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December 16, 2005
Tobacco Scenes In Movies Boost Teen Smoking
The review concludes that eliminating scenes of smoking in new youth-rated films should substantially reduce smoking initiation in the adolescent years, when the vast majority of smokers start.
"The weight of dozens of studies, after controlling for all other known influences, shows the more smoking that kids see on screen, the more likely they are to smoke," said lead author Annemarie Charlesworth, a research specialist at the University of California, San Francisco Institute for Health Policy Studies. "This strong empirical evidence affects hundreds of thousands of families".
The research review, published in the recent issue of Pediatrics, a peer-reviewed publication of the American Academy of Pediatrics, examined the findings of 42 studies on how viewing on-screen smoking affects adolescent and teen smoking behavior.
Among the conclusions:
December 14, 2005, 8:12 PM CT
Depression Improves After Epilepsy Surgery
The study, which is published in the December 13, 2005, issue of Neurology, the scientific journal of the American Academy of Neurology, found that the rate of depression and anxiety disorders decreased by more than 50 percent up to two years after the surgery. People who no longer experienced any seizures after surgery were even more likely to be free of depression and anxiety.
"These results are important because depression and anxiety can significantly affect the quality of life," said study author Orrin Devinsky, MD, Professor of Neurology, Neurosurgery, and Psychiatry at New York University School of Medicine and Director of the NYU Comprehensive Epilepsy Center. "For people with refractory epilepsy, studies show that depression is more likely to affect their quality of life than how often they have seizures or how a number of drugs they have to take.".
The study involved 360 people in seven U.S. epilepsy centers who were undergoing epilepsy surgery to remove the area of the brain producing the seizures. Epilepsy surgery is generally reserved for those whose seizures cannot be adequately controlled by medication. The majority of participants had surgery on the brain's temporal lobe. The participants' mental health and any symptoms of depression and anxiety were evaluated before surgery and at three months, one year, and two years after surgery.
Previous to the surgery, 22 percent of the participants met the criteria for a diagnosis of depression, compared to 9 percent two years after the surgery. For anxiety disorders, 18 percent met the criteria for a diagnosis before the surgery, compared to 10 percent two years after the surgery.........
December 14, 2005
Improving Alcoholism Treatment
The study is supported by a $2,670,633 grant awarded by the National Institute on Alcohol Abuse and Alcoholism.
One hundred and fifty New York State Office of Alcoholism and Substance Abuse Services outpatient clinics across the state will be invited to participate over the course of the two-year recruitment period. Staff at the clinics will receive an intensive package of materials and an on-site presentation focusing on a Motivational Interviewing(MI)-based preparatory session. During the year after receiving the materials, clinicians will be asked to complete short questionnaires regarding whether they have incorporated the technique into their clinical work.
MI, which originated in the field of addictions, is a powerful client-centered method for exploring and resolving the natural ambivalence that clients have toward change. An MI-based preparatory session, delivered early in therapy, may reduce the risk that clients will end therapy prematurely and increase the likelihood that clients will make needed changes in their drinking.
"In a clinical trial conducted at RIA, we have shown that an MI-based preparatory session reduces therapy dropout rates, increases session attendance and improves therapy outcomes for outpatient clients," Kimberly S. Walitzer, Ph.D., explained. "If we can help individuals stay in therapy, we have a better chance of helping them make real changes in their lives.".
Walitzer, RIA's deputy director, is the principal investigator on the study. She also is a research associate professor in the Department of Psychology, UB College of Arts and Sciences.........
December 14, 2005
Bipolar Disorder In Preschoolers
Mania can be confused with attention deficit hyperactivity disorderChild psychiatry scientists at Washington University School of Medicine in St. Louis have identified a small group of preschoolers who appear to suffer from bipolar disorder, also known as manic-depressive illness. The findings, presented this fall at the annual meeting of the American Academy of Child and Adolescent Psychiatry, highlight symptoms that distinguish bipolar disorder from other mental health problems in very young children.
Diagnosing bipolar disorder in children is difficult because the manic phase of the illness can be confused with the more common attention deficit hyperactivity disorder (ADHD). The confusion arises because mania and ADHD both involve hyperactivity, irritability and distractibility. These issues may be even more difficult in young children who display some of these behaviors and emotions normally. However, Joan Luby, M.D., an associate professor of child psychiatry, found mania symptoms, as defined by psychiatry's Diagnostic and Statistical Manual (DSM-IV), did not occur in healthy preschoolers and that three main symptoms distinguished bipolar disorder from ADHD in preschoolers: elation, grandiosity and hypersexuality.
Similar to the mania symptoms in older bipolar children - first outlined by Barbara Geller, M.D., professor of child psychiatry at Washington University School of Medicine - young children who manifested elation, grandiosity and hypersexuality had dramatically higher odds of having bipolar disorder when compared to children with ADHD.
"This is different than the ordinary, energetic state of young children, even children with ADHD," Luby explains. "When you ask healthy young children what they're capable of doing, they are known to inflate their capabilities and say they can run very fast or jump very high or even fly like Superman. What's different about grandiose children is that they become delusional and actually believe they can do things like run the preschool. An extreme example that I've seen involved a manic preschooler who believed that she made the sun rise and set."
December 13, 2005
Popularity Doesn't Necessarily Make Prozac Best Antidepressant
Scientists led by Andrea Cipriani, M.D., compared Prozac (fluoxetine) to other selective serotonin reuptake inhibitors, and to other antidepressants and found that Zoloft (sertraline) and Effexor (venlafaxine) were somewhat better for treating depression.
The review also compared the tolerability of fluoxetine and several other often-prescribed antidepressants. Patients found fluoxetine more tolerable than both Elavil or Endep (amitryptilline) and Tofranil (imipramine).
Cipriani, a psychiatry expert at the University of Verona in Italy, said in an e-mail, "Fluoxetine, the most widely studied SSRI, has progressively replaced amitriptyline and imipramine as the standard of comparison for newer medications. We chose fluoxetine because of its long-time position as the market leader and because it has been often used as a reference compound for newer [antidepressants].".
Psychiatry expert Xavier Amador, a member of the board of directors for the National Alliance for the Mentally Ill, said, "Prozac was available years before other SSRIs. Since, as a group, the SSRIs were far safer than [earlier antidepressants] the first one, Prozac, became hugely popular. It has tremendous name recognition for this reason.".
The review appeared in the latest issue of the Cochrane Library. The Cochrane Library is a publication of The Cochrane Collaboration, an independent international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.........
December 13, 2005
Link Between Caffeine Dependence And Family History Of Alcoholism
Withdrawal symptoms, functional impairment and craving were cited by the women as reasons they could not cut out or cut back on caffeine use.
None of the women had a current alcohol-use diagnosis, and none had been treated for alcohol problems.
"Results of this study suggest that genetic vulnerability reflected in a family history of alcoholism may also be at the root of the inability to stop caffeine use," said co-lead author Roland R. Griffiths, Ph.D., a professor in the departments of Psychiatry and Neuroscience at The Johns Hopkins University School of Medicine.
The study appears in the recent issue of the American Journal of Psychiatry.
Griffiths, whose past studies of caffeine use helped establish the drug's addictive nature, collected data on caffeine and alcohol use from 44 pregnant women seeking prenatal care from a private obstetrics and gynecology practice in a suburban community. Results showed that half of the women who had both a lifetime history of caffeine dependence and a family history of alcoholism ignored their doctor's recommendation to abstain from caffeine use and consumed caffeine in amounts greater than those considered safe during pregnancy.
Women in the study without these dual risk factors were able to abstain from caffeine during pregnancy, Griffiths said.
"This study helps to validate the diagnosis of caffeine dependence as a clinically significant phenomenon," Griffiths said. "It's one thing to speculate how powerful the dependence is, but here we have an example of people who are not following clinician recommendations and are unable to quit caffeine in spite of wanting to do so.".........
December 13, 2005
Pre-K And Early Head Start Programs Enhance Children's Development
Findings from both studies confirm the positive effects of these programs for children from birth to age five, including higher performance in children's cognitive and language functioning. The Early Head Start program benefited children's social and emotional development and health as well as reduced aggressive behavior, and improved parent-child relations, and the pre-K program increased parents' involvement in school and home activities.
In the study authored by public policy professor William T. Gormley, Jr., Ph.D., and colleagues of Georgetown University, 1,567 pre-K 4-year-old children and 1,461 children who just completed one of the pre-K programs in Tulsa, Oklahoma, were compared on letter-word identification, spelling and applied problems. Statistical controls for demographic characteristics equalized the two groups. Those children who participated in the state-funded universal pre-K program did better on cognitive tests that measured pre-reading and reading skills, prewriting and spelling skills and math reasoning and problem-solving skills than those children who did not participate in the pre-K program.
The pre-K program improved performances for children from different ethnic backgrounds (Hispanic, Black, White and Native American) and income brackets (measured by those who are eligible for a full price lunch, a reduced-price lunch and no lunch subsidy), according to the study. Disadvantaged children and Hispanic children benefited the most.........
December 12, 2005
Washington University Researchers Study Gambling
Image courtesy Washington University In St. LouisMore than 80 percent of the U.S. population gambles at some time in their lives. It might be the lottery, bingo or poker. Most never need therapy for problem gambling, but others lose control and lose their houses or cars and damage family relationships as a result of compulsive gambling.
Little is known about why people gamble and how to predict who is likely to become a pathological gambler, but scientists at Washington University in St. Louis have developed a diagnostic tool for identifying pathological gambling disorder, and they're beginning to learn who is at risk and what causes the problems.
Investigators from the Department of Psychiatry in the School of Medicine and the George Warren Brown School of Social Work have developed a tool known as the Gambling Assessment Module (GAM)© that can help determine whether a person is a pathological gambler and what particular type of gambling triggers problems for that individual. The assumption is that different people have problems with different types of gambling and that scientists would do better not to lump football betting, slot machines, bingo and craps under a single umbrella just as they would not consider marijuana, cocaine and heroin simply as "drugs."
"We hope to be able to move beyond the question of whether a person is a pathological gambler or not and do what we do in substance abuse research," says Renee M. Cunningham-Williams Ph.D., visiting associate professor at the George Warren Brown School of Social Work and principal investigator on several gambling studies. "If a person is dependent upon marijuana, for example, they might have a very different profile than one who is dependent upon cocaine. We're trying to move gambling research in that direction."
Substance abuse is a good model for gambling disorders, she says, because much of the language used to describe gambling disorders is identical to criteria used to diagnose substance abuse disorders.........
December 12, 2005
African-american Women's Decisions To Join A Screening
The scientists report that telephone-based care for people with generalized anxiety disorder and panic disorder significantly improves both their symptoms of anxiety and depression and their mental health-related quality of life. The Pitt scientists also found the intervention results in fewer missed workdays and lower levels of emergency room usage.
This study is among the first to evaluate the efficacy of a telephone-based collaborative care intervention for anxiety disorders in a primary care setting, garnering results that could have far-reaching impact on how patients in all types of communities - urban, suburban and rural - can be helped. "Collaborative care" involves care managers who support patients by taking the time needed to familiarize the patients with their illnesses and therapy options while teaching self-management techniques and promoting adherence with recommended therapys according to evidence-based guidelines and under the direction of the patients' primary care physicians with specialist involvement when necessary. By providing support and monitoring progress, the use of care managers can result in much better outcomes for patients.
More than 30 million Americans have suffered from anxiety disorders at some point in their lives. Approximately 12 to 22 percent of patients present symptoms of anxiety-related distress to their primary care physicians. The direct and indirect costs of anxiety disorders have been estimated at $42 billion a year in the United States; 10 percent of those costs come from missed work days and other workplace costs. These facts establish the need for cost-effective and generalizable strategies for treating these patients.........
December 12, 2005
Studying Autism Susceptibility Genes
Michael Zwick, PhD, assistant professor of Human Genetics at Emory University School of Medicine, has received a five-year grant totaling approximately $1.3 million from a public/private partnership of government health agencies and private advocacy organizations, including five institutes within the National Institutes of Health (NIH), Cure Autism Now, the National Alliance for Autism Research, and the Southwest Autism Research and Resource Center. The Emory grant is one of five grants awarded nationally for genetic autism research.
Autism has an incidence rate of 1 in every 166 children. Symptoms include varying degrees of impairment in communication and social skills and repetitive patterns of behavior. Strong evidence from twin and family studies indicates that at least some cases of autism are inherited; however, no single gene has been found to explain autism, and researchers now believe genetic susceptibility may be caused by multiple genes, along with environmental factors.
Dr. Zwick helped develop the microarray resequencing technology first as a post-doctoral fellow at Johns Hopkins, and then as a Navy reservist working at the Naval Medical Research Center in Silver Spring, Md. Microarray, or DNA chip resequencing, allows researchers to determine 300,000 base pairs of an individual's genome (the G, A, T, C in the DNA sequence) using square chips that are just .75 inches long by .75 inches wide. This allows researchers to examine specific chromosomal regions in large collections of human patients to uncover subtle variations that could have significant consequences for health and disease.........
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