it didn’t work. One reason treatment “fails” is because it’s not the right treatment for the person’s anxiety. According to Thieda, “It is best to work with a professional who uses cognitive-behavioral therapy techniques and is specifically trained in working with people who struggle with anxiety.”

They might’ve tried medication or psychotherapy alone, but they’d do better with a combination of treatments, she said. It’s also possible that your partner tried to take on too much, and ended up feeling even more anxious. “Maybe they need to approach their treatment in a different way, breaking down the challenges into smaller, more manageable pieces.”

Ultimately, the decision to seek treatment rests with your partner, Thieda said. “No amount of begging, pleading, or threatening is going to be effective, and will likely make things worse.”

The best thing you can do is to be supportive, encouraging and loving when they do decide to seek help, she said.

Having a spouse who’s struggling with anxiety can naturally become stressful for partners. But while this can be challenging, by educating yourself, setting healthy boundaries and practicing self-care, you can truly help your spouse and your relationship.

The art of blaming situations, people, and events for the quality of our own lives is a skill we acquire as a child. Children however, do not start out lying and blaming others. In fact, children generally begin by blaming themselves for the poor behavior of others. A child will eventually learn to lie because it eases the pain of what he or she has done, or what he or she is experiencing. (Lying is therefore a mood changing behavior and can become habit forming.)

For example, a child will break something and generally feel bad even though they might not look that way to others when the incident is first discovered. The broken object is now of less value. Even worse, the child may also feel like he or she are of less personal value as well, because he or she had failed to properly care for the object that is now broken.

This experience is painful enough for a child to endure without the hurtful consequences often imposed by adults. The toy is no longer the same and the child feels bad that they were unable to take care of it in the way that he or she had imagined they could. It can get even worse when others who have no knowledge of how the toy has broken discover the losses. If the child who broke the toy is emotionally shut down or fragmented, he or she will fail to take responsibility for the broken object and the blame game will begin. It is most likely that others will want to assign the responsibility to someone.

Assigning responsibility usually comes in form of blame and generally is accompanied by shame. You can see this for yourself in the following case example:

Mom: John, do not run when you are carrying that piggy bank!

John: Thinks to himself – what the heck, I can do it – I can do anything!

Sound: C R A S H

Mom: John!!!! How could you? Your grandmother just brought you that piggy bank. You should be ashamed of yourself. You are going to be the death of me!

John: It dropped. I did not do it. I don’t care about some dumb piggy bank anyway. Where is the candy? I am hungry! There is never any food in this house.

A child says, “It broke” and an adult, provided he or she has become an adult, says, “I broke it.” The child is failing to take responsibility. The adult is accepting responsibility. If however, we as adults continue to shirk responsibility for our own lives, our own feelings, and our own behaviors, we will inevitably need to assign the responsibility to someone. We look outside of ourselves. We blame.

If we are to grow in our romantic relationships we are going to need to avoid blaming, lying, and hurting. While the tendency to look outside ourselves for the cause of our own discomfort is a character defect that many of us acquired as children, unfortunately it has become as ineffective for us as adults as any other addictive behavior or drug of choice.

This is because we blame others when the perceived or real costs for appearing “wrong” are frighteningly high. During these high-stakes moments in childhood, and then in adulthood as well, many of us discovered that lying would ease the pain of what we have done. The “drug like” behavior of deceiving others, and eventually ourselves, became a “first addiction” for those of us who have perfected the art of self-justification. Yes, blaming and diverting responsibility away from ourselves sometimes appears to be an addiction in its own right.

Intimacy is about openness, honesty, and vulnerability. An inadequately treated addiction however, will erode each one of those features of true intimacy. If we are to create and maintain a true lasting relationship with our partner, we will need to be free of our dependence on blaming others – especially our partner – for our own thoughts, feelings, and behaviors. We need to break our habit of lying to ourselves and to others. We must take responsibility for our own lives and decisions so that we can bring our true selves to each other in open and vulnerable honesty.

This article was written by John & Elaine Leadem, senior supervisors of the Leadem Counseling & Consulting offices in Toms River, NJ and East Brunswick, NJ. The content of this article is based on the recently published book from Leadem Counseling: “Ounce of Prevention: A Course in Relapse Prevention.”

By Jennine Estes, MFT 47653 .
If you recognize any of these excuses, here’s why you should go to counseling anyway.
Going to counseling can be a scary concept, so if you’re avoiding it — you’re not alone. You might wonder if counseling will work, what it means about your relationship that you want a mediator, and if the financial investment is really worth it. People put off finding counseling for plenty of reasons, but the truth is that you don’t have to be ashamed about wanting help, and putting it off can likely make your situation worse. Here are some of the main reasons people avoid counseling.

10. The Financial Aspect: Yes, coming to counseling will cost money. Think of counseling as an investment in your life, whether it’s individual counseling or couples counseling. It’s OK to put yourself first and spend money getting back on track — it’s worth it in the long run.

9. Horror Stories: Sometimes you might a story from a friend or other loved one about counseling gone bad. Maybe your friend left counseling feeling that it didn’t work, or your sister says she had a therapist who wouldn’t really listen to her. It can be hard to be motivated to go to counseling yourself when you’ve heard a bad story. Counseling is different for each person, and it’s important not to let someone else’s bad experience steer you clear of counseling.

8. Bad Previous Experience: Maybe you haven’t hear horror stories from others, but you yourself have gone to counseling before and didn’t think it helped you. Remember that each counselor is different, and many use entirely different styles and theories. Instead of writing off all counseling, look for a counselor who uses a different approach than your previous counselor.

7. It’s Only for “Crazy” People: No, counseling isn’t just for crazy people, or couples who are totally dysfunctional. Counseling can address so many issues, and is really just a safe space to talk freely about what you’re going through and get help moving forward. It can benefit almost anyone who needs to figure out the reason behind bad feelings or troubled communication.

6. Privacy Concerns: If you’re a private or reserved person, it seems intimidating to open up in front of a complete stranger, it’s true. You might also have reservations about repeating personal conversations. However, a good counselor will make you feel comfortable, and over time you can actually feel quite safe about being honest in counseling. And, of course, any thing you say in counseling is completely confidential and won’t be repeated.

5. Other Peoples’ Opinions: Even if you don’t announce that you’re going to counseling, at some point your friends and family may find out you are going to counseling, and it’s easy to be anxious about what they’ll think. In reality, counseling is about your personal development, and you might be surprised that people who love you are totally supportive about you wanting to improve yourself. Even if other people judge you in a negative way, the benefits of counseling outweigh listening to a negative opinion about it.

4. Asking For Help is Hard: If you pride yourself on being self-sufficient, stepping into a counselor’s office might feel like you’re letting yourself down. You might think you can handle your problems on your own, and asking for help means you’re weak. On the contrary — counseling helps you build a stronger self-esteem and learn new tools for handling whatever life throws at you. You’re not weak for reaching out!

3. It’s Overwhelming: The thought of tackling a big problem is overwhelming, so you might procrastinate going to counseling or avoid it altogether. This won’t make your problems disappear, however, and things might get a whole lot worse. Your counselor will help you tackle issues piece by piece, and give you realistic goals so you won’t be overwhelmed.

2. Drudging Up the Past is Scary: Bringing up past hurt isn’t fun, and the thought of going as far back as childhood might be a deal breaker for people considering counseling. Yes, you will probably have to bring up some past issues in counseling. But keep in mind that these issues will be there whether you enter counseling or not — at least when you go to counseling you can start to work through them. Pretending that past hurt doesn’t matter anymore won’t make it go away.

1. Small Problems Don’t Require Counseling: Many people think your problems must be HUGE before you go to counseling. So, they put off seeking help because it seems silly to go to counseling over what they conceive to be a minor issue. The thing is, small problems can snowball into big ones. It often makes sense to get counseling if you have a problem that is haunting you or your relationship, no matter how minor, so you can prevent it from getting bigger.

What Is Dyslexia?
Dyslexia is a chronic reading problem. It is a very common learning difficulty, affecting a large percentage of those labeled “learning disabled.” According to the National Institutes of Health, up to 15% of the U.S. population has significant difficulty learning to read. People with a learning difference like dyslexia may have trouble with reading, writing, spelling, math, and sometimes, music. Three times as many boys as girls have dyslexia.

Most people think dyslexia is a condition that involves reading from right to left and reversing words and letters. While some people with dyslexia do have these problems, they are not the most common or most important characteristics of dyslexia. Experts say dyslexia has little to do with recognizing the visual form of words; rather, the brains of people with dyslexia are wired differently, making it difficult for them to break the letters of written words into the distinct sounds (or phonemes) of their language, a capability called phonological awareness.

Diagnosis and Treatment

Dyslexia can occur at any level of intellectual ability. Sometimes children with dyslexia appear to their teachers and parents to lack motivation or not to be trying hard enough. Dyslexia may be accompanied by — but is not a result of — lack of motivation, emotional or behavioral problems, and sensory impairment.

A more positive view of dyslexia describes people with dyslexia as visual, multidimensional thinkers who are intuitive, highly creative, and excel at hands-on learning. Many dyslexic people shine in the arts, creativity, design, computing, and lateral thinking.

What Causes Dyslexia?
Dyslexia tends to run in families, and researchers have identified the genes that may be responsible for the condition.

Scientists have also found specific brain differences involved in dyslexia. Brain images show that dyslexia results from certain structural differences in the brain, particularly in the left hemisphere.

Brains of people with dyslexia show very little activity in areas known to be highly important in linking the written form of words with their phonetic components. So in order to read, people with dyslexia must develop alternative neurological pathways. They compensate by making more use of a front-brain section called Broca’s area, traditionally associated with other aspects of language processing and speech.

By Heather Hatfield
WebMD FeatureReviewed by Hansa D. Bhargava, MDTalking with your child about his ADHD isn’t always easy. But it’s important to do, and it goes better if you keep it productive and positive.

“I have two children with ADHD, so I can speak from experience here,” says Terry Dickson, MD, director of the Behavioral Medicine Clinic of NW Michigan, and an ADHD coach. “The reason why you need to talk about your child’s ADHD with him directly is because you want them to be involved, to understand, and to be on board.”

These eight tips will help you talk about it.

ADHD in Children
Start Talking
When you find out your child has ADHD, that’s the time to start communicating with them about it.

“It’s never too early to start talking with your child about his ADHD,” says Patricia Collins, PhD, director of the Psychoeducational Clinic at North Carolina State University.

You’ll talk about it many times as your child grows and develops. Start having those talks as early as possible.

A good approach is to help your child understand what ADHD means, what it doesn’t mean, and how to be successful at school and in life. What you say should be appropriate for their age.

“You need to help your child feel special, and like he is part of the plan,” Dickinson says. “He should feel like he is involved.”

1. DO make sure your child feels loved and accepted.
Help him understand that ADHD has nothing to do with his intelligence or his ability, and it’s not a flaw, Dickson says.

2. DO pick the discussion time wisely.
“It should be a time when you are unlikely to be interrupted,” Collins says.

Try to pick a time when your child isn’t eager to do something else, like playing outside or before dinner or bed.

Leave some time for follow-up, so you’re available to the child after the conversation is over if he has extra questions.

3. DO let them know they’re not alone.
Many other people have ADHD, too, and everyone with ADHD can be successful.

Give your child examples of people who have or had ADHD that they might know, like Walt Disney, Michael Phelps, and designer Tommy Hilfiger.

Let your child know they are special and they can succeed as well as anyone else.

4. DO learn more about ADHD.
Talk to your doctor, reach out to advocacy groups, and find support groups in your area.

“One of the best things you can do is talk to other parents who already have experience with ADHD about what they’ve learned,” Collins says.

5. DON’T focus on the negative.
“Focus on their strengths, what they do well, and praise their accomplishments,” Dickinson says.

“Whether its sports, arts, or dance, they can pursue their interests and do well with your support.”

6. DON’T let your kids use their ADHD as an excuse.
“Kids can’t take the easy way out by blaming their setbacks on their ADHD,” Collins says.

“Parents need to help their child understand that ADHD is not a reason to not turn in homework, to not try their hardest, or to give up.”

7. DON’T expect instant interest.
Don’t be surprised if your child doesn’t respond immediately or seems uninterested, Collins says.

It takes some children, particularly younger ones, some time for new information to make sense, or for them to know what questions to ask.

8. DO maintain open communication.
“One conversation is just the beginning,” Dickinson says.

“Keep the dialogue going, talk about school, their friends, homework, extracurricular activities, and keep a positive attitude.”

All day long we’re surrounded by faces. We see them on the subway sitting two by two, pass them on the sidewalk as we make our way to work, then nod to them in the elevator.

But most of those faces don’t tell us much about the emotional life of the person behind the face.

“People don’t just go around the world smiling or grimacing or frowning,” says psychologist Marcus Munafo of the University of Bristol. “The majority of the facial expressions that you come into contact with — people walking past you in the street, for example — will be ambiguous to some extent.” And because most of the faces we encounter are emotionally ambiguous, we’re forced into interpretations. Does the expression of that man coming toward you have the smallest tinge of threat around the eyes. Or is that just surprise?

“When you see someone just looking relatively neutral,” Munafo explains, “then it’s really down to you which of those interpretations you choose, and different groups of people see different things.” Research has shown that when depressed people look out at the ambiguous faces around them, they see sadness in those faces more often than people who are not depressed. People with anxiety see fear. But it’s people with aggression that particularly interested Munafo and a group of his colleagues in the U.K.

“People with aggression show a tendency to interpret ambiguity as reflecting hostility,” Munafo says.

Which makes sense. “If you’ve grown up in a tough environment where actually a lot of the time people are out to get you, then that default assumption is probably a relatively safe assumption to make,” Munafo points out. “The problem is when you take that assumption into a more benign environment, into the wider world, if you like, and start responding inappropriately to people who have no hostile intent.”

Then the strategy that you developed to help you survive becomes a kind of prison. You see aggression everywhere and respond aggressively, which causes the people around you to actually be aggressive, even if they didn’t begin that way. It’s a vicious cycle. So is there some way to alter the cycle? To retune the perceptual biases that aggressive people carry into the world?

Munafo and his colleagues designed an experiment to find out. The results were published in a recent issue of the journal Psychological Science. Their experiment took place in a youth program for troubled teens, two-thirds of whom already had some kind of criminal conviction.

There they set up an intervention that attempted to retrain the way those kids interpreted faces. To begin, the kids were placed at computers and asked to identify the emotions in a series of faces that flashed on the screen. Some of the faces were clearly happy, and some were clearly angry; but most were somewhere in the middle. “There were 15 faces along the continuum,” Munafo says, “and people were simply asked to judge whether that face was happy or angry.”

In the first round, the goal was simply to identify the point on the continuum where each teen stopped seeing happiness in an ambiguous face and started seeing anger — in other words, their set point. Next the teens were divided into two groups. One group essentially got no treatment; in the other, the researchers attempted to shift the point on the continuum where they started seeing angry faces.

To try to retrain troubled teens to reinterpret facial expressions, researchers showed them images of happy, angry and neutral faces, and then gave them feedback on how they described them. To try to retrain troubled teens to reinterpret facial expressions, researchers showed them images of happy, angry and neutral faces, and then gave them feedback on how they described them. To try to retrain troubled teens to reinterpret facial expressions, researchers showed them images of happy, angry and neutral faces, and then gave them feedback on how they described them. They did this by showing the kids the same faces in the same way, only after each face, they were given feedback.

Here’s the trick: For two of the faces that they previously described as angry, if they called them angry again, the feedback informed them that they were mistaken: It wasn’t an angry face, it was a happy face.

For a week, day after day, the kids looked at the faces again and again, relearning which faces were angry and which were happy. Then the researchers tracked the number of aggressive incidents the kids were involved in. For weeks, they followed both the kids who got the treatment and the kids who didn’t. The staff at the program evaluated each teen without knowing whether or not they had been retrained. What they found surprised them.

The kids who had been trained to visually see differently interacted with the world in a different way: They came at the world with less aggression. “There was a 30 percent difference between the two groups,” Munafo says.

In fact, researchers have been trying this approach — of modifying visual biases — in people with anxiety and depression, and have gotten similar results. Ian Penton-Voak, another psychologist, says the value of the work is clear. “It demonstrates that the way you see the emotional world around you affects your behavior in a kind of causal way,” he says. That’s an insight the researchers hope might ultimately lead to new interventions.

In case you missed it, Rock Center with Brian Williams did a fantastic story on Adult ADHD this past Friday. The piece focused on what it’s like for an adult with undiagnosed ADHD, and also touched on how things can change for the better with treatment.

It’s rare to see a story in the media (especially one on a popular network program) take such a personal approach to ADHD and the adults who have been diagnosed with it. I was pleasantly surprised to see that no one was villianized in this story; not the adults with ADHD, not the doctors who diagnose it, and not the pharmaceutical companies who make the medicines that treat it. Instead, we got a glimpse into the lives of real people, and that is refreshing.

I highly recommend taking the time to view this video, and taking the time to pass it along, too!

http://www.nbcnews.com/video/rock-center/51448675#51448675

So, should ADHD kids be made to sit still?

I would say probably not; however, that doesn’t mean just letting them bounce off the walls. I encourage parents to find strategies that fit these two categories. It definitely requires more creativity, but there are so many ways available now to help kids learn and focus better, without requiring them to sit still during boring tasks. Here are three of my favorite products. (Note: I am not affiliated with any of these companies, nor have I received any sort of compensation whatsoever for mentioning these products. I just think they are really cool!)

The Safco AlphaBetter® Desk is standing desk with a swinging foot bar. This combines several great ideas. First, standing helps many people focus better on their work. The foot bar incorporates a movement strategy, that is much less annoying that foot tapping. Third, there is a chair as well so kids can sit and stand alternatively. It’s not cheap ($300-450), compared to regular school desks ($100-150), but I think many parents and teachers can see the advantages of a standing desk like this one.

The Time Tracker from Learning Resources is a visual timer that helps kids see how much time is left. The visual aspect can help them remain on task better, and fidget less, especially if they know that the end of a boring task is coming soon. I’ve seen this priced around $35 usually. Learning Resources also makes a Time Tracker “mini” version that is only $14.

The Sunrise System Alarm Clock is probably one of the best things I’ve ever bought myself. This clock hooks up to a bedside lamp and mimics the sunrise in the morning over 45 minutes or so, and comes with a back up buzzer alarm as well. Adding more light in the morning, gradually, will help the ADHDer who struggles to wake up in the morning. It’s a little pricey ($99), but provides much more light via a lamp than other sunrise clocks that have a built in light.
- See more at: http://www.spectrumpsychological.net/1/post/2013/04/adhd-tips-for-parents-should-they-sit-still.html#sthash.p0QkPfBk.dpuf

Disorder often goes undiagnosed in adults, but it’s quite common and can cause big lifestyle problems

By Linda Lewis Griffith — Special to The Tribune

A recent study published in the journal Pediatrics reports that two-thirds of children diagnosed with ADHD continue to have symptoms into adulthood. A problem that was once thought to disappear with maturity not only interferes with adult sufferers’ functioning but is often accompanied by other serious psychiatric illnesses.

This information may be startling to the general public. But it’s old news to the estimated 8 million men and women already grappling with the disorder.

Adult ADHD often flies under the diagnostic radar because it presents itself differently at different stages of life. For instance, children diagnosed with ADHD may be easily distracted or have difficulty following directions. They may have trouble sitting still, find it hard to wait their turn or blurt out answers in the classroom. On the other hand, adults with ADHD might put things off until the last minute or fail to follow through on work or family commitments. They report feeling restless and impatient, always needing to be on the go, even when they’re on vacation. They frequently interrupt others’ sentences and have problems maintaining relationships.

Other symptoms of adult ADHD include poor listening skills, difficulty starting a task, chronic lateness, angry outbursts and an inability to establish priorities. Adults with ADHD are also apt to have problems managing money, be involved in frequent traffic violations and impulsively change jobs.

Research conducted by Dr. William Barbaresi, director of the Developmental Medicine Center at Boston Children’s Hospital, found that adults with ADHD were five times more likely to commit suicide. More than 25 percent of those who had ADHD and another mental disorder abused alcohol; 16 percent abused other substances. Personality disorders and mood disorders, such as anxiety and depression, were also common.

Treatment for adult ADHD involves a multifaceted approach. Stimulant medications, such Ritalin, Adderal and Vyvanse, are commonly prescribed. Anti-depressants such as Wellbutrin and Effexor are also used. Equally important are behavioral and environmental changes as well as counseling and marital therapy.

Linda Lewis Griffith is a local marriage and family therapist. For information or to contact her, visit http://indalewisgriffith.com.

TRY THESE STEPS TO HELP MANAGE YOUR ADULT ADHD

• Follow a routine. Your life is inherently chaotic. You need to impose structure and control from the outside. Eat meals at regular times. Develop a regular sleep routine. Exercise at set times throughout the week.

• Purchase a date book. Write down every activity you perform during your week. Carry it with you wherever you go so you can add and refer to it often.

• Make lists. Write down everything you need to accomplish each day. Put the most important items at the top. Check tasks off as they’re completed.

• Keep a notepad handy. Details are apt to slip your mind. So it’s helpful to jot notes to jog your memory. For instance, write down where you parked your car or that you drive the carpool at 2:45.

• Avoid clutter. Prevent clutter by throwing away items you’re not using and tidying your desk at the end of each day. If clutter is already a problem, designate time to tackle one specific area. Or ask help from a friend or loved one to help you stay on track.

• Put things in the same place. Avoid the stress of looking for lost items by creating a home in which everything lives. Put your keys in a bowl on your dresser. Hang your purse on the back of the chair.

• Break tasks down to a manageable size. It’s easy to feel overwhelmed and then avoid those chores that feel daunting. Instead, decide on a first step that you can accomplish. When that’s completed, move on to step two.

• Use an alarm clock, watch or timer. Punctuality is not your strong suit. Timers ensure you’re always on time or don’t get distracted. Set your alarm clock to get up in the morning. Program your cellphone to alert you of impending meetings. Set a timer to ring when you’ve spent 20 minutes on the Internet.

• Avoid credit card debt. Credit cards can entice you to spend money that you don’t have. If you do use credit cards, pay your full balance every month. If you’re frequently in financial trouble because of your cards, pay off your debt as quickly as possible, then cut up the cards and pay cash.

• Exercise. Exercise decreases stress and anxiety and enhances your mood. It improves impulse control and reduces compulsive behavior.

• Get counseling. Knowledgeable therapists can help you create personal structure and devise strategies for decreasing your symptoms. They’ll also hold you accountable for the changes you’ve committed to making.

Read more here: http://www.sanluisobispo.com/2013/04/09/2462328/when-adhd-grows-up.html#storylink=cpy

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on April 9, 2013

Autistic Kids Tend to Imitate ‘Efficiently,’ Not ‘Socially’ Normally, kids copying adult behavior will go out of their way to repeat each and every element of the behavior even if they realize parts of it don’t make any sense.

But a new study shows that when a child with autism copies the actions of an adult, he or she is likely to omit anything “silly” about what they’ve just seen.

Researcher say the findings, reported in the journal Current Biology, are the first to show that the social nature of imitation is very important — and challenging for children with autism. They also emphasize just how important it is for most children to be like other people.

“The data suggest that children with autism do things efficiently rather than socially, whereas typical children do things socially rather than efficiently,” said Antonia Hamilton, Ph.D., of the University of Nottingham.

“We find that typical children copy everything an adult does, whereas autistic children only do the actions they really need to do.”

The researchers made the discovery after testing 31 children with autism spectrum conditions and 30 typically developing children who were matched for verbal mental age.

On each of five trials, each child was asked to watch carefully as a demonstrator showed how to retrieve a toy from a box or build a simple object. Importantly, each demonstration included two necessary actions (e.g. unclipping and removing the box lid) and one unnecessary action (e.g. tapping the top of the box twice).

The box was then reset behind a screen and handed to the child, who was instructed to “get or make the toy as fast as you can.” They were not specifically told to copy the behavior they’d just seen.

Investigators discovered almost all of the children successfully reached the goal of getting or making the toy, but typically developing children were much more likely to include the unnecessary step as they did so, a behavior known as overimitation.

Those children copied 43 to 57 percent of the unnecessary actions, compared to 22 percent in the children with autism. That’s despite the fact that the children correctly identified the tapping action as “silly,” not “sensible.”

Researchers now plan to investigate precisely what kind of actions children copy, and how that tendency to copy everything might contribute to human cultural transmission of knowledge.

Hamilton said parents and teachers should be aware of the social value in going beyond the successful completion of such tasks.

By Rick Nauert PhD Senior News Editor
Age appears to play a critical factor for the development of pathological gambling, and the clinical course the addiction may follow.

In a new study, researchers reviewed more than 2,300 patients aged from 17 to 86 years and discovered that some personality traits associated with age are risk factors in different stages of life.

For example, younger patients (from 17 to 35 years) are more likely to be impulsive and seek new sensations that act as precipitating factors of gambling.

In contrast, older patients (from 55 to 86 years) are less impulsive and thrill-seeking yet more likely to have risk factors such as anxiety and excessive worrying.

“Older people do not gamble to seek awards or for the challenge of winning or for competitiveness as young people do, but they gamble to modulate negative emotional states,” said Susana Jiménez-Murcia, Ph.D., lead researcher.

“Older patients try to flee from loneliness, dissatisfaction or even physical discomfort.”

“The only personality factor that does not vary with age is self-direction, the ability to take control of our lives, to be persistent with a goal,” said Jiménez-Murcia.

Researchers believe the current study confirms that self-direction “is low at all stages and that could be one of the keys to the treatment and prevention of the disorder.”

Investigators discovered young patients are associated with a higher severity in their gambling conduct. “Early intervention in these patients allows us to understand the causes of the problem in the early stages and we can give to patients tools to control it.”

A key finding from the study is that pathological gambling is a temporary and episodic condition in patient’s life.

“We observe,” Jimenez said, “that at certain times of the life, some social, environmental and personal factors can ease to control this behavior but in other moments it is not so easy, and the psychopathology could be more serious. But the good news is that it is not a chronic disorder for life.”

For individuals aged from 55 to 86 years, the gambling addiction is associated with health problems, while in middle age the disorder is associated with economic problems.

Gender also is a variable in the presentation of the addiction as researchers detected a later gambling onset in women, from 35 to 40 years, while men begin to gamble younger.

Gambling has also changed with the times as recent profiles reflect online gambling opportunities.

“We see younger, college-educated and higher socioeconomic level patients. We must continue working to promote responsible gaming and also to inform of the potential risk of gambling.”

Source: IDIBELL-Bellvitge Biomedical Research Institute

Individuals with ADD and ADHD have a tendency towards addictive behavior. As I wrote in an earlier piece on gambling, addictive and impulsive behaviors are common place for people with ADD/ADHD. Last October, scientists from McGill University in Canada released a study suggesting that there’s a genetic link between childhood ADHD and heavy tobacco consumption as an adult (McGill University Study). The study also goes on to explain how it is important for people with ADD/ADHD to identify programs that are catered to the individual if he or she is looking to quit.

So does this mean that a child with ADD/ADHD is going to run to his or her local store and buy cigarettes the rest of his or her life? Obviously not, but what it does tell us and helps us to understand is that there’s a little more to this than just being addicted to nicotine. We need to look at this from a bigger-picture standpoint. If individuals with ADD/ADHD are more-likely to smoke when he or she gets older (from a genetic and scientific perspective), than the problem goes much deeper than just saying no. But at the same time, just because one’s genetically more likely to take on an activity doesn’t mean he or she is going to do it.

With my clients that have expressed an interest in quitting tobacco use, I always suggest he or she starts slow. Instead of stopping, cut down. Set short-term and achievable goals aimed at eventually stopping the activity. For example, if an individual smokes a pack-a-day, start by smoking three less cigarettes a day for one week. If that is successful, make it six less for the next week. And so on and so forth. If a goal is set to quit smoking with no real plan, it is almost-always going to fail. Approach quitting smoking gradually and with achievable goals. There will be slip-ups, but try to hold to your goal as well as you can.

For more information on my ADD, ADHD and Executive Functioning coaching, please visit www.adhdcoachchicago.com. To learn more information about some of the other services I provide, please visit www.carrolleducationalgroup.com and www.iepexperts.com. I can be found on Twitter at ADHDEFCoach. You can also find me on Facebook, Google Plus and Tumblr. My good friend and fellow ADD/ADHD Coach Tara McGillicuddy invites me as a regular guest on ADD/ADHD Support Talk Radio. Tara does many wonderful things and you should check out her website here. Feel free to email me at jonathan@adhdefcoach.com or call 773.888.ADHD (2343) with any additional questions.

Posted on Wednesday, April 11, 2012 9:58 AM

Earlier this week I blogged about a practical alternative which I regularly offer to individuals and families who have questions about ADHD and related disorders, but aren’t sure they’re ready to spring for a full neuropsychological evaluation. The next post here at this blog was a consideration of how to determine when such evaluation is in fact right for you or your family member.

So what happens after a neuropsychological evaluation? After all the testing and scoring and writing up the results…what next?

The Feedback Session

As much as I enjoy (I really do!) administering the various tests which make up the neuropsychological battery, and as interesting as it is to score these tests and look at the pattern of strengths and weaknesses, the real heart of the neuropsychological evaluation is the Feedback Session.

Usually scheduled a week or two after the evaluation is complete (you’ll need a chance to breathe!), the feedback session offers the client and his spouse or parents a chance to review the test scores with the neuropsychologist and “make sense of the scores” together.

In the Feedback Session, I’ll explain how a neuropsychologist thinks about these tests and scores and how I pull this data together to answer referral questions. In the Feedback Session we’ll connect the dots – I’ll relate your chief concerns to my own mental status exam observations and to the test scores. We’ll identify patterns of strengths and weaknesses among test scores and relate those patterns to know patterns of brain-behavior relationships in the scientific literature. (There are identifiable patterns among neuropsychological test data which suggest, for example, ADHD or dementia or brain injury or depression-related concentration problems.)

Feedback Session data typically fall into three categories:

1.It confirms what the client already knew or suspected about him/herself;
2.It challenges the client to see him/herself in a new way, but seems reasonable or acceptable or “true”;
3.It just doesn’t seem to fit – the client says “nope, I don’t think that fits the picture for me, doesn’t seem consistent with my experience of myself.”

When my clients reject feedback data, I assume that maybe they’re right or maybe they’re not ready to hear that feedback about themselves just yet. Either way, we don’t focus on feedback data that falls into category #3. We focus on that second category – feedback which the client can accept, but which “pushes” him/her a bit, and offers a new way of seeing himself or moving towards treatment or rehabilitation or supports.We typically consider two or three next steps. As a result of this feedback, what are you going to do next? What are you going to do differently? What will help? We set specific behavioral goals and agree to meet again for the Followup Feedback Session.

The Followup Feedback Session

A unique feature (as far as I know) of my own evaluations is the Followup Feedback Session scheduled for 6-8 weeks after the first feedback meeting. This second feedback session allows the client, his family, and I to “check in” and see what they might have missed from the first feedback hour, and what they need to review.

The Followup Feedback Session builds in a bit of accountability. Did the client do what he said he/she was going to do as a result of the first feedback visit? If so – how is it working out? And if not – why not, what obstacles have prevented that follow-through? At the Followup Feedback Session the client and her spouse or parents have had a chance to review my report and offer any comments or feedback to me, or to clarify any remaining questions.

What recommendations might follow a neuropsychological evaluation for attentional or learning problems?

Speaking with a mom who was considering neuropsychological evaluation for her son, I indicated that I try to write jargon-free reports which are user-friendly for parents, doctors, teachers, and therapists. I also let her know that I don’t presume to tell pediatricians how to do medicine, or to suggest to occupational therapists how to plan OT interventions. And I don’t tell educators how to do curriculum planning or how to teach. At this point, mom asked, “Hmmm, what do you recommend then, David, after your evaluation?” It was a good question, and the answer depends on the type and severity of neurocognitive deficit identified in the evaluation. But some interventions which might follow my evaluation include:

•preferential seating for the distracted student
•frequent checks for understanding (by the teacher) for a student with auditory processing problems
•use of multi-sensory teaching styles for students with auditory processing problems or easy distractibility
•reduced homework assignments (as permitted by classroom objectives) for a student with speed of information processing challenges
•”buddy system” with either younger students (to give the child the experience of teaching) or older students (to give a child the experience of learning from a slightly more mature student who has mastered navigating lockers and hallways and other “executive” challenges outside the classroom)
•considering special education services (for students with adhd, learning disability, or general developmental delay)
•considering Section 504 services (for the same students noted above)
•considering state agency support (for students with documented head injury or students with developmental delay)
•involvement of occupational therapy (for students with sensory overload, or students who need more sensory input throughout the day)
•involvement of speech/language services (for students with developmental articulation problems or with “language pragmatics” problems associated with autistic spectrum disorder)
•allowing alternate ways of turning in homework (google docs, memory sticks, faxing at start of day, etc).
•use of FM system (lapel microphone) for students with central or peripheral hearing/auditory impairment
•regular teacher-family communication re: homework details (for students who “lie” or “forget” about homework assignements as a way of avoiding hard work)

None of these recommendations is appropriate for every student with a particular diagnosis, and some of them might even be a bad idea for a particular student. That’s why any recommendation should flow logically from the findings of neuropsychological evaluation. For each recommendation, I ought to be able to answer a question like “why do you think this strategy would work for this student?”

By Margarita Tartakovsky, M.S.
Associate Editor

3 Handy Ways to Help Your Child Overcome Negative Thinking Negative thinking isn’t something that just plagues adults. It also plagues kids.

In the book Freeing Your Child From Negative Thinking: Powerful Practical Strategies to Build a Lifetime of Resilience, Flexibility and Happiness, child psychologist Tamar E. Chansky, Ph.D, writes that for kids with a “negative thinking bias,” negative thoughts become “the default, the first, last and final word.”

Kids simply don’t realize that they have a choice in whether they internalize these thoughts. Instead, they start to see these inaccurate beliefs as absolute truths.

Fortunately, Chansky says that parents can help! Whether your child expresses negative thoughts occasionally or on a regular basis, you can help them overcome these harmful patterns of thinking. Below are three activities to try with your kids.

Spotting Negative Thoughts

But first, in order to tackle negative thoughts, you have to be able to spot them. Chansky provides this list of red flags.
•Exaggerating and extending the importance of an adverse event
•Blaming self for something that was caused by external circumstances; blaming big for small things
•Generalizing that whatever happened always happens
•Becoming easily angry with self
•Not trying activities unless sure can excel
•Thinking bad things always happen, good things never happen
•Trouble tolerating mistakes, disappointment or losing
•Shutting down in the face of any obstacle

Strategies

1. Distinguishing between negative and accurate thoughts

For kids, telling the difference between negative and more accurate thoughts is tough. (It’s tough enough for adults!)

One simple way to help young kids make the distinction is by using stuffed animals to represent each line of thinking. Chansky says: “The cranky puppy and the happy bear can both be looking at the same situation—spilling the milk—and have two very different versions of the story.”

If your child is older, take a piece of paper and draw a line down the middle. On one side, write “Negative Thoughts or “Meany Brain Thoughts.” On the other side, write “My Good Thoughts” or “Smart Thoughts.”

2. Becoming an optimistic thinker

Cultivating optimism in kids also is key in addressing negative thinking. Chansky gives a good example in her book. Say two kids are at an ice cream shop and their rocky road slips off the cone. One exclaims, “It wasn’t on right, so it fell. I want another one.” The other child says, “Why does this always happen to me? This store always does it wrong. Everything’s ruined. This is the worst day of my life.”

In the first example, the optimistic child relays the facts and sees a solution for the problem. However, the pessimistic child “inserts extraneous material from outside the script, attributing intention, permanency and a global quality to something that was a small accident, plain and simple.” (Which might sound familiar to many of us adults!)

Parents can play the “Unfortunately, Fortunately” game with their kids. Together with your child, come up with “five sticky situations,” which you write down on cards and put in a hat. Each person then pulls out a card and says the unfortunate situation (Chansky uses the example: “Unfortunately, the movie I wanted to see was sold out”). The other person responds with a fortunate perspective (“But fortunately, I went to see another movie”). Then you go back and forth, each mentioning unfortunate and fortunate circumstances.

The next time your child is going through a difficult situation, you might say, according to Chansky, “There are a lot of ‘unfortunatelys’ stacking up. Can we see if there are any ‘fortunatelys’ in this situation?”

3. Building distance from negative thoughts

It’s also important to help your child get “some distance and perspective” on a situation. To do so, avoid saying that they’re being negative. Instead, blame the “negative brain.” (This also makes you an ally, Chansky says, in helping defend your child against this “troublesome third party of Mr. No—the real bad guy ruining her day.”)

According to Chansky, this relabeling “begins to demote the validity of negative thinking, encouraging the child to not trust it as the ‘truth,’ but as the annoying, upsetting, overprotective or just sort of ill-informed voice that it is.”

Ask your child to pick a name for their negative brain. Chansky gives the following examples: Mr. Sad, Meany Mouse, Fun Blocker. Have them draw the character and create a voice, too. Plus, they can brainstorm ways to talk back to that negative brain: “You’re not the boss of me; you make me feel bad; I’m not listening to you; you see everything as awful; you need new glasses!”

Chansky also has a suggestion on how to initiate the chat with your child about creating the negative brain character. You might say: “Remember when you said you were ‘stupid’ because you drew on the table by accident? You don’t feel that way now, right? But what would you call that voice in your head that made you feel that way then?”

In general, the goal isn’t to halt, deny or fight negative thoughts, Chansky says. Instead, she writes (by the way, an important lesson not just for kids!):

New research suggests that drinking soda, especially diet soda, is associated with an increased risk of depression.
WEDNESDAY, Jan. 9, 2013 — Just under half of all Americans reported drinking at least one glass of soda per day, while two-thirds said they drink at least one cup of coffee daily, according to a 2012 Gallup poll. Despite popular opinion about soda and weight gain, the same poll found that frequent soda drinkers do not weigh more than non-soda drinkers.

But health experts still say that even one glass of soda a day is too much, as it has been linked to a variety of health problems, including a relatively new one, clinical depression.

Preliminary data from a National Institutes of Health report that will be released in March at the American Academy of Neurology’s 65th Annual Meeting in San Diego show that regular soda drinkers, particularly those who drink diet soda, are more likely to be diagnosed with depression. The data showed that coffee drinkers, on the other hand, have a slightly lower risk of a depression diagnosis.

The researchers do not say that soda causes depression — they did not determine whether people who are likely to become depressed are also simply more likely to drink soda in the first place, and the study did not control for all relevant factors, such as socioeconomic status. What they did find was that people who drank more than four cans or cups of soda per day were 30 percent more likely to develop depression over the course of the 10-year study than people who drank no soda. Fruit punch drinkers were 38 percent more likely to develop depression than those who did not drink sweetened drinks. Depression risk appeared to be even greater for people who drank diet soda rather than regular soda, and diet rather than regular fruit punches and iced tea.

Meanwhile, heavy coffee drinkers in the study experienced more than a caffeine buzz: They were also about 10 percent less likely to develop depression than those who drank no coffee.

This most recent finding doesn’t necessarily mean you should quit Diet Coke cold turkey and run out for a cup of joe instead. But it’s not the first time researchers have found a link between soda consumption and mood. One study of teens in Boston found that those who drank six or more cans of soda per week were more likely to be violent with family and friends and even carry weapons. Researchers associated heavy soda consumption with a 9 percent to 15 percent increase in the risk for aggressive behavior, and suggested that sugar or caffeine may be to blame.

Because past studies have linked poor emotional health to the sugar in soda, this most recent finding is a little more ambiguous. It either indicates that both sugar and the artificial sweeteners in diet drinks may be related to depression, or that other factors contribute to the link between soda drinking and clinical depression. Still, cutting down on both regular and diet soda can help your health in a number of ways.

“Our research suggests that cutting out or down on sweetened diet drinks or replacing them with unsweetened coffee may naturally help lower your depression risk,” said study author Honglei Chen, MD, PhD, in a release. “More research is needed to confirm these findings, and people with depression should continue to take depression medications prescribed by their doctors.”

Caroline Miller

Editorial Director
Child Mind Institute
Kids who seem oppositional are often severely anxious
A 10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room and down the hall. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the Emergency Room.

To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.

But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Dr. Jerry Bubrick, director of the Anxiety & Mood Disorders Center at the Child Mind Institute. “He can’t tolerate any—even constructive—criticism. He just will shut down altogether. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”

James’s story illustrates something that parents and teachers may not realize—that disruptive behavior is often generated by unrecognized anxiety. A child who appears to be oppositional or aggressive may be reacting to anxiety—anxiety he may, depending on his age, not be able to articulate effectively, or not even fully recognize that he’s feeling.

“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Dr. Rachel Busman, a clinical psychologist at the Child Mind Institute, “but you can also see tantrums and complete meltdowns.”

A great masquerader

Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.

“Anxiety is one of those diagnoses that is a great masquerader,” explains Dr. Laura Prager, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “It can look like a lot of things. Particularly with kids who may not have words to express their feelings, or because no one is listening to them, they might manifest their anxiety with behavioral dysregulation.”

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in his own room or separating from his parents, avoidance of certain activities, a behaviorally inhibited temperament. “Anyone would recognize those symptoms,” notes Dr. Prager, who is also an assistant professor at the Harvard Medical School, and co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.

“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what that means,” she explains, “but it’s not uncommon, when kids like that come in to the ER, for the diagnosis to end up being a pretty profound anxiety disorder.”

To demonstrate the surprising range of ways young children express anxiety, Dr. Prager mentions a case she had just seen of a young child who presented with hallucinations, but whose diagnosis she predicted will end up being somewhere on the anxiety spectrum. “Little kids who say they’re hearing things or seeing things, for example, may or may not be doing that. These may not be the frank hallucinations we see in older patients who are schizophrenic, for example. They might be a manifestation of anxiety and this is the way the child expresses it.”

Problems at school

It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.

Dr. Nancy Rappaport, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”

Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”

When a teacher is able to build a relationship with a child, to find out what’s really going on with him, what’s provoking the behavior, she can often give him tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.

“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make her miserable, it changes her approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.” If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.

Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or oppositionality.

“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of his seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “His behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why she has to answer so many questions, and why he’s so wrapped up in what other kids are doing, whether they’re following the rules.”

People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.

How to identify anxiety

“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”

First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”

And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.

Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attentional or learning issues, but she might need to be treated for the anxiety before she can really be evaluated for those. She uses the example of a teenager with OCD who she’s “doing terribly” in school. “She’s ritualizing three to four hours a day, and having constant intrusive thoughts—so we need to treat that, to get the anxiety under control before we ask, how is she learning?”

Author: Torkel Klingberg, MD, PhD, Professor of Cognitive Neuroscience at the Karolinska Institute
Working memory deficits occur in many conditions
There is a normal variability from individual to individual in working memory capacity. In the individual, capacity can also be temporarily decreased due to stress or lack of sleep. Moreover, there is a normal decline in capacity with aging, starting around 25-30 years of age, with a decline of about 5-10% per decade.

Except for this normal variability, working memory capacity is also affected in a range of clinical conditions, affecting the neural systems underlying working memory. Studies on both animals and humans have shown that the prefrontal and parietal cortexes are essential for working memory performance; as is the basal ganglia, as well as correct dopaminergic transmission. When these systems are affected, working memory is impaired.

Stroke affecting the frontal lobe is associated with working memory deficits, as are traumatic brain injuries (Robertson and Murre, 1999). In these cases, the working memory deficits lead to attention and planning problems. Attention Deficit Hyperactivity Disorder (ADHD and ADD) is associated with disturbances of both the frontal lobe and the dopaminergic system, and is consequently also associated with working memory deficits. Learning disability is another prevalent condition, in children and in adults, which can be defined as academic difficulties that are not due to inadequate opportunity to learn, general intelligence, nor to physical/emotional disorders, but to basic disorders in specific psychological processes. It has been shown that learning disability can be directly linked to deficits in working memory (Gathercole and Pickering, 2000).

ADHD is a widespread and serious disorder with a key WM component
ADHD is a disorder which includes severe problems of attention, impulsivity and hyperactivity. ADHD affects 3-5% of children between 6-16 years, which makes it the most common neuropsychiatric disorder. When children with ADHD grow older, the hyperactivity decreases, but problems of inattention, which often lead to academic and occupational failure, remain in the majority of cases. ADHD has a strong genetic component, with heritability estimated around 70%. Deficits in working memory are thought to be of central importance in explaining many cognitive and behavioral problems in ADHD (Barkley, 1997; Castellanos and Tannock, 2002; Rapport et al. , 2000; Westerberg et al., 2004). Westerberg et al. (2004) com¬pared working memory tasks with other tasks and showed that children had most problems with working memory tasks. A meta-analysis of 46 studies (Martinussen et al., 2005) confirmed the WM deficits in ADHD, and also showed that the deficits are most pronounced in the visuo-spatial domain.

Can working memory be improved?
Torkel Klingberg, MD PhD, has conducted research at Karolinska Institutet for several years concerning the neural basis of working memory and working memory deficits in children. Working memory capacity has generally been held to be a fixed property of the individual.However, Klingberg, Helena Westerberg, Ph.D., and others at the Department for Neuropediatrics at Astrid Lind¬gren’s Children’s Hospital (part of Karolinska University Hospital), started to develop methods for improving working memory in 1999. These methods are influenced by animal research on mechanisms for training induced plasticity (Buonomano and Merzenich, 1998). Development was conducted in collaboration with Jonas Beckeman and David Skoglund, professional game developers who helped solve technical issues and helped make the training more rewarding.

The training consists of a specific set of working memory tasks that are performed on a computer, where the difficulty level is adjusted according to a specific algorithm. The users complete a fixed number of trials every day, taking about 30-40 minutes daily. This is done for five days a week over five weeks. During training, performance results are saved and can be used for later analysis.

The program is called Cogmed RM, and has been developed by Cogmed Systems AB.

Author: Torkel Klingberg, MD, PhD, Professor of Cognitive Neuroscience at the Karolinska Institute
Summary

Working memory is the ability to keep information online for a brief period of time, which is essential for many cognitive tasks such as control of attention and problem solving. In contrast to what was previously assumed, we have shown that systematic training can improve working memory capacity, in both children and adults. Brain imaging studies also show that working memory training leads to increased brain activity in the prefrontal and parietal cortex. Improving working memory capacity leads to better performance on several tasks that require working memory and control of attention and it translates to increased attentiveness in everyday life.

Working Memory is a key function necessary for critical cognitive tasks
Working memory is the ability to keep and manipulate information online for a brief period of time. This ability can be measured for example by testing how many digits a subject can repeat back after hearing them once (verbal working memory) or how many positions a subject can remember after seeing them once (visual working memory).

In daily life we use working memory to remember plans or instructions of what to do next. But keeping information online is a very basic function that has proved to be of central importance in a wide range of cognitive tasks. Verbal working memory is necessary for comprehending long sentences; and verbal working memory capacity predicts performance on reading comprehension in the scholastic aptitude test (SAT) (Daneman and Carpenter, 1980). Working memory is also important for control of attention, and to maintain task-relevant information during problem solving. More generally, working memory has been suggested to be the single most important factor in determining general intellectual ability (SüB et al., 2002). About 50% of differences between individuals in non-verbal IQ can be explained by differences in working memory capacity (Conway et al., 2003).

More recently, it has also become clear that there is a strong link between working memory capacity and the ability to resist distractions and irrelevant information. One study used the so called “cocktail party effect”, i.e. our ability to focus on one voice despite noisy surroundings, and showed that this ability is related to working memory capacity (Conway et al., 2001). Recent studies have also shown that low working memory is related to being “off-task” and daydreaming (Kane et al., 2007). These psychological studies are consistent with neuroimaging studies, which have shown that subjects with higher working memory capacity are less likely to store irrelevant information (Vogel et al., 2005). The prefrontal cortex is important in providing this “filtering” of irrelevant information, and subjects with higher working memory capacity have a higher prefrontal activity and are better at filtering out distractors (McNab and Klingberg, 2008).

When people have deficits in working memory, they are often experienced as “inattention problems”, e.g. to have problems focusing on reading a text; or “memory problems”, e.g. forgetting what to do in the few seconds of walking from one room to the another, or being easily distracted while trying to focus on a task. In children the problem is often remembering what to do next, which makes them unable to finish an activity according to plan.

In conclusion, working memory allows us to hold on to information in order to complete a task, and is especially important in any cognitively demanding environment with irrelevant distractions.

By Jessica B. Konopa

ADHD isn’t just a kid’s problem. An estimated 2 to 4 percent of adults live with the disorder. Half of those who have ADHD as children continue to have it when they grow up. In fact, it often goes undiagnosed. Many adults who have ADHD had it when they were kids, but were never diagnosed.

Like kids with ADHD, adults who suffer from the disorder often:

•Have a hard time completing tasks they consider boring or difficult
•Are distracted easily
•Are forgetful
•Are prone to losing things

In addition, they may fidget and easily lose their tempers. They often feel hyperactive and can’t relax.
These behaviors often interfere with an adult’s ability to work or have relationships. ADHD can interfere with an adult’s ability to:
•Stay organized
•Manage time
•Complete tasks that require concentration

Adults with ADHD may have a problem with jobs that use these skills. As a result, they may change jobs a lot or experience conflict at the office.

ADHD can make personal relationships difficult, too. It can be hard for people with ADHD to share their feelings with others. They may also find it hard to pay attention when other people are speaking. This can create strained conversations. An estimated 75 percent of adults with ADHD have emotional problems. All of these things can make it difficult for adults to maintain long-term relationships and friendships. Adults with ADHD often have marital problems, battle depression, or may abuse alcohol or drugs. At first glance, ADHD may seem daunting for adults. However, they can often overcome it by making small changes to the way they do things. This includes:

•Breaking large tasks into smaller ones
•Making lists to keep track of things that need to be done
•Communicating when they need help

In reality, research indicates that only 10 percent of adults with ADHD experience problems in their daily lives. About 50 percent report that their ADHD sometimes interferes with their daily lives. Finally, about 33 percent of adults say they have learned to manage their symptoms or no longer suffer from ADHD symptoms.

Not sure if you have ADHD? Your health care provider will be able to evaluate you and diagnose ADHD, if appropriate. Your provider will also help you develop a plan to manage it.

References

1.National Resource Center on AD/HD. (2008, February). The Disorder Named ADHD – What We Know – Info Sheets on AD/HD. Retrieved August 24, 2010, from http://www.help4adhd.org/about/what/WWK1.
2.WebMD. (2005, October 1). Attention-deficit hyperactivity disorder: ADHD in adults. Retrieved August 24, 2010, from http://www.webmd.com/add-adhd/guide/adhd-adults
3.Preidt, R. (2003, June 25). National ADHD education campaign launched. HealthDayNews. Retrieved August 24, 2010, from http://www.healthscout.com/template.asp?page=newsdetail&ap=1&id=513770
4.WebMD. (2006, May 31). ADHD guide: Treatment overview. Retrieved August 24, 2010, from http://www.webmd.com/add-adhd/tc/attention-deficit-hyperactivity-disorder-adhd-treatment-overview

Written by Wendy Leonard, MPH
The most common cause of dementia is Alzheimer’s disease (AD). AD is a progressive and irreversible brain disorder. The actual cause of AD is unknown. AD slowly damages, and then destroys, a person’s memory, judgment, reasoning skills, personality, autonomy, and bodily functions.

The disease specifically affects several components of the brain. These include:
•a gradual loss of brain cells, called neurons
•damage to neurons so they no longer function properly
•the loss of neural connections—called synapses— where messages are passed from neuron to neuron

Forgetfulness: A Normal Part of Aging?

It’s normal to sometimes forget things, but as we age, it often takes longer to learn new skills or remember words, names, or where we left our glasses. Of course, this does not mean an individual has dementia. In fact, scientists have found that healthy older adults perform just as well as their young counterparts on complex and learning tests—if given extra time to complete.

However, there’s a difference between occasional forgetfulness and behavior that may be cause for concern. Not recognizing a familiar face, trouble performing common tasks (such as using the telephone or driving home); or being unable to comprehend or recall recent information are all red flags that need to be checked by a medical professional.

Who Gets AD?

Also known as late-onset Alzheimer’s disease, AD is primarily a disease of the elderly. The first noticeable symptoms can occur as early as age 60.

When AD runs in families, it’s called familial Alzheimer’s disease (FAD).

AD sometimes can affect people as young as 30. This type of AD is called early-onset AD. It is rare and affects less than one out of every 1,000 people with AD.

The underlying cause or causes of AD, and specific risk factors, remain unclear. Yet experts believe AD is likely due to a combination of environmental and genetic factors. Lifestyle choices, such as diet, exercise, and staying mentally active like learning new skills, also are factors.
About 5.3 million Americans have AD, according to the National Institutes of Health (NIH). That number will only climb as the elderly population rises.

AD is the sixth leading cause of death in the U.S. and the fifth leading in Americans age 65 and older. Worldwide, approximately 24 million people have AD.

What’s Being Done?

Scientists are working to better understand AD in order to create more effective early diagnostic tools, improve treatments, and perhaps even discover a cure.

In terms of what’s immediately available, there are numerous reputable resources and services for people who suffer with AD and their loved ones and caregivers. Some current treatment options even may slow the progression of AD, however, their effectiveness varies and diminishes over time.

By Annie Murphy Paul
College-admission letters go out this month, and most recipients (and their parents) will place great importance on which universities said yes and which said no. A growing body of evidence, however, suggests that the most significant thing about college is not where you go, but what you do once you get there. Historian and educator Ken Bain has written a book on this subject, What the Best College Students Do, that draws a road map for how students can get the most out of college, no matter where they go.

As Bain details, there are three types of learners: surface, who do as little as possible to get by; strategic, who aim for top grades rather than true understanding; and deep learners, who leave college with a real, rich education. Bain then introduces us to a host of real-life deep learners: young and old, scientific and artistic, famous or still getting there. Although they each have their own insights, Bain identifies common patterns in their stories:

Pursue passion, not A’s. When he was in college, says the eminent astrophysicist Neil deGrasse Tyson, he was “moved by curiosity, interest and fascination, not by making the highest scores on a test.” As an adult, he points out, “no one ever asks you what your grades were. Grades become irrelevant.” In his experience as a student and a professor, says Tyson, “ambition and innovation trump grades every time.”

Get comfortable with failure. When he was still a college student, comedian Stephen Colbert began working with an improvisational theater in Chicago. “That really opened me up in ways I hadn’t expected,” he tells Bain. “You must be O.K. with bombing. You have to love it.” Colbert adds, “Improvisation is a great educator when it comes to failing. There’s no way you are going to get it right every time.”

Make a personal connection to your studies. In her sophomore year in college, Eliza Noh, now a professor of Asian-American studies at California State University at Fullerton, took a class on power in society: who has it, how it’s used. “It really opened my eyes. For the first time in my life, I realized that learning could be about me and my interests, about who I was,” Noh tells Bain. “I didn’t just listen to lectures, but began to use my own experiences as a jumping-off point for asking questions and wanting to pursue certain concepts.”

Read and think actively. Dean Baker, one of the few economists to predict the economic collapse of 2008, became fascinated in college by the way economic forces shape people’s lives. His studies led him to reflect on “what he believed and why, integrating and questioning,” Bain notes. Baker says: ”I was always looking for arguments in something I read, and then pinpointing the evidence to see how it was used.”

Ask big questions. Jeff Hawkins, an engineer who created the first mobile computing device, organized his college studies around four profound questions he wanted to explore: Why does anything exist? Given that a universe does exist, why do we have the particular laws of physics that we do? Why do we have life, and what is its nature? And given that life exists, what’s the nature of intelligence? For many of the subjects he pursued, Bain notes, “there was no place to ‘look it up,’ no simple answer.”

Cultivate empathy for others. Reyna Grande, author of the novels Across a Hundred Mountains and Dancing with Butterflies, started writing seriously in her junior year in college. “Writing fiction taught Reyna to empathize with the people who populated her stories, an ability that she transferred to her life,” Bain notes: “As a writer, I have to understand what motivates a character, and I see other people as characters in the story of life,” Grande says. “When someone makes mistakes, I always look at what made them act the way they do.”

Set goals and make them real. Tia Fuller, who later became an accomplished saxophone player, began planning her future in college, envisioning the successful completion of her projects. ”I would keep focused on the light at the end of the tunnel, and what that accomplishment would mean,” she tells Bain. “That would help me develop a crystalized vision.”

Find a way to contribute. Joel Feinman, now a lawyer who provides legal services to the poor, was set on his career path by a book he read in college: The Massacre at El Mozote, an account of a 1981 slaughter of villagers in El Salvador. After writing and staging a campus play about the massacre, and traveling to El Salvador, Feinman “decided that I wanted to do something to help people and bring a little justice to the world.”

Read more: http://ideas.time.com/2013/03/13/secrets-of-the-most-successful-college-students/#ixzz2O0ieR0nw

By Dennis Thompson Jr.
Medically reviewed by Pat F. Bass III, MD, MPH

Deep connections exist between chronic pain and depression. A person experiencing chronic pain is more likely than a well person to be depressed. And the connection runs in the other direction, too — depressed people are more likely to complain of chronic aches and pains.

Studies have found that people dealing with chronic pain run three times the risk of developing a mood disorder such as depression or anxiety. About a third of people with persistent pain experience clinical depression.

What’s more, people with depression have three times the risk of chronic pain. “When people have chronic depression over a long period of time, about half of them will develop chronic pain problems without any clear injury to explain that pain,” says Michael Moskowitz, MD, assistant clinical professor for the department of anesthesiology and pain medicine at the University of California, Davis and a board member of the American Pain Foundation.

Pain and Depression Connections

Doctors believe the structure and function of the human brain form the basis of the link between chronic pain and depression:

Brain structure. There is a lot of overlap among the parts of the brain that deal with pain signals and the locations where mood disorders develop. “If you look at the nine places in the brain where pain occurs, six of them are where we experience mood disorders like depression and anxiety,” Dr. Moskowitz says.

Brain function. Some of the neurotransmitters that the brain uses to receive and process pain signals also are used to regulate mood. These include serotonin and norepinephrine. It’s no coincidence that most drugs used to treat mood disorders have been found to be effective when used for pain relief.

Chronic pain and chronic depression both can alter your brain structure and chemistry, with each condition influencing the other. As Moskowitz explains, “Your brain changes every day of your life, with connections made and broken all the time. The brain remodels all the time due to the stimulus it gets.”

“What actually happens in the brain is a kind of expansionism,” Moskowitz continues. “The nerve cells dedicated to pain branch into a new area when there’s chronic pain. With mood and pain sharing so many areas, sometimes they’re kind of encroaching into each other’s areas.”

How to Manage Pain and Depression

How do you manage pain in the face of chronic depression, and how do you treat depression in someone who is experiencing chronic pain? Medical experts believe you need to treat both conditions simultaneously, with initial emphasis on whichever one occurred first.

“You have to look at what the person presents with,” Moskowitz says. “If it comes from the mood, you start with the mood first. If it started from an injury, you start with the cause of the pain first.”

Pain management can be achieved through the use of pain medications and physical therapy, while also tackling depression through exercise, psychotherapy, and antidepressant drugs. Some techniques like progressive muscle relaxation, cognitive-behavioral therapy, and meditation can help with both manage pain and depression.

The goal is to help the brain rewire itself out of both chronic conditions. “You’re retraining the brain to move back to a more normal state,” Moskowitz says.

Mar. 15, 2013 — Secondary school students who follow an in-class mindfulness programme report reduced indications of depression, anxiety and stress up to six months later. Moreover, these students were less likely to develop pronounced depression-like symptoms. The study, conducted by Professor Filip Raes (Faculty of Psychology and Educational Sciences, KU Leuven), is the first to examine mindfulness in a large sample of adolescents in a school-based setting.

Mindfullness is a form of meditation therapy focused on exercising ‘attentiveness’. Depression is often rooted in a downward spiral of negative feelings and worries. Once a person learns to more quickly recognise these feelings and thoughts, he or she can intervene before depression sinks in.

While mindfulness has already been widely tested and applied in patients with depression, this is the first time the method has been studied in a large group of adolescents in a school-based setting, using a randomised controlled design. The study was carried out at five middle schools in Flanders, Belgium. About 400 students between the ages of 13 and 20 took part. The students were divided into a test group and a control group. The test group received mindfulness training, and the control group received no training. Before the study, both groups completed a questionnaire with questions indicative of depression, stress or anxiety symptoms. Both groups completed the questionnaire again directly after the training, and then a third time six months later.

Before the start of the training, both the test group (21%) and the control group (24%) had a similar percentage of students reporting evidence of depression. After the mindfulness training, that number was significantly lower in the test group: 15% versus 27% in the control group. This difference persisted six months after the training: 16% of the test group versus 31% of the control group reported evidence of depression. The results suggest that mindfulness can lead to a decrease in symptoms associated with depression and, moreover, that it protects against the later development of depression-like symptoms.

The study was carried out in cooperation with the Belgian not-for-profit Mindfulness and with support from the Go for Happiness Foundation.