Sep. 12, 2013 — NIMH grantees have demonstrated that a form of behavioral therapy can augment antidepressant treatment of obsessive compulsive disorder (OCD) better than an antipsychotic. The researchers recommend that this specific form of cognitive behavior therapy (CBT) — exposure and ritual prevention — be offered to OCD patients who don’t respond adequately to treatment with an antidepressant alone, which is often the case. Current guidelines favor augmentation with antipsychotics.
(EDIT- FROM JOURNAL ARTICLE- description of CBT intervention:
EX/RP Augmentation
Patients randomized to EX/RP received 17 twice-weekly 90- minute sessions delivered over 8 weeks by a study therapist. Treatment included 2 introductory sessions, 15 exposure sessions (during which patients faced their obsessional fears for a prolonged period without ritualizing), daily homework (at least 1 hour of self-directed exposures daily), and between- session telephone check-ins.16 At least 2 sessions occurred outside the clinic to promote generalization to daily life. The goal was for patients to stop their rituals as early in treatment as possible; patients were asked to try refraining from ritualizing after the first exposure session. Formal cognitive therapy procedures were not used, but dysfunctional cognitions were discussed within the context of exposure.)
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In the controlled trial with 100 antidepressant-refractory OCD patients, 80 percent of those who received CBT responded, compared to 23 percent of those who received the antipsychotic risperidone, and 15 percent of those who received placebo pills. Forty-three percent experienced symptoms reduced to a minimal level following CBT treatment, compared to 13 percent for risperidone and 5 percent for placebo.
The study, published September 11, 2013 in JAMA Psychiatry, was led by Helen Blair Simpson, M.D., of Columbia University, in New York City; and Edna Foa, Ph.D., of the University of Pennsylvania, Philadelphia.
In an accompanying editorial, grantees Kerry Ressler, M.D., and Barbara Rothbaum, Ph.D., of Emory University, Atlanta, note that antidepressants are effective in treating only a subset of OCD patients. They add that the targeted form of CBT works via different mechanisms — such as retraining the brain’s habit-forming circuitry to unlearn compulsive rituals.
Matthew Rudorfer, M.D., chief of the NIMH Somatic Treatments Program, which funded the study, said that in demonstrating how different patients respond best to different approaches, it helps to move the field toward the goal of more personalized treatment.
“For some people social anxiety is pretty pervasive,” said Justin Weeks, Ph.D, an assistant professor of psychology and director of the Center for Evaluation and Treatment of Anxiety at Ohio University. For others, the anxiety arises in specific social situations, he said.
The most common example is anxiety over public speaking. Making small talk, eating in front of others and using public restrooms also can trigger worry and unease for some.
Some people engage in what Weeks called “covert avoidance.” For example, they might go to parties but instead of mingling, they hang back in the kitchen, he said.
Social anxiety is defined as anxiety anticipating a social situation or anxiety during or after that situation, Weeks said. “At the heart of social anxiety is the fear of evaluation.” And it’s not just negative evaluation that people worry about; it’s positive evaluation, too.
Weeks’s research suggests that people perceive negative consequences from a social situation whether they do poorly or well. (Here’s one study.) For instance, people who do well at work might worry about the social repercussions of outshining their coworkers, he said.
In other words, people with social anxiety simply don’t want to stand out. “They want to be as inconspicuous as possible.”
Anxiety about social situations lies on a spectrum. “The consensus among the experts is that shyness and social anxiety disorder are all part of one continuum,” Weeks said. “It’s a question of severity.”
How much does social anxiety interfere with your life?
For instance, you might wish that you were more comfortable when interacting with people, Weeks said. But “you don’t feel like it’s holding you back,” in terms of your personal or professional goals.
“Social anxiety is more severe.” A person might avoid going to college because schools require passing a public speaking course and interacting with new people. They might want a romantic relationship but worry so much about rejection that they avoid potential partners.
Below, Weeks shared his suggestions for overcoming social anxiety.
If social anxiety is stopping you from doing things you want or need to do, or you haven’t had much success with self-help, seek professional help. Find a therapist who specializes in anxiety disorders. You can start your search here.
The Workbook Recommended by Dr Justin Weeks. Click Image To Read Reviews and View Content
3. Practice deep breathing every day.
It’s helpful to engage in deep breathing before an anxiety-provoking social situation, Weeks said. But practice this technique every day. This way it becomes second nature, and you don’t hyperfocus on deep breathing and miss an entire conversation, he said. Here’s more on deep breathing.
4. Create an exposure hierarchy.
An exposure hierarchy is a list – akin to a ladder – where you write down situations that cause you anxiety, in order of severity. Then you perform the easiest behavior, and keep moving up the list.
To create your own hierarchy, list 10 anxiety-provoking situations, and rate them on a 100-point scale (zero being no anxiety; 100 being severe anxiety). Your list might start with asking a stranger for directions and end with joining Toastmasters.
This website features a link to various worksheets on coping with social anxiety, and includes “the fear and avoidance hierarchy.” (Look for “managing social anxiety: workbook.”)
5. Create objective goals.
People tend to disqualify the positive when they feel anxious, Weeks said. They might do well, even great, but because of their anxious feelings, they see their performance as abysmal. That’s why therapists encourage clients to create objective behavioral goals, he said.
These are behaviors that anyone in the room would be able to observe. It doesn’t matter how you feel or whether you’re blushing or sweating (which you can’t control anyway) in a social situation.
For instance, if you’re working in a group setting, the objective behavior would be to make three comments, Weeks said.
This also gives you a good barometer for judging your progress. Again, you’re not focusing on whether you felt nervous. Rather, you’re focusing on whether you performed the actual behavior.
My Recommended Workbook for Teens. Click Image To Read Reviews and View Content
Also, avoid focusing on others’ reactions. It doesn’t matter how your colleagues received your idea in the meeting. What matters is that you actually spoke up. It doesn’t matter whether a girl or guy said yes to your dinner invite. What matters is that you actually asked. It doesn’t matter how your child’s teacher reacted when you declined to volunteer for yet another school trip. What matters is that you were assertive and respected your own needs.
As Weeks said, “You did what you wanted to in a situation. We can’t control what another person is going to do.”
6. Keep a rational outlook.
Dispute both bleak thoughts that undermine your performance and fuel your anxiety, and equally unrealistic thoughts that are irrationally positive, Weeks said.
For instance, if you’re giving a speech, you might initially think, “I’m going to bomb.” But if you’ve given speeches before and done well, then this isn’t a rational or realistic perspective. You might say instead, “I’ve given speeches before. I’m prepared, and I’ll give it my best shot.”
If you’re asking someone out, it’s not rational to think, “They’re definitely going to say yes.” But it is rational to consider, “They might,” according to Weeks.
If social anxiety is sabotaging your goals and stopping you from living the life you want, seek help and try the above strategies. Social anxiety is highly treatable, Weeks said. You can get better, and grow in the process.
A computerized self help intervention may help adolescents who suffer from depression. The specialized computer therapy acts much the same way as they do from one-to-one therapy with a clinician, according to a study published on BMJ.
Depression is common in adolescents, but many are reluctant to seek professional help. So researchers from the University of Auckland, New Zealand, set out to assess whether a new innovative computerized cognitive behavioral therapy intervention called SPARX could reduce depressive symptoms as much as usual care can.
SPARX is an interactive 3D fantasy game where a single user undertakes a series of challenges to restore balance in a virtual world dominated by GNATs (Gloomy Negative Automatic Thoughts). It contains seven modules designed to be completed over a four to seven week period. Usual care mostly involved face-to-face counseling by trained clinicians.
The research team carried out a randomized controlled trial in 24 primary healthcare sites across New Zealand. All 187 adolescents were between the ages of 12 and 19, were seeking help for mild to moderate depression and were deemed in need of treatment by primary healthcare clinicians. One group underwent face-to-face treatment as usual and the other took part in SPARX.
Participants were followed up for three months and results were based on several widely used mental health and quality of life scales.
Results showed that SPARX was as effective as usual care in reducing symptoms of depression and anxiety by at least a third. In addition significantly more people recovered completely in the SPARX group (31/69 (44%) of those who completed at least four homework modules in the SPARX group compared with 19/83 (26%) in usual care).
When questioned on satisfaction, 76/80 (95%) of SPARX users who replied said they believed it would appeal to other teenagers with 64/80 (81%) recommending it to friends. Satisfaction was, however, equally high in the group that had treatment as usual.
The authors conclude that SPARX is an “effective resource for help seeking adolescents with depression at primary healthcare sites. Use of the program resulted in a clinically significant reduction in depression, anxiety, and hopelessness and an improvement in quality of life.” They suggest that it is a potential alternative to usual care and could be used to address unmet demand for treatment. It may also be a cheaper alternative to usual care and be potentially more easily accessible to young people with depression in primary healthcare settings.
The University of Houston’s Tracey Ledoux, assistant professor of health and human performance, is using an innovative approach to studying food addictions in hopes of finding strategies to assess and treat them.
“There is a growing body of research that shows that consumption of palatable food stimulates the same reward and motivation centers of the brain that recognized addictive drugs do,” Ledoux said. “These cravings are related to overeating, unsuccessful weight loss and obesity.”
Ledoux and Professor Patrick Bordnick, director of the UH Graduate College of Social Work‘s Virtual Reality Lab, will use virtual environments to try to induce food cravings. Bordnick’s body of research has focused on addictive behaviors and phobias and has used virtual reality as a tool to assess and treat them.
In this new investigation, participants will wear a virtual reality helmet to enter a “real -world” restaurant, complete with all the sights, sounds and smells. A joystick will allow them to walk to a buffet, encounter waitstaff and other patrons.
“Virtual reality will allow us to identify food and food-related stimuli of the built, home, school and social environment that cue food cravings, which has public policy, public health and clinical treatment implications,” Ledoux said. “Our study is innovative because it provides a very effective, cost-efficient tool that can be used to increase our understanding of food cravings.”
Ledoux is recruiting normal-weight women who do not have dietary restrictions or are trying to lose weight. Participants will be invited to two appointments, which may last between 30 minutes and an hour, and will receive a small compensation plus a chance to win a Kindle e-reader. For more information contact Tracey Ledoux at 713-743-1870 or TALedoux@uh.edu.
“Obesity is a pervasive and intractable problem with significant public health and economic costs in our society,” she said. “Finding the elements that promote overeating is critical for reversing the dangerous obesity trend.”
It seems like many of our children will no longer have to worry about those embarrassing photos popping up at 16,18th or 21st birthdays anymore. Many of them will have their lives broadcast as they grow via the internet, some before they are even born! The following article, based on research undertaken by internet security company AVG raises some interesting and concerning questions about how we publicly share our childrens’ lives, beginning before they are even old enough to speak, let alone protest…
Digital Birth: Welcome to the Online World
AVG Study Finds a Quarter of Children Have Online Births Before Their Actual Birth Dates
Uploading prenatal sonogram photographs, tweeting pregnancy experiences, making online photo albums of children from birth, and even creating email addresses for babies – today’s parents are increasingly building digital footprints for their children prior to and from the moment they are born.
“Secondly, it reinforces the need for parents to be aware of the privacy settings they have set on their social network and other profiles. Otherwise, sharing a baby’s picture and specific information may not only be shared with friends and family but with the whole online world.”
Internet security company AVG surveyed mothers in North America (USA and Canada), the EU5 (UK, France, Germany, Italy and Spain), Australia/New Zealand and Japan, and found that 81 percent of children under the age of two currently have some kind of digital profile or footprint, with images of them posted online. In the US, 92 percent of children have an online presence by the time they are two compared to 73 percent of children in the EU5.
According to the research, the average digital birth of children happens at around six months with a third (33%) of children’s photos and information posted online within weeks of being born. In the UK, 37 percent of newborns have an online life from birth, whereas in Australia and New Zealand the figure is 41 percent.
Almost a quarter (23%) of children begin their digital lives when parents upload their prenatal sonogram scans to the Internet. This figure is higher in the US, where 34 percent have posted sonograms online, while in Canada the figure is even higher at 37 percent. Fewer parents share sonograms of their children in France (13%), Italy (14%) and Germany (15%). Likewise only 14 percent of parents share these online in Japan.
Seven percent of babies and toddlers have an email address created for them by their parents, and five percent have a social network profile.
When asked what motivates parents to post images of their babies on the Internet, more than 70 percent of all mothers surveyed said it was to share with friends and family. However, more than a fifth (22%) of mothers in the US said they wanted to add more content to their social network profiles, while 18 percent of US mothers said they were simply following their peers.
Lastly, AVG asked mothers how concerned they are (on a scale of one to five with five being very concerned) about the amount of online information available on their children in future years. Mothers were moderately concerned (average 3.5), with Spanish mothers being the most concerned.
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According to AVG CEO JR Smith, “It’s shocking to think that a 30-year-old has an online footprint stretching back 10–15 years at most, while the vast majority of children today will have online presence by the time they are two-years-old – a presence that will continue to build throughout their whole lives.
“Our research shows that the trend is increasing for a child’s digital birth to coincide with and in many cases pre-date their real birth date. A quarter of babies have sonogram photos posted online before they have even physically entered into the world.
“It’s completely understandable why proud parents would want to upload and share images of very young children with friends and families. At the same time, we urge parents to think about two things:
“First, you are creating a digital history for a human being that will follow him or her for the rest of their life. What kind of footprint do you actually want to start for your child, and what will they think about the information you’ve uploaded in future?
“Secondly, it reinforces the need for parents to be aware of the privacy settings they have set on their social network and other profiles. Otherwise, sharing a baby’s picture and specific information may not only be shared with friends and family but with the whole online world.”
The research was conducted by Research Now among 2200 mothers with young (under two) children during the week of 27 September. Mothers in the EU5 (UK, Germany, France, Italy, Spain), Canada, the USA, Australia, New Zealand and Japan were polled.
Key results
1 – Mothers with children aged under two that have uploaded images of their child Overall – 81%
USA – 92% Canada – 84%
UK – 81% France – 74% Italy – 68% Germany – 71% Spain – 71% (EU5 – 73%)
Australia – 84% New Zealand – 91% Japan – 43%
2 – Mothers that uploaded images of their newborn Overall – 33%
USA – 33% Canada – 37%
UK – 37% France – 26% Italy – 26% Germany – 30% Spain – 24% (EU5 – 28.6%)
Australia – 41% New Zealand – 41% Japan – 19%
3 – Mothers that have uploaded antenatal scans online Overall – 23%
USA – 34% Canada – 37%
UK – 23% France – 13% Italy – 14% Germany – 15% Spain – 24% (EU5 – 20%)
Australia – 26% New Zealand – 30% Japan – 14%
4 – Mothers that gave their baby an email address Overall – 7%
USA – 6% Canada – 9%
UK – 4% France – 7% Italy – 7% Germany – 7% Spain – 12% (EU5 – 7%)
Australia – 7% New Zealand – 4% Japan – 7%
5 – Mothers that gave their baby a social network profile Overall – 5%
USA – 6% Canada – 8%
UK – 4% France – 2% Italy – 5% Germany – 5% Spain – 7% (EU5 – 5%)
The following is re-posted from Psychcentral’s Dr John M Grohol, and poses some interesting questions about some trends towards over-parenting or “Helicopter Parenting” and it’s possible impacts on our kids. While there are many children who come from situations of parental neglect and laxity, there are also concerns regarding over protection. See what you think about what he has to say…
Everyday, the same scene plays itself out across American neighborhoods across the United States. Mothers pull up in their Suburbans and Lexus SUVs at the entrance to their housing development. Even though the families live in perfectly safe, middle-class (or better) neighborhoods, parents feel the need to chauffeur their children the few blocks from the bus stop to home. Why?
This behavior may be understandable if the child is 5 or 6. But at 8 or 10, this behavior is ludicrous and symptomatic of a dangerous infection that has spread throughout this country in the latest generation of parents.
If not stopped, we may end up raising a whole generation or two of children who have little effective life coping skills and no connection or understanding to the world around them.
If you’re around 30 or older, think back to your own childhood. How much time was scheduled by your parents, and how much free time did you have on your own, to do with as you please? You may be surprised at the contrast between the scripted lives you as a parent plan for your children versus your own unscripted, imagination-driven childhood.
Here’s another scene from modern parenting. A child holds their 8th birthday party at a local birthday party place. All the parents not only arrive to drop off their child to attend the party, but also stay to supervise the child during the entire time they are at the party.
This isn’t just one or two worried parents — this appears to be very much the norm in many towns throughout middle-class America now. When it’s time to eat the cake, the birthday song is sung, the cake is cut, and then all the kids sit down at long rows of tables and begin eating. Their parents stand, like a prison lineup, along the outside walls of the room, keeping a close eye on their child.
At the first sign of a child’s conflict, parents are quick to intervene nowadays. “I just want everyone to play nicely,” they may explain. But they’re depriving their child of the opportunity to learn invaluable problem-solving skills. Especially if a child has no siblings, how else are they going to learn such skills except through trial-and-error interaction with their peers?
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There are many rationales for these kinds of parenting behaviors. But if we look at some of the most common ones, they all don’t stand up to tests of data, reasoning or logic.
One rationale is safety. “I’ll do anything to protect my child!” Okay, then why are you driving them home from the bus stop a few blocks away? Because statistics show that your child (age 15 years or younger) is 5 to 7 times more likely to die in your car than they are to be abducted by a stranger. And put into perspective, both are highly unlikely occurrences to begin with. With approximately 78 million children in the U.S., only 1,638 children died in car accidents in 2008, compared with only 200 who were abducted by a stranger.
Still another excuse for this behavior is a sense that there’s no reason not to help out our children or placate them with this thing or that. Why not buy them that toy while we’re out shopping for some new clothes? Why not pick them up at the entrance to our housing development?
Because it teaches our children that every outing is a chance for a reward. So much like a mouse in a cage pressing a button to receive a pellet of food, our children can inadvertently learn that any type of outing results in a toy and all of life is just another opportunity for a reward. When a reward isn’t granted, it’s an excuse to act out or punish those who grant the rewards.
Another rationale is wanting to provide our children with all the benefits we didn’t have. If our parents seemed uninterested or didn’t spend as much time with us as we may have wished, we’re going to ensure we’re there every minute for our children.
But somehow this has become twisted to trying to smooth over every life bump our child experiences, so that they experience virtually none at all. By the time they go off to college, they have had only this womb-like protected life that little prepares them for the realities of life — people who treat us badly, failure at something we want to be good at, rejection by others, and honest hardship.
Understandably, there may be times where a parent has good reason to need to pick up their child at their bus-stop, or attend a birthday party with them. But these should be exceptions, not the rule.
There is no “right way” to parent (contrary to what the hundreds of parenting books suggest). The right way is to find the way that works for you and your partner, while respecting the needs of your child. Those needs include the need to be connected with nature, to be connected and learn how to interact with other children who aren’t their siblings, with no adults around.
What if your child doesn’t want to play outside or walk from the bus stop? Well, they often don’t want to learn arithmetic or do their chores, and yet we still find a way to have them understand the value of each. And if you’re feeling pressure from other moms, well, now’s the time to take a stand for what you believe in and what the research shows. Your child will thank you in the end.
Children — like adults — learn by doing, as much as they learn through formal teaching. If we take those informal learning opportunities away from our children, we ultimately hurt them while ironically trying to help them. We hurt their ability to learn the way they were intrinsically built to learn — through natural experiences, through interactive experiences with their peers, and through unscripted, unstructured play time.
If you want to help your child today, give them time to be a child.
Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992.
Could your personality kill you—or might it make you live longer? Could it give you heart disease, or protect you from illness? Could it push you toward or away from doctor appointments?
Personality traits play a distinct role in determining how healthy we are, psychologists say. “Everything is related to everything else. How stressed or angry you are, and how you interact with the world, is contingent in large part on your personality style,” says Michael Miller, editor in chief of the Harvard Mental Health Letter. “And that is going to have an enormous impact on your health.”
Here’s a look at common personality types and traits and how each can help or hurt your health (sometimes both):
Hostile
One of the aspects of the impatient, hard-charging Type A personality that is known to increase heart disease risk is hostility. Hostile people eat and smoke more and exercise less than other personality types, says Redford Williams, head of behavioral medicine at Duke University Medical Center and author of Anger Kills. They’re likelier to be overweight in middle age and have higher cholesterol and blood pressure. Williams’s past research suggests hostile people are also more likely to develop irregular heart rhythms, and to die before reaching their 50s. Most of these problems can be traced back to elevated levels of the stress hormone cortisol, as well as increased inflammation in the walls of the coronary arteries, which leads to a greater risk of heart attack.
No personality is set in stone, however, and Type A’s can be taught how to take the edge off their hostility. Hostile heart patients who attend workshops that teach coping skills, for instance, have a lower incidence of depression and healthier blood pressure than Type A’s who don’t go. The key, Williams says, is learning how to communicate more clearly and how to control anger and other negative emotions. He suggests asking yourself four questions when you get angry: Is this issue truly important? Is what I’m feeling appropriate to the facts? Can I modify the situation in a positive way? Is taking such action worth it? Meditation, deep breathing, and yoga can damp hostility with a layer of calm.
Impulsive
Because Type A personalities are defined by competitiveness, a drive to succeed, and a sense of urgency, they are prone to take risks and act without thinking, neither of which is likely to improve health. Non-Type A’s can be impulsive, too. Such people are often not as well-grounded as others, says Robin Belamaric, a clinical psychologist in Bethesda, Md.: “They’ll look at an opportunity that comes along and say, ‘Hmm, that sounds like fun,’ whereas another, more thoughtful person, will say, ‘I’m going to pass, because I’m not sure it’s the best idea.’ ”
Relaxed
If you’re a Type B, you roll with the punches. You’re relaxed, take life a day a time, and handle stress without cracking. That translates to a higher quality of life and lower likelihood of heart disease—less anxiety strengthens the immune system. The more we chill, the better off we are, says Miller: “You don’t want to get locked into a stressful, tense state of mind.” Over the long term, he adds, relaxing and managing stress effectively will lengthen your life, help your heart and gastrointestinal system, and just make you feel better overall.
Extrovert People who are outgoing, involved in their communities, and have strong social connections reap health benefits. An analysis of 148 studies published in the online journal PLoS medicine in July found that on average, adults enrolled in a study with many close friendships were 50 percent likelier to survive until their study ended than were those with few friendships. And a 2009 study published in Perspectives in Psychological Science suggests that social support leads to improved coping skills, healthy behavior, and adherence to medical regimens. Bonding with others also reduces stress and improves the immune system—so making friends and getting involved becomes, in effect, a well-being tonic.
What drives at least some of the health benefits goes beyond biology, Miller says. “It may have to do with the fact that when you’re around people, you think, ‘Oh, Martha has gone for her mammogram—that reminds me, I should, too.’ ”
Eager to please
People-pleasers—Type C’s—are conforming, passive, and want to accommodate. That can be a good thing when it comes to patient compliance: They’re more likely to take the right medicines in the right doses at the right times, for instance—once they see a doctor, that is. Making and following through on appointments can be challenging for Type C’s, who tend to accept their fate as inevitable and fall readily into hopelessness and helplessness. That means others must push them to take care of themselves. “They may be less likely to maintain their health on their own,” Belamaric says. “If they develop a problem, they may just complain about it, hoping somebody says, ‘I have a good doctor, I’ll make you an appointment.’ ”
Some Type C’s may be so mired that they don’t seek medical attention—even when it’s clearly necessary—and slough off preventive behaviors, like watching what they eat. “If they get a serious diagnosis, they may be passive, throw their hands up, and say, ‘Well, there’s nothing I can do about it, anyway. If it’s my time, it’s my time,’ ” Belamaric says.
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Stressed and distressed
Type D’s—D is for distressed—dwell on negative emotions and are afraid to express themselves in social situations. Compared to more optimistic sorts, a Type D may face three times the risk for future heart problems, according to a recent study in the journal Circulation: Cardiovascular Quality and Outcomes. Type D’s also face a higher likelihood of compulsive overeating and substance abuse. “If you’re a person who is prone to depression or anxiety, or if you’re overly self-critical, there’s more of a chance of turning to gratifying behavior to feel better,” Miller says.
Optimistic versus pessimistic
Optimism “heavily influences physical and mental health,” concluded a study published in May in the journal Clinical Practice & Epidemiology in Mental Health after researchers followed more than 500 males for 15 years. The rate of heart-related deaths was 50 percent lower among optimists than among pessimists. “Optimists have a higher quality of life, and they may be more resilient in the way they deal with stress,” Miller says. “So if a problem comes along, they’re able to handle it better, and they become less symptomatic.” Glass-half-empty types harbor little hope for the future and tend more toward depression and anxiety disorders.
But there’s a catch for those at the extreme end of the optimism spectrum: They think of themselves as impervious to risks. Extreme optimists who smoke are the best examples. They believe they won’t develop lung cancer. Why give up smoking to prevent a nonexistent risk?
The “self-healing personality”
That is the name Howard Friedman, a professor of psychology at the University of California-Riverside, attaches to people who are curious, secure, constructive, responsive, and conscientious. These traits translate to enthusiasm for life, emotional balance, and strong social relationships. “Positive emotions buffer hormonal responses to stress,” says Friedman, who studies the relationship between personality and longevity. Self-healers, he says, “have healthier behavior patterns: more physical activity, a better diet, and less smoking and substance abuse.”
Source: ScienceDaily (Sep. 15, 2010) — The millions of middle-aged and older adults who suffer from insomnia have a new drug-free prescription for a more restful night’s sleep. Regular aerobic exercise improves the quality of sleep, mood and vitality, according to a small but significant new study from Northwestern Medicine.
The study is the first to examine the effect of aerobic exercise on middle-aged and older adults with a diagnosis of insomnia. About 50 percent of people in these age groups complain of chronic insomnia symptoms.
The aerobic exercise trial resulted in the most dramatic improvement in patients’ reported quality of sleep, including sleep duration, compared to any other non-pharmacological intervention.
“This is relevant to a huge portion of the population,” said Phyllis Zee, M.D., director of the Sleep Disorders Center at Northwestern Medicine and senior author of a paper to be published in the October issue of Sleep Medicine. The lead author is Kathryn Reid, research assistant professor at Feinberg.
“Insomnia increases with age,” Zee said. “Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep. Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous.”
The drug-free strategy also is desirable, because it eliminates the potential of a sleeping medication interacting with other drugs a person may be taking, Reid said.
Sleep is an essential part of a healthy lifestyle, like nutrition and exercise, noted Zee, a professor of neurology, neurobiology, and physiology at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.
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“By improving a person’s sleep, you can improve their physical and mental health,” Zee said. “Sleep is a barometer of health, like someone’s temperature. It should be the fifth vital sign. If a person says he or she isn’t sleeping well, we know they are more likely to be in poor health with problems managing their hypertension or diabetes.” The study included 23 sedentary adults, primarily women, 55 and older who had difficulty falling sleep and/or staying asleep and impaired daytime functioning. Women have the highest prevalence of insomnia. After a conditioning period, the aerobic physical activity group exercised for two 20-minute sessions four times per week or one 30-to-40-minute session four times per week, both for 16 weeks. Participants worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill.Participants in the non-physical activity group participated in recreational or educational activities, such as a cooking class or a museum lecture, which met for about 45 minutes three to five times per week for 16 weeks. Both groups received education about good sleep hygiene, which includes sleeping in a cool, dark and quiet room, going to bed the same time every night and not staying in bed too long, if you can’t fall asleep. Exercise improved the participants’ self-reported sleep quality, elevating them from a diagnosis of poor sleeper to good sleeper. They also reported fewer depressive symptoms, more vitality and less daytime sleepiness. “Better sleep gave them pep, that magical ingredient that makes you want to get up and get out into the world to do things,” Reid said. The participants’ scores on the Pittsburgh Sleep Quality Index dropped an average of 4.8 points. (A higher score indicates worse sleep.) In a prior study using t’ai chi as a sleep intervention, for example, participants’ average scores dropped 1.8 points. “Exercise is good for metabolism, weight management and cardiovascular health and now it’s good for sleep,” Zee said. The research was funded by the National Institute on Aging
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.
Researchers from Royal Holloway, University of London have found that pregnant and postnatal women, while wanting to do the best for their baby, do not follow medical advice without question and are more likely to adopt practices their mothers and grandmothers carried out during their pregnancies.
The study by Professor Paula Nicolson and Dr Rebekah Fox from the Department of Health and Social Care at Royal Holloway is published in the Journal of Health Psychology and explores three recent generations of women’s experiences of pregnancy, questioning those who gave birth in the 1970s, 1980s and 2000s.
The women who were interviewed said they knew their mothers and grandmothers had their best interests at heart when they offered them advice. For the older women questioned, the advice from their female relations was their main source of information.
The 1980s and 2000s group, however, had to reconcile what they heard from older generations with direct advice from their doctors, midwives and health visitors as well as the numerous health messages on the web and self-help books.
Professor Nicolson says, “It is much to the credit of contemporary women that despite the unprecedented pressures from the media, medicine and the ‘pregnancy police’ that they are still able to filter-in the advice that really suits them from all these sources. Each of the three generations found ways to ‘resist’ what they considered inappropriate pressures from advisors and were more likely to follow advice given to them from their mothers and grandmothers even if it went against the medical professions advice.
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“Women tend to discuss the advice they are given with their female relatives and this leads to resistance to some types of advice. For example, despite being advised to cut down on caffeine during pregnancy one woman we questioned said she continued to drink tea because her grandmother told her it relieved her morning sickness.”
Professor Nicolson says women who take notice of general public health information about what is a healthy lifestyle, i.e not smoking, taking regular exercise, not taking drugs and drinking alcohol in moderation are those who are most likely to be in-tune with their bodies and can therefore ‘use’ guidelines but not be constrained by them.
She added: “Taking all the guidelines too seriously leads to anxieties. Lack of self-confidence also can lead to worry about ‘doing the wrong thing’ which is potentially more harmful than taking the odd glass of wine or eating soft cheese.”
I’m a Clinical Psychologist and have a private practice and consultancy in Brisbane Australia. I have 24 years experience in child, adult and family clinical psychology. I have a wonderful wife and three kids.
I like researching issues of the brain & mind, reading and seeking out new books and resources for myself and my clients. I thought that others might be interested in some of what I have found also, hence this blog…
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Peter H Brown Clinical Psychologist 