By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on April 7, 2010
Experts acknowledge that some mental health conditions can be triggered by environmental stimuli and often occur in response to stressful life events.
New research, using an animal model, hopes to discover why some people are at risk.
Well-known examples of stress-induced mental illness include depression and schizophrenia. Researchers are aware that some people have a genetic predisposition for stress-induced disorders.
They have learned that a high number of depressed people have a genetic change that alters a protein cells use to talk to each other in the brain. Also, brain imaging of people with depression also shows that they have greater activity in some areas of their brain.
Unfortunately, the techniques that are currently available have not been able to determine why stress induces pathological changes for some people and how their genetics contribute to disease.
A new mouse model may provide some clues about what makes some people more likely to develop depression after experiencing stress. A collaborative group of European researchers created a mouse that carries a genetic change associated with depression in people.
“This model has good validity for understanding depression in the human, in particularly in cases of stress-induced depression, which is a fairly widespread phenomenon,†says Dr. Alessandro Bartolomucci, the first author of the research published in the journal, Disease Models and Mechanisms (DMM).
The scientists made genetic changes in the transporter that moves a signaling protein, serotonin, out of the communication space between neurons in the brain. The changes they made are reminiscent of the genetic changes found in people who have a high risk of developing depression.
“There is a clear relationship between a short form of the serotonin transporter and a very high vulnerability to develop clinical depression when people are exposed to increasing levels of stressful life events,†says Dr. Bartolomucci.
“This is one of the first studies performed in mice that only have about 50 percent of the normal activity of the transporter relative to normal mice, which is exactly the situation that is present in humans with high vulnerability to depression.”
Mice with the genetic change were more likely to develop characteristics of depression and social anxiety, which researchers measure by their degree of activity and their response to meeting new mice.
The work from this study now allows researchers to link the genetic changes that are present in humans with decreased serotonin turnover in the brain. It suggests that the genetic mutation impedes the removal of signaling protein from communication areas in the brain, which may result in an exaggerated response to stress.
Dr. Bartolomucci points out that many of the chemical changes they measured occurred in the areas of the brain that regulate memory formation, emotional responses to stimuli and social interactions, which might be expected.
“What we were surprised by was the magnitude of vulnerability that we observed in mice with the genetic mutation and the selectivity of its effectsâ€.
Source: The Company of Biologists
http://psychcentral.com/news/2010/04/07/genetic-link-for-stress-induced-depression/12658.html
Related News Articles
By John M Grohol PsyD
The U.S. Federal Aviation Administration (FAA) on Friday cleared pilots who have depression to regain their flying privileges, with one tiny caveat — they have to be taking one of only four “approved†antidepressants. I can only express my extreme disappointment at this decision because while it has the potential to help pilots take to the air again if they were suffering from depression, it fails to recognize other effective treatments for depression.
Apparently, the FAA doesn’t recognize the effectiveness of psychotherapy in the treatment of depression. This despite something on the order of four decades’ (or more) worth of research demonstrating its effectiveness for everything from mild to severe depression. In fact, if anything, there’s more research that calls into question the effectiveness of these four antidepressants than there is showing they help.
The Los Angeles Times has the upshot:
FAA policy bans pilots from flying if they have depression because the condition can be distracting in the cockpit and pose a safety risk, according to the agency. Under the new policy, pilots with depression can seek treatment with one of the four medications and keep flying.
You know what else can be distracting in the cockpit? Laptops. Guess what the FAA doesn’t ban in the cockpit. Yes, laptops. So how can this be about “distraction†rather than simple ignorance about mental illness? Does a diagnosis of attention deficit disorder (ADD) also get you banned from the cockpit (given that one of its hallmarks is distraction)? No, it doesn’t, unless you happen to be taking a medication to treat it.
In fact, if you’re taking any psychiatric medication outside of these four antidepressants, you’re going to lose your pilot’s license unless you go off of them for at least 90 days. The FAA doesn’t care about your illness or your mental health. All they care about are possible side effects of the medications — but not the effects or symptoms of the illness itself! (The exceptions are substance/alcohol abuse, schizophrenia and bipolar disorder — all of which are grounds for a license denial.)
None of this makes any sense. Either disqualify pilots from obtaining their license with any kind of mental health issue outright, or qualify them if they are seeking and in treatment for them. Don’t hand out piecemeal, arbitrary decisions like this one about specific types of treatment you accept that are apparently based upon, not research, but something else. What that something else is (given 3 of the 4 antidepressants are generics, I don’t think it was pharmaceutical lobbying) is anyone’s guess.
From the FAA press release:
On a case-by-case basis beginning April 5, pilots who take one of four antidepressant medications – Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa), or Escitalopram (Lexapro) – will be allowed to fly if they have been satisfactorily treated on the medication for at least 12 months. The FAA will not take civil enforcement action against pilots who take advantage of a six-month opportunity to share any previously non-disclosed diagnosis of depression or the use of these antidepressants.
I don’t feel any less safe flying knowing that pilots who are seeking and getting treatment for their depression and in the cockpit. I’d feel far less safe flying knowing the FAA was pretending that mental health conditions don’t exist or don’t affect their pilots, or that pilots weren’t taking action to help themselves. The FAA still lives in a state of denial about the prevalence of these disorders, and is hiding its head in the sand by approving just these four drugs.
Read the full article: Depressed pilots may fly with medication, FAA says
FAA Disease Protocols (note the lack of any mental illness protocols outside of substance abuse)
http://psychcentral.com/blog/archives/2010/04/03/faa-still-stigmatizes-depression-mental-illness/
If You’re Depressed, Fearful, It Might Help To Worry, Too
A new study of brain activity in depressed and anxious people indicates that some of the ill effects of depression are modified – for better or for worse – by anxiety.
The study, in the journal Cognitive, Affective & Behavioral Neuroscience, looked at depression and two types of anxiety: anxious arousal, the fearful vigilance that sometimes turns into panic; and anxious apprehension, better known as worry.
The researchers used functional Magnetic Resonance Imaging (fMRI) at the Beckman Institute’s Biomedical Imaging Center to look at brain activity in subjects who were depressed and not anxious, anxious but not depressed, or who exhibited varying degrees of depression and one or both types of anxiety.
“Although we think of depression and anxiety as separate things, they often co-occur,” said University of Illinois psychology professor Gregory A. Miller, who led the research with Illinois psychology professor Wendy Heller. “In a national study of the prevalence of psychiatric disorders, three-quarters of those diagnosed with major depression had at least one other diagnosis. In many cases, those with depression also had anxiety, and vice versa.”
Previous studies have generally focused on people who were depressed or anxious, Miller said. Or they looked at both depression and anxiety, but lumped all types of anxiety together.
Miller and Heller have long argued that the anxiety of chronic worriers is distinct from the panic or fearful vigilance that characterizes anxious arousal.
In an earlier fMRI study, they found that the two types of anxiety produce very different patterns of activity in the brain. Anxious arousal lights up a region of the right inferior temporal lobe (just behind the ear). Worry, on the other hand, activates a region in the left frontal lobe that is linked to speech production.
(Other research has found that depression, by itself, activates a region in the right frontal lobe.)
In the new study, brain scans were done while participants performed a task that involved naming the colors of words that had negative, positive, or neutral meanings. This allowed the researchers to observe which brain regions were activated in response to emotional words.
The researchers found that the fMRI signature of the brain of a worried and depressed person doing the emotional word task was very different from that of a vigilant or panicky depressed person.
“The combination of depression and anxiety, and which type of anxiety, give you different brain results,” Miller said.
Perhaps most surprisingly, anxious arousal (vigilance, fear, panic) enhanced activity in that part of the right frontal lobe that is also active in depression, but only when a person’s level of anxious apprehension, or worry, was low. Neural activity in a region of the left frontal lobe, an area known to be involved in speech production, was higher in the depressed and worried-but-not-fearful subjects.
Despite their depression, the worriers also did better on the emotional word task than those depressives who were fearful or vigilant. The worriers were better able to ignore the meaning of negative words and focus on the task, which was to identify the color – not the emotional content – of the words.
These results suggest that fearful vigilance sometimes heightens the brain activity associated with depression, whereas worry may actually counter it, thus reducing some of the negative effects of depression and fear, Miller said.
“It could be that having a particular type of anxiety will help processing in one part of the brain while at the same time hurting processing in another part of the brain,” he said. “Sometimes worry is a good thing to do. Maybe it will get you to plan better. Maybe it will help you to focus better. There could be an up-side to these things.”
Researchers from the University of Illinois, Pennsylvania State University and the University of Colorado collaborated on the study. The National Institute of Mental Health and the National Institute of Drug Abuse at the National Institutes of Health; the Beckman Institute and Intercampus Research Initiative in Biotechnology supported the research.
Miller is affiliated with the U. of I. department of psychology, the Beckman Institute, the Neuroscience Program in the College of Liberal Arts and Sciences, and the department of psychiatry in the College of Medicine.
Article,: “Co-occurring Anxiety Influences Patterns of Brain Activity in Depression”
Source:
Diana Yates
University of Illinois at Urbana-Champaign
http://www.medicalnewstoday.com/articles/184310.php
It’s a dreadful place.
Relapse.
Maybe you had hoped you’d never go there. Or maybe you stay awake fearing you will. It doesn’t matter. You don’t have to stay there for long. You’ll be on your way shortly.
I prefer to use the term “set back†when I get sucked back into the Black Hole — bam! — stuck inside a brain that covets relief, any form of relief, and will do just about anything to get it. Because it’s certainly not the end of recovery. From depression or any addiction. A relapse merely gives you a new starting place.
Since I’ve been struggling with this recently in my own life, I’ve laid out seven strategies to get unstuck … to recover from a relapse.
1. Listen to the right people.
If you’re like me, you’re convinced that you are lazy, ugly, stupid, weak, pathetic, and self-absorbed when you are depressed or have given into an addiction. Unconsciously, you seek people, places, and things that will confirm those opinions. So, for example, when my self-esteem has plummeted to below-seawater status, I can’t stop thinking about the relative who asked me, after I had just returned from the psych ward and was doing everything I possibly could to recover from depression: “Do you WANT to feel better?†Indicating that I was somehow willing myself to stay sick in order to get attention or maybe because fantasizing about death is so much fun. I can’t get her and that question out of my mind when I’m pedaling backward. SO I draw a picture of her, with her question inside a bubble. Then I draw me with a bubble that says “HELL YES, DIMWIT!†Then I get out my self-esteem file and read a few of the affirmations of why I’m not lazy, ugly, stupid, weak, pathetic, and self-absorbed.
2. Make time to cry.
I’ve listed the healing faculties of tears in my piece “7 Good Reasons to Cry Your Eyes Out.†Your body essentially purges toxins when you weep. It’s as if all your emotions are bubbling to the surface, and when you cry, you release them, which is why it is so cathartic. Lately, I’ve been allowing myself 10 to 15 minutes in the morning to have a good cry, to say whatever I want without cognitive adjustments, to let it all out, and not to judge it.
3. Ditch the self-help.
As I wrote in my piece “Use Caution with Positive Thinking,†cognitive-behavioral adjustments can be extremely helpful for persons struggling with mild to moderate depression, or struggling with an addition that isn’t destroying them. With severe depression or a crippling addiction, though, positive thinking can sometimes make matters worse. I was so relieved the other day when my psychiatrist told me to put the self-help books away. Because I do think they were contributing to my self-battery.
Right now, when I start to think “I can’t take it anymore,†I try not to fret. I don’t worry about how I can adjust those thoughts. I simply consider the thoughts as symptoms of my bipolar disorder, and say to myself, “It’s okay. You won’t feel that way when you’re better. The thoughts are like a drop in insulin to a diabetic … a symptom of your illness, and a sign you need to be especially gentle with yourself.”
4. Distract yourself.
Instead of sitting down with some self-help books, you would be better off doing whatever you can to distract yourself. I remember this from my former therapist who told me, during the months of my severe breakdown, to do mindless things … like word puzzles and reading trashy novels. Recently, I’ve been going to Navy football games, which does take my mind off of my thoughts for a few hours on Saturdays. Not that I understand football … but there is a lot to watch besides the cheerleaders. Like my children trying to score all kinds of junk food.
5. Look for signs of hope.
The little, unexpected signs of hope kept me alive during my mega-breakdown, and they are the gas for my sorry-performing engine during a fragile time like this. Yesterday, a saw a rose bloom on our rose bush out front. In October! Since roses symbolize healing for me, I took it as a sign of hope … that I won’t plummet too far … there are things in this life that I’m meant to do.
6. Say yes anyway.
In her book Solace: Finding Your Way Through Grief and Learning to Live Again, author Roberta Temes suggests a policy whereby you always say yes to an invitation out. That keeps you from isolating, which is so easy to do when you’re grieving or stuck in a depression or off the wagon in a big way. I’ve been following this piece of advice. When a friend asks me to have coffee (and I really hope she doesn’t!), I have to say yes. It’s non-negotiable. Until I feel better and get back my brain.
7. Break your day into moments.
Most depressives and addicts would agree that “a day at a time†simply doesn’t cut it. That’s WAY too long. Especially first thing in the morning. I have to get to bedtime? Are you kidding me? So when rear-ended in the depression tunnel or fighting one of my many addictions, I break the day into about 850 moments. Each minute has a few moments. Right now it’s 11:00. I only have to worry about what I’m doing now, until, say 11:02.
For all 12 strategies on how to recover from a relapse, click here!
Source:Â http://psychcentral.com/blog/archives/2010/04/03/7-strategies-to-help-you-recover-from-a-relapse/
By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on April 1, 2010
New research suggests postpartum blues can occur even when a baby or child is adopted. The altered mood often follows unrealistic expectations that peak during the adoption process.
“People often hear about postpartum blues when having a baby, but the emotional well-being of adoptive parents once the child is placed in the home is not really talked about,†said Karen J. Foli, an assistant professor of nursing and an adoptive mother.
“In this study, the majority of the adoptive parents who self-reported having experienced depression after the child was placed in their home often described unmet or unrealistic expectations of him- or herself, the child, family and friends, or society.
“For example, some parents shared that they did not anticipate that bonding with their child would be a struggle or that family members or friends would not offer the same support that birthparents enjoy.”
The signs and symptoms of depression include depressed mood, decreased interest or pleasure in activities, significant weight changes, difficulty sleeping or excessive sleeping, feeling agitated, fatigue, excessive guilt and shame, and indecisiveness.
“Postadoption depression not only affects the parents, but it also has an influence on the well-being of the child,†she said.
Foli, who is co-author of the book The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption, interviewed 21 adoptive parents about their adoption and depression experiences, as well as 11 adoption experts and professionals.
The adopted children’s range of age at placement was newborn to 12 years, and when the study was conducted the children’s ages ranged from 12 months to 24 years. Foli’s findings are published in this month’s Western Journal of Nursing Research.
“Many adoptive parents spend their time during the adoption process demonstrating they are not only going to be fit parents, but super parents, and then they struggle with trying to be the world’s best parent when the child is placed in the home,†Foli said.
“Adoptive parents also may experience feelings about their legitimacy as a parent, or even surprise if they don’t readily bond with the infant or child.”
Other factors that contribute to postadoption depression may include the expectations surrounding the child’s attachment to the parent, a lack of peers, the lack of boundaries with birthparents in open adoptive agreements, and society’s attitude toward adoptive families as a whole.
Adoptive parents also are tired by the time the child comes into the home, Foli said. They have endured a rigorous adoption process and much of their lives have been out of their control.
“Obtaining that next form or checking that next box while waiting for the child can shift the focus away from parenting and emphasize the process of adoption,†Foli said.
It’s estimated there are 2 million adoptive parents in the United States. Adoptions can take place through public agencies, international organizations, private organizations, kinship agreements or tribal adoptions.
“Even though adoption continues to grow in the United States and become more mainstream, there is conventional wisdom that implies adoption was ‘Plan B’ for the parents,†Foli said.
“New adoptive parents often realize they weren’t as prepared as they thought they were and the child’s needs may overwhelm them. Some family members may not be receptive to news about an adoption or they may even treat the adopted children differently.
“Some parents in the study reported that acquaintances or strangers felt entitled to ask probing questions about the adoption, such as, ‘How much did the child cost?”
The adoption professionals who participated in the study said parents were often reluctant to admit their struggles out of fear and shame.
Parents also echoed feelings of extreme guilt and confusion over how they were struggling, particularly after their intense longing and eagerness to bring a child home.
“We need to empower parents to share their feelings with adoption-smart professionals, online or face-to-face support groups, trusted significant others, and friends,†Foli said.
“Parents should realize they are not being disloyal to their children or families to feel the way they do. Health-care providers, especially nurses, can be instrumental in detecting issues related to depression or the mental well-being of the parents.
“Being more open about such concerns can lead to a healthier, happier family. By helping themselves, they are helping their children.”
Source: Purdue University
http://psychcentral.com/news/2010/04/01/postpartum-depression-in-adoptive-parents/12519.html
Self-esteem rises steadily as people age but starts declining around the time of retirement, according to a longitudinal study of men and women ranging in age from 25 to 104.
Self-esteem was lowest among young adults but increased throughout adulthood, peaking at age 60, before it started to decline. These results are reported in the latest issue of the Journal of Personality and Social Psychology, published by the American Psychological Association.
Four times between 1986 and 2002, researchers surveyed a total of 3,617 adults living in the United States. The researchers measured self-esteem by asking participants to rate their level of agreement with statements such as, “I take a positive attitude toward myself,” which suggests high self-esteem; “At times I think I am no good at all” and “All in all, I am inclined to feel that I am a failure,” which both suggest low self-esteem.
Subjects were also asked about their ethnicity, education, income, work status, relationship satisfaction, marital status, health, social support and if they had experienced stressful life events. Some examples of stressful life events are suddenly losing a job, being the victim of a violent crime, or experiencing the death of a parent or of a child.
On average, women had lower self-esteem than did men throughout most of adulthood, but self-esteem levels converged as men and women reached their 80s and 90s. Blacks and whites had similar self-esteem levels throughout young adulthood and middle age. In old age, average self-esteem among blacks dropped much more sharply than self-esteem among whites. This was the result even after controlling for differences in income and health. Future research should further explore these ethnic differences, which might lead to better interventions aimed at improving self-esteem, wrote the study’s authors.
Education, income, health and employment status all had some effect on the self-esteem trajectories, especially as people aged. “Specifically, we found that people who have higher incomes and better health in later life tend to maintain their self-esteem as they age,” said Orth. “We cannot know for certain that more wealth and better health directly lead to higher self-esteem, but it does appear to be linked in some way. For example, it is possible that wealth and health are related to feeling more independent and better able to contribute to one’s family and society, which in turn bolsters self-esteem.”
People of all ages in satisfying and supportive relationships tend to have higher self-esteem, according to the findings. However, despite maintaining higher self-esteem throughout their lives, people in happy relationships experienced the same drop in self-esteem during old age as people in unhappy relationships. “Although they enter old age with higher self-esteem and continue to have higher self-esteem as they age, they decline in self-esteem to the same extent as people in unhappy relationships,” said co-author Kali H. Trzesniewski, PhD, of the University of Western Ontario. “Thus, being in a happy relationship does not protect a person against the decline in self-esteem that typically occurs in old age.”
There are numerous theories as to why self-esteem peaks in middle age and then drops after retirement, said the researchers. “Midlife is a time of highly stable work, family and romantic relationships. People increasingly occupy positions of power and status, which might promote feelings of self-esteem,” said co-author Richard Robins, PhD, of the University of California, Davis. “In contrast, older adults may be experiencing a change in roles such as an empty nest, retirement and obsolete work skills in addition to declining health.”
Orth doesn’t think baby boomers will skew self-esteem trajectories as the majority of that generation reach retirement age. But with medical advances, they will be healthier longer and, therefore, may be able to work and earn money longer. “It is possible that the decline in self-esteem might occur later in life for baby boomers,” he said.
Article: “Self-Esteem Development From Young Adulthood to Old Age: A Cohort-Sequential Longitudinal Study,” Ulrich Orth, PhD, University of Basel, Kali H. Trzesniewski, PhD, University of Western Ontario and Richard W. Robins, PhD, University of California, Davis; Journal of Personality and Social Psychology, Vol. 98, No. 4.
Source:
Audrey Hamilton
American Psychological Association
National Suicide Prevention Campaign For Teens
The Substance Abuse and Mental Health Services Administration (SAMHSA), working in collaboration with the Ad Council and the Inspire USA Foundation, announced today the launch of a national public service announcement PSA campaign designed to reduce the incidence of suicide and suicide attempts among teens in the United States.
Suicide is the third leading cause of death among 15-24 year-olds, following unintended injuries and homicide. While suicides account for approximately 1.4 percent of all deaths in the United States annually, they comprise 12 percent of deaths among this age group. In 2006, 4,189 people between ages 15 and 24 died by suicide. Furthermore, for every youth who died by suicide, it is estimated that 100-200 attempts are made.
“Suicide is a preventable tragedy,” said SAMHSA Administrator Pamela S. Hyde, J.D. “That’s why we have made it an explicit part of our top priority at SAMHSA – prevention of substance abuse and mental illness. We are aligning and bringing to bear the full force of our resources to reduce the risk and increase the protective factors that are linked with suicide. This new public service advertising campaign is a critical step in raising awareness among young people that there are places where they can turn for help.”
“Our new campaign with SAMHSA and Inspire USA connects with teens by identifying with the various challenges they are facing, while empowering them to cope by showing them how their peers have made it through,” said Peggy Conlon, president and CEO of the Ad Council. “These ads and our online resources will give teens hope and this campaign has the potential to save many lives.”
In an effort to provide support for teens who may be contemplating suicide, SAMHSA and the Ad Council launched the Teen Suicide Prevention campaign. Created by DDB New York through the Ad Council, the We Can Help Us effort includes television, radio, print and interactive PSAs, as well as in-school and mall posters, directed at 13-17 year-olds. The ads were based on the understanding that teens face a myriad of problems and many are seeking effective ways to cope with them.
The PSAs tell teens that they are not alone in their struggles with emotional and mental health problems, and that other teens have successfully worked through the same issues. Young people seeking help are urged to visit http://www.reachout.com, where they can hear success stories and strategies from teens.
The reachout.com Web site was developed by the Inspire USA Foundation, an organization that seeks to promote the mental health and wellbeing of young people. Reach Out integrates youth generated, expert-reviewed information and real-life stories with opportunities to connect with others in a supportive, safe environment.
Issues covered include warning signs for suicide, depression, eating disorders, as well as advice on relationships and coping strategies. The site includes videos, audio stories and other interactive features. Visitors can also view a series of animations that bring to life stories submitted by teens. Teens’ stories were shared with animation studios around the world who each added their unique artistic sensibilities to the animations, which also can be shared as viral videos.
Each page onreachout.com includes a prominent call-out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), a resource for individuals who are in crisis and need immediate help and support.
“Walk into any American high school classroom and the odds are that two of the young people before you will have attempted suicide over the past 12 months,” said Jack Heath, president of the Inspire USA Foundation. “Through our collaboration with SAMSHA and the Ad Council, the We Can Help Us campaign can bring a message of hope to literally millions of young Americans having a tough time.”
“At DDB, we were motivated to do our part to further awareness of the critically important issue of teen suicide,” said Peter Hempel, president, DDB New York. “The campaign creative is very positive in tone, to give those affected a sense of hope at a very dark time in their lives,” he added.
To extend the reach of the PSA campaign to teens nationwide, the Ad Council and SAMHSA will be collaborating with Students Against Destructive Decisions (SADD), National Organizations for Youth Safety (NOYS) and a number of other youth and mental health organizations.
The Ad Council is a private, non-profit organization that marshals talent from the advertising and communications industries, the facilities of the media, and the resources of the business and non-profit communities to produce, distribute and promote public service campaigns on behalf of non-profit organizations and government agencies. The Ad Council addresses issue areas such as improving the quality of life for children, preventive health, education, community well-being, environmental preservation and strengthening families.
Inspire USA Foundation is a 501c3 nonprofit established in San Francisco in 2007. Inspire’s mission is to help young Americans lead happier lives. Inspire takes a strength-based, public health approach to its work with a focus on mental health promotion and the prevention of high risk behavior, with a particular interest in suicide prevention.
Source
SAMHSA
http://www.medicalnewstoday.com/articles/184129.php
Girls at Risk for Depression May Not Process Reward and Loss Properly
ScienceDaily (Apr. 6, 2010) — Young girls at high risk for depression, but who have not experienced any symptoms, show differences in neural response patterns when processing the possibility of receiving a reward or sustaining a loss, according to a report in the April issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
“A hallmark characteristic of major depressive disorder is the diminished experience of pleasure or reward,” the authors write as background information in the article. “For example, compared with non-depressed persons, depressed individuals have been found to be characterized by attenuated [decreased] reactivity to slides depicting pleasant scenes, to amusing film clips, to pleasant drinks and to monetary reward contingencies.” Recent research has suggested that these variations are reflected in underlying differences in the way the brain processes pleasant stimuli.
To begin assessing whether these deficits precede the onset of depression or are a consequence of the disorder, Ian H. Gotlib, Ph.D., of Stanford University, Calif., and colleagues studied 13 10- to 14-year-old girls who did not have depression themselves but whose mothers had recurrent depression (high-risk group). They were compared with 13 girls who were the same age but had no personal or family history of depression (low-risk group).
All 26 participants underwent functional magnetic resonance imaging (fMRI) while completing a task involving the possibility of reward and punishment. They were first shown a target and told that if a circle appeared, they could gain points by being fast enough to hit the target. If a square appeared, they could avoid losing points by hitting the target quickly. If a triangle appeared, they could neither win nor lose points and should avoid responding. The task consisted of 100 six-second trials, each of which contained an anticipation phase and a feedback phase, during which the girls were told whether they gained or lost points. The points could be redeemed for prizes at the end of the task.
The images revealed important differences in the way the two groups responded to the task. The high-risk group displayed diminished neural responses during both anticipation and receipt of the reward when compared with the low-risk group. Specifically, they did not show any activation in a brain area known as the dorsal anterior cingulate cortex, which appears to be involved in reinforcing past experiences to facilitate learning. However, compared with low-risk girls, high-risk girls showed an increased activation in this area when receiving punishment. This suggests they may more easily integrate information about loss and punishment than reward and pleasure over time.
“Considered together with reduced activation in the striatal areas commonly observed during reward, it seems that the reward processing system is critically impaired in daughters who are at elevated risk for depression, although they have not yet experienced a depressive episode,” the authors conclude. “Clearly, longitudinal studies are needed to determine whether the anomalous activations observed in this study during the processing of rewards and losses are associated with the subsequent onset of depression.”
Journal Reference:
- 1. Ian H. Gotlib; J. Paul Hamilton; Rebecca E. Cooney; Manpreet K. Singh; Melissa L. Henry; Jutta Joormann. Neural Processing of Reward and Loss in Girls at Risk for Major Depression. Arch Gen Psychiatry, 2010; 67 (4): 380-387 [link]
http://www.sciencedaily.com/releases/2010/04/100406205500.htm
ScienceDaily (Apr. 6, 2010) — The percentage of clinicians who meet criteria for depression appears to increase significantly during medical internship, according to a report posted online today that will appear in the June print issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Increased work hours, stressful life events, genetic predisposition and receiving a medical education in the United States are among the factors that appear to be associated with depressive symptoms among medical interns.
