School year 'relative age' causing bias in ADHD diagnosis

October 9, 2017

Science Daily/University of Nottingham

Younger primary school children are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older peers within the same school year, new research has shown.

 

The study, led by a child psychiatrist at The University of Nottingham with researchers at the University of Turku in Finland, suggests that adults involved in raising concerns over a child's behaviour -- such as parents and teachers -- may be misattributing signs of relative immaturity as symptoms of the disorder.

 

In their research, published in The Lancet Psychiatry, the experts suggest that greater flexibility in school starting dates should be offered for those children who may be less mature than their same school-year peers.

 

Kapil Sayal, Professor of Child & Adolescent Psychiatry at the University's School of Medicine and the Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan at the Institute of Mental Health in Nottingham, was the lead author on the study.

 

He said: "The findings of this research have a range of implications for teachers, parents and clinicians. With an age variation of up to 12 months in the same class, teachers and parents may misattribute a child's immaturity. This might lead to younger children in the class being more likely to be referred for an assessment for ADHD.

 

"Parents and teachers as well as clinicians who are undertaking ADHD assessments should keep in mind the child's relative age. From an education perspective, there should be flexibility with an individualised approach to best meets the child's needs."

 

Evidence suggests that worldwide, the incidence of ADHD among school age children is, at around five per cent, fairly uniform. However, there are large differences internationally in the rates of clinical diagnosis and treatment.

 

Although this may partially reflect the availability of and access to services, the perceptions of parents and teachers also play an important role in recognising children who may be affected by ADHD, as information they provide is used as part of the clinical assessment.

 

The study centred on whether the so-called 'relative age effect' -- the perceived differences in abilities and development between the youngest and oldest children in the same year group -- could affect the incidence of diagnosis of ADHD.

 

Adults may be benchmarking the development and abilities of younger children against their older peers in the same year group and inadvertently misinterpreting immaturity for more serious problems.

 

Previous studies have suggested that this effect plays an important role in diagnosis in countries where higher numbers of children are diagnosed and treated for ADHD, leading to concerns that clinicians may be over-diagnosing the disorder.

 

The latest study aimed to look at whether the effect also plays a significant role in the diagnosis of children in countries where the prescribing rates for ADHD are relatively low.

 

It used nationwide population data from all children in Finland born between 1991 and 2004 who were diagnosed with ADHD from the age of seven years -- school starting age -- onwards. In Finland, children start school during the calendar year they turn 7 years of age, with the school year starting in mid-August. Therefore, the eldest in a school year are born in January (aged 7 years and 7 months) and the youngest in December (6 years and 7 months).

 

The results showed that younger children were more likely to be diagnosed with ADHD than their older same-year peers -- boys by 26 per cent and girls by 31 per cent.

 

For children under the age of 10 years, this association got stronger over time -- in the more recent years 2004-2011, children born in May to August were 37 per cent more likely to be diagnosed and those born in September to December 64 per cent, compared to the oldest children born in January to April

 

The study found that this 'relative age affect' could not be explained by other behavioural or developmental disorders which may also have been affecting the children with an ADHD diagnosis.

 

However, the experts warn, the study did have some important limitations -- the data did not reveal whether any of the young children were held back a year for educational reasons and potentially misclassified as the oldest in their year group when in fact they were the youngest of their original peers.

 

The flexibility in school starting date could explain why the rate of ADHD in December-born children (the relatively youngest) were slightly lower than those for children born in October and November.

 

And while the records of publicly-funded specialised services which are free at the point of access will capture most children who have received a diagnosis of ADHD, it will miss those who were diagnosed in private practice.

https://www.sciencedaily.com/releases/2017/10/171009191508.htm

Women warriors at no greater risk for PTSD than men

August 20, 2015

Science Daily/Veterans Affairs Research Communications

While past research on the question has been mixed, a new study suggests that women in the military are at no greater risk than men for developing posttraumatic stress disorder, given similar experiences -- including combat.

 

The findings are in the September 2015 Journal of Psychiatric Research.

 

The study involved active-duty troops and veterans who are part of the Millennium Cohort Study. That effort has more than 200,000 participants in all.

 

The new PTSD study included more than 2,300 pairs of men and women who were matched based on an array of variables--including combat exposure--and followed about seven years, on average.

 

"This is the first study to prospectively investigate the development of PTSD in male and female service members who were matched on multiple important characteristics that could explain some of the differences in PTSD, including military sexual trauma," says one of the authors, Dr. Shira Maguen. "We found no gender differences in the development of PTSD. Consequently, our focus should be on the types of traumatic experiences that people have been exposed to, rather than any inherent gender differences in the development of PTSD."

 

Maguen is the mental health director of the OEF/OIF Integrated Care Clinic and a staff psychologist at the San Francisco VA Medical Center. She's also an associate professor at UCSF Medical School.

 

Lead author on the study was Dr. Isabel Jacobson of the Naval Health Research Center in San Diego.

 

All the men and women in the study were free of PTSD at the outset of the research, and they all deployed to Iraq or Afghanistan at least once. They completed a baseline survey in 2001 -- 2003, and follow-up surveys in 2004 -- 2006 and 2007 -- 2008.

 

While female troops in general are less likely to see combat, the researchers selected the study sample so there would be equal numbers of men and women with combat experiences. This was in addition to the pairs of men and women in the study being matched on factors such as age, race, education, marital status, service branch, and military occupation and pay grade.

 

The researchers also sought to match them on various health characteristics, including alcohol misuse, anxiety, and depression. Another factor the researchers took into account was stressful life events: divorce, a violent assault, or the death of a family member.

 

The matching technique helped ensure like-to-like comparisons. For example, while women service members are far more likely than men to experience sexual assault, the study matched men and women on this basis too, ensuring equal numbers of such events in each matched pair. The study also took into account sexual assaults that may have occurred over the follow-up period, during or after military service.

 

During the course of the study, 6.7 percent of women and 6.1 percent of men developed PTSD. The researchers say the difference was not statistically significant. Likewise, for those who did develop PTSD, there was no difference in severity between men and women.

 

Maguen points out that these rates of PTSD are lower than the commonly cited rates of 11 to 20 percent among returning Iraq and Afghanistan veterans because the study excluded men and women who had PTSD at the outset.

 

"Generally, when studies look at PTSD rates among returning veterans, they look at everyone, regardless of whether they had PTSD in the past from pre-military traumas or prior deployments. Here we were only looking at new cases," she explains.

 

In contrast to the new study, past research on civilians has found that women are at higher risk than men for PTSD. That body of literature, though, is not based on comparisons of men and women with similar trauma exposures.

 

Maguen: "I do think military women are extremely resilient, but I think the differences in rates in the civilian literature actually have to do with a number of factors, including women having much higher rates of interpersonal traumas, which we know put people at high risk for PTSD."

 

Maguen and her colleagues point to several limitations of their study. For example, while they tried to match men and women on the basis of military occupation--among all the other factors--they acknowledge that members with the same occupational code could have performed different duties while overseas.

 

Also, the survey questions about combat exposure may not have distinguished adequately between those who saw dead or wounded troops or civilians, and those who actively took part in the fighting.

 

Despite these and other limitations, the researchers say the study is the first to be able to answer the question: "If a man and woman are equivalent on all other factors, including history of sexual assault, which is more likely to develop PTSD in a deployed environment with or without experiencing combat?"

 

The researchers say the findings support Department of Defense efforts to integrate women into combat roles. Gender alone is not an indicator of PTSD risk, they say.

 

"This study supports the positive direction being taken by the expansion of women's occupations into combat arms roles, and suggests continued support from the [Department of Defense] for women seeking occupational equality in the military setting," write the authors.

 

Dr. Dawne Vogt, acting deputy director of the Women's Health Sciences Division of VA's National Center for PTSD, says, "These findings are important because of their focus on new-onset PTSD." She points out that they are consistent with those from "several other recent studies that have shown that U.S. female service members are no more vulnerable than male service members to the negative mental health consequences of warfare exposure."

http://www.sciencedaily.com/releases/2015/08/150820185912.htm

Children of military parents, caregivers at greater risk for adverse outcomes

August 17, 2015

Science Daily/The JAMA Network Journals

Children with parents or caregivers currently serving in the military had a higher prevalence of substance use, violence, harassment and weapon-carrying than their nonmilitary peers in a study of California school children, according to an article.

 

While most young people whose families are connected to the military demonstrate resilience, war-related stressors, including separation from parents because of deployment, frequent relocation and the worry about future deployments, can contribute to struggles for some of them, according to the study background.

 

Kathrine Sullivan, M.S.W., of the University of Southern California School of Social Work, Los Angeles, and coauthors analyzed data collected in 2013 that included 54,679 military-connected and 634,034 nonmilitary-connected secondary school students from public civilian schools in every county and almost all the school districts in California. Students were defined as military connected if they had a parent or caregiver currently serving in the military. Latino students were the largest percentage of the sample (51.4 percent) and 7.9 percent of students indicated having a parent in the military, according to the results.

 

·      45.2 percent of military-connected youth reported lifetime alcohol use compared with 39.2 percent of their nonmilitary-connected peers

·      12.2 percent of military-connected youth reported recently smoking cigarettes in the previous 30 days compared with about 8.4 percent of their nonmilitary peers

·      62.5 percent of military-connected students reported any physical violence compared with 51.6 percent of nonmilitary-connected students

·      17.7 percent of military-connected youth reported carrying a weapon at school compared with 9.9 percent of nonmilitary students

·      11.9 percent of military-connected students reported recent other drug use (e.g., cocaine and lysergic acid diethylamide [LSD]) compared with 7.3 percent of nonmilitary peers

 

The authors note the data they used were cross-sectional and therefore cannot infer causality. The data also come from a self-report survey and students may have been reluctant to report risky behavior.

 

"Based on the totality of findings from this study and others, further efforts are needed to promote resilience among military children who are struggling. More efforts in social contexts, including civilian schools and communities, to support military families during times of war are likely needed," the study concludes.

http://www.sciencedaily.com/releases/2015/08/150817132003.htm

 

Mindfulness-based stress reduction therapy decreases PTSD symptom severity among veterans

August 4, 2015

Science Daily/The JAMA Network Journals

In a randomized trial that included veterans with posttraumatic stress disorder (PTSD), those who received mindfulness-based stress reduction therapy showed greater improvement in self-reported PTSD symptom severity, although the average improvement appears to have been modest, according to a study.

 

Posttraumatic stress disorder affects 23 percent of veterans returning from Afghanistan and Iraq. Left untreated, PTSD is associated with high rates of other disorders, disability, and poor quality of life. Evidence suggests that mindfulness-based stress reduction, an intervention that teaches individuals to attend to the present moment in a nonjudgmental, accepting manner, can result in reduced symptoms of depression and anxiety. By encouraging acceptance of thoughts, feelings, and experiences without avoidance, mindfulness-based interventions target experiential avoidance, a key factor in the development and maintenance of PTSD, and may be an acceptable type of intervention for veterans who have poor adherence to existing treatments for PTSD, according to background information in the article.

 

Melissa A. Polusny, Ph.D., of the Minneapolis Veterans Affairs Health Care System, and colleagues randomly assigned 116 veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy (n = 58) or present-centered group therapy (n = 58), an active-control condition consisting of nine weekly group sessions focused on current life problems. Outcomes were assessed before, during, and after treatment and at 2-month follow-up.

 

Participants in the mindfulness-based stress reduction group demonstrated greater improvement in self-reported PTSD symptom severity during treatment and at 2-month follow-up. Although participants in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (49 percent vs 28 percent with present-centered group therapy) at 2-month follow-up, there was no difference in rates of loss of PTSD diagnosis at posttreatment (42 percent vs 44 percent) or at 2-month follow-up (53 percent vs 47 percent).

 

"Findings from the present study provide support for the efficacy of mindfulness-based stress reduction for the treatment of PTSD among veterans," the researchers write. "However, the magnitude of the average improvement suggests a modest effect."

http://www.sciencedaily.com/releases/2015/08/150804142744.htm

Cures for PTSD often remain elusive for war veterans

August 4, 2015

Science Daily/NYU Langone Medical Center / New York University School of Medicine

New light shed on the 'invisible wounds of war'

Our nation's veterans continue to suffer emotional and psychological effects of war -- some for decades. And while there has been greater attention directed recently toward post-traumatic stress disorder, and more veterans are seeking help, current psychotherapy treatments are less than optimal, according to a new narrative review.

 

In a review of medical literature over a 35-year period, researchers from the Steven and Alexandra Cohen Center for Post-Traumatic Stress and Traumatic Brain Injury -- a program in the Department of Psychiatry at NYU Langone Medical Center -- and other institutions found that non-medical approaches to treat PTSD were effective in some patients but not in others, suggesting a need for broader, more personalized approaches to care.

 

The researchers looked at randomized clinical trials of psychotherapy for military-related PTSD to examine which psychotherapies improve symptoms. This included, in particular, a review of trials of two commonly-used, evidence-based treatment models: cognitive processing therapy (CPT) and prolonged exposure (PE) therapy.

 

Searches were conducted via PubMED, PsycINFO, and PILOTS for randomized clinical trials of individual and group psychotherapies for PTSD in military personnel and veterans published from January 1980 to March 2015. Of 891 publications initially identified, 36 were included in the JAMA Narrative review, representing 2,083 participants.

 

"Our findings showed that PE and CPT are not as broadly effective as we might have once thought or hoped," says Maria M. Steenkamp, PhD, assistant professor of psychiatry at NYU Langone and lead author of the study. "As many as two-thirds of veterans receiving CPT or PE keep their PTSD diagnosis after treatment, even if their symptoms improve. So there is room for improvement."

 

"The emotional effects of war are gaining attention," says Charles R. Marmar, MD, the Lucius Littauer Professor and chair of psychiatry at NYU Langone, director of its Cohen Veterans Center, and the senior author of the JAMA study. "And there are veterans from all wars who are struggling, not just those who most recently served in the wars in Iraq and Afghanistan."

 

In fact, recently released findings from another study led by Dr. Marmar and published July 22, 2015 in JAMA Psychiatry --the National Vietnam Veterans Longitudinal Study--found that over 270,000 Vietnam veterans -- 40 years since the end of that war -- are still suffering from clinically important levels of PTSD symptoms, and one-third of those have a current, major depressive disorder.

 

"There is a pressing need for innovation in treatments for PTSD and TBI to protect a new generation of veterans," adds Dr. Marmar.

 

Dr. Steenkamp suggests that the JAMA study indicates there is still much to learn about how to optimize PTSD treatments of veterans. "It is clear that there is no one-size-fits-all approach," she says. "Ideally, we have to move toward clinical options that match patients to treatments, based on their preferences and their comfort with talking about their trauma. One thing we do know is that veterans are unlikely to benefit unless they complete a full course of treatment. Finding ways to develop treatments that align with patient needs and preferences is important."

 

The U.S. Veterans Administration and the U.S. Department of Defense have been funding such approaches to treatment, Dr. Marmar says. "There are encouraging findings that while therapies that focus on processing trauma are generally effective for veterans who complete that course of treatment, there are alternatives for veterans who are emotionally unprepared to confront their war-zone experiences," he adds.

 

Understanding the underlying mechanisms that occur in specific patients is key. A novel five-year multicenter study led by NYU Langone's Cohen Veterans Center is looking into objective biological markers of PTSD and TBI in returning soldiers of the wars in Iraq and Afghanistan. The goal is to transform the way mental health disorders are diagnosed by identifying specific brain imaging and blood and other biological markers that can tell clinicians definitively that a person is suffering from PTSD or TBI or a combination. Presently, there is no single valid diagnostic test that can independently confirm either diagnosis. Stanford University, Emory University and the U.S. Department of Defense Systems Biology Program at Fort Detrick, Maryland are partners in this research.

 

"Collectively, these studies may bring us one-step further in tailoring treatment to the individual, monitoring progress, and measuring long-term effectiveness," Dr. Marmar says.

http://www.sciencedaily.com/releases/2015/08/150804142738.htm

New insights into the circuitry of PTSD, mild traumatic brain injury

July 23, 2015

Science Daily/Elsevier

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) can have devastating consequences. Both are associated with high rates of disability and suicide, and although they are separate conditions, they commonly co-occur. For example, a soldier who has developed PTSD as a result of a traumatic experience may have also sustained a brain injury during that experience.

 

Significant research has been conducted to understand the brain mechanisms underlying PTSD and TBI, but there has still been a lack of knowledge regarding exactly which brain networks are disturbed in these disorders.

 

To fill this gap, Dr. Jeffrey Spielberg and his colleagues at the VA Boston Healthcare System examined brain networks in veterans with trauma exposure using functional magnetic resonance imaging and graph theory tools. As the authors explain, graph theory is a sophisticated analysis that allows us to understand brain networks at a level of complexity that was previously impossible. It permits examination of the patterns of brain connections, as opposed to examining individual connections.

 

The researchers recruited 208 veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, all of whom had experienced a traumatic event. They found that veterans who had more severe PTSD re-experiencing symptoms (e.g., flashbacks or reliving the event) showed weaker connectivity in two networks.

 

The first altered network includes the hippocampus and prefrontal cortex, and is involved in providing contextual information. This suggests that perhaps the hippocampus may be overgeneralizing trauma-related memories, and therefore, fails to correctly classify non-threatening cues as "safe."

 

The second network, which was identified only in veterans with comorbid mild TBI, includes the basal ganglia and prefrontal cortex, and plays a role in working memory.

 

Because the veterans studied here had already experienced a traumatic event, this research cannot identify with certainty whether the observed brain network disturbances were present in these individuals before the trauma occurred, or whether they occurred as a result of the trauma exposure. Future research of at-risk individuals, perhaps examining soldiers before and after military deployment, will be necessary to clarify this point.

 

"It may never be possible to fully distinguish the role of the severity of stress, the capacity for resilience to stress effects, and the presence of mild TBI in PTSD-related distress and disability because these factors are so complex and intimately entwined," said Dr. John Krystal, Editor of Biological Psychiatry.

 

"However, this study suggests that there are subtle but important differences in brain circuit functional connectivity related to the impact of traumatic stress among individuals with and without TBI. These data provide additional evidence that TBI may complicate the capacity for recovery from traumatic stress-related symptoms."

http://www.sciencedaily.com/releases/2015/07/150723101002.htm

Some Vietnam vets currently have PTSD 40 years after war ended

July 22, 2015

Science Daily/The JAMA Network Journals

While it has been 40 years since the Vietnam War ended, about 271,000 veterans who served in the war zone are estimated to have current full posttraumatic stress disorder (PTSD) plus subthreshold war-zone PTSD and more than one-third have current major depressive disorder, according to an article.

 

The study by Charles R. Marmar, M.D., of the New York University Langone Medical Center, and colleagues builds on the National Vietnam Veterans Readjustment Study (NVVRS), which was implemented from 1984 through 1988 (about 10 years after the war ended). The authors' National Vietnam Veterans Longitudinal Study (NVVLS) is the first follow-up to NVVRS. There were 1,839 veterans from the original study still living at the time of the NVVLS from July 2012 to May 2013 and 78.8 percent (n=1,450) of the veterans participated in at least one phase of the study.

 

The authors estimate a prevalence among male war zone veterans of 4.5 percent for a current PTSD diagnosis based on the Clinician-Administered PTSD Scale for DSM-5; 10.8 percent based on that assessment plus subthreshold PTSD; and 11.2 percent based on the PTSD Checklist for DSM-5 items for current war-zone PTSD. Among female veterans, the estimates were 6.1 percent, 8.7 percent and 6.6 percent, respectively.

 

The study also found coexisting major depression in 36.7 percent of veterans with current war-zone PTSD.

 

About 16 percent of war zone Vietnam veterans reported an increase of more than 20 points on a PTSD symptom scale while 7.6 percent reported a decrease of greater than 20 points on the symptom scale. "An important minority of Vietnam veterans are symptomatic after four decades, with more than twice as many deteriorating as improving," the study notes.

 

The authors conclude: "Policy implications include the need for greater access to evidence-based mental health services; the importance of integrating mental health treatment into primary care in light of the nearly 20 percent mortality; attention to the stresses of aging, including retirement, chronic illness, declining social support and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans," the study concludes.

 

Editorial: Measuring the Long-Term Impact of War Zone Military Service

 

In a related editorial, Charles W. Hoge, M.D., of the Walter Reed Army Institute of Research, Silver Spring, Md., writes: "This methodologically superb follow-up of the original NVVRS cohort offers a unique window into the psychiatric health of these veterans 40 years after the war's end. No other study has achieved this quality of longitudinal information, and the sobering findings tell us as much about the Vietnam generation as about the lifelong impact of combat service in general, relevant to all generations."

http://www.sciencedaily.com/releases/2015/07/150722115520.htm

Why does PTSD increase the risk of cardiovascular disease?

July 15, 2015

Science Daily/American Physiological Society (APS)

A new review article finds that post-traumatic stress disorder (PTSD) leads to overactive nerve activity, dysfunctional immune response and activation of the hormone system that controls blood pressure. These changes can ultimately increase risk of cardiovascular disease.

 

The authors found evidence that PTSD leads to overactive nerve activity, dysfunctional immune response and activation of the hormone system that controls blood pressure (the renin-angiotensin system). "These changes ultimately contribute to the culmination of increased cardiovascular disease risk," the authors wrote. Cardiovascular events, including stroke and heart attack, also can be stressful enough to cause PTSD symptoms, "putting these individuals at greater risk for future adverse cardiovascular events," the authors noted.

http://www.sciencedaily.com/releases/2015/07/150715091252.htm

 

Bright light therapy at midday helped patients with bipolar depression

Six weeks of light therapy decreased depression, increased daily functioning in patients

October 10, 2017

Science Daily/Northwestern University

Daily exposure to bright white light at midday significantly decreased symptoms of depression and increased functioning in people with bipolar disorder, a recent study found. More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received a dim placebo light.

 

Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD.). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

 

Compared to dim placebo light, study particpants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

 

The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn't been able to finish prior to treatment.

 

The study was published Oct. 3 in the American Journal of Psychiatry.

 

"Effective treatments for bipolar depression are very limited," said lead author Dr. Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks."

 

Patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

 

"As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this," said Sit, also a Northwestern Medicine psychiatrist.

 

The study included 46 participants who had at least moderate depression, bipolar disorder and who were on a mood stabilizer. Patients were randomly assigned to either a 7,000 lux bright white light or a 50 lux placebo light. The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start. Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

 

"By starting at a lower dose and slowly marching that dose up over time, we were able to adjust for tolerability and make the treatment suitable for most patients," Sit said.

 

Sit and her colleagues also observed a noticeable effect of bright light therapy by four weeks, which is similar to other studies that test light therapy for non-seasonal depression and depression during pregnancy.

 

Light therapy has conventionally been tested using morning light at awakening because previous research has suggested that morning light helps reset circadian rhythms and can be helpful in the treatment of SAD, Sit said. However, the mechanism of response is unclear in bipolar disorder. To understand the possible effects of midday bright light on circadian rhythms in patients with depression and bipolar disorder, Sit and colleagues are planning new studies to investigate.

https://www.sciencedaily.com/releases/2017/10/171010143231.htm

A spoonful of oil: Fats and oils help to unlock full nutritional benefits of veggies

October 9, 2017

Science Daily/Iowa State University

Some dressing with your greens may help you absorb more nutrients, according to a new study. The research found enhanced absorption of multiple fat-soluble vitamins in addition to beta-carotene and three other carotenoids. The results may ease the guilt of countless dieters who fret about adding dressing to their salads.

 

The song says a spoonful of sugar helps the medicine go down, but an Iowa State University scientist has published new research suggesting a spoonful of oil makes vegetables more nutritious.

 

A new study led by Wendy White, an associate professor of food science and human nutrition, shows that eating salad with added fat in the form of soybean oil promotes the absorption of eight different micronutrients that promote human health. Conversely, eating the same salad without the added oil lessens the likelihood that the body will absorb the nutrients.

 

The study appeared recently in the peer-reviewed American Journal of Clinical Nutrition, and the results may ease the guilt of countless dieters who fret about adding dressing to their salads.

 

White's study found added oil aided in the absorption of seven different micronutrients in salad vegetables. Those nutrients include four carotenoids -- alpha and beta carotene, lutein and lycopene -- two forms of vitamin E and vitamin K. The oil also promoted the absorption of vitamin A, the eighth micronutrient tracked in the study, which formed in the intestine from the alpha and beta carotene. The new study builds on previous research from White's group that focused on alpha and beta carotene and lycopene.

 

White said better absorption of the nutrients promotes a range of health benefits, including cancer prevention and eyesight preservation.

 

The study also found that the amount of oil added to the vegetables had a proportional relationship with the amount of nutrient absorption. That is, more oil means more absorption.

 

"The best way to explain it would be to say that adding twice the amount of salad dressing leads to twice the nutrient absorption," White said.

 

That doesn't give salad eaters license to drench their greens in dressing, she cautioned. But she said consumers should be perfectly comfortable with the U.S. dietary recommendation of about two tablespoons of oil per day.

 

The study included 12 college-age women who consumed salads with various levels of soybean oil, a common ingredient in commercial salad dressings. The subjects then had their blood tested to measure the absorption of nutrients. Women were chosen for the trial due to differences in the speed with which men and women metabolize the nutrients in question.

 

The results showed maximal nutrient absorption occurred at around 32 grams of oil, which was the highest amount studied, or a little more than two tablespoons. However, White said she found some variability among the subjects.

 

"For most people, the oil is going to benefit nutrient absorption," she said. "The average trend, which was statistically significant, was for increased absorption."

 

Research collaborators include Yang Zhou, a former ISU postdoctoral researcher; Agatha Agustiana Crane, a former graduate research assistant in food science and human nutrition; Philip Dixon, a University Professor of Statistics, and Frits Quadt of Quadt Consultancy, among others.

 

Unilever, a global food company, provided funding for the research. The company had no input in the publication of the study.

 

So a spoonful or two of salad dressing may indeed help you derive the optimal nutritional benefit from your veggies. The relationship between a spoonful of sugar and the medicine going down, however, remains outside the scope of White's research.

https://www.sciencedaily.com/releases/2017/10/171009124026.htm

 

Breast cancer survivors benefit from practicing mindfulness-based stress reduction

December 29, 2011

Science Daily/University of Missouri-Columbia

Women recently diagnosed with breast cancer have higher survival rates than those diagnosed in previous decades, according to new research. However, survivors continue to face health challenges after their treatments end. Previous research reports as many as 50 percent of breast cancer survivors are depressed. Now, researchers say a meditation technique can help breast cancer survivors improve their emotional and physical well-being.

 

Yaowarat Matchim, a former nursing doctoral student; Jane Armer, professor of nursing; and Bob Stewart, professor emeritus of education and adjunct faculty in nursing, found that breast cancer survivors' health improved after they learned Mindfulness-Based Stress Reduction (MBSR), a type of mindfulness training that incorporates meditation, yoga and physical awareness.

 

"MBSR is another tool to enhance the lives of breast cancer survivors," Armer said. "Patients often are given a variety of options to reduce stress, but they should choose what works for them according to their lifestyles and belief systems."

 

"Post diagnosis, breast cancer patients often feel like they have no control over their lives," Armer said. "Knowing that they can control something -- such as meditation -- and that it will improve their health, gives them hope that life will be normal again."

http://www.sciencedaily.com/releases/2011/12/111229203000.htm

Stress reduction and mindful eating curb weight gain among overweight women

December 7, 2011

Science Daily/University of California - San Francisco

Mastering simple mindful eating and stress-reduction techniques helped prevent weight gain even without dieting in overweight women.

 

In a study by UCSF researchers published online in the Journal of Obesity, mastering simple mindful eating and stress-reduction techniques helped prevent weight gain even without dieting.

 

Women in the study who experienced the greatest reduction in stress tended to have the most loss of deep belly fat. To a greater degree than fat that lies just under the skin, this deep abdominal fat is associated with an elevated risk for developing heart disease or diabetes.

"You're training the mind to notice, but to not automatically react based on habitual patterns -- to not reach for a candy bar in response to feeling anger, for example," said UCSF researcher Jennifer Daubenmier, PhD, from the Osher Center for Integrative Medicine. "If you can first recognize what you are feeling before you act, you have a greater chance of making a wiser decision."

 

Daubenmier led the current study with UCSF psychologist Elissa Epel, PhD. The study, published online in October, is part of ongoing UCSF research into how stress and the stress hormone cortisol are linked to eating behavior, fat and health.

 

Recognizing Sensations of Hunger, Fullness and Taste Satisfaction

The women who participated were not on calorie-counting diets. Instead, 24 of the 47 chronically stressed, overweight and obese women were randomly assigned to mindfulness training and practice, and the other 23 served as a control group. Although no diets were prescribed, all participants attended one session about the basics of healthy eating and exercise.

 

The training included nine weekly sessions, each lasting 2 1/2 hours, during which the women learned stress reduction techniques and how to be more aware of their eating by recognizing bodily sensations -- including hunger, fullness and taste satisfaction. At week six they attended an intensive seven-hour, silent meditation retreat.

 

They were asked to set aside 30 minutes daily for meditation exercises and to practice mindful eating during meals. Researchers used a scientifically tested survey to gauge psychological stress before and after the four-month study, and recorded the women's fat and cortisol levels.

 

Among women in the treatment group, changes in body awareness, chronic stress, cortisol secretion and abdominal fat were clearly linked. Those who had greater improvements in listening to their bodies' cues, or greater reductions in stress or cortisol, experienced the greatest reductions in abdominal fat.

 

Among the subset of obese women in the study, those who received the mindfulness training had significant reductions in cortisol after awakening and also maintained their total body weight, compared to women in the waitlist group, who had stable cortisol levels and continued to gain weight.

 

In a separate, ongoing study with lower-income, pregnant women who are overweight, Epel,Daubenmier and colleagues are teaching similar mindful-eating techniques. Pregnancy is a time when heavy women tend to gain an excessive amount of weight and later find it very hard to lose it. Furthermore, excessive weight gain during pregnancy can harm the baby's health.

 

"We are intervening at a critical point, when the health of the next generation is being shaped,"Epel said. "We hope to improve the health of both the mothers and their babies."

http://www.sciencedaily.com/releases/2011/12/111207152418.htm

Don't worry, be happy: Understanding mindfulness meditation

November 1, 2011

Science Daily/Association for Psychological Science

 

In times of stress, we're often encouraged to pause for a moment and simply be in the 'now.' This kind of mindfulness, an essential part of Buddhist and Indian Yoga traditions, has entered the mainstream as people try to find ways to combat stress and improve their quality of life. And research suggests that mindfulness meditation can have benefits for health and performance, including improved immune function, reduced blood pressure, and enhanced cognitive function.

But how is it that a single practice can have such wide-ranging effects on well-being? A new article published in the latest issue of Perspectives on Psychological Science, a journal of the Association for Psychological Science, draws on the existing scientific literature to build a framework that can explain these positive effects.

The goal of this work, according to author Britta Hölzel, of Justus Liebig University and Harvard Medical School, is to "unveil the conceptual and mechanistic complexity of mindfulness, providing the 'big picture' by arranging many findings like the pieces of a mosaic." By using a framework approach to understand the mechanisms of mindfulness, Hölzel and her co-authors point out that what we think of as mindfulness is not actually a single skill. Rather, it is a multi-faceted mental practice that encompasses several mechanisms.

The authors specifically identify four key components of mindfulness that may account for its effects: attention regulation, body awareness, emotion regulation, and sense of self. Together, these components help us attend to and deal with the mental and physiological effects of stress in ways that are non-judgmental.

Although these components are theoretically distinct, they are closely intertwined. Improvement in attention regulation, for example, may directly facilitate our awareness of our physiological state. Body awareness, in turn, helps us to recognize the emotions we are experiencing. Understanding the relationships between these components, and the brain mechanisms that underlie them, will allow clinicians to better tailor mindfulness interventions for their patients, says Hölzel.

On the most fundamental level, this framework underscores the point that mindfulness is not a vague cure-all. Effective mindfulness meditation requires training and practice and it has distinct measurable effects on our subjective experiences, our behavior, and our brain function. The authors hope that further research on this topic will "enable a much broader spectrum of individuals to utilize mindfulness meditation as a versatile tool to facilitate change -- both in psychotherapy and in everyday life."

http://www.sciencedaily.com/releases/2011/10/111031154134.htm

Spiritual retreat can lower depression, raise hope in heart patients

August 1, 2011

Science Daily/University of Michigan Health System

 

Attending a non-denominational spiritual retreat can help patients with severe heart trouble feel less depressed and more hopeful about the future, a University of Michigan Health System study has found.

Heart patients who participated in a four-day retreat that included techniques such as meditation, guided imagery, drumming, journal writing and outdoor activities saw immediate improvement in tests measuring depression and hopefulness. Those improvements persisted at three- and six-month follow-up measurements.

The study was the first randomized clinical trial to demonstrate an intervention that raises hope in patients with acute coronary syndrome, a condition that includes chest pain and heart attack. Previous research has shown that hope and its opposite, hopelessness, have an impact on how patients face uncertain futures.

"The study shows that a spiritual retreat like the Medicine for the Earth program can jumpstart and help to maintain a return to psycho-spiritual well-being," says study lead author Sara Warber, M.D., associate professor of family medicine at the U-M Medical School and director of U-M's Integrative Medicine program. "These types of interventions may be of particular interest to patients who do not want to take antidepressants for the depression symptoms that often accompany coronary heart disease and heart attack."

The findings were published in the July issue of Explore: the Journal of Science and Healing.

The retreat group was compared to two other groups: one received standard cardiac care and the other participated in a lifestyle change retreat run by the U-M Cardiovascular Center that focused on nutrition, physical exercise and stress management.

The spiritual retreat portion of the study was conducted at the Windrise Retreat Center in Metamora, Michigan, about 50 miles north of Detroit. In the Medicine for the Earth program, participants are encouraged to see themselves as part of an interconnected web of life. The approach is founded on the work of co-author Sandra Ingerman, M.A., who wrote the book Medicine for the Earth: How to Transform Personal and Environmental Toxins, which emphasizes principles of love, harmony, beauty, unity and peace.

The study used a number of standard mental and physical benchmarks to assess the success of the program.

The spiritual retreat group went from a baseline score of 12 on the Beck Depression Inventory, indicating mild to moderate depression, to an improved score of 6 immediately afterward, a 50-percent reduction. Their scores remained that low half a year later. The lifestyle group saw their scores drop from 11 to 7 and remain there. The control group's score started at 8 and went down to 6.

Participants also showed marked improvement in their scores on a test measuring hope. Scores on the State Hope Scale can range from 6 to 48, with higher scores indicating greater hope. All three study groups started with average scores between 34 and 36. After the spiritual retreat, participants' average scores rose and stayed at 40 or above, while the other two groups' averages remained significantly lower, ranging from 35 to 38, three and six months later.

"Our work adds an important spiritual voice to the current discussion of the importance of psychological well-being for patients facing serious medical issues, such as acute coronary artery disease," Warber says.

 

http://www.sciencedaily.com/releases/2011/08/110801094724.htm

Yoga boosts stress-busting hormone, reduces pain

July 27, 2011

Science Daily/York University

A new study finds that practicing yoga reduces the physical and psychological symptoms of chronic pain in women with fibromyalgia. The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. Participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

 

The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. The condition, which predominantly affects women, is characterized by chronic pain and fatigue; common symptoms include muscle stiffness, sleep disturbances, gastrointestinal discomfort, anxiety and depression.

 

Previous research has found that women with fibromyalgia have lower-than-average cortisol levels, which contribute to pain, fatigue and stress sensitivity. According to the study, participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

 

"Ideally, our cortisol levels peak about 30-40 minutes after we get up in the morning and decline throughout the day until we're ready to go to sleep," says the study's lead author, Kathryn Curtis, a PhD student in York's Department of Psychology, Faculty of Health. "The secretion of the hormone, cortisol, is dysregulated in women with fibromyalgia" she says.

 

Cortisol is a steroid hormone that is produced and released by the adrenal gland and functions as a component of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress.

 

"Hatha yoga promotes physical relaxation by decreasing activity of the sympathetic nervous system, which lowers heart rate and increases breath volume. We believe this in turn has a positive effect on the HPA axis," says Curtis.

http://www.sciencedaily.com/releases/2011/07/110727131421.htm

Meditation practice may have potential to change brain's physical structure

July 14, 2011

Science Daily/University of California - Los Angeles

Researchers have found that long time meditators have stronger connections between brain regions, and show less age-related atrophy when compared to a control group. Having stronger connections influences the ability to rapidly relay electrical signals in the brain. And significantly, these effects are evident throughout the entire brain, not just in specific areas.

 

Two years ago, researchers at UCLA found that specific regions in the brains of long-term meditators were larger and had more gray matter than the brains of individuals in a control group. This suggested that meditation may indeed be good for all of us since, alas, our brains shrink naturally with age.


Now, a follow-up study suggests that people who meditate also have stronger connections between brain regions and show less age-related brain atrophy. Having stronger connections influences the ability to rapidly relay electrical signals in the brain. And significantly, these effects are evident throughout the entire brain, not just in specific areas.

 

Results showed pronounced structural connectivity in meditators throughout the entire brain's pathways. The greatest differences between the two groups were seen within the corticospinal tract (a collection of axons that travel between the cerebral cortex of the brain and the spinal cord); the superior longitudinal fasciculus (long bi-directional bundles of neurons connecting the front and the back of the cerebrum); and the uncinate fasciculus (white matter that connects parts of the limbic system, such as the hippocampus and amygdala, with the frontal cortex).

 

"It is possible that actively meditating, especially over a long period of time, can induce changes on a micro-anatomical level," said Luders, herself a meditator. As a consequence, she said, the robustness of fiber connections in meditators may increase and possibly lead to the macroscopic effects seen by DTI.

 

"Meditation, however, might not only cause changes in brain anatomy by inducing growth but also by preventing reduction," Luders said. "That is, if practiced regularly and over years, meditation may slow down aging-related brain atrophy, perhaps by positively affecting the immune system."

 

"It's possible that meditators might have brains that are fundamentally different to begin with," Luders said. "For example, a particular brain anatomy may have drawn an individual to meditation or helped maintain an ongoing practice -- meaning that the enhanced fiber connectivity in meditators constitutes a predisposition towards meditation, rather than being the consequence of the practice."

 

Still, she said, "Meditation appears to be a powerful mental exercise with the potential to change the physical structure of the brain at large. Collecting evidence that active, frequent and regular meditation practices cause alterations of white-matter fiber tracts that are profound and sustainable may become relevant for patient populations suffering from axonal demyelination and white-matter atrophy."

http://www.sciencedaily.com/releases/2011/07/110714091940.htm

Teaching the Neurons to Meditate

July 10, 2011

Science Daily/Association for Psychological Science

In the late 1990s, Jane Anderson was working as a landscape architect. That meant she didn't work much in the winter, and she struggled with seasonal affective disorder in the dreary Minnesota winter months. She decided to try meditation and noticed a change within a month. "My experience was a sense of calmness, of better ability to regulate my emotions," she says. Her experience inspired a new study which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science, which finds changes in brain activity after only five weeks of meditation training.

Previous studies have found that Buddhist monks, who have spent tens of thousands of hours of meditating, have different patterns of brain activity. But Anderson, who did this research as an undergraduate student together with a team of University of Wisconsin-Stout faculty and students, wanted to know if they could see a change in brain activity after a shorter period.

 

At the beginning of the study, each participant had an EEG, a measurement of the brain's electrical activity. They were told: "Relax with your eyes closed, and focus on the flow of your breath at the tip of your nose; if a random thought arises, acknowledge the thought and then simply let it go by gently bringing your attention back to the flow of your breath."

Then 11 people were invited to take part in meditation training, while the other 10 were told they would be trained later. The 11 were offered two half-hour sessions a week, and encouraged to practice as much as they could between sessions, but there wasn't any particular requirement for how much they should practice.

After five weeks, the researchers did an EEG on each person again. Each person had done, on average, about seven hours of training and practice. But even with that little meditation practice, their brain activity was different from the 10 people who hadn't had training yet. People who had done the meditation training showed a greater proportion of activity in the left frontal region of the brain in response to subsequent attempts to meditate. Other research has found that this pattern of brain activity is associated with positive moods.

The shift in brain activity "was clearly evident even with a small number of subjects," says Christopher Moyer, one of Anderson's coauthors at the University of Wisconsin-Stout. "If someone is thinking about trying meditation and they were thinking, 'It's too big of a commitment, it's going to take too much rigorous training before it has an effect on my mind,' this research suggests that's not the case." For those people, meditation might be worth a try, he says. "It can't hurt and it might do you a lot of good."

"I think this implies that meditation is likely to create a shift in outlook toward life," Anderson says. "It has really worked for me."

 

http://www.sciencedaily.com/releases/2011/07/110707173321.htm

Tai chi could help overcome cognitive effects of chemotherapy

June 7, 2011

Science Daily/University of Missouri-Columbia

Previous studies have indicated that a significant number of patients who receive chemotherapy also experience cognitive declines, including decreases in verbal fluency and memory. Now, one psychologist has found evidence that indicates Tai Chi, a Chinese martial art, might help overcome some of those problems.

 

According to the American Cancer Society, more than 11.4 million Americans are currently living with cancer. While cancer treatments are plentiful, many have negative side effects. Previous studies have indicated that a significant number of patients who receive chemotherapy also experience cognitive declines, including decreases in verbal fluency and memory. Now, one University of Missouri health psychologist has found evidence that indicates Tai Chi, a Chinese martial art, might help overcome some of those problems.

 

"Scientists have known for years that Tai Chi positively impacts physical and emotional health, but this small study also uncovered evidence that it might help cognitive functioning as well," said Stephanie Reid-Arndt, assistant professor and chair of the Department of Health Psychology in the School of Health Professions. "We know this activity can help people with their quality of life in general, and with this new study, we are encouraged about how Tai Chi could also help those who have received chemotherapy. I also hope this encourages more people to think about Tai Chi positively on a broader scale in their lives."

 

"Tai Chi really helps individuals focus their attention, and this study also demonstrates how good Tai Chi could be for anyone, whether or not they have undergone treatment for cancer," Reid-Arndt said. "Due to the small size of this study, we really need to test a larger group of individuals to gain a better understanding of the specific benefits of this activity for patients who have been treated with chemotherapy and how significant these improvements might be."

http://www.sciencedaily.com/releases/2011/06/110606152208.htm

 

Health-care providers are prescribing nontraditional medicine: Use of mind-body therapies on the rise

May 11, 2011

Science Daily/Beth Israel Deaconess Medical Center

Prior research suggests that mind-body therapies, while used by millions of patients, is still on the fringe of mainstream medical care in America. New research suggests that attitudes are changing.

 

Prior research suggests that MBT, while used by millions of patients, is still on the fringe of mainstream medical care in America. New research suggests that attitudes are changing.

In a study from Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, researchers found that one in 30 Americans using MBT has been referred by a medical provider.

 

"There's good evidence to support using mind-body therapies clinically," said lead author Aditi Nerurkar, MD, Integrative Medicine Fellow, Harvard Medical School and BIDMC. "Still, we didn't expect to see provider referral rates that were quite so high."

 

The results of the study appear in the May 9 issue of the Archives of Internal Medicine.

 

Nerurkar and her colleagues collected information from more than 23,000 U.S. households from the 2007 National Health Interview Survey. They found that nearly 3 percent (representing more than 6.3 million Americans) used MBT due to provider referral and that these Americans were sicker and used the health care system more than people who self-referred for MBT.

 

"What we learned suggests that providers are referring their patients for mind-body therapies as a last resort once conventional therapeutic options have failed. It makes us wonder whether referring patients for these therapies earlier in the treatment process could lead to less use of the health care system, and possibly, better outcomes for these patients," said Nerurkar.

 

"These data suggest that mind-body therapies have really become a mainstream approach to care," adds Russell Phillips, MD, Chief of Primary Care at BIDMC and the senior author on the study. "But more research is needed to guide physician and patient decision-making regarding their use.

http://www.sciencedaily.com/releases/2011/05/110509161642.htm

 

More knowledge not always helpful for women dealing with heart disease

May 4, 2011

Science Daily/Ohio State University

 

Women with congestive heart failure who repress their emotions, especially anger, are more likely than emotionally expressive women to experience symptoms of depression associated with knowledge about their disease, according to new research.

Coping styles of women in the study influenced how depressed or anxious they felt. The less they talked about or expressed their emotions, the more likely they were to have symptoms of depression and anxiety.

When Ohio State University researchers examined the influence of knowledge about their illness on the patients' mental well-being, they found that some women with heart failure felt worse emotionally when they had more information about the disease. For those women -- who tend to deny their emotions -- less information is better. For them, certain types of knowledge can actually lower their emotional quality of life, according to the research.

The findings of this pilot study suggest that clinicians should consider patients' individual coping styles when educating them about their illness, the researchers say. For example, women who cope by denying their emotions might become particularly distressed by information that provokes fear -- such as learning about the increased risk of hospitalization as a consequence of not taking medication or exercising enough.

"We're not saying knowledge is not a good thing," said Charles Emery, professor of psychology at Ohio State and co-author of the study. "For patients who are greater in denial, knowledge seemed to be a negative factor. Whereas for people who either had difficulty expressing emotion or putting a label on their emotion, knowledge is still beneficial."

Emery co-authored the study with Jamie Jackson, a former Ohio State graduate student who is now a postdoctoral fellow at Northwestern University. The study is published in a recent issue of the journal Heart & Lung.

The study involved 35 women diagnosed with at least stage C congestive heart failure as categorized by the American College of Cardiology, meaning they had structural heart damage, experienced symptoms that might include shortness of breath and swelling in the legs and abdomen, and were managing the disease with medication. Heart failure is a condition in which the heart muscle is weakened, resulting in reduced blood flow throughout the body.

The researchers asked the participants to complete a number of questionnaires to measure their coping styles, illness knowledge, emotional quality of life and physical quality of life.

Women's coping styles were categorized in three ways: anger-in, or a tendency to withhold angry emotions; alexithymia, or difficulty identifying and describing feelings; and emotional expressivity, which could be either low or high.

Overall, the women reported elevated symptoms of depression and anxiety compared to national data on these symptoms in healthy adults.

Depressive symptoms -- which can include loneliness, sadness, fear, sleep problems and an unshakable sense of the "blues" -- as well as anxiety symptoms were associated with repression of anger, difficulty describing feelings and low emotional expressivity. Those with a higher level of emotional expression were less likely to report depressive symptoms.

"The basic idea is very simple: that in general, it is better to express your emotions than to hold them in," said Emery, also an investigator in Ohio State's Institute for Behavioral Medicine Research. "The correlations in this paper are exactly what one would expect."

And when the researchers then factored in how much the women knew about their illness, a clear link emerged between higher knowledge and more depressive symptoms in women who repressed their anger.

"These are women who would not want to deal with their negative emotions. I think the reason we're seeing this pattern is that if you're scared about your health condition, and you're confronted with more and more information, that makes it more real to you," Jackson said. "If you're somebody who doesn't want to acknowledge the emotion around the situation, it may result in reacting with greater negative emotion.

"In this particular study, depressive symptoms are where we see the effect."

On the other hand, women who had trouble describing their emotions felt more anxious if they had less knowledge about their illness than did women with similar coping traits who had greater knowledge.

The study showed no indication that coping style and illness knowledge influenced the patients' physical quality of life.

Emery noted that the education patients receive about an illness is critical to keeping them informed about the best ways to maintain their health. So ensuring that patients receive the information in a way that preserves their emotional health is likely to encourage greater compliance with doctors' orders, he said.

"The longer-term purpose of this line of research is to better predict which patient is going to benefit from which kind of intervention," he said. "Even with a high-denial patient, we would still embrace using knowledge. But we might identify non-aversive ways of presenting them with the knowledge."

The researchers suggest in the paper that clinicians may want to consider using mindfulness strategies for patients who tend to repress anger or have trouble describing their feelings. This technique helps people monitor their emotional response and observe their thoughts without judgment, said Jackson, who has been trained to provide mindfulness-based interventions in a clinical setting.

"Mindfulness encourages people to be comfortable with living in the moment with whatever emotional experience they're having," she said. "If we can help patients do that, they might be more receptive to information about their condition, and might have a better quality of life in general."

 

http://www.sciencedaily.com/releases/2011/05/110504111141.htm

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