Wednesday, October 21, 2015

Guns in the US! “Wouldn’t it be great if you could get your hands on access to mental health care” as fast as you can get your hands on a gun?

APA-IPS: Gun ownership is a public health issue


NEW YORK – The prevalence of guns in the United States is a public health issue that must be addressed head-on by clinicians – including psychiatrists, experts said at the American Psychiatric Association’s Institute on Psychiatric Services.
Part of the challenge is bridging the cultural disconnect between some psychiatrists and patients. About 10% of psychiatrists own guns, but the ownership rate among U.S. households ranges from 40%-50%, said Dr. John Rozel, a psychiatrist affiliated with the Western Psychiatric Institute and Clinic at the University of Pittsburgh. “Most of us psychiatrists might not intrinsically get it.”
The United States has more than 270,000,000 civilian-owned firearms, which is more than the next 18 countries combined.
The United States has more than 270,000,000 civilian-owned firearms, which is more than the next 18 countries combined.
Facing the ubiquity of guns in American life might be a good place to start. The United States has more than 270,000,000 civilian-owned firearms, which is more than the next 18 countries combined, Dr. Rozel said, quoting 2007 data from the global Small Arms Survey. “Wouldn’t it be great if you could get your hands on access to mental health care” as fast as you can get your hands on a gun?
The secure place of guns within American life requires “radical acceptance” on the part of psychiatrists, Dr. Abhishek Jain said at the session.
“The Second Amendment is not going anywhere,” said Dr. Jain, also a psychiatrist with the clinic. “Keep in mind how much buying [of guns] there is in your jurisdiction. Pay attention to your own state laws. Variability is considerable.”
An understanding of these laws needs to occur while recognizing that the public is largely misinformed about the tendency of people with mental illness to turn to violence. “Little population-level evidence supports the notion that individuals diagnosed with mental illness are more likely than anyone else to commit gun crimes,” Dr. Jonathan M. Metzl and Kenneth T. MacLeish, Ph.D., wrote in a recent review (Am J Public Health. 2015 Feb;105[2]:240-9). “Databases that track gun homicides, such as the National Center for Health Statistics, similarly show that fewer than 5% of the 120,000 gun-related killings in the United States between 2001 and 2010 were perpetrated by people diagnosed with mental illness,” according to the Centers for Disease Control and Prevention.
People with mental illness are more likely to hurt themselves than others. Furthermore, tighter gun laws are associated with lower rates of suicide. A recent study found a connection between more stringent laws involving waiting periods, universal background checks, gun locks, and open carrying regulations in four states and a drop in suicide rates (Am J Public Health. 2015;105[10]:2049-58). “We should talk about individual safety,” Dr. Jain said.

Talking with your patients about guns
Dr. Layla Soliman encouraged developing a working knowledge about some of the fine points of guns, such as how they work. “After every tragedy, we see [in the comments section of online articles] ‘why can’t psychiatrists stop these people?’ We’re part of the discussion, whether we want to be or not,” said Dr. Soliman, a psychiatric attending on the inpatient unit at the hospital.
Using motivational interviewing is a good way to get patients to open up about their access to guns and how they view them.
Using motivational interviewing is a good way to get patients to open up about their access to guns and how they view them.
Asking all patients about the role of guns in their lives should be routine, she said. “We are trained to do this [as part of] a checklist. We have to ask in the same way we ask about past violence [and] substance use.” Document these conversations with patients defensively, Dr. Soliman said. “I would suggest an integrated risk assessment in your documentation.”
Dr. Rozel agreed. “We’ve learned a lot of lessons from our colleagues in pediatrics [and] how they talk with patients about vaccinations,” he said. Dr. Rozel is trained as a child psychiatrist and holds a master of studies in law degree.
Using motivational interviewing is a good way to get patients to open up about their access to guns and how they view them. “It’s about collaboration, not confrontation,” Dr. Rozel said. “It’s about accepting their reality [and] not imposing our will on them. They may not want to have this conversation. Express empathy [by saying]: ‘I don’t want to take any unnecessary chances with your life.’ ”
Dr. Rozel, Dr. Jain, and Dr. Soliman are also assistant professors of psychiatry at Western Psychiatric Institute and Clinic. They said they had no disclosures.

Tuesday, October 20, 2015

you snooze you loose? not so true!

As humans, we spend about a third of our lives asleep. So there must be a point to it, right? Scientists have found that sleep helps consolidate memories, fixing them in the brain so we can retrieve them later. Now, new research is showing that sleep also seems to reorganize memories, picking out the emotional details and reconfiguring the memories to help you produce new and creative ideas, according to the authors of an article inCurrent Directions in Psychological Science.
"Sleep is making memories stronger," says Jessica D. Payne of the University of Notre Dame, who co-wrote the review with Elizabeth A. Kensinger of Boston College. "It also seems to be doing something which I think is so much more interesting, and that is reorganizing and restructuring memories."
Payne and Kensinger study what happens to memories during sleep, and they have found that a person tends to hang on to the most emotional part of a memory. For example, if someone is shown a scene with an emotional object, such as a wrecked car, in the foreground, they're more likely to remember the emotional object than, say, the palm trees in the background -- particularly if they're tested after a night of sleep. They have also measured brain activity during sleep and found that regions of the brain involved with emotion and memory consolidation are active.
"In our fast-paced society, one of the first things to go is our sleep," Payne says. "I think that's based on a profound misunderstanding that the sleeping brain isn't doing anything." The brain is busy. It's not just consolidating memories, it's organizing them and picking out the most salient information. She thinks this is what makes it possible for people to come up with creative, new ideas.
Payne has taken the research to heart. "I give myself an eight-hour sleep opportunity every night. I never used to do that -- until I started seeing my data," she says. People who say they'll sleep when they're dead are sacrificing their ability to have good thoughts now, she says. "We can get away with less sleep, but it has a profound effect on our cognitive abilities."

Story Source:
The above post is reprinted from materials provided by Association for Psychological ScienceNote: Materials may be edited for content and length.

Journal Reference:
  1. Elizabeth A. Kensinger and Jessica D. Payne. Sleep’s Role in the Consolidation of Emotional Episodic MemoriesCurrent Directions in Psychological Science,

Our Brain is filing away during sleep! Science Rocks.

"A great way to understand sleep better,  we dream crazy stuff, our hearts continue beating, our breathing  never stops! we wake up not remembering much unless the support staff in the head office leaks nightmarish memory consolidation activity. the human brain is incredible "

Sleep is usually considered an all-or-nothing state: The brain is either entirely awake or entirely asleep. However, MIT neuroscientists have discovered a brain circuit that can trigger small regions of the brain to fall asleep or become less alert, while the rest of the brain remains awake.
This circuit originates in a brain structure known as the thalamic reticular nucleus (TRN), which relays signals to the thalamus and then the brain's cortex, inducing pockets of the slow, oscillating brain waves characteristic of deep sleep. Slow oscillations also occur during coma and general anesthesia, and are associated with decreased arousal. With enough TRN activity, these waves can take over the entire brain.
The researchers believe the TRN may help the brain consolidate new memories by coordinating slow waves between different parts of the brain, allowing them to share information more easily.
"During sleep, maybe specific brain regions have slow waves at the same time because they need to exchange information with each other, whereas other ones don't," says Laura Lewis, a research affiliate in MIT's Department of Brain and Cognitive Sciences and one of the lead authors of the new study, which appears in the journal eLife.
The TRN may also be responsible for what happens in the brain when sleep-deprived people experience brief sensations of "zoning out" while struggling to stay awake, the researchers say.
The paper's other first author is Jakob Voigts, an MIT graduate student in brain and cognitive sciences. Senior authors are Emery Brown, the Edward Hood Taplin Professor of Medical Engineering and Computational Neuroscience at MIT and an anesthesiologist at Massachusetts General Hospital, and Michael Halassa, an assistant professor at New York University. Other authors are MIT research affiliate Francisco Flores and Matthew Wilson, the Sherman Fairchild Professor in Neurobiology and a member of MIT's Picower Institute for Learning and Memory.

Local control
Until now, most sleep research has focused on global control of sleep, which occurs when the entire brain is awash in slow waves -- oscillations of brain activity created when sets of neurons are silenced for brief periods.
However, recent studies have shown that sleep-deprived animals can exhibit slow waves in parts of their brain while they are still awake, suggesting that the brain can also control alertness at a local level.
The MIT team began its investigation of local control of alertness or drowsiness with the TRN because its physical location makes it perfectly positioned to play a role in sleep, Lewis says. The TRN surrounds the thalamus like a shell and can act as a gatekeeper for sensory information entering the thalamus, which then sends information to the cortex for further processing.
Using optogenetics, a technique that allows scientists to stimulate or silence neurons with light, the researchers found that if they weakly stimulated the TRN in awake mice, slow waves appeared in a small part of the cortex. With more stimulation, the entire cortex showed slow waves.
"We also found that when you induce these slow waves across the cortex, animals start to behaviorally act like they're drowsy. They'll stop moving around, their muscle tone will go down," Lewis says.
The researchers believe the TRN fine-tunes the brain's control over local brain regions, enhancing or reducing slow waves in certain regions so those areas can communicate with each other, or inducing some areas to become less alert when the brain is very drowsy. This may explain what happens in humans when they are sleep-deprived and momentarily zone out without really falling asleep.
"I'm inclined to think that happens because the brain begins to transition into sleep, and some local brain regions become drowsy even if you force yourself to stay awake," Lewis says.
Natural sleep and general anesthesia
Understanding how the brain controls arousal could help researchers design new sleep and anesthetic drugs that create a state more similar to natural sleep. Stimulating the TRN can induce deep, non-REM-like sleep states, and previous research by Brown and colleagues uncovered a circuit that turns on REM sleep.
Brown adds, "The TRN is rich in synapses -- connections in the brain -- that release the inhibitory neurotransmitter GABA. Therefore, the TRN is almost certainly a site of action of many anesthetic drugs, given that a large classes of them act at these synapses and produce slow waves as one of their characteristic features."
Previous work by Lewis and colleagues has shown that unlike the slow waves of sleep, the slow waves under general anesthesia are not coordinated, suggesting a mechanism for why these drugs impair information exchange in the brain and produce unconsciousness.

Story Source:
The above post is reprinted from materials provided by Massachusetts Institute of TechnologyNote: Materials may be edited for content and length.

The compulsion to repeat! The complexities of being human.

A study led by Cathy Spatz Widom, Distinguished Professor of Psychology at John Jay College, found that offspring of parents with histories of child abuse and neglect are themselves at risk for childhood neglect and sexual abuse but not physical abuse. Titled "Intergenerational Transmission of Child Abuse and Neglect: Real or Detection Bias?" the study's findings were reported in the March 27 issue of the journal Science.
As part of a prospective longitudinal study, Widom followed a large group of children with documented cases of childhood abuse and neglect and a demographically matched group of children without documented histories of abuse or neglect into adulthood. Widom and her team interviewed both groups of individuals who are now adults in their 40s and early 50s and a sample of their offspring.
Researchers found that the parents with documented cases of childhood abuse or neglect reported more neglect toward their children than parents without such histories, but did not report more physical and sexual abuse. The offspring of these parents with a history of abuse and neglect were more likely to report having been sexually abused and neglected than offspring of parents without those histories. Given these surprising findings, the researchers speculated that a shift in societal attitudes toward physical abuse may account for the decline in the reports of this type child maltreatment.
Because self-reports are not always consistent with official reports, the researchers also looked at Child Protective Services reports. They found that parents with histories of abuse or neglect and children of parents with these histories were twice as likely to be reported to Child Protective Services. However, what is striking is that these analyses involved only parents and children who reported either engaging in or experiencing maltreatment, leading the researchers to speculate that these adults and their families may be disproportionately scrutinized.

Story Source:
The above post is reprinted from materials provided by John Jay College of Criminal JusticeNote: Materials may be edited for content and length.

Journal Reference:
  1. C. S. Widom, S. J. Czaja, K. A. DuMont. Intergenerational transmission of child abuse and neglect: Real or detection bias? Science, 2015; 347 (6229): 1480 DOI: 10.1126/science.1259917

Science Rocks! I have practiced this for decades.

"I  believe that emotional abuse results in greater, both in numbers and intensity, personality disorders than physical abuse. It is an abstract infliction. The pretense of a non violent environment is false. The family is invaded by silent screams and denial. No bruises, nor broken bones to point to, so no external acknowledgement of the pain. This is not a discovery but a scientific validation of what great clinicians have utilized meticulously in their treatment plans for decades." 
Dr. Shandiz Zandi

Emotional abuse may be as harmful as physical abuse and neglect. This finding led by a team of researchers at McGill complements previous imaging research showing that emotional and physical pain both activate the same parts of the brain.
Different types of abuse, same consequences
Emotional abuse, which includes behaviors such as ridicule, intimidation, rejection, and humiliation, is much more common than physical abuse and neglect. Worldwide prevalence estimates suggest that approximately one third of children experience emotional abuse. However, "although people assume physical abuse is more harmful than other types of abuse, we found that they are associated with similar consequences," says David Vachon, a McGill professor in the Department of Psychology and the study's first author. "These consequences are wide-ranging and include everything from anxiety and depression to rule-breaking and aggression." The discovery may pave the way for more effective means of addressing how different forms of child abuse should be recognized and treated.
Summer camp shows kids of all stripes
Vachon, working with his former post-doctoral mentor Robert Krueger, used data from a study by Dante Cicchetti (University of Minnesota) and Fred Rogosch (University of Rochester) that was conducted through Mt. Hope Family Center. Cicchetti and Rogosh have been running a summer research camp for over 20 years to study low-income, school-aged children ages 5-13 years. About half of the camp-goers had a well-documented history of child maltreatment. Various types of child-, peer-, and counselor-reports were used to assess psychiatric and behavioral problems, and the camp counsellors were not told which campers were abused. Using their data, Vachon studied 2,300 racially and ethnically diverse boys and girls who participated in the summer camp.
Different types of child abuse have equivalent, broad, and universal effects
"We also tested other assumptions about child maltreatment," adds Vachon, "including the belief that each type of abuse has specific consequences, and the belief that the abuse has different consequences for boys and girls of different races." Once again, the study produced surprising findings: "We found that these assumptions might also be wrong. In fact, it seems as though different types of child abuse have equivalent, broad, and universal effects."
Need to rethink beliefs about child abuse
The study may significantly change how researchers, clinicians, and the public think about child abuse. "One implication," adds Vachon, "is that effective treatments for maltreatment of any sort are likely to have comprehensive benefits. Another implication is that prevention strategies should emphasize emotional abuse, a widespread cruelty that is far less punishable than other types of child maltreatment."
When asked about next steps, Vachon said, "One plan is to examine the way abuse changes personality itself -- does it change who we are? The point is to go beyond symptoms and ask whether abuse changes the way we tend to think, feel, and act."

Story Source:
The above post is reprinted from materials provided by McGill University.Note: Materials may be edited for content and length.

Journal Reference:
  1. David D. Vachon, Robert F. Kruger, Fred Rogosch, Dante Cicchetti.Assessment of the Harmful Psychiatric and Behavioral Effects of Different Forms of Child MaltreatmentJAMA Psychiatry, 2015 DOI:10.1001/jamapsychiatry.2015.1792

Monday, October 19, 2015

Babies Rock!

Babies as young as two months know when they are about to be picked up and change their body posture in preparation, according to new research.
Professor Vasu Reddy, of the University of Portsmouth, has found most babies aged two to four months understand they are about to be picked up the moment their mothers come towards them with their arms outstretched and that they make their bodies go still and stiff in anticipation, making it easier to be picked up.
This is the first study to examine how babies adjust their posture in anticipation to offset the potentially destabilising effect of being picked up.
Professor Reddy said: "We didn't expect such clear results. From these findings we predict this awareness is likely to be found even earlier, possibly not long after birth.
"The results suggest we need to re-think the way we study infant development because infants seem to be able to understand other people's actions directed towards them earlier than previously thought. Experiments where infants are observers of others' actions may not give us a full picture of their anticipatory abilities."
The findings could also be used as an early indicator of some developmental problems, including autism. It was reported by researchers in 1943 that children with autism don't appear to make preparatory adjustments to being picked up.
The researchers, who included Dr Gabriela Markova of the Czech Academy of Sciences, Prague, and Dr Sebastian Wallot of the University of Aarhus, did two studies, one on 18 babies aged three months, and a second on ten babies aged two to four months old.
In both, babies were placed on a pressure mat which measured their postural adjustments during three phases: As their mothers chatted with their babies; as the mothers opened their arms to pick them up; and as the babies were picked up.
The results revealed infants as young as two months made specific adjustments when their mother stretched her arms out to pick them up. These included extending and stiffening the legs which increases body rigidity and stability, and widening or raising their arms, which helps to create a space for the mother to hold the infant's chest.
Between two and three months of age the babies' gaze moved from mostly looking at their mother's face to often looking at her hands as she stretched her arms out towards them.
The results reveal two important findings -- first, that from as early as two months babies make specific postural adjustments to make it easier to pick them up even before their mother touches them. And second, it appears that babies learn to increase the smoothness and coordination of their movements between two and four months, rather than develop new types of adjustment.
"In other words, they rapidly become more adept at making it easier for parents to pick them up," Professor Reddy said.
The mothers in the study were asked about their babies' physical responses before the tests and some reported their babies stiffened their legs or raised their arms in preparation for being picked up, but video footage watched frame by frame revealed physical adjustments happened to a greater degree and more subtly than mothers had noticed.
The researchers suggest more research now needs to be done to examine the extent to which infants discriminate between different kinds of actions directed at them, between familiar and unfamiliar actions, and how infant anticipation of these actions is influenced by the different maternal styles they each experience.
The research is published in the latest issue of the journal Plos One.

Story Source:
The above post is reprinted from materials provided by University of PortsmouthNote: Materials may be edited for content and length.

Journal Reference:
  1. Vasudevi Reddy, Gabriela Markova, Sebastian Wallot. Anticipatory Adjustments to Being Picked Up in InfancyPLoS ONE, 2013; 8 (6): e65289 DOI: 10.1371/journal.pone.0065289

Tuesday, October 6, 2015

A special protein enhances sleep’s healing power and speeds flu recovery.
Originally published: 
Jan 23 2015 - 1:30pm
Katharine Gammon, Contributor

 – How many times has a grandmother recommended sleep to calm the flu? Now, science is showing that she’s right – thanks to help from a special brain protein. The finding could lead to some novel treatments to help the body fight the flu virus, sprayed right up the nose.
“We’ve known for a long time that microbes affected sleep, at least superficially – Hippocrates even wrote about sleep 2,500 years ago,” said James Krueger, a researcher at Washington State University in Spokane, Washington.
Krueger showed that a brain-specific protein called AcPb speeds recovery in lab mice by promoting the healing power of sleep. When he infected mice that lacked the protein with the influenza virus H1N1 – the strain that was common in the 2009 flu season -- their symptoms were more severe and they died at higher rates. Mice that had the brain protein slept more, and recovered more quickly from the flu.
The research also looked at the way that AcPb interacted with an immune system that is signaling a chemical known as interleukin-1. Interleukin-1 is a family of cytokines, which are inflammatory molecules that cause people to feel lousy when sick with the flu.
When the brain protein links up with the inflammatory molecule in healthy animals, it helped to regulate their sleep. Prior research has shown that sleep keeps the immune system healthy and is vital to the body’s ability to battle all kinds of infections. The research was published recently in the journal Brain, Behavior and Immunity.
The finding still leaves a question for the researchers, since influenza is typically viewed as an illness of the lungs, not the brain.
“The virus doesn’t replicate in brain, so the big question is why is this doing this in the brain?” Krueger asked.  “Why is a brain protein improving a lung disease?”
The next steps in the research are to harness the brain protein’s soporific powers to develop new methods of treating the flu.
Axel Steiger, director of the sleep laboratory at Germany's Max Planck Institute of Psychiatry, in Munich, said that the work is important because it connects the basic science of sleep regulation with a clinical application – better therapies for infectious diseases.
“Influenza is maybe not seen as such a spectacular disease like Ebola, but it’s a serious disease with high death rate and a high morbidity in many countries, and so it would be very useful to have new therapies,” Steiger said. He added that there was no reason this brain protein is limited to helping the flu -- it may be found to help other infectious diseases as well.
“It’s an example of nature working for you – with an infection, patients often become sleepy, and on the other hand, sleep helps to recover,” said Steiger.
Krueger said it’s vitally important to get new defense forces to fight the flu.
“Influenza is a tough nut to crack and sooner or later the virologists say we’re overdue for a pandemic for influenza,” he said. “This is one tiny contribution in a bigger endeavor. We don’t have a lot of artificial defense mechanisms that we can offer people.”
Other studies have shown that acute illnesses are more frequent in teenagers who sleep less (or miss sleep several nights in a row) and that people who have insomnia have lower flu antibody counts – both before and after getting a flu vaccine.
Lower antibody counts make the flu vaccine less effective, explained Kimberly Kelly, an associate professor of psychology at the University of North Texas in Denton, Texas. “It’s not totally surprising,” laughed Kelly. “There is a ton of data showing the effects of sleep deprivation on illness.”
Krueger, who was sick with the flu at the time of the interview, cautioned that while work in humans is still years off, treating mice is the first step. “This whole area is quite a ways – years away -- from a successful treatment of humans. Hopefully someone will pick it up quickly so they can cure me.”

Katharine Gammon is a freelance science writer based in Santa Monica, California, and writes for a wide range of magazines covering technology, society, and animal science. She tweets at @kategammon.
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