Analyses of a national sample of individuals with alcohol dependence (alcoholism) reveal five distinct subtypes of the disease, according to a new study by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH).

“Our findings should help dispel the popular notion of the ‘typical alcoholic,’” notes first author Howard B. Moss, M.D., NIAAA Associate Director for Clinical and Translational Research.  “We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes.  More than half of the alcoholics in the United States have no multigenerational family history of the disease, suggesting that their form of alcoholism was unlikely to have genetic causes.”

“Clinicians have long recognized diverse manifestations of alcoholism,” adds NIAAA Director Ting-Kai Li, M.D, “and researchers have tried to understand why some alcoholics improve with specific medications and psychotherapies while others do not. The classification system described in this study will have broad application in both clinical and research settings.”  A report of the study is now available online in the journal Drug and Alcohol Dependence.

Previous efforts to identify alcoholism subtypes focused primarily on individuals who were hospitalized or otherwise receiving treatment for their alcoholism.  However, recent reports from NIAAA’s National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a nationally representative epidemiological study of alcohol, drug, and mental disorders in the United States, suggest that only about one-fourth of individuals with alcoholism have ever received treatment. Thus, a substantial proportion of people with alcoholism were not represented in the samples previously used to define subtypes of this disease.

In the current study, Dr. Moss and colleagues applied advanced statistical methods to data from the NESARC.  Their analyses focused on the 1,484 NESARC survey respondents who met diagnostic criteria for alcohol dependence, and included individuals in treatment as well as those not seeking treatment.  The researchers identified unique subtypes of alcoholism based on respondents’ family history of alcoholism, age of onset of regular drinking and alcohol problems, symptom patterns of alcohol dependence and abuse, and the presence of additional substance abuse and mental disorders:

• Young Adult subtype: 31.5 percent of U.S. alcoholics.  Young adult drinkers, with relatively low rates of co-occurring substance abuse and other mental disorders, a low rate of family alcoholism, and who rarely seek any kind of help for their drinking.


• Young Antisocial subtype: 21 percent of U.S. alcoholics.  Tend to be in their mid-twenties, had early onset of regular drinking, and alcohol problems.  More than half come from families with alcoholism, and about half have a psychiatric diagnosis of Antisocial Personality Disorder.  Many have major depression, bipolar disorder, and anxiety problems.  More than 75 percent smoked cigarettes and marijuana, and many also had cocaine and opiate addictions. More than one-third of these alcoholics seek help for their drinking.


• Functional subtype: 19.5 percent of U.S. alcoholics. Typically middle-aged, well-educated, with stable jobs and families.  About one-third have a multigenerational family history of alcoholism, about one-quarter had major depressive illness sometime in their lives, and nearly 50 percent were smokers.


• Intermediate Familial subtype: 19 percent of U.S. alcoholics.  Middle-aged, with about 50 percent from families with multigenerational alcoholism.  Almost half have had clinical depression, and 20 percent have had bipolar disorder. Most of these individuals smoked cigarettes, and nearly one in five had problems with cocaine and marijuana use. Only 25 percent ever sought treatment for their problem drinking.


• Chronic Severe subtype:  9 percent of U.S. alcoholics. Comprised mostly of middle-aged individuals who had early onset of drinking and alcohol problems, with high rates of Antisocial Personality Disorder and criminality.  Almost 80 percent come from families with multigenerational alcoholism.  They have the highest rates of other psychiatric disorders including depression, bipolar disorder, and anxiety disorders as well as high rates of smoking, and marijuana, cocaine, and opiate dependence.  Two-thirds of these alcoholics seek help for their drinking problems, making them the most prevalent type of alcoholic in treatment.

The authors also report that co-occurring psychiatric and other substance abuse problems are associated with severity of alcoholism and entering into treatment.  Attending Alcoholics Anonymous and other 12-step programs is the most common form of help-seeking for drinking problems, but help-seeking remains relatively rare.

Exercise has a similar effect to antidepressants on depression. This has been shown by previous research. Now Astrid Bjørnebekk at Karolinska Institutet has explained how this can happen: exercise stimulates the production of new brain cells.

In a series of scientific reports, she has searched for the underlying biological mechanisms that explain why exercise can be a form of therapy for depression and has also compared it with pharmacological treatment with an SSRI drug.

The experiment studies were conducted on rats. The results show that both exercise and antidepressants increase the formation of new cells in an area of the brain that is important to memory and learning. Astrid Bjørnebekk's studies confirm previous research results, and she proposes a model to explain how exercise can have an antidepressant effect in mild to moderately severe depression. Her study also shows that exercise is a very good complement to medicines.

"What is interesting is that the effect of antidepressant therapy can be greatly strengthened by external environmental factors," she says.

Previous studies have shown that drug abusers have lowered levels of the dopamine D2 receptor in the brain's reward system. It has been speculated that this may be of significance to the depressive symptoms drug abusers often suffer from. These rat studies show that genetic factors may influence how external environmental factors can regulate levels of the dopamine D2 receptor in the brain.

"Different individuals may have differing sensitivity to how stress lowers dopamine D2 receptor levels, for example. This might be significant in explaining why certain individuals develop depression more readily than others," she says.

Researchers at the University of Pennsylvania say that practicing even small doses of daily meditation may improve focus and performance.

Meditation, according to Penn neuroscientist Amishi Jha and Michael Baime, director of Penn's Stress Management Program, is an active and effortful process that literally changes the way the brain works. Their study is the first to examine how meditation may modify the three subcomponents of attention, including the ability to prioritize and manage tasks and goals, the ability to voluntarily focus on specific information and the ability to stay alert to the environment.

In the Penn study, subjects were split into two categories. Those new to meditation, or "mindfulness training," took part in an eight-week course that included up to 30 minutes of daily meditation. The second group was more experienced with meditation and attended an intensive full-time, one-month retreat.

Researchers found that even for those new to the practice, meditation enhanced performance and the ability to focus attention. Performance-based measures of cognitive function demonstrated improvements in a matter of weeks. The study, published in the journal Cognitive, Affective, & Behavioral Neuroscience, suggests a new, non-medical means for improving focus and cognitive ability among disparate populations and has implications for workplace performance and learning.

Participants performed tasks at a computer that measured response speeds and accuracy. At the outset, retreat participants who were experienced in meditation demonstrated better executive functioning skills, the cognitive ability to voluntarily focus, manage tasks and prioritize goals. Upon completion of the eight-week training, participants new to meditation had greater improvement in their ability to quickly and accurately move and focus attention, a process known as "orienting." After the one-month intensive retreat, participants also improved their ability to keep attention "at the ready."

The results suggest that meditation, even as little as 30 minutes daily, may improve attention and focus for those with heavy demands on their time. While practicing meditation may itself may not be relaxing or restful, the attention-performance improvements that come with practice may paradoxically allow us to be more relaxed.

Fish use the threat of punishment to keep would-be jumpers in the mating queue firmly in line and the social order stable, a new study led by Australian marine scientists has found. Their discovery, which has implications for the whole animal kingdom including humans, has been hailed by some of the world’s leading biologists as a “must read” scientific paper and published in the Proceedings of the Royal Society of London Series B.

Studying small goby fish at Lizard Island on Australia’s Great Barrier Reef, Dr Marian Wong and colleagues from the ARC Centre of Excellence for Coral Reef Studies at James Cook University and, the Biological Station of Donana, Spain, have shown the threat of expulsion from the group acts as a powerful deterrent to keep subordinate fish from challenging those more dominant than themselves.

In fact the subordinate fish deliberately diet - or starve themselves - in order to remain smaller than their superiors and so present no threat that might lead to their being cast out, and perishing as a result. “Many animals have social queues in which the smaller members wait their turn before they can mate. We wanted to find out how they maintain stability in a situation where you’d expect there would be a lot of competition,” says Dr Wong. In the case of the gobies, only the top male and top female mate, and all the other females have to wait their turn in a queue based on their size – the fishy equivalent of the barnyard pecking order.

Dr Wong found that each fish has a size difference of about 5 per cent from the one above and the one below it in the queue. If the difference in size decreases below this threshold, a challenge is on as the junior fish tries to jump the mating queue – and the superior one responds by trying to drive it out of the group. Her fascinating discovery is that, in order to avoid constant fights and keep the social order stable, the fish seem to accept the threat of punishment – and adjust their own size in order to avoid presenting a challenge to the one above them, she says. “Social hierarchies are very stable in these fish and in practice challenges and expulsions are extremely rare – probably because expulsion from the group and the coral reef it occupies means almost certain death to the loser. “It is clear the fish accept the threat of punishment and co-operate as a way of maintaining their social order – and that’s not so very different to how humans and other animals behave.”

Dr Wong said that experimentally it has always proved extremely difficult to demonstrate how higher animals, such as apes, use punishment to control subordinates and discourage anti-social activity because of the difficulty in observing and interpreting their behaviour. In the case of the gobies the effect is much more apparent because they seek to maintain a particular size ratio relative to the fish above them in the queue, in order not to provoke a conflict. “The gobies have shed new light on our understanding of how social stability is maintained in animals,” she says. “While it not be accurate to draw a direct link between fish behaviour and specific human behaviour, it is clear there are general patterns of behaviour which apply to many higher life forms, ourselves included. These help us to understand why we do the things we do.”

Why does putting our feelings into words - talking with a therapist or friend, writing in a journal - help us to feel better? A new brain imaging study by UCLA psychologists reveals why verbalizing our feelings makes our sadness, anger and pain less intense. [complete press release from UC News Wire]

Disturbed sleep is a commonly reported symptom among individuals diagnosed with anxiety disorders. However, the direct cause of disrupted sleep is poorly understood. Proper sleep is critical for cognitive and daily functioning, and reduced quality of sleep has the potential to exacerbate pre-existing psychological conditions, according to a research abstract presented Wednesday at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS).

To effectively evaluate differences in sleep architecture after induced stress, Robert Ross MacLean, of Boston University, utilized an objective measure of anxiety and recorded subsequent sleep-wake behavior in rats. In the rodent model, many previous studies had observed differences in sleep-wake behavior after shock exposure, but the level of anxiety was merely assumed or absent.

MacLean's study exposed naïve rats to one of three paradigms: escapable shock, inescapable shock or fear conditioning. Immediately after experimental manipulation, individual level of anxiety was assessed using the elevated-plus maze apparatus, and polygraphic signs of sleep-wake behavior were recorded for six hours.

By measuring individual anxiety level prior to recording sleep, MacLean was able to make comparisons between sleep architecture and level of anxiety. In doing so, MacLean intended to establish a direct link between variation in sleep architecture and heightened anxiety in the rodent model.

"These changes could elucidate sleep-wake behavior associated with the subjective complaint of disrupted sleep, thus creating the potential for new diagnostic and assessment criteria for anxiety disorders," said MacLean. "This information is relevant given the recent influx of psychological disorders in Iraq war veterans, particularly generalized anxiety and post-traumatic stress disorder."

The amount of sleep a person gets affects his or her physical health, emotional well-being, mental abilities, productivity and performance. Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes.

Experts recommend that adults get between seven and eight hours of sleep each night to maintain good health and optimum performance.

Washington — Young adults with a short temper or mean disposition also tend to have compromised lung function, says a recent study published in the journal Health Psychology, by the American Psychological Association (APA). This occurred even when asthma and smoking were ruled out as possible causes of lung dysfunction.

In a study of 4,629 Black and White 18-30 year olds from four metropolitan areas (sampled from the Coronary Artery Risk Development in (Young) Adults Study cohort (CARDIA), psychologists examined whether the tendency to be hostile went along with having decreased lung function in otherwise healthy young adults. The results indicated that the more hostile one’s personality—characterized by aggression or anger, for example—the lower levels one’s of lung function even after controlling for age, height, socioeconomic status, smoking status and presence of asthma.

People with higher levels of general frustration predicted statistically significant reductions in pulmonary function for Black women, White women, and Black men. The only marginally strong finding occurred among the White men sampled. The authors speculate that people in lower status roles, Black women, White women, and Black men, who display hostility (and may be pushing against social expectations), elicit stronger social consequences than White men, resulting in higher levels of internalized stress that can make them sick. Further research is required to rule out if environmental toxins such as air pollution may contribute to both higher hostility and lower lung function.

Hostility was measured using the Cook-Medley Questionnaire which is derived from the items on the Minnesota Multiphasic Personality Inventory. Pulmonary function was measured while participants were standing and wearing a nose clip, blowing into a machine to measure their lung capacity, which can indicate upper airway obstruction.

“Recent research demonstrates that greater hostility predicts lung function decline in older men. This is the first study of young adults to offer a detailed examination of the inverse link between hostility and pulmonary function,” states lead author and psychologist Benita Jackson PhD MPH, Smith College. “It’s remarkable to see reductions in lung function during a time of life we think of as healthy for most people. Right now, we can’t say if having a hostile personality causes lung function decline, though we now know that these things happen together. More research is needed to establish whether hostility is associated with change in pulmonary function during young adulthood.” This research has implications for future research exploring the possible influence of social status on personality functioning and pulmonary health.

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Article: Does Harboring Hostility Hurt" Associations Between Hostility and Pulmonary Function in the Coronary Artery Risk Development in (Young) Adults (CARDIA) Study, Journal of Health Psychology, Vol. 26 No. 3

Full text of the article is available at http://www.apa.org/journals/releases/hea263333.pdf