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Archive for January, 2011

 

ScienceDaily (Sep. 2, 2010) — Insomnia and other sleep disorders are very common, yet are not generally well understood by doctors and other health care professionals. Now the British Association for Psychopharmacology (BAP) has released up-to-the-minute guidelines in the Journal of Psychopharmacology, published by SAGE, to guide psychiatrists and physicians caring for those with sleep problems.

BAP members, representative clinicians with a strong interest in sleep disorders and experts from the US and Europe got together in May 2009 in London, England to share their knowledge of insomnia, parasomnias and circadian rhythm disorders. As well as a chance to share literature reviews and clinical trial data, the event gave experts the opportunity to reach a consensus on the best current treatments for sleep disorders. The BAP then used this and further rounds of consultation with the event participants to create its guidelines, BAP consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders, which the organisation hopes will present a comprehensive guide to clinicians, who are managing patients in primary or secondary medical care.

Sleep experts agree that insomnia is a condition of unsatisfactory sleep, either in terms of sleep onset, sleep maintenance or early waking. They also agree that insomnia is a disorder that impairs daytime well-being and subjective abilities and functioning, and so can be considered a ’24-hour’ disorder. Insomnia can also be viewed as a syndrome similar to pain, because it is subjective and its diagnosis is through clinical observations rather than measurements. In some cases physicians will be unable to pinpoint a cause, although this doesn’t prevent diagnosis.

Stress, life changes, a new baby, or shift work are typical factors that can trigger insomnia, but for some people this acute insomnia persists into a chronic state. Anxiety about sleep, maladaptive sleep habits and the possibility of an underlying vulnerability in sleep regulating mechanisms are all likely causes, as are other co-morbid disorders such as anxiety and depression, and diseases including cancer or arthritis. The recommendations address issues such as pregnancy, menopause, ageing, childhood disorders and other specific factors with suggestions for treatment, and an indication of the degree of agreement among experts in each case.

The good news is that insomnia can often be improved with specialist cognitive behavioral therapy (CBT) targeted at insomnia, which is as effective as prescription medications for short-term treatments for chronic insomnia. In addition, CBT is more likely to have a longer-lasting effect than drug treatment. However access to this type of treatment for insomnia sufferers is not always easy to access in the UK.

Women have a higher incidence of insomnia than men, and the older we get the more likely we are to suffer from poor sleep. Around a third of adults in Western countries will experience some difficulty getting to sleep or staying asleep at least once a week, and between six and 15 percent are thought to have full-blown insomnia.

Circadian rhythm disorders occur when our internal clocks don’t match our daily lives. Caused most often by shift work and jet lag, some people also routinely have difficulty going to bed before two or three AM and waking up in the morning on time (delayed sleep phase syndrome). Others get cumulatively later as time goes, a condition known as free running sleep disorder.

Night terrors, sleep walking and violent behaviour at night are known as ‘parasomnias.’ Physicians may need to refer patients experiencing these distressing episodes to a specialist sleep centre for polysomnography and video recording for a correct diagnosis, and to discover whether the attacks occur during REM (rapid eye movement) or non-REM sleep, which can mean differing treatments.

Read in Full:  http://www.sciencedaily.com/releases/2010/09/100902073459.htm



 

Young people who rob themselves of sleep by spending all night surfing the internet and playing computer games are tripling their chances of developing a mental illness, according to research.

Published: 7:30AM BST 02 Sep 2010

People who sleep less than five hours a night are up to three times more likely to become mentally ill than those sleeping eight or nine hours, the report said.

A 17-24 year old sleeps on average eight to nine hours per night, but this figure has been decreasing due to the amount of time young people spend on electronic gadgets in their bedrooms.

Researchers from George Institute for Global Health in Sydney, Australia, analysed the sleeping habits of almost 20,000 people aged between 17 and 24.

They found over half of those who got fewer than six hours sleep had high levels of psychological distress, compared with one quarter of those who slept eight to nine hours a night.

Professor Nick Glozier, who led the study, said: “Over the past few decades young adults have been sleeping fewer and fewer hours, whereas the rest of us have generally been sleeping more hours.

“There’s a whole load of gadgets that kids and young adults now have in their bedrooms that they never used to have.

“Yet of course they have to get up and go to school or college or go to university at exactly the same time. So there’s a group of them who are becoming more and more sleep-deprived.”

A lack of sleep could have potentially serious effects, he said.

Read in Full:  http://www.telegraph.co.uk/health/healthnews/7976621/Sleep-deprived-teenagers-triple-chances-of-mental-illness-by-spending-nights-online.html



 

Tamara H. Sone • Special to La Quinta Sun • September 2, 2010

The La Quinta High School Theatre was filled with dancing and singing monkeys, elephants, tigers and other wild animals last weekend.

The Coachella Valley Autism Society, the local chapter of the Autism Society of America, performed Disney’s “The Jungle Book” Saturday and Sunday.

The musical theater class was formed in February as part of the society’s social recreation program, said Carolyn Russom, resource coordinator,

“We decided to put on a show, so we wrote a grant and were lucky enough to be awarded that grant by the Irene W. and Guy L. Anderson Children’s Foundation,” Russom said.

 Practices for the performance started in mid-June with 22 kids learning how to sing and dance in front of a live audience. The performers ranged in age from 4 to 17.

Cliff Plummer, who teaches musical theater, designed and directed the performance.

“I chose ‘The Jungle Book’ because all of the music is upbeat, and the energy level is up all of the time. The kids seem to be able to stay focused when there is a lot of energy involved,” Plummer said.

Children with autism tend to lack or have a delay of spoken language, show little or no eye contact and use repetitive words and/or mannerisms such as hand flapping or twirling objects.

“This program has been a good outlet for the kids. We have one boy that is nonverbal, but he will sing. He won’t speak, but he will sing words,” Plummer said.

Read in Full:  http://www.mydesert.com/apps/pbcs.dll/article?AID=20109010336



 

OPELOUSAS, La. — At 18 months, Kyle Warren started taking a daily antipsychotic drug on the orders of a pediatrician trying to quell the boy’s severe temper tantrums.

Thus began a troubled toddler’s journey from one doctor to another, from one diagnosis to another, involving even more drugs. Autism, bipolar disorder, hyperactivity, insomnia, oppositional defiant disorder. The boy’s daily pill regimen multiplied: the antipsychotic Risperdal, the antidepressant Prozac, two sleeping medicines and one for attention-deficit disorder. All by the time he was 3.

He was sedated, drooling and overweight from the side effects of the antipsychotic medicine. Although his mother, Brandy Warren, had been at her “wit’s end” when she resorted to the drug treatment, she began to worry about Kyle’s altered personality. “All I had was a medicated little boy,” Ms. Warren said. “I didn’t have my son. It’s like, you’d look into his eyes and you would just see just blankness.”

Today, 6-year-old Kyle is in his fourth week of first grade, scoring high marks on his first tests. He is rambunctious and much thinner. Weaned off the drugs through a program affiliated with Tulane University that is aimed at helping low-income families whose children have mental health problems, Kyle now laughs easily and teases his family.

Ms. Warren and Kyle’s new doctors point to his remarkable progress — and a more common diagnosis for children of attention-deficit hyperactivity disorder — as proof that he should have never been prescribed such powerful drugs in the first place.

Kyle now takes one drug, Vyvanse, for his attention deficit. His mother shared his medical records to help document a public glimpse into a trend that some psychiatric experts say they are finding increasingly worrisome: ready prescription-writing by doctors of more potent drugs to treat extremely young children, even infants, whose conditions rarely require such measures.

More than 500,000 children and adolescents in America are now taking antipsychotic drugs, according to a September 2009 report by the Food and Drug Administration. Their use is growing not only among older teenagers, when schizophrenia is believed to emerge, but also among tens of thousands of preschoolers.

A Columbia University study recently found a doubling of the rate of prescribing antipsychotic drugs for privately insured 2- to 5-year-olds from 2000 to 2007. Only 40 percent of them had received a proper mental health assessment, violating practice standards from the American Academy of Child and Adolescent Psychiatry.

“There are too many children getting on too many of these drugs too soon,” Dr. Mark Olfson, professor of clinical psychiatry and lead researcher in the government-financed study, said.

Such radical treatments are indeed needed, some doctors and experts say, to help young children with severe problems stay safe and in school or day care. In 2006, the F.D.A. did approve treating children as young as 5 with Risperdal if they had autistic disorder and aggressive behavior, self-injury tendencies, tantrums or severe mood swings. Two other drugs, Seroquel from AstraZeneca and Abilify from Bristol-Myers Squibb, are permitted for youths 10 or older with bipolar disorder.

But many doctors say prescribing them for younger and younger children may pose grave risks to development of both their fast-growing brains and their bodies. Doctors can legally prescribe them for off-label use, including in preschoolers, even though research has not shown them to be safe or effective for children. Boys are far more likely to be medicated than girls.

Dr. Ben Vitiello, chief of child and adolescent treatment and preventive research at the National Institute of Mental Health, says conditions in young children are extremely difficult to diagnose properly because of their emotional variability. “This is a recent phenomenon, in large part driven by the misperception that these agents are safe and well tolerated,” he said.

Even the most reluctant prescribers encounter a marketing juggernaut that has made antipsychotics the nation’s top-selling class of drugs by revenue, $14.6 billion last year, with prominent promotions aimed at treating children. In the waiting room of Kyle’s original child psychiatrist, children played with Legos stamped with the word Risperdal, made by Johnson & Johnson. It has since lost its patent on the drug and stopped handing out the toys.

Greg Panico, a company spokesman, said the Legos were not intended for children to play with — only as a promotional item.

Cheaper to Medicate

Dr. Lawrence L. Greenhill, president of the American Academy of Child and Adolescent Psychiatry, concerned about the lack of research, has recommended a national registry to track preschoolers on antipsychotic drugs for the next 10 years. “Psychotherapy is the key to the treatment of preschool children with severe mental disorders, and antipsychotics are adjunctive therapy — not the other way around,” he said.

But it is cheaper to medicate children than to pay for family counseling, a fact highlighted by a Rutgers University study last year that found children from low-income families, like Kyle, were four times as likely as the privately insured to receive antipsychotic medicines.

Texas Medicaid data obtained by The New York Times showed a record $96 million was spent last year on antipsychotic drugs for teenagers and children — including three unidentified infants who were given the drugs before their first birthdays.

In addition, foster care children seem to be medicated more often, prompting a Senate panel in June to ask the Government Accountability Office to investigate such practices.

In the last few years, doctors’ concerns have led some states, like Florida and California, to put in place restrictions on doctors who want to prescribe antipsychotics for young children, requiring a second opinion or prior approval, especially for those on Medicaid. Some states now report prescriptions are declining as a result.

A study released in July by 16 state Medicaid medical directors, which once had the working title “Too Many, Too Much, Too Young,” recommended that more states require second opinions, outside consultation or other methods to assure proper prescriptions. The F.D.A. has also strengthened warnings about using some of these drugs in treating children.

No Medical Reason

Kyle was rescued from his medicated state through a therapy program called Early Childhood Supports and Services, established in Louisiana through a confluence of like-minded child psychiatrists at Tulane, Louisiana State University and the state. It surrounds troubled children and their parents with social and mental health support services.

Read in Full:  http://www.nytimes.com/2010/09/02/business/02kids.html?_r=2&partner=TOPIXNEWS&ei=5099



 

ScienceDaily (Sep. 1, 2010) — Kennedy Krieger Institute have announced new study results showing an early marker for later communication and social delays in infants at a higher-risk for autism may be infrequent gazing at other people when unprompted. Published in the September issue of the Journal of Child Psychology and Psychiatry, the study also found that six-month-old high-risk infants demonstrated the same level of cause and effect learning skills when compared to low-risk infants of the same age.

The study observed 25 infant siblings of children with autism (high-risk group) and 25 infants with no family history of autism (low-risk group) at six months of age in order to assess cause and effect learning as well as social engagement. Infant siblings of children with autism are considered at high-risk for the disorder, as they are 25 times more likely to develop autism. Researchers at Kennedy Krieger, in collaboration with colleagues at the University of Delaware, created a novel, multi-stimuli social learning task, where infants were seated in a custom chair with an attached joystick within easy reach, a musical toy located to the right and their caregiver on the left. Researchers evaluated how quickly the infant learned that the joystick activated the toy and the infant’s level of social engagement with their caregiver.

Read in Full:  http://www.sciencedaily.com/releases/2010/09/100901111628.htm



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By Daniel Tomasulo, Ph.D. 

“What you call people is how you treat them. What you call my sister is how you will treat her. If you believe she’s ‘retarded’ it invites taunting, stigma. It invites bullying and it also invites the slammed doors of being treated with respect and dignity.”
–14-year-old Nick Marcellino, Rosa’s brother, in testimony to the Maryland General Assembly

Say what you will about New Jersey. Yeah, we are called the Soprano state, and, yeah, everyone in Jersey is rumored to have an attitude. You got a problem with that? But I couldn’t be more proud of its recent legislation.

The U.S. Senate passed the bill known as Rosa’s Law in August 2010, and in September it goes before the House. Terms such as “mental retardation” and “mentally retarded” will be removed from federal education, health, and labor laws. Additionally, “a person with a disability” is preferred rather than a “disabled person.” New Jersey passed a similar law in June.

The federal government removed “feeble-minded” and replaced it with “mental retardation” over 40 years ago. It was time for a more positive change.

Read in Full:  http://psychcentral.com/blog/archives/2010/09/01/the-r-word-sticks-stones-and-rosas-law/



 

ScienceDaily (Sep. 1, 2010) — A study in the Sept. 1 issue of the journal Sleep shows that teens who slept less than eight hours per weeknight ate higher proportions of fatty foods and snacks than adolescents who slept eight hours or more. The results suggest that short sleep duration may increase obesity risk by causing small changes in eating patterns that cumulatively alter energy balance, especially in girls.

Results show that a shorter mean weekday sleep duration was significantly associated with an increase in the percentage of calories consumed from fats and a decrease in the percentage of calories from carbohydrates. After adjusting for potential confounders such as age, sex and race, teens who slept less than eight hours on weeknights consumed 2.2 percent more calories from fats and 3.0 percent fewer calories from carbs than teens who slept eight hours or more. Further adjustments for body mass index (BMI) had little effect on these associations. In secondary analyses stratified by sex, the results were significant among girls but not boys.

Read in Full:  http://www.sciencedaily.com/releases/2010/09/100901072854.htm



 

ScienceDaily (Sep. 1, 2010) — Young adults who get fewer than eight hours of sleep per night have greater risks of psychological distress, a combination of high levels of depressive and anxious symptoms, according to a study in the Sept. 1 issue of the journal Sleep.

Using an average self-reported nightly sleep duration of eight to nine hours as a reference, the study found a linear association between sleep durations of less than eight hours and psychological distress in young adults between 17 and 24 years of age. The risk of psychological distress increased by 14 percent for each hour of nightly sleep loss, such that those sleeping less than six hours a night were twice as likely to be experiencing distress as average sleepers. A similar association was found between sleep duration and persistent psychological distress; the risk that a person with psychological distress at baseline would be distressed at the one-year follow-up increased by five percent for each hour of nightly sleep loss after adjusting for potential confounders (RR 1.05). Long sleep durations of more than nine hours showed no association with distress at any time point.

“In young adults already experiencing distress, the fewer hours they sleep the worse the outcome across the range of sleep hours,” said lead author Nick Glozier, MBBS, MRCPsych, PhD, associate professor of psychological medicine at the Brain and Mind Research Institute and the Centre for Integrated Research and Understanding of Sleep (CIRUS) at the University of Sydney in Australia.

Read in Full:  http://www.sciencedaily.com/releases/2010/09/100901072910.htm



 

September 1, 2010

Email is a fantastic tool, but these ten psychology studies remind us of its dark side.

Like the telephone or the TV, email is a technology so embedded in our lives, we think nothing of it. Both help and hindrance, on one hand it’s the internet’s original ‘killer application’ and on the other it’s a spam-spewing slave-driver.

We’re used to hearing about the negative side of the balance-sheet, about email’s addictive nature and the unnecessary stress it injects into the modern worker’s life, but we downplay these problems because it’s so incredibly useful.

Now that email is well into middle age (the first emails were sent in 1965), let’s take stock of what we know about the darker side of email.

1. 59 per cent check email from the bathroom

You don’t need to be an expert on Pavlov’s drooling dogs to work out why email is so habit-forming. Most of it is humdrum, but occasionally we get something exciting and that’s what we’re hoping for when we check our email. In psychological terms email is a ‘variable-interval reinforcement’: we don’t know exactly when the good stuff is coming so we have to keep checking.

It’s no wonder, according to AOL’s 2010 survey, 47% claim to be hooked on it, 25% of people can’t go without email for more than 3 days, 60% check email on vacation and 59% check email from the bathroom.

2. You check more often than you think

Participants in a study by Renaud et al. (2006) claimed to check their email, on average, once an hour. However when the researchers spied on them, it turned out they checked their email every five minutes.

Despite the small sample size in Renaud’s study (6 people), further research has suggested people do set their email program to check their email every 5 minutes (Jackson et al., 2002) as well as significantly underestimating how often they check their email. As a consequence we also underestimate how disruptive it can be.

3. Email eats a quarter of the working day

When Czerwinski et al. (2004) carried out a diary study of people in various different occupations they found that, on average, people spent 23% of their working day dealing with email.

This is because people are not just using email to communicate, they are also using it as a way of tracking tasks—one study has found that workers are managing an average of 65 tasks in 10 different spheres at any one time (Gonzalez & Mark, 2004).

4. It takes 64 seconds to recover from an email

We often react quickly to incoming email, almost like the phone ringing. In one workplace study, Jackson et al. (2002) found that 70% of emails were reacted to within 6 seconds of their arrival, and 85% within 2 minutes.

The problem is that it took participants in the same study 64 seconds to recover their train of thought after an email interruption.

Add this to the fact that Gonzalez & Mark (2004) have found that people spend an average of only 3 minutes on each task before they switch to another, and it’s difficult to see how anyone can achieve the psychological state of ‘flow’ necessary for complex tasks.

5. Stressed emailers

Given the effort we put into email and all the task-switching that’s going on, it’s unsurprising that it generates stress. Of course we each deal with email in different ways, Hair et al. (2005) have identified three types of emailer:

  1. Relaxed responders treat email almost like snail mail. They refuse to let it control them and get back to people when they feel like it.
  2. Driven responders try to reply instantly to email and expect others to do the same.
  3. Stressed responders don’t find email useful, to them it is mostly an irritation.

My survey revealed 57% of people consider themselves relaxed, 32% driven and 11% stressed emailers, but this may well underestimate the actual number of stressed emailers.

Read in Full:  http://www.spring.org.uk/2010/09/emails-dark-side-10-psychology-studies.php



 

Article Date: 01 Sep 2010 – 3:00 PDT

With summer fading, anxiety is on the rise for some students anticipating the return of school. But it isn’t just the first days of classes that can provoke angst — anxiety in school is seasonal and age dependent, say pediatric psychiatrists.

And, they add, these issues are often predictable and highly treatable. “If parents are aware of the fears that might affect their school-age children at different times of the year, and at certain ages, there is a lot they can do to help,” says Dr. John T. Walkup, director of child and adolescent psychiatry at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and vice chair of the Department of Psychiatry at Weill Cornell Medical College.

“It is about knowing when problems occur, anticipating them, and intervening effectively so that children do not suffer academically or socially,” he says. “Untreated anxiety and depression lead to coping and adaptation difficulties over time — all of which can be prevented by early recognition and treatment.”

Dr. Walkup adds that these anxiety disorders are much more common than parents (and teachers) realize, and while anxiety is a fact of life, many children are impaired enough that they should be assessed and treated. “Behavioral therapy works well for many students,” he says. “Others may need medication.”

Seasons of Anxiety

Culled from his clinical experience with many children with anxiety disorders, Dr. Walkup outlines what he dubs the “Seasons of Anxiety”:

* September: Separation anxiety as school starts. This usually occurs in children under the age of 12 as they anticipate returning to school after a summer spent with their family. With the anticipation of returning to school, these children may have trouble falling asleep, stomach aches in the morning, clingy behavior and apprehension about leaving home and going to school. At school they may go to the nurse with vague symptoms and want to come home.

Although some mild and transient separation anxiety with starting school is common in children ages 4 to 6, separation anxiety in children 7 to 12 is of more concern. Separation anxiety can start abruptly or sharply worsen in this age group. “These kids really worry about separation,” Dr. Walkup says. “They worry something bad will happen to their parents or to them. At home, they often don’t want to be alone, won’t do sleepovers during the school year and often don’t want to go to camp in the summertime. Monday morning is more difficult than Friday for these children.”

Separation anxiety can be treated with behavioral therapy, such as the well-known “Coping Cat” program, in which a trained professional works with the child and family to identify the fears and develop strategies to manage and overcome them, he says. “It is important that children learn to handle their fears and worries at an early age so that when they are older they don’t use avoidance as a coping strategy for routine challenges in living. Kids should be curious about new (safe) situations and experiences, not fearful and avoidant. If they learn they can handle new situations and challenges as an early age they will be more likely to handle challenging situations in adolescence and adulthood. Teens who have had anxiety as children often don’t have the kind of complex and supple coping skills in adolescence and often complain of feeling overwhelmed by even routine stresses.”

Read in Full:  http://www.medicalnewstoday.com/articles/199568.php