By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on November 8, 2010

A UK psychologist believes untreated ADHD is a significant underlying cause of crime.

Dr. Susan Young, at Broadmoor Hospital, shares her beliefs in a paper in which she explores the connection between ADHD and criminal activity.

Young believes early intervention can reduce crime and actually divert youths from a criminal path.

The paper, co-written by Emily Goodwin, King’s College London and Institute of Psychiatry, was published in the Expert Review of Neurotherapeutics, an international journal on drugs and medicines in clinical neurology and neuropsychiatry.

Young said, “Failure to recognize and treat ADHD offenders is likely to have serious consequences for mental health and social outcomes.

“The high rates of ADHD among this group, the consumption and costs of the resources they incur, mean that it is not a condition we can afford to ignore. Given that ADHD is a treatable condition with interventions available that are used to effectively treat ADHD symptoms and related behavioral problems in the general population, the enormity of this problem and its associated costs are too great to bear.”

Source: West London Mental Health NHS Trust

By Psych Central News Editor Reviewed by John M. Grohol, Psy.D. on March 7, 2011

In any given year, nearly 1 in 60 teens would qualify for an eating disorder diagnosis such as anorexia, bulimia or binge eating disorder. More specifically, a new study from the National Institute of Mental Health found that the one-year prevalence rate of eating disorders in teens is 1.7 percent.

That figure is a more precise measure that is in line with previous estimates.

Sonja Swanson, Sc.M., of the National Institute of Mental Health, and colleagues examined eating disorders with data from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative sample of U.S. adolescents. the sample included face-to-face interviews with 10,123 adolescents ages 13 to 18 years.

Eating disorders are a group of mental health concerns that include anorexia, bulimia, binge eating disorder, and other types of disordered eating.

The objectives of the study included determining the lifetime and 12-month prevalences of anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED) and subthreshold eating disorders; examining their sociodemographic and clinical correlates and patterns of comorbidity with other mental disorders; and to describe the magnitude of role impairment, suicidal behavior, and service use associated with these disorders.

A subthreshold eating disorder is defined as a set of symptoms that do not meet existing eating disorder criteria. A person with such symptoms, however, may meet the criteria for an eating disorder criteria in the future.

The researchers felt as if they had sufficient information as to define subthreshold anorexia (SAN) and subthreshold bulimia (SBED) among those youths who did not meet criteria for AN, BN, or BED.

The researchers found that lifetime prevalence rates — that is, the likelihood of a person having it over the course of their lifetime — of AN, BN and BED were 0.3 percent, 0.9 percent and 1.6 percent, respectively.

The 12-month prevalence rates of anorexia, bulimia, and binge eating disorder were 0.2 percent, 0.6 percent and 0.9 percent respectively (equaling a 1.7 percentage rate for all three disorders together).

For subthreshold eating disorders, the lifetime prevalence rates were 0.8 percent for SAN and 2.5 percent for SBED, while the 12-month prevalence rates were 0.1.1 for SBED.

Regarding lifetime prevalence estimates, there were no sex differences in the prevalence of AN or SBED, whereas BN, BED, and SAN were more prevalent in girls.

Although the lifetime prevalence estimates of eating disorders from population-based studies of adults are relatively low, their severity and dramatic effects have been repeatedly demonstrated through elevated rates of impairment, medical complications, other illnesses, death and suicide, according to background information in the article.

The majority of respondents with an eating disorder met criteria for at least 1 other lifetime DSM-IV disorder (classification of mental disorders) assessed in this study across the lifetime, with 55.2 percent, 88.0 percent, 83.5 percent, 79.8 percent, and 70.1 percent of adolescents with AN, BN, BED, SAN, and SBED, respectively, endorsing 1 or more co-existing psychiatric disorders.

Among adolescents with 12-month AN, BN, BED, and SBED, 97.1 percent, 78.0 percent, 62.6 percent, and 34.6 percent, respectively, reported impairment in the past 12 months; 24.2 percent, 10.7 percent, 8.7 percent, and 2.8 percent, respectively, reported severe impairment. Eating disorders were most strongly associated with social impairment.

Nearly all of those with anorexia (88.9 percent) reported social impairment, and 19.6 percent reported severe social impairment associated with their eating disorder. Lifetime suicidality was associated with all subtypes of eating disorders.

Although the majority of adolescents with an eating disorder sought some form of treatment, only a minority received treatment specifically for their eating or weight problems.

According to the authors, “… this study provides key information concerning the epidemiology of eating disorders in the U.S. adolescent population. the prevalence of these disorders is higher than previously expected in this age range, and the patterns of comorbidity, role impairment, and suicidality indicate that eating disorders represent a major public health concern. Finally, these findings support the nosological distinction [classification of diseases] between the major subtypes of eating disorders as well as the importance of inclusion of the full spectrum of eating behaviors in estimating the magnitude and correlates of eating disorders in the U.S. population.”

The study was published in the March 7 issue of the Archives of General Psychiatry.

Source: Archives of General Psychiatry. doi:10.1001/archgenpsychiatry.2011.22.

By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on March 3, 2011

A sleep deficit of less than one hour of nightly sleep, over the course of six days, can cause children with attention deficit hyperactivity disorder (ADHD) to be wary and less attentive.

Researchers writing in the journal Sleep discovered even moderate reductions in sleep duration can affect an ADHD child’s brain and their neurobehavioral functioning, which in turn appears to have a negative impact on their academic performance.

Investigators discovered an average nightly sleep loss of about 55 minutes for six nights was associated with deteriorating performance including inattention, omission and depressed reaction time in children with attention deficit disorder.

“Moderate sleep restriction leads to a detectable negative impact on the neurobehavioral functioning of children with ADHD and healthy controls, leading to a clinical level of impairment in children with ADHD,” said lead author and principal investigator Reut Gruber, Ph.D.

The National Institute of Mental Health reports that ADHD is one of the most common childhood disorders and is characterized by inattention, hyperactivity and impulsivity. To be diagnosed with the disorder, a child must have symptoms for 6 months or more and to a degree that is greater than other children of the same age.

The study involved 43 children, 11 with ADHD and 32 controls. they had a mean age of about 9 years. after their baseline sleep was monitored for six nights, children were asked to eliminate one hour of nightly sleep for six consecutive nights by going to sleep one hour later than usual.

During the baseline and experimental periods, sleep was monitored at home using an actigraph, a computerized device that looks like a wristwatch. Mean nightly sleep time dropped from 487.75 minutes at baseline to 433.07 minutes for the ADHD group, and from 478.81 minutes at baseline to 444.67 minutes for the control group.

“the reduction in sleep duration in our study was modest and similar to the sleep deprivation that might occur in daily life,” Gruber said.

“Thus, even small changes in dinner time, computer time, or staying up to do homework could result in poorer neurobehavioral functioning the following day and affect sustained attention and vigilance, which are essential for optimal academic performance.”

Gruber added that the problem of inadequate sleep in students needs to be prioritized and addressed by the educational system.

“an important implication of the present study is that investments in programs that aim to decrease sleep deprivation may lead to improvements in neurobehavioral functioning and academic performance,” she said.

Source: American Academy of Sleep Medicine

By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on February 28, 2011

A new research effort studies a non-pharmacological approach to improving the quality of life for people diagnosed with Alzheimer’s disease: storytelling.

University of Missouri scientists found that participation in TimeSlips, a drug-free, creative storytelling intervention, improves communication skills and positive affect in persons with dementia.

The discovery is important as nearly 16 million Americans will be diagnosed with Alzheimer’s disease or another type of dementia by 2050, according to the Alzheimer’s Association. Symptoms include mood and behavior changes, disorientation, memory loss and difficulty walking and speaking. The effects of anti-dementia drugs on patients’ emotions and behaviors have been inconsistent.

TimeSlips is a nationally recognized storytelling program for people with dementia that encourages participants to use their imaginations to create short stories as a group.

Rather than relying on factual recall, participants respond verbally to humorous images presented by facilitators who record the responses and read narratives to further develop or end the stories.

“TimeSlips provides rich, engaging opportunities for persons with dementia to interact with others while exercising their individual strengths,” said Lorraine Phillips, Ph.D., assistant professor in the Sinclair School of Nursing.

“It encourages participants to be actively involved and to experience moments of recognition, creation and celebration. Meaningful activities, such as TimeSlips, promote positive social environments that are central to person-centered care.”

The storytelling program is an easy and affordable activity for long-term care facilities to implement and allows caregivers to interact with multiple residents at a time, Phillips said.

“TimeSlips offers a stimulating alternative to typical activities in long-term care facilities,” she said. “It is an effective and simple option for care providers, especially those who lack resources or skills required for art, music or other creative interventions.”

In the study, Phillips and her colleagues delivered the TimeSlips intervention in one-hour sessions, held twice weekly for six consecutive weeks. The results included increased expressions of pleasure and initiation of social communication.

Improvements in participants’ affect lasted several weeks following the final session. The intervention is acceptable for people with mild to moderate dementia, Phillips said.

The study was published in Nursing Research.

Source: University of Missouri

By Rick Nauert PhD Senior News EditorReviewed by John M. Grohol, Psy.D. on December 10, 2010

Fetal development is influenced by a wealth of factors, including maternal depression. University of Michigan researchers have found that more severe depression in mothers during pregnancy was linked to higher levels of stress hormones in their children at birth and other neurological and behavioral differences.

“The two possibilities are that they are either more sensitive to stress and respond more vigorously to it, or that they are less able to shut down their stress response,” says the study’s lead investigator, Delia M. Vazquez, M.D.

The analysis, which appears online ahead of print publication in Infant Behavior and Development, examined links between maternal depression and the development of an infants’ neuroendocrine system, which controls the body’s stress response and impacts moods and emotions.

At two weeks old, researchers found that the children of depressed mothers had decreased muscle tone compared to those born to mothers who weren’t depressed, yet they adjusted more quickly to stimuli like a bell, rattle or light – a sign of neurological maturity.

“It’s difficult to say to what extent these differences are good or bad, or what impact they might have over a longer time frame,” says the study’s lead author, Sheila Marcus, M.D., clinical director of U-M’s Child and Adolescent Psychiatry Section.

“We’re just beginning to look at these differences as part of a whole collection of data points that could be risk markers. These in turn would identify women who need attention during pregnancy or mother/infant pairs who might benefit from postpartum programs known to support healthy infant development through mom/baby relationships.”

The longer-term question for researchers is the degree to which the hormonal environment in the uterus may act as a catalyst for processes that alter infant gene expression, neuroendocrine development and brain circuitry – potentially setting the stage for increased risk for later behavioral and psychological disorders.

While cautioning against alarm, the researchers recommended that mothers experiencing symptoms of depression during pregnancy talk to a therapist.

They also noted that interventions aimed at mother-child bonding after birth can act as countermeasures, stimulating children’s neurological development and lowering the possible effects of stress hormone production early in life.

Postpartum depression is one of the most common complications of pregnancy and up to 1 in 5 women may experience symptoms of depression during pregnancy.

Along with tracking the mothers’ depressive symptoms throughout gestation, U-M researchers took samples of umbilical cord blood right after birth. They found elevated levels of adrenocorticotropic hormone (ACTH) in babies born to mothers with depression. ACTH tells the adrenal gland to produce the stress hormone cortisol.

Cortisol levels, however, were similar in children of mothers with varying levels of depression, likely an indication of the high level of stress associated with the birth itself, the researchers note.

Source: University of Michigan