Peter H Brown Clinical Psychologist

Psychology News & Resources

Don’t Say “Don’t Panic”: How To Help Someone With A Panic Disorder

Credit: From , former About.com Guide

The Experience of Recurring Panic Attacks

To understand panic disorder with agoraphobia, we must first talk about panic attacks. Sudden and recurring panic attacks are the hallmark symptoms of panic disorder. If you have never had recurring panic attacks, it may be hard to understand the difficulties your friend or loved one is going through. During a panic attack, the body’s alarm system is triggered without the presence of actual danger. The exact cause of why this happens is not known, but it is believed that there is a genetic and/or biological component.

Sufferers often use the terms fear, terror and horror to describe the frightening symptoms of a full-blown panic attack. But even these frightening words can’t convey the magnitude of the consuming nature of panic disorder. The fear becomes so intense that the thought of having another panic attack is never far from conscious thought. Incessant worry and feelings of overwhelming anxiety may become part of your loved one’s daily existence.

These Intense Symptoms Must Mean Something…Something Terrible

At the onset of panic disorder, your loved one may be quite certain they are suffering from a heart condition or other life-threatening illness. This may mean trips to the nearest emergency room and intensive testing to rule out physical disease. But, even when he or she is assured that these symptoms are not life-threatening, it does little to put his or her mind at ease. The feelings experienced during panic attacks are so overwhelming and uncontrollable, sufferers are convinced they are going to die or are going crazy.

A New Way of Life Emerges: Fear and Avoidance

So frightening are the symptoms of panic disorder, that your loved one may go to any and all lengths to avoid another attack from occurring. This may include many avoidant types of behavior and the development of agoraphobia. But, despite the efforts to avoid another panic episode, the attacks continue without rhyme or reason. There is no place to escape, and the sufferer becomes a prisoner of an insidious and illogical fear. Without appropriate treatment, your loved one may become so disabled that he or she is unable to leave his or her home at all.

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Self Image Is Redefined

At times, we’ve all experienced nervousness, anxiousness, fear and, perhaps, even terror or horror. But in the midst of a catastrophic event, we understand these symptoms. Once the event is over, so, too, are the symptoms. But, imagine reliving these symptoms over and over again, without any warning or explanation.

This type of fear is life-changing. As abilities become inabilities, things once taken for granted, like going to into a store, become anxiety-filled events. Some enjoyable activities, like going to concerts or movies, may be avoided altogether. It is not uncommon for sufferers to experience a sense of shame, weakness and embarrassment as their self-image is redefined by fear.

Panic disorder is not just being nervous or anxious. Panic disorder is not just about the fear, terror and horror experienced during a full-blown panic attack because it does not end when the panic subsides. It is a disorder that is quick to invade and can alter one’s very essence, redefine one’s abilities and take over every aspect of one’s life.

Your Role As A Support Person

As a support person, you can play an important role in your loved one’s recovery process. Understanding what panic disorder is, and what it is not, will help you on this journey. Author Ken Strong provides a lot of information for supporting a person with panic disorder in his book, Anxiety:The Caregivers, Third Edition.

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September 10, 2010 Posted by | anxiety, brain, Cognition, depression, research, stress | , , , , , , , , , | 10 Comments

Sleep Well: Why You Need To Fight For Good Sleep

A collection of studies published last Wednesday in the journal Sleep tackled some important questions: What are the health effects of not getting enough sleep? How does sleep deprivation affect teens? Does insomnia have long-term consequences?

Credit: Time Magazine

Given that past research has shown that short sleepers (and unusually long sleepers) die younger than people who get 6.5 to 7.5 hours per night, a new Penn State study looked at the impact of insomnia on mortality. The consequences could be dire: the study of 1,741 men and women in Pennsylvania found that insomniac men who slept less than 6 hours per day were four times more likely to die than those who got a full night’s rest. The study even adjusted for other medical conditions that affect sleep (and death rates), such as obesity, alcohol and depression. Of note, sleep deprivation did not affect women’s mortality.

In another study in Sleep, University of Sydney researchers focused on adolescents and young adults who weren’t getting enough sleep — an increasingly common problem among the digital generation, who stays up late plugged into their computers and smart phones. Turns out, burning the midnight oil can have long-term consequences. Researchers found that for each hour of lost sleep, levels of psychological distress rose by 5% in nearly 3,000 17-to-24-year-olds who were followed for 12 to 18 months. Overall, short sleepers were 14% more likely to report symptoms of psychological distress on a standard test, compared with people who got adequate sleep. The effect was especially pronounced among young people who already suffered from anxiety; in this group, lack of sleep triggered more serious mental health problems like full-blown depression and even bipolar disorder, according to the study’s lead author, Professor Nick Glozier. But even among those who began the study in good health, less than five hours of sleep meant tripling their odds of psychological distress.

A third Sleep study this week found that teens who didn’t get enough z’s consumed more calories than their well-rested peers. The study of 240 adolescents, average age 18, revealed that teenagers who slept less than 8 hours a night on weeknights ate 2% more calories from fat per day and 3% more calories from carbs than teens who slept longer. They also tended to get their calories from snacks instead of healthful meals. Cumulatively, this behavior increases the risk of obesity and, in turn, the chances of developing cardiovascular disease later in life.

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The American Academy of Sleep Medicine suggests that adults get an average of seven to eight hours of sleep per night, while the National Sleep Foundation recommends that adolescents need at least 8.5 hours, though only 15% of them get enough.

“Sleep disorders are common in the general population and even more so in clinical practice, yet are relatively poorly understood by doctors and other health care practitioners,” wrote Sue Wilson, the lead author of new guidelines published today by the British Association of Psychopharmacology to help doctors treat insomnia and other sleep disorders. Her advice: get a diagnosis from a sleep specialist for patients, then try behavioral therapy to improve their sleep before jumping to prescription medication. Most of all, pay attention to who you are treating: postmenopausal women might need hormone therapy, small children with ADHD might require melatonin treatment.

And if you suffer from disordered sleep patterns, consider these tips from the National Sleep Foundation:

Avoid caffeine. Tea, coffee, soda and energy drinks can keep you awake for up to 12 hours. Instead, when your mid-afternoon slump hits, try an energizing snack like nuts or yogurt.

Nest. Make your bed as comfortable as possible. Keep your sleep environment dark, cool and work-free.

Establish a routine. About an hour before bedtime, start a nightly relaxation routine that can include reading, taking a bath or anything else that soothes you. Complete all exercise at least three hours before bedtime. Don’t look at screens before you go to sleep, which can stimulate your brain.

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September 7, 2010 Posted by | Adolescence, Age & Ageing, anxiety, Cognition, Exercise, Health Psychology, research | , , | 3 Comments

A Spoonful Of Sugar DOES Makes The Medicine Go Down! Sweet Solutions Reduce Kids Experience Of Pain From Needles

Infants who receive sweet solutions before being immunised experience less pain and are more comfortable, reveals research published ahead of print in the Archives of Disease in Childhood.

Read The Abstract Here

Healthcare professionals should consider giving infants aged 112 months a sweet solution of sucrose or glucose before immunising a child, the international team of researchers recommended, because of the child’s improved reaction to injections.

Existing research shows the effectiveness of giving newborn infants and those beyond the newborn period, a small amount (e.g. a few drops to about half a teaspoon) of sucrose and glucose as analgesics during minor painful procedures.

Little is known, however, about the effect of such solutions on pain, so a team of researchers from Toronto in Canada, Melbourne in Australia and Sao Paulo in Brazil, funded by a Canadian Institutes of Health Research Knowledge Synthesis grant, collected the findings from 14 relevant trials involving 1,674 injections given to children aged 112 months.

They found that giving a child a small amount of sweet solution, compared to water or no treatment moderately decreased crying in the child during or following immunisation in 13 of the 14 studies (92.9%).

The authors conclude that infants aged 112 months given sucrose or glucose before immunisation had cried less often and for less time.

The amount of glucose or sucrose given made a difference and the researchers found that infants receiving 30% glucose in some trials were almost half as likely to cry following immunisation.

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The researchers could not identify the ideal dose of sucrose or glucose because of the variety of volumes and concentrations used in the various trials.

Analgesic effects of sweet solutions given to older infants were more moderate than those in newborn infants.

They conclude: “Healthcare professionals responsible for administering immunisations should consider using sucrose or glucose during painful procedures.

“This information is important for healthcare professionals working with infants in both inpatient and out-patient settings, as sweet solutions are readily available, have a very short onset of time to analgesia, are inexpensive and are easy to administer.”

Source: Eurekalert

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May 13, 2010 Posted by | anxiety, Pain, Parenting, Resilience, stress | , , , , , , , , , , , , , , | Leave a comment

Should I Tell Or Not? Mood Disorders & The Workplace

Credit: Therese J. Borchard via psychcentral

Just when I think our world has moved a baby step in the right direction regarding our understanding of mental illness, I get another blow that tells me otherwise. For example, awhile back I quoted an intelligent woman who wrote an article in a popular women’s magazine about dating a bipolar guy when she was bipolar herself. She recently discovered that she had jeopardized a job prospect because the article came up — as well as all those who referenced it, like Beyond Blue — when you Googled her name. So she requested everyone who picked up that article to go back and change her real name to a pseudonym.

Because talking about bipolar disorder in the workplace is pretty much like singing about AIDS at the office a hundred years ago or maybe championing civil rights in the 60s.

I totally get why this woman created a pseudonym. Trust me, I entertained that possibility when I decided to throw out my psychiatric chart to the public. It’s risky. Extremely risky. Each person’s situation is unique, so I can’t advise a general “yes ” or “no.” As much as I would love to say corporate America will embrace the person struggling with a mood disorder and wrap him around a set of loving hands, I know the reality is more like a bipolar or depressive being spit upon, blamed, and made fun of by his boss and co-workers. Because the majority of professionals today simply don’t get it.

Not at all.

They don’t get it even though the World Health Organization predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease; that major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institute of Mental Health; that the direct cost of depression to the United States in terms of lost time at work is estimated at 172 million days yearly.

I realize every time I publish a personal blog post — one in which I describe my severe ruminations, death thoughts, and difficulty using the rational part of my brain — I jeopardize my possibilities for gainful employment in the future. I can pretty much write off all government work because, from what I’ve been told, you have to get a gaggle of people to testify that you have no history of psychiatric illnesses (and, again, all it takes is one Google search to prove I’m crazy).

It’s totally unfair.

Do we penalize diabetics for needing insulin or tell people with disabling arthritis to get over it? Do we advise cancer victims to use a pseudonym if they write about their chemo, for fear of being labeled as weak and pathetic? That they really should be able to pull themselves up by their bootstraps and heal themselves because it’s all in their heads?

But I don’t want to hide behind a pseudonym. I use my real name because, for me, the benefit of comforting someone who thinks they are all alone outweighs the risk of unemployment in the future. Kay Redfield Jamison did it. She’s okay. So is Robin Williams. And Kitty Dukasis. And Carrie Fisher. Granted all four of those people have talent agents ready to book them as speakers for a nice fee.

In their book, Living with Someone Who’s Living with Bipolar Disorder Chelsea Lowe and Bruce M. Cohen, MD, Ph.D., list the pros and the cons of going public with a mood disorder. I’m paraphrasing a little bit, but here are the pros:

  • There’s nothing disgraceful about the condition, any more than there would be about cancer or heart disease.
  • Carrying a secret is an enormous burden. Sharing it lightens it.
  • The more people who know and are looking out for you, the more likely you’ll be able to get help before the problems turn serious.
  • Sharing the information lessons the burden on your partner.
  • Lots of people have psychiatric issues; maybe your boss or family member does too.
  • Taking about the diagnosis is an opportunity to educate others.

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The authors suggest telling your employer under these circumstances:

  • If you are taking a new medication and may need time for adjustment.
  • If your schedule doesn’t allow for regular, restful sleep–which is an important factor in controlling the disorder–or if you need to request certain adjustments to your schedule, like telecommuting.
  • If you need to be hospitalized or take a leave of absence.
  • If the disorder is affecting your behavior or job performance.
  • If you need to submit benefit claims through your employer rather than the insurance company, or if your employer requires medical forms for extended absences.

And the cons:

  • Prejudice and stigma about psychiatric disorders are still common in our society. A disclosure of bipolar disorder [or any mental illness] will inevitably color your employer’s and coworkers’ perceptions of his job performance: “Did Jerry miss that meeting because the bus was late, or because he was off his meds?” Potential problems include discrimination, stigmatization, fear and actual job loss.
  • You can’t un-tell a secret.
  • Your chances for promotion could be hurt.
  • The employer is under no obligation to keep your condition secret.
  • Discrimination is illegal but difficult to prove.
  • You could be written off as “crazy.”

It’s Tricky! What are your thoughts?

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May 3, 2010 Posted by | anxiety, Books, depression, Education, General, mood | , , , , , , , , , , , , , | 2 Comments

Emotional Intelligence: Learning To Roll With The Punches

It’s a hot-buzz topic that covers everything from improving workplace performance and successfully climbing the corporate ladder to building the happiest of marriages to ending school bullying. But what exactly is Emotional Intelligence (EI)? If we lack it, can we learn it? And how do we know if our EI is high or low? Is it only high if we’re really, really nice?

Three scholarly researchers – including University of Cincinnati Psychology Professor Gerry Matthews – delved into the science of EI and published “What We Know About Emotional Intelligence: How it Affects Learning, Work, Relationships, and Our Mental Health.”

Published by MIT Press (2009), the book was recently awarded the American Publishers Award for Professional and Scholarly Excellence – the PROSE Awards – in the biological and life sciences category of biomedicine and neuroscience. The book, co-authored by Matthews, Moshe Zeidner (University of Haifa) and Richard D. Roberts (Center for New Constructs, Educational Testing Service, Princeton, N.J.), was also on display at the UC Libraries’ Authors, Editors and Composers Reception and Program from 3:30-5 p.m., Thursday, April 22, in the Russell C. Myers Alumni Center.

MIT Press promotions describe EI as the “ability to perceive, regulate and communicate emotions – to understand emotions in ourselves and others.” Workplaces want to test for it to find the most EI-talented employees, and consultants are touting training and EI tests to improve productivity. “In the popular writings, EI tends to be defined very broadly and one can’t proceed with scientific research with such a vague and broad definition,” Matthews says.

Matthews’ research interests have explored how stress, mood and coping ability can affect performance on tests, in the workplace and on the highway. He adds that amid the grim economy, even the people who have jobs are feeling high levels of stress in the workplace and are feeling more challenged by workplace demands and concerns about job security. In general terms, those who can roll with the punches – with a shrug and a smile – may have higher Emotional Intelligence.

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Then again, “The intimate association of personality and emotion sets a trap for researchers interested in Emotional Intelligence,” writes Matthews. “It might seem that happy, calm states of mind should be seen as the person imbued with high Emotional Intelligence. However, such emotional tendencies may be no more than a consequence of biases in brain functioning or information-processing routines operating without insight or ‘intelligence.’ Some individuals – in part because of their DNA – are simply fortunate in being prone to pleasant moods, so it follows that emotional states do not alone provide an index of Emotional Intelligence,” Matthews states in the book.

In fact, Matthews says he’s skeptical that people who are better at managing stress hold higher Emotional Intelligence, but as the researchers found as they tried to narrow down the science of Emotional Intelligence, more research is needed. For instance, is someone with higher EI in the workplace more productive, or are they just better at self-promotion and forming positive relationships with co-workers? Matthews says he believes EI appears to be very modestly related to workplace performance, and could turn out to be nothing more than a business fad.

He adds the researchers are also skeptical about all of those EI tests, particularly those self-assessments. After all, people could be rating themselves the way they see themselves or the way they would like to be seen, and not like they actually are.

Currently, authors Matthews and Roberts are researching the testing of EI through video scenarios. The situation judgment test involves watching the videos unfold a challenging situation, and then the video comes to a stop and offers different options for resolving the problem. Matthews is building on his earlier research which explored whether negative moods affected good decision making abilities. “Through the video project, the idea is to see if emotionally intelligent people are better able to make rational decisions under stress,” he says.

The researchers are also examining the link between EI and school social and emotional learning programs.

Source:
Dawn Fuller
University of Cincinnati

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May 2, 2010 Posted by | anxiety, Books, Cognition, Health Psychology, Identity, Positive Psychology, research, Resilience | , , , , , , , , , , , | 4 Comments

All By Myself…The Tyranny of The Loneliness Epidemic

Credit Dr Ronald Pies, M.D. via psychcentral.com

The recent controversy over the still-developing DSM-5 — that compendium of mental disorders the media love to call, inappropriately, “The Bible of Psychiatry” –has gotten me thinking about loneliness. Now, thankfully, nobody has seriously proposed including loneliness in the DSM-5. Indeed, loneliness is usually thought of as simply an unpleasant part of life — one of the “slings and arrows” that pierce almost all of us from time to time. Loneliness, in some ways, remains enmeshed in a web of literary and cultural clichés, born of such works as Nathaniel West’s darkly comic novel, Miss Lonelyhearts, and the Beatles’ whimsical anthem, “Sgt. Pepper’s Lonely Hearts Club Band.”

But loneliness turns out to be a serious matter. And as psychiatry debates the diagnostic minutiae of DSM-5, all of us may need to remind ourselves that millions in this country struggle against the downward tug of loneliness. Yet even among health care professionals, few seem aware that loneliness is closely linked with numerous emotional and physical ills, particular among the elderly and infirm.

It’s easy to assume that loneliness is simply a matter of mind and mood. Yet recent evidence suggests that loneliness may injure the body in surprising ways. Researchers at the University of Pittsburgh School of Medicine studied the risk of coronary heart disease over a 19-year period, in a community sample of men and women. The study found that among women, high degrees of loneliness were associated with increased risk of heart disease, even after controlling for age, race, marital status, depression and several other confounding variables. (In an email message to me, the lead author, Dr. Rebecca C. Thurston, PhD, speculated that the male subjects might have been more reluctant to acknowledge their feelings of loneliness).

Similarly, Dr. Dara Sorkin and her colleagues at the University of California, Irvine, found that for every increase in the level of loneliness in a sample of 180 older adults, there was a threefold increase in the odds of having heart disease. Conversely, among individuals who felt they had companionship or social support, the likelihood of having heart disease decreased.

The young, of course, are far from immune to loneliness. Researchers at Aarhus University in Denmark studied loneliness in a population of adolescent boys with autism spectrum disorders (an area of great controversy in the proposed DSM-5 criteria). More than a fifth of the sample described themselves as “often or always” feeling lonely—a finding that seems to run counter to the notion that those with autism are emotionally disconnected from other people. Furthermore, the study found that the more social support these boys received, the lower their degree of loneliness. We have no cure for autism in adolescents–but the remedy for loneliness in these kids may be as close as the nearest friend.

And lest there be any doubt that loneliness has far ranging effects on the health of the body, consider the intriguing findings from Dr. S.W. Cole and colleagues, at the UCLA School of Medicine. These researchers looked at levels of gene activity in the white blood cells of individuals with either high or low levels of loneliness. Subjects with high levels of subjective social isolation—basically, loneliness — showed evidence of an over-active inflammatory response. These same lonely subjects showed reduced activity in genes that normally suppress inflammation. Such gene effects could explain reports of higher rates of inflammatory disease in those experiencing loneliness.

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Could inflammatory changes, in turn, explain the correlation between loneliness and heart disease? Inflammation is known to play an important role in coronary artery disease. But loneliness by itself may be just one domino in the chain of causation. According to Dr. Heather S. Lett and colleagues at Duke University Medical Center, the perception of poor social support — in effect, loneliness — is a risk factor for development, or worsening, of clinical depression. Depression may in turn bring about inflammatory changes in the heart that lead to frank heart disease. This complicated pathway is still speculative, but plausible.

Loneliness, of course, is not synonymous with “being alone.” Many individuals who live alone do not feel “lonely.” Indeed, some seem to revel in their aloneness. Perhaps this is what theologian Paul Tillich had in mind when he observed that language “… has created the word “loneliness” to express the pain of being alone. And it has created the word “solitude” to express the glory of being alone.” Conversely, some people feel “alone” or disconnected from others, even when surrounded with people.

Let’s admit that not everybody is capable of experiencing the “glory of being alone” or of transforming loneliness into “solitude.” So what can a socially-isolated person do to avoid loneliness and its associated health problems? Joining a local support group can help decrease isolation; allow friendships to form; and give the lonely person an opportunity both to receive and to provide help. This reciprocity can bolster the lonely person’s ego and improve overall well-being. Support groups geared to particular medical conditions can also help reduce disease-related complications. Although there are always risks in going “on line” to find support, Daily Strength appears to be a legitimate and helpful website for locating support groups of all types, including those for loneliness. Psych Central also provides opportunities to exchange ideas and “connect” with many individuals who feel isolated or alone. For those who feel lonely even in the midst of friends, individual psychotherapy may be helpful, since this paradoxical feeling often stems from a fear of “getting close” to others.

No, loneliness is not a disease or disorder. It certainly shouldn’t appear in the DSM-5 — but it should be on our minds, as a serious public health problem. Fortunately, the “treatment” may be as simple as reaching out to another human being, with compassion and understanding.

Ronald Pies MD is a psychiatrist affiliated with Tufts University School of Medicine and SUNY Upstate Medical University. He is also Editor-in-Chief of Psychiatric Times and author of Everything Has Two Handles: The Stoic’s Guide to the Art of Living. . Disclosure information for Dr. Pies may be found at www.psychiatrictimes.com

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April 29, 2010 Posted by | Age & Ageing, anxiety, Aspergers Syndrome, Books, brain, depression, diagnosis, Health Psychology, Identity, mood, Pain, self harm, stress | , , , , , , , , , , , , , , , , , | 1 Comment

Anxiety & Depression: Self-Help Internet Interventions Work!

A little while ago I posted a list of free interactive self-help web sites, all research based, which have been shown to effective in the treatment of anxiety & depression. A recent study adds to the body of evidence which supports web based intervention as a viable treatment option or adjunct.

Cognitive behaviour therapy (CBT) via the internet is just as effective in treating panic disorder (recurring panic attacks) as traditional group-based CBT. It is also efficacious in the treatment of mild and moderate depression. This according to a new doctoral thesis soon to be presented at Karolinska Institutet.

Read the original research thesis here (PDF)

“Internet-based CBT is also more cost-effective than group therapy,” says Jan Bergström, psychologist and doctoral student at the Center for Psychiatry Research. “The results therefore support the introduction of Internet treatment into regular psychiatry, which is also what the National Board of Health and Welfare recommends in its new guidelines for the treatment of depression and anxiety.”

It is estimated that depression affects some 15 per cent and panic disorder 4 per cent of all people during their lifetime. Depression can include a number of symptoms, such as low mood, lack of joy, guilt, lethargy, concentration difficulties, insomnia and a low zest for life. Panic disorder involves debilitating panic attacks that deter a person from entering places or situations previously associated with panic. Common symptoms include palpitations, shaking, nausea and a sense that something dangerous is about to happen (e.g. a heart attack or that one is going mad).

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It is known from previous studies that CBT is an effective treatment for both panic disorder and depression. However, there is a lack of psychologists and psychotherapists that use CBT methods, and access to them varies greatly in Sweden as well as in many other countries. Internet-based CBT has therefore been developed, in which the patient undergoes an Internet-based self-help programme and has contact with a therapist by email.

The present doctoral thesis includes a randomised clinical trial of 104 patients with panic disorder and compares the effectiveness of Internet-based CBT and group CBT within a regular healthcare service. The study shows that both treatments worked very well and that there was no significant difference between them, either immediately after treatment or at a six-month follow-up. Analyses of the results for the treatment of depression show that Internet-based CBT is most effective if it is administered as early as possible. Patients with a higher severity of depression and/or a history of more frequent depressive episodes benefited less well from the Internet treatment.

Jan Bergström works as a clinical psychologist at the Anxiety Disorders Unit of the Psychiatry Northwest division of the Stockholm County Council. This research was also financed by the Stockholm County Council.

“Thanks to our research, Internet treatment is now implemented within regular healthcare in Stockholm, at the unit Internetpsykiatri.se of Psychiatry Southwest, which probably makes the Stockholm County Council the first in the world to offer such treatment in its regular psychiatric services,” says Jan Bergström.

Read the original research thesis here (PDF)

Credit: Adapted from materials provided by Karolinska Institutet.

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April 18, 2010 Posted by | anxiety, Books, Cognitive Behavior Therapy, depression, diagnosis, Education, Internet, research, stress, Technology, therapy | , , , , , , , , , , , , , , , , , , , | 10 Comments

Sticks & Stones AND Words Can Hurt You: How Words Can Cause Physical Pain

“Watch out, it’ll hurt for a second.” Not only children but also many adults get uneasy when they hear those words from their doctor. And, as soon as the needle touches their skin the piercing pain can be felt very clearly. “After such an experience it is enough to simply imagine a needle at the next vaccination appointment to activate our pain memory,” knows Prof. Dr. Thomas Weiss from the Friedrich-Schiller-University Jena.

Read the original research paper (PDF)

As the scientist and his team from the Dept. of Biological and Clinical Psychology could show in a study for the first time it is not only the painful memories and associations that set our pain memory on the alert. “Even verbal stimuli lead to reactions in certain areas of the brain,” claims Prof. Weiss. As soon as we hear words like “tormenting,” “gruelling” or “plaguing,” exactly those areas in the brain are being activated which process the corresponding pain. The psychologists from Jena University were able to examine this phenomenon using functional magnetic resonance tomography (fMRT). In their study they investigated how healthy subjects process words associated with experiencing pain. In order to prevent reactions based on a plain negative affect the subjects were also confronted with negatively connotated words like “terrifying,” “horrible” or “disgusting” besides the proper pain words.

“Subjects performed two tasks,” explains Maria Richter, doctoral candidate in Weiss’s team. “In a first task, subjects were supposed to imagine situations which correspond to the words,” the Jena psychologist says. In a second task, subjects were also reading the words but they were distracted by a brain-teaser. “In both cases we could observe a clear activation of the pain matrix in the brain by pain-associated words,” Maria Richter states. Other negatively connotated words, however, do not activate those regions. Neither for neutrally nor for positively connotated words comparable activity patterns could be examined.

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Can words intensify chronic pain?

“These findings show that words alone are capable of activating our pain matrix,” underlines Prof. Weiss. To save painful experiences is of biological advantage since it allows us to avoid painful situations in the future which might be dangerous for our lives. “However, our results suggest as well that verbal stimuli have a more important meaning than we have thought so far.” For the Jena psychologist the question remains open which role the verbal confrontation with pain plays for chronic pain patients. “They tend to speak a lot about their experiencing of pain to their physician or physiotherapist,” Maria Richter says. It is possible that those conversations intensify the activity of the pain matrix in the brain and therefore intensify the pain experience. This is what the Jena psychologists want to clarify in another study.

And so far it won’t do any harm not to talk too much about pain. Maybe then the next injection will be only half as painful.

Read the original research paper (PDF)

Adapted from ScienceDaily March 31 2010

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April 14, 2010 Posted by | Age & Ageing, anxiety, Cognition, Pain, research, Technology | , , , , , , , , , , , , , , , , | 5 Comments

“Out Of The Way People…I Want Stuff!”: How Materialism Affects The Work-Family Conflict & Marital Satisfaction

The more materialistic individuals are, the more likely they are to view their family as an obstacle to work. This is the finding of a study published online on 8th April 2010, in the Journal of Occupational and Organizational Psychology.

Mark Promislo from Temple University, Philadelphia, USA and colleagues John Deckop, Robert Giacalone and Carole Jurkiewicz, carried out the study to investigate to what extent a person’s materialistic values were linked to their experience of work-family conflict. Mark Promislo said: “Needs associated with materialistic values are far more likely to be attained through work, so it is possible that people who place a high value on income and material possessions feel that the family demands get in the way of their work time.”

A total of 274 people replied to a questionnaire which asked to what extent their work demands interfered with their family responsibilities, and to what extent their family demands interfered with their work. They were also asked to complete a questionnaire that assessed how materialistic they were.

Materialism was significantly associated with the measures of family interference with work, and also their experience of work-overload – the perception of having too many things to do and not enough time to do them.

Mark Promislo continued: “Highly materialistic people pour their efforts into work as this produces tangible materialistic rewards – money and possessions. They therefore see any obstacle to work -including their family, as disruptive. This finding adds ‘work-family conflict’ to the already long list of the negative effects of materialistic values on personal well-being.”

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Materialism is also related to Marital Dissatisfaction

While there has been a relatively large number of studies conducted to investigate associations between financial problems and marital outcomes, little research has been done to examine possible relationships between materialistic attitudes, perceived financial problems, and marital outcomes.

A 2005 study by Lukas Dean of Brigham Young University was designed to examine a conceptual model linking materialism, perceived financial problems, and relationship satisfaction among married couples.

Data was obtained from 600 married heterosexual couples who took the RELATE test; a multidimensional couple assessment instrument that contains 271 questions that are designed to measure respondents’ perceptions about themselves and their partners in four main contexts of premarital and marital relationships.

His findings indicate that wives’ materialism is negatively related to husbands’ marital satisfaction. Husbands’ and wives’ materialism is positively related with increased perception of financial problems which is in turn negatively associated with marital satisfaction. As expected, income was positively related to marital satisfaction, however, income had no relation to perception of financial problems. Materialism had a stronger impact on perception of financial problems than income.

Distinct gender findings indicate that although husbands’ variables had no significant relation with wives’ outcomes, wives’ variables were significantly related to husbands’ outcomes. Specifically, wives’ materialism is positively related with husbands’ increased perception of financial problems, and wives’ perceived financial problems is negatively associated with husbands’ marital satisfaction.

These findings support the notion that materialism is indirectly related to marital satisfaction, and in some ways directly related to marital satisfaction.

Both these studies add to a growing body of work which demonstrates the negative psychosocial impacts of materialism.

Sources:

British Psychological Society

Dean, L.R. (2005) MATERIALISM, PERCEIVED FINANCIAL PROBLEMS,
AND MARITAL SATISFACTION (Unpublished Thesis)
Brigham Young University, Provo, Utah

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April 12, 2010 Posted by | anxiety, Books, Health Psychology, Marriage, Parenting, research, Social Psychology, Spirituality | , , , , , , , , , , , , , , | 2 Comments

Compulsive Collecting: Finding Hope In The Misunderstood Mess of Hoarding

Compulsive collecting or Hoarding is a misunderstood and debilitating mental health issue. Many psychologists and counsellors never see someone with this condition as they very rarely present for help. This article from an Australian newspaper provides an excellent overview of the condition and issues underlying hoarding, and I have included links to two brilliant books co-authored by the researchers discussed in the article, who have developed a wholistic and novel approach to it’s treatment.

Credit: Kate Benson, Sydney Morning Herald April 8 2010

They may dress well or hold down a good job. But hoarders are unhappy people who suffer from a debilitating condition.

Every suburb has one. The elderly woman weaving through an overgrown backyard full of cardboard boxes, old tyres and discarded furniture. Cats perch on every surface; kittens roll about among the rusted drums and long grass.

Inside, behind closed curtains, the rooms are piled high with papers, cups, plates and bottles. Broken toys, old clothes and shopping bags spill across kitchen benches and floor, smothering the stove and filling the sink, neither of which has been used in years.

The stench of cat faeces, urine and food scraps fill the house.

To her neighbours, she is an oddity. Or a pest, bringing down house values and encouraging vermin.

But to therapists she is one of a growing band across Australia suffering from a debilitating condition known as compulsive hoarding, where people feel a need to collect and store items that seem useless to others.

Their homes become havens of insurmountable clutter and junk, often leaving them unable to sleep in their beds or use appliances. Many end up with electricity or gas supplies disconnected or their fridge and washing machines unusable because they fear their lifestyle will be revealed if they contact a tradesmen to make repairs.

This secrecy and shame make it difficult to know exactly how many people have the disorder.

Some experts think between 200,000 and 500,000 Australians compulsively hoard, but others put the figure closer to 800,000.

“It’s a sleeping giant,” Chris Mogan, a clinical psychologist and expert on hoarding, says. “There is no systematic estimate of how many hoarders there are in any Australian setting. I suspect there are many, many more out there than we are aware of.”

Louise Newman, the president of the Royal Australian and New Zealand College of Psychiatrists, agrees.

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“I’ve only seen one case in my career [because] these people usually only come to light when the council steps in and orders a clean-up. Hoarders desperately want to keep hoarding. They don’t want to be stopped.”

There is little research on the condition in Australia and not much in the way of funding or treatment programs, but experts are hopeful hoarding will be included in the next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible used by mental health experts to diagnose psychiatric conditions.

Many sufferers fall between the cracks because hoarding is not a clinical diagnosis in its own right, but is seen more as an offshoot of obsessive compulsive disorder, muddled with depression, anxiety, panic disorder and low self-esteem.

“But it is different to OCD and once we get it in the DSM-V, therapists, psychiatrists, psychologists and social workers can then be trained in the management of it [and] we can attract funding for research,” Mogan says.

Jessica Grisham, a clinical psychologist who specialises in obsessive compulsive disorder, also believes compulsive hoarding should be included in the next edition as it requires specialised treatment.

She cites recent neural imaging studies in the US that showed that different parts of the brain were activated in hoarders than in obsessive compulsive disorder patients.

Mogan and Grisham agree that cognitive behaviour therapy, where sufferers are slowly taught to change their thought patterns, is more effective than medication alone.

But hoarders responded better to a specially adapted version of the therapy, developed by the American hoarding experts Gail Steketee and Randy Frost. It had been achieving success with about 60 per cent of hoarders – far more than standard cognitive behaviour therapy.

“But it has to be a long-term project. You don’t go in to someone’s place and do a sudden excavation against their will,” Grisham says.

“That’s a violation and it’s very traumatic for them. It might make great TV, but it’s not good clinically.”

Mogan agrees. A pay TV show, Hoarders, was damaging to the public’s understanding of the illness, because it focused on forcefully cleaning houses in three days.

“Within six to 12 months that house will be recluttered because it is a compulsion … they suffer a lot of grief after things are taken away.”

Mogan makes weekly home visits to hoarders, and focuses on getting them to reduce the associated dangers by ensuring their home has two exits for safety, and working appliances and smoke alarms.

“Just as we do with drugs and alcohol, we’re into harm minimisation. Once the house is safe, we gradually set more goals. If they are comfortable with that, they will continue to stay in touch and not reject us.”

Sometimes the problem extends beyond mounds of paperwork and clothes. Mogan and Grisham know patients who hoarded urine or fingernail clippings. Some stored their own faeces or collected one particular item, such as bicycles. One sufferer was hoarding so much junk, the only access to the house was a 30-centimetre gap at the top of the front door.

But for Allie Jalbert, of the RSPCA, the most distressing hoarders are those who keep scores of cats and dogs, all battling for attention and food on a crowded suburban block.

She has been calling for years to have hoarding classified as an illness in its own right to allow more people to receive treatment and put an end to the 100 per cent recidivism rate.

“Often, we find that hoarders might be treated for peripheral symptoms such as anxiety or depression, but their core problem, the hoarding, is not addressed. So once we have cleaned out the house, they reoffend, which is very, very frustrating for everyone involved,” Jalbert says.

Some people threatened suicide and had to be removed by police when faced with the prospect of giving up their animals or clutter.

“There’s a mixed bag of emotion when you deal with hoarders. Firstly, there is the concern for your personal safety but there is also a degree of empathy because often these people are quite emotional and attached to the animals. But it’s quite frustrating to see animals living in such horrific situations,” she says.

“I’ve seen bathtubs full of faeces and rubbish, sinks that no longer work, homes with no heating or cooling. Sometimes it’s quite an overwhelming experience.”

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Who develops the condition and why?

Some studies have shown that many hoarders have been brought up in households where chaos reigned. Some were neglected as children and witnessed pets being treated poorly.

Mogan accepts the aetiology is mostly unknown, but cites an Australian study that found sufferers reported failing to connect with their parents or growing up in households lacking emotional warmth.

“The lack of attachment causes them to become ambivalent about their identity and about other people. As a compensatory mechanism, they link with things, which they find more compelling, more predictable and dependable and less rejecting.”

But Grisham believes there is no real trigger, apart from children of hoarders being rewarded for saving things and getting punished for discarding. “Sometimes there is a traumatic head injury but those cases are very rare.”

The condition affects slightly more women than men but is found across all occupations, age groups and ethnicities. “And they are in relationships,” Mogan says. “Albeit strained ones.

“Some are going out to work, but they make sure no one comes to their house. They’re not agoraphobic. On the contrary, many hoarders go out a lot to escape. But their children’s lives can’t be normalised because they can never sit down for a meal or find space to do homework. It’s a real impost on the family experience.”

Mogan runs group therapy sessions in Melbourne and says that many patients do want to be cured.

“This condition is a disability and the source of quite a lot of human suffering and neglect. A lot of these people are quite relieved to get help.”

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April 10, 2010 Posted by | anxiety, Books, Cognitive Behavior Therapy, diagnosis, Identity, research, Resources, therapy | , , , , , , , , , , , , | 9 Comments