UC-Davis researcher urges healthcare providers to look for signs of intimate partner violence

SACRAMENTO, Calif. -- Seven years ago, Elizabeth Miller was a volunteer physician in a community-based clinic in Boston, Mass., which offered confidential services to teens. She is still haunted by the memory of a 15-year old girl who asked her for a pregnancy test. It was negative, but two weeks later the girl was treated for a severe head injury in a nearby emergency room. The girl’s boyfriend had pushed her down a flight of stairs.

“I assumed all she needed was to be educated about her contraceptive options,” Miller recalled. “Later, I wondered what I had missed. Could I have asked a question that would have identified that she was in an abusive relationship"”

That nagging question inspired Miller, now a pediatrician with UC Davis Children’s Hospital, to dedicate her career to trying to understand the unique characteristics of adolescent partner violence.

In a new qualitative clinical study published in the September-October issue of the journal Ambulatory Pediatrics, Miller and her research colleagues report that a quarter of the teenage girls interviewed for the study – all of whom had histories of abusive relationships – say their partners were actively trying to get them pregnant. The study, available online today, is the first in the general adolescent health literature to document the role of abusive partners in promoting teen pregnancy.

“Physicians are trained to think about domestic violence in adult terms,” said Miller, a physician trained in both adult and pediatric medicine who specializes in treating adolescents. “Our study suggests that health-care providers who come in contact with teens, especially those seeking pregnancy testing and emergency contraception, should ask about the possibility of abuse in the relationship and specifically whether the young woman’s partner may be trying to get her pregnant.”

Miller’s study is based on interviews with 61 girls from a variety of racial and ethnic backgrounds with a known history of intimate partner violence living in the poorest neighborhoods in Boston. The analysis included 53 girls between the ages of 15 and 20 who reported being sexually active and involved in relationships that included recurring patterns of physical, sexual or emotional abuse from a male partner. Twenty-six percent of these girls reported that their partners were actively trying to get them pregnant by manipulating condom use, sabotaging birth control use and making explicit statements about wanting them to become pregnant.

“We were floored by what these girls told us,” Miller recalled. “You think of forced sex as an aspect of abusive relationships, but this takes that abuse a step further to reproductive control of a young woman’s body.”

Despite the small sample size, Miller describes the current study as a critically important first step toward understanding the nuances of control in intimate relationships and its role in teen pregnancy.

“Our study suggests that those providing care, especially reproductive care, to adolescent girls need to ask questions that reveal the complexities of partner violence, specifically whether a partner is actively trying to get her pregnant when she doesn’t want to be,” Miller said. “Historically, assessments in clinical settings have focused on physical and sexual violence – and for good reasons. However, our data argues for including questions, for instance, about whether a boyfriend is flushing birth control pills down the toilet or saying he used a condom when he didn’t. And pregnancy prevention programs should include discussions about reproductive control as a form of abuse in relationships.”

“This study demonstrates for the first time that abusive boys and men often actively promote pregnancy including contraceptive nonuse in their relationships,” said Jay Silverman, director of Violence Preventions Programs for the Harvard School of Public Health and senior author on the study. “The implications are clear – when we see girls who cannot consistently use contraception, who are requesting frequent emergency contraception or who seek repeat pregnancy testing, we need to be asking very directly about abuse from male partners and find ways to support them and promote their safety.”

Miller added that she and her colleagues will next look at the phenomenon of reproductive control in a larger study and at the population level. They just completed a clinic-based survey of 825 youth in the Boston area designed to address the prevalence of intimate partner violence and related behaviors among boys and girls seeking confidential care, and they are in the process of designing a national study to address these same issues.

Miller has also designed a study that would test interventions for partner violence in family planning clinics among women ages 16 to 24 years, and she is planning a study of dating violence intervention to be conducted in school-based clinics in California and Massachusetts. These interventions involve identifying intimate partner violence through screening questions and include a protocol for providing referrals to appropriate resources, such as advocacy groups, shelters, counseling and agencies that can address safety.

“Our work is aimed at documenting the severity and prevalence of intimate partner violence in teens,” Miller said. “Ultimately, we want to reduce teen pregnancy and the devastating effects of partner violence.”

Caring for Your Introvert
by Jonathan Rauch

An article in The Atlantic (March 2003)

When trying to understand someone's intentions, non-human primates expect others to act rationally by performing the most appropriate action allowed by the environment, according to a new study by researchers at Harvard University.

The findings appear in the Sept. 7 issue of the journal of Science. The work was led by Justin Wood, a graduate student in the Department of Psychology in the Faculty of Arts and Sciences at Harvard, with David Glynn, a research assistant, and Marc Hauser, professor of psychology at Harvard, along with Brenda Phillips of Boston University.

“A dominant view has been that non-human primates attend only to what actions 'look like' when trying to understand what others are thinking," says Wood. "In contrast, our research shows that non-human primates infer others' intentions in a much more sophisticated way. They expect other individuals to perform the most rational action that they can, given the environmental obstacles that they face."

The scientists studied the behavioral response of over 120 primates, including cotton-top tamarins, rhesus macaques and chimpanzees. These species represent each of the three major groups of primates: New World monkeys, Old World monkeys and apes. All three species were tested in the same way, and the results showed the same responses among the different types.

In the first experiment, the primates were presented with two potential food containers, and the experimenter either purposefully grasped one of the containers, or flopped their hand onto one of the containers in an accidental manner. For all three species, the primates sought the food container that was purposefully grasped a greater number of times than the container upon which the hand was flopped. This indicates that the primate inferred goal-oriented action on the part of the experimenter when he grasped the container, and was able to understand the difference between the goal-oriented and accidental behavior.

In the second experiment, the researchers asked if the primates infer others' goals under the expectation that other individuals will perform the most rational action allowed by the environmental obstacles. Again, the primates were presented with two potential food containers. In one scenario, an experimenter touched a container with his elbow when his hands were full, and in another scenario, touched a container with his elbow when his hands were empty. The primates looked for the food in the container indicated with the elbow more often when the experimenter's hands were full. The primates considered, just as a human being would, that if someone's hands are full then it is rational for them to use their elbow to indicate the container with food, whereas if their hands are empty it is not rational for them to use their elbow, because they could have used their unoccupied hand.

Developmental psychologists have long understood that young children are able to engage in this type of rational action perception, but scientists have not understood if this ability is unique to human beings, or shared with other animals. This study suggests that this ability evolved as long as 40 million years ago, with non-human primates.

“This study represents one of the broadest comparative studies of primate cognition, and the significance of the findings is reinforced by the fact that these results were consistent across three different species of primates,” says Wood. “The results have significant implications for understanding the evolution of the processes that allow us to make sense of other people's behavior.”

ABSTRACT: Disgust is a basic emotion characterized by revulsion and rejection, yet it is relatively unexamined in the literature on prejudice. In the present investigation, interpersonal-disgust sensitivity (e.g., not wanting to wear clean used clothes or to sit on a warm seat vacated by a stranger) in particular predicted negative attitudes toward immigrants, foreigners, and socially deviant groups, even after controlling for concerns with contracting disease. The mechanisms underlying the link between interpersonal disgust and attitudes toward immigrants were explored using a path model. As predicted, the effect of interpersonal-disgust sensitivity on group attitudes was indirect, mediated by ideological orientations (social dominance orientation, right-wing authoritarianism) and dehumanizing perceptions of the out-group. The effects of social dominance orientation on group attitudes were both direct and indirect, via dehumanization. These results establish a link between disgust sensitivity and prejudice that is not accounted for by fear of infection, but rather is mediated by ideological orientations and dehumanizing group representations. Implications for understanding and reducing prejudice are discussed.

Hodson, G. & Costello, K. (2007). Interpersonal disgust, ideological orientations, and dehumanisation as predictors of intergroup attitudes. Psychological Science, 18, 691-698.

Horowitz, A.V. and Wakefield, J.C. (2007). The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. NY: Oxford University Press. (link to Amazon.com)

Suggests that loss of treatment response is likely due to loss of placebo response

Providence, RI – A new study by Rhode Island Hospital researchers indicates that a relapse during antidepressant continuation treatment may be due to a relapse in patients who were not true drug responders. The loss of drug response may be due to loss of placebo response (a positive medical response to taking a placebo as if it were an active medication.). The study was published in the August issue of the Journal of Clinical Psychiatry.

Historically, the treatment of depression is divided into three phases – initial/acute, continuation and maintenance. During the initial phase, the goal is to reduce symptoms and psychosocial impairment. During the continuation phase, usually six months to one year after initial treatment response, the goal is to maintain the gains and prevent a relapse. In the maintenance phase, which occurs after a sustained period of improvement, the goal is to further maintain the gains and prevent recurrence of the disorder.

Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital and associate professor of psychiatry and human behavior at the Warren Alpert School of Medicine at Brown University, is the paper’s lead author. Zimmerman, along with his colleague Tavi Thongy, MD, also of Rhode Island Hospital and Brown University, conducted a meta-analysis of continuation studies of new generation antidepressants that began as placebo-controlled acute phase studies. Treatment studies of depression have found that approximately 50 to 65 percent of patients respond to medication and that approximately 25 to 35 percent respond to placebo.

Past studies have indicated that a number of patients who respond to treatment in the initial phase experience a relapse or recurrence despite ongoing pharmacotherapy during the two latter phases of treatment. This return of symptoms is often interpreted as a loss of efficacy of antidepressant activity, and is referred to as tachyphylaxis or the “poop-out” effect. Zimmerman says, “When a patient improves after being prescribed an antidepressant medication you do not know if they got better because of the medication or because they had a placebo response.”

The researchers used formulas developed by Quitkin and colleagues more than a decade ago to calculate the relapse rate attributable to relapse in presumptive placebo responders. “Our study suggests that the return of symptoms despite ongoing treatment during the continuation and maintenance phases of treatment may not represent a loss of drug effect because the patient may not have experienced a true drug response in the first place.” Zimmerman also notes, “While our conclusion is limited to the continuation phase of treatment, our results suggest that these findings probably also apply to the maintenance phase of treatment.”

The researchers note that these findings are not inconsistent with conclusions that continuation and maintenance studies of antidepressants have clearly established the benefit of ongoing treatment beyond the acute phase.

Dollinger, S.J. (2007). Creativity and conservatism. Personality and Individual Differences, 43, 1025-1035.

Abstract
Across a range of disciplines it is assumed that conservatism and creativity are polar opposites. Although conservatism correlates negatively with appreciation of certain art forms, are conservatives in fact less creative? Four hundred and twenty-two undergraduates completed a Creative Behavior Inventory and creative products judged by the consensual assessment technique. Compared to more liberal college students, those endorsing more conservative positions on a brief version of the Conservatism scale had fewer creative accomplishments and devised photo essays and drawings judged as less creative. Results for accomplishments and drawing products held true when controlling for verbal ability and openness.

There’s a troubling psychological phenomenon that just about everyone has experienced but few will admit to; having difficulty distinguishing between people of different racial groups. This isn’t merely a nod to the denigrating expression “they all look the same.” Indeed, the “cross-race effect” is one of the most well replicated findings in psychological research and can lead to embarrassment, social castigation, or the disturbingly common occurrence of eye-witness misidentifications.

Although a potentially charged experience, the causes of the cross-race effect are unclear. In one camp, psychologists argue that in a society where de facto segregation is the norm, people often don’t have much practice with individuals of other racial groups and are thus less capable of recognizing distinguishing features. But researchers from Miami University have a different idea of why the cross-race effect occurs. They argue this effect arises from our tendency to categorize people into in-groups and out-groups based on social categories like social class, hobbies, and of course, race.

In a series of experiments, Miami University undergraduates were led to believe that they would view the faces of fellow Miami students (the in-group) and students from Marshall University (a perennial football rival, making them the ultimate out-group) on a computer screen. In reality, none of the faces, all of whom were white, were students at either university. By merely labeling them, however, the participants better recognized faces that they believed were fellow Miami students.

The study, conducted by psychologist Kurt Hugenberg and graduate students Michael Bernstein and Steven Young, will be published in the August issue of Psychological Science, a journal of the Association for Psychological Science.

Hugenberg and his colleagues believe the study suggests that recognition deficits can occur without the need for race or different physical characteristics, arguing instead that there is more than just unfamiliarity with other races at play in the cross-race effect. According to the researchers, “people frequently split the world up into us and them, in other words into social groups, be they racial, national, occupational, or even along the lines of university affiliation. Our work suggests that the cross-race effect is due, at least in part, to this ubiquitous tendency to see the world in terms of these in-groups and out-groups.”

Albert Ellis, who developed Rational-Emotive Behavior Therapy (REBT), died on 24 July 2007 at the age of 93. He will be greatly missed.

Albert Ellis Institute's Tribute
Ellis' last interview at Prospect

Brown, A.M (2007). A cognitive approach to dogmatism: An investigation into the relationship of verbal working memory and dogmatism. Journal of Research in Personality, 41 (4), 946-952.

Abstract: This study investigated the relationship of working memory to open and closed belief systems. Two hundred college students completed a working memory span test to measure verbal working memory, and Rokeach’s Dogmatism Scale (1956). Regression analysis was undertaken to determine the contribution of verbal working memory to dogmatism. A negative correlation was found between dogmatism scores and working memory scores (p = .002) confirming the hypothesis that those participants who display a larger working memory capacity would show lower levels of dogmatic beliefs than participants displaying a smaller working memory capacity. Error analysis was employed to determine the significance of inhibition processes; indicating that capacity limits in verbal working memory, and not processing deficits, were primarily responsible for poor working memory scores. Dogmatism was not found to be related to gender, age, ethnicity, religious affiliation, academic major, or level of education.

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.

---

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

All anxiety is not created equal, and a research team at the University of Illinois now has the data to prove it. The team has found compelling evidence that differing patterns of brain activity are associated with each of two types of anxiety: anxious apprehension (verbal rumination, worry) and anxious arousal (intense fear, panic, or both).

Their work appears this month online in Psychophysiology. [press release from UIUC]

BOSTON, MA — The editors of the American Heritage® dictionaries have compiled a list of 100 words they recommend every high school graduate should know.

"The words we suggest," says senior editor Steven Kleinedler, "are not meant to be exhaustive but are a benchmark against which graduates and their parents can measure themselves. If you are able to use these words correctly, you are likely to have a superior command of the language."

The following is the entire list of 100 words:

abjure abrogate abstemious acumen antebellum auspicious belie bellicose bowdlerize chicanery chromosome churlish circumlocution circumnavigate deciduous deleterious diffident enervate enfranchise epiphany equinox euro evanescent expurgate facetious fatuous feckless fiduciary filibuster gamete gauche gerrymander hegemony hemoglobin

homogeneous hubris hypotenuse impeach incognito incontrovertible inculcate infrastructure interpolate irony jejune kinetic kowtow laissez faire lexicon loquacious lugubrious metamorphosis mitosis moiety nanotechnology nihilism nomenclature nonsectarian notarize obsequious oligarchy omnipotent orthography oxidize parabola paradigm parameter

pecuniary photosynthesis plagiarize plasma polymer precipitous quasar quotidian recapitulate reciprocal reparation respiration sanguine soliloquy subjugate suffragist supercilious tautology taxonomy tectonic tempestuous thermodynamics totalitarian unctuous usurp vacuous vehement vortex winnow wrought xenophobe yeoman ziggurat

Houghton Mifflin Press Release

An interview with Albert Ellis, developer of Rational Emotive Behavior Therapy (REBT). The groundbreaking treatment rests on the premise that most of our emotional problems are based on irrational beliefs.

Eternal sunshine
It's sold as happiness in a blister pack - a cure-all that has changed the way we think about wellbeing. As Prozac reaches its 20th birthday, Anna Moore presents 20 things you need to know about the most widely used antidepressant in the world

13 May 2007
The Observer

Scientists examining documents dating back 3,500 years say they have found proof that the origins of modern medicine lie in ancient Egypt and not with Hippocrates and the Greeks. The research team from the KNH Centre for Biomedical Egyptology at The University of Manchester discovered the evidence in medical papyri written in 1,500 BC – 1,000 years before Hippocrates was born.

"Classical scholars have always considered the ancient Greeks, particularly Hippocrates, as being the fathers of medicine but our findings suggest that the ancient Egyptians were practising a credible form of pharmacy and medicine much earlier," said Dr Jackie Campbell. "When we compared the ancient remedies against modern pharmaceutical protocols and standards, we found the prescriptions in the ancient documents not only compared with pharmaceutical preparations of today but that many of the remedies had therapeutic merit."

The medical documents, which were first discovered in the mid-19th century, showed that ancient Egyptian physicians treated wounds with honey, resins and metals known to be antimicrobial. The team also discovered prescriptions for laxatives of castor oil and colocynth and bulk laxatives of figs and bran. Other references show that colic was treated with hyoscyamus, which is still used today, and that cumin and coriander were used as intestinal carminatives. Further evidence showed that musculo-skeletal disorders were treated with rubefacients to stimulate blood flow and poultices to warm and soothe. They used celery and saffron for rheumatism, which are currently topics of pharmaceutical research, and pomegranate was used to eradicate tapeworms, a remedy that remained in clinical use until 50 years ago.

"Many of the ancient remedies we discovered survived into the 20th century and, indeed, some remain in use today, albeit that the active component is now produced synthetically," said Dr Campbell. "Other ingredients endure and acacia is still used in cough remedies while aloes forms a basis to soothe and heal skin conditions."

Fellow researcher Dr Ryan Metcalfe is now developing genetic techniques to investigate the medicinal plants of ancient Egypt. He has designed his research to determine which modern species the ancient botanical samples are most related to. "This may allow us to determine a likely point of origin for the plant while providing additional evidence for the trade routes, purposeful cultivation, trade centres or places of treatment," said Dr Metcalfe. "The work is inextricably linked to state-of-the-art chemical analyses used by my colleague Judith Seath, who specialises in the essential oils and resins used by the ancient Egyptians."

Professor Rosalie David, Director of the KNH Centre, said: "These results are very significant and show that the ancient Egyptians were practising a credible form of pharmacy long before the Greeks. "Our research is continuing on a genetic, chemical and comparative basis to compare the medicinal plants of ancient Egypt with modern species and to investigate similarities between the traditional remedies of North Africa with the remedies used by their ancestors of 1,500 BC."

In the 1980's, a spate of high profile child abuse convictions gave way to heightened concern about false memory reports given by children. Take, for example, the case of Kelly Michaels, a preschool teacher who was convicted on 115 counts of sexual abuse based on the testimony of 20 of her pupils. After serving seven years of her 47 year sentence, Michaels' conviction was overturned after the techniques used to interview the children were shown to be coercive and highly suggestive.

Since then, a sizeable literature on children's false memories has accumulated and until recently, the picture that had emerged was quite consistent: false memories of events were found to decrease with age throughout childhood and adolescence. In other words, as we grow into adulthood, our memory accuracy improves.

However, psychologists Charles Brainerd and Valerie Reyna of Cornell University believe that the relationship between age and memory accuracy may not be so simple. Drawing upon fuzzy-trace theory — the popular psychological theory that humans encode information on a continuum from verbatim to "fuzzy" traces that convey a general meaning — Brainerd and Reyna predicted that false memories may actually increase with age under certain circumstances. In other words, adults would have less accurate memories than children. [read more]

Sleep remains one of the big mysteries in biology. All animals sleep, and people who are deprived of sleep suffer physically, emotionally and intellectually. But nobody knows how sleep restores the brain.

Now, Giulio Tononi, a professor of psychiatry at the University of Wisconsin-Madison School of Medicine and Public Health, has discovered how to stimulate brain waves that characterize the deepest stage of sleep. The discovery could open a new window into the role of sleep in keeping humans healthy, happy and able to learn.

The brain function in question, called slow wave activity, is critical to the restoration of mood and the ability to learn, think and remember, Tononi says. [read more]

Sleep not only protects memories from outside interferences, but also helps strengthen them, according to research that will be presented at the American Academy of Neurology’s 59th Annual Meeting in Boston, April 28 – May 5, 2007.

The study looked at memory recall with and without interference (competing information). Forty-eight people between the ages of 18 and 30 took part in the study. All had normal, healthy sleep routines and were not taking any medications. Participants were divided evenly into four groups—a wake group without interference, a wake group with interference, a sleep group without interference and a sleep group with interference. All groups were taught the same 20 pairs of words in the initial training session.

The wake groups were taught the word pairings at 9 a.m. and then tested on them at 9 p.m. after 12 hours awake. The sleep groups were taught the word pairs at 9 p.m. and tested on them at 9 a.m. after a night of sleep. Just prior to testing, the interference groups were given a second list of word pairs to remember. The first word in each pair was the same on both lists, but the second word was different, testing the brain’s ability to handle competing information, known as interference. The interference groups were then tested on both lists.

The study found that people who slept after learning the information performed best, successfully recalling more words. Those in the sleep group without interference were able to recall 12 percent more word pairings from the first list than the wake group without interference. With interference, the recall rate was 44 percent higher for the sleep group.

"This is the first study to show that sleep protects memories from interference," said study author Jeffrey Ellenbogen, MD, with Harvard Medical School in Boston, MA, and Fellow of the American Academy of Neurology. "These results provide important insights into how the sleeping brain interacts with memories: it appears to strengthen them. Perhaps, then, sleep disorders might worsen memory problems seen in dementia."

Memorizing a series of facts is one thing, understanding the big picture is quite another. Now a new study demonstrates that relational memory – the ability to make logical “big picture” inferences from disparate pieces of information – is dependent on taking a break from studies and learning, and even more important, getting a good night’s sleep.

Led by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women’s Hospital (BWH), the findings appear on-line in today’s Early Edition of the Proceedings of the National Academy of Sciences (PNAS).

“Relational memory is a bit like solving a jigsaw puzzle,” explains senior author Matthew Walker, PhD, Director of the Sleep and Neuroimaging Laboratory at BIDMC and Assistant Professor of Psychology at Harvard Medical School (HMS). “It’s not enough to have all the puzzle pieces – you also have to understand how they fit together.”

Adds lead author Jeffrey Ellenbogen, MD, a postdoctoral fellow at HMS and sleep neurologist at BWH, “People often assume that we know all of what we know because we learned it directly. In fact, that’s only partly true. We actually learn individual bits of information and then apply them in novel, flexible ways.” For instance, if a person learns that A is greater than B and B is greater than C, then he or she knows those two facts. But embedded within those is a third fact – A is greater than C – which can be deduced by a process called transitive inference, the type of relational memory that the researchers examined in this study.

Earlier research by Walker and colleagues had shown that sleep actively improves task-oriented “procedural memory” – for example, learning to talk, to coordinate limbs, musicianship, or to play sports. Because relational memory is fundamental to knowledge and learning, Walker and Ellenbogen decided to explore how and when this “inferential” knowledge emerges, hypothesizing that it develops during “off-line” periods and that, like procedural memory, would be enhanced following a period of sleep.

So, the researchers tested 56 healthy college students, each of whom was shown five pairs of unfamiliar abstract patterns – colorful oval shapes resembling Faberge eggs. The students were then told that some of the patterns were “correct” while others were “incorrect,” for example, Shape A wins over Shape B, Shape B wins over Shape C, and so on. All of the students learned the individual pairs but were not told that there was a hidden “hierarchy” linking all five of the pairs together.

After a 30-minute study period, the students were separated into three groups to test their understanding of the larger “big picture” relationship between the individual patterns: Group One was tested after a period of 20 minutes; Group Two was tested after a 12-hour period; and Group Three was tested after a 24-hour time span. In addition, approximately half of the students in Group Two slept during the 12-hour period, while the other half remained awake. All of the students in Group Three had a full night’s sleep.

The test results showed striking differences among the three groups, especially between the students who had a period of sleep and those who remained awake. “Group One, the students who were tested soon after their initial learning period, performed the worst,” says Walker. “While they were able to learn and recall the component pieces [for example, Shape A is greater than Shape B, Shape B is greater than Shape C] they could not discern the hierarchical relationships between the pieces [Shape A is greater than Shape C] – they couldn’t yet see ‘the big picture.’” Groups Two and Three, on the other hand, demonstrated a clear understanding of the interrelationship between the pairs of shapes.

“These individuals were able to make leaps of inferential judgment just by letting the brain have time to unconsciously mull things over,” he says. But, perhaps most notable, he adds, when the inferences were particularly difficult, the students who had had periods of sleep in between learning and testing significantly outperformed the other groups. “This strongly implies that sleep is actively engaged in the cognitive processing of our memories,” notes Ellenbogen. “Knowledge appears to expand both over time and with sleep.”

Concludes Walker, “These findings point to an important benefit [of sleep] that we had not previously considered. Sleep not only strengthens a person’s individual memories, it appears to actually knit them together and helps realize how they are associated with one another. And this may, in fact, turn out to be the primary goal of sleep: You go to bed with pieces of the memory puzzle, and awaken with the jigsaw completed.”


20 April 2007
Beth Israel Deaconess Medical Center News

A Brown University-led research team has, for the first time, recorded activity inside the cells of the hippocampus while simultaneously measuring activity in the neocortex. Recordings from these two brain regions – seats of memory creation and storage – revealed a surprisingly complex pattern of activity. These findings, in the Proceedings of the National Academy of Sciences, are part of a growing body of evidence that challenges traditional theories of the role of sleep in learning and memory. [read more]

Those persons who are labeled a “night owl” report more pathological symptoms related to insomnia, despite many having the opportunity to compensate for their nocturnal sleeplessness by extending their time in bed and being able to gain more total sleep time, according to a study published in the April 15th issue of the Journal of Clinical Sleep Medicine (JCSM).

The study, authored by Jason C. Ong, PhD, and colleagues at Stanford University, consisted of 312 patients, who were categorized as morning, intermediate and evening chronotypes based upon scores on the Morningness-Eveningness Composite Scale. Group comparisons were made on self-report measures of nocturnal sleep, sleep period variability and waking correlates and consequences of insomnia.

Compared to the morning and intermediate types, people with insomnia who prefer evening activities (i.e., “night owls”) reported the most sleep/wake irregularities and waking distress, even after adjusting for severity of sleep disturbance. “Our findings indicate that further research should investigate the relationship between circadian rhythms and insomnia, especially with the severity of the ‘night owl’ group,” said Ong. “These factors may serve to perpetuate the insomnia disorder, and might be particularly important to consider when treating this subgroup of insomniacs.”

Insomnia, a classification of sleep disorders defined by difficulty falling asleep or staying asleep, waking up too early, or poor quality sleep, is the most common sleep complaint at any age. About 30 percent of adults have symptoms of insomnia.

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. Those who think they might have insomnia, or another sleep disorder, are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.

While the government spends billions of dollars on educational and prevention programs to persuade teens not to do things like smoke, drink or do drugs, a Temple University psychologist suggests that competing systems within the brain make adolescents more susceptible to engaging in risky or dangerous behavior, and that educational interventions alone are unlikely to be effective.


Laurence Steinberg, Distinguished University Professor and the Laura H. Carnell Professor of Psychology at Temple, outlines his argument in, “Risk Taking in Adolescence: New Perspectives from Brain and Behavioral Science,” in the April issue of the journal, Current Directions in Psychological Science. [read more]

Groundbreaking international legal principles on sexual orientation, gender identity, and international law have been released by 29 international human rights experts, led by University of Nottingham academic, Professor Michael O'Flaherty.

The "Yogyakarta Principles" call for worldwide action against violence, discrimination and abuse, by governments, the UN human rights system, national human rights institutions, non-governmental organisations, and others. The 29 principles contained in the Yogyakarta Principles on the Application of International Human Rights Law in Relation to Sexual Orientation and Gender Identity establish the first ever set of principles on sexual orientation and gender identity, and are based upon a comprehensive analysis of current international human rights laws.

The principles identify the legal obligations of all States to ensure the universal reach of human rights protections. They were launched to coincide with the UN Human Rights Council's session in Geneva, where, in 2006, 54 States called for the Council to act against egregious violations of the rights of lesbian, gay, bisexual, and transgender people. "States have the primary obligation to respect, protect, and promote human rights," said Professor O'Flaherty, who is also a member of the UN Human Rights Committee, "Ending violence and abuse against people because of their sexual orientation or gender identity must become a global priority for governments."

The Yogyakarta Principles address a broad range of human rights standards. They were developed in response to well-documented patterns of abuse targeted toward persons because of their actual or perceived sexual orientation and gender identity.

Worldwide, human rights defenders point to violations including extrajudicial executions, violence and torture, repression of free speech and assembly, and discrimination in work, health, education, access to justice, and immigration.

The Principles were adopted by a group of distinguished experts in international law following a meeting in Yogyakarta, Indonesia. Among the group of experts are a former United Nations High Commissioner for Human Rights, UN independent experts, current and former members of human rights treaty bodies, judges, academics and human rights defenders.

The full text of the Yogyakarta Principles on the Application of International Human Rights Law in Relation to Sexual Orientation and Gender Identity is available at: http://yogyakartaprinciples.org

The presence of guns in homes is strongly associated with higher suicide rates, a new U.S. study found.

Spending on prescription drugs to treat depression, anxiety, pain, schizophrenia and other conditions climbed from $7.9 billion in 1997 to $20 billion in 2004 - over a 150 percent increase, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

• The sharpest increase was for antipsychotic agents, medications used to manage schizophrenia, bipolar disorder and other psychoses. They saw an increase from $1.3 billion to $4.1 billion from 1997 to 2004.
  
  
• Spending for central nervous system stimulants to treat pain and control seizures, nearly tripled over the same time period, increasing from $0.6 billion to $1.7 billion.
  
  
• Spending on antidepressants more than doubled from 1997 to 2004, increasing from $5.1 billion to $12.1 billion, as did expenditures for anxiolytics, sedatives, and hypnotics for anxiety and sleep disorders. Spending for these drugs rose from $.9 billion to $2.1 billion.
  
  
• During the same time period, overall prescriptions for psychotherapeutic drugs increased from 141.9 million to 244.3 million; the number of people prescribed at least one such drug rose from 21 million to 32.6 million; and the average price per purchase increased from $55.80 to $82.00.

AHRQ, a part of the U.S. Department of Health and Human Services, works to improve the quality, safety, efficiency and effectiveness of health care in the United States. The data in this AHRQ News and Numbers comes from the Agency's Medical Expenditure Panel Survey, a highly detailed source of information on the health services that Americans use, how frequently they use them, the cost of these services, and how they are paid.

For more information on this AHRQ News and Numbers see Trends in the Use and Expenditures for the Therapeutic Class Prescribed Psychotherapeutic Agents and All Subclasses, 1997 and 2004 (PDF).

http://www.ahrq.gov

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Medical News Today
30 March 2007

AMES, Iowa – New research by Iowa State University psychologists provides more concrete evidence of the adverse effects of violent video game exposure on the behavior of children and adolescents.

ISU Distinguished Professor of Psychology Craig Anderson, Assistant Professor of Psychology Douglas Gentile, and doctoral student Katherine Buckley share the results of three new studies in their book, "Violent Video Game Effects on Children and Adolescents" (Oxford University Press, 2007). It is the first book to unite empirical research and public policy related to violent video games.

Anderson and Gentile presented their findings last week at the Society for Research in Child Development Biennial Meeting in Boston.

The book's first study found that even exposure to cartoonish children's violent video games had the same short-term effects on increasing aggressive behavior as the more graphic teen (T-rated) violent games. The study tested 161 9- to 12-year-olds, and 354 college students. Each participant was randomly assigned to play either a violent or non-violent video game. "Violent" games were defined as those in which intentional harm is done to a character motivated to avoid that harm. The definition was not an indication of the graphic or gory nature of any violence depicted in a game.

The researchers selected one children's non-violent game ("Oh No! More Lemmings!"), two children's violent video games with happy music and cartoonish game characters ("Captain Bumper" and "Otto Matic"), and two violent T-rated video games ("Future Cop" and "Street Fighter"). For ethical reasons, the T-rated games were played only by the college-aged participants.

The participants subsequently played another computer game designed to measure aggressive behavior in which they set punishment levels in the form of noise blasts to be delivered to another person participating in the study. Additional information was also gathered on each participant's history of violent behavior and previous violent media viewing habits.

The researchers found that participants who played the violent video games -- even if they were children's games -- punished their opponents with significantly more high-noise blasts than those who played the non-violent games. They also found that habitual exposure to violent media was associated with higher levels of recent violent behavior -- with the newer interactive form of media violence found in video games more strongly related to violent behavior than exposure to non-interactive media violence found in television and movies.

"Even the children's violent video games -- which are more cartoonish and often show no blood -- had the same size effect on children and college students as the much more graphic games have on college students," said Gentile. "What seems to matter is whether the players are practicing intentional harm to another character in the game. That's what increases immediate aggression -- more than how graphic or gory the game is."

Another study detailed in the book surveyed 189 high school students. The authors found that respondents who had more exposure to violent video games held more pro-violent attitudes, had more hostile personalities, were less forgiving, believed violence to be more typical, and behaved more aggressively in their everyday lives. The survey measured students' violent TV, movie and video game exposure; attitudes toward violence; personality trait hostility; personality trait forgiveness; beliefs about the normality of violence; and the frequency of various verbally and physically aggressive behaviors.

The researchers were surprised that the relation to violent video games was so strong.

"We were surprised to find that exposure to violent video games was a better predictor of the students' own violent behavior than their gender or their beliefs about violence," said Anderson. "Although gender aggressive personality and beliefs about violence all predict aggressive and violent behavior, violent video game play still made an additional difference.

"We were also somewhat surprised that there was no apparent difference in the video game violence effect between boys and girls or adolescents with already aggressive attitudes," he said.

The study found that one variable -- trait forgiveness -- appeared to make that person less affected by exposure to violent video games in terms of subsequent violent behavior, but this protective effect did not occur for less extreme forms of physical aggression.

A third new study in the book assessed 430 third-, fourth- and fifth-graders, their peers, and their teachers twice during a five-month period in the school year. It found that children who played more violent video games early in the school year changed to see the world in a more aggressive way, and became more verbally and physically aggressive later in the school year -- even after controlling for how aggressive they were at the beginning of the study. Higher aggression and lower pro-social behavior were in turn related to those children being more rejected by their peers.

"I was startled to find those changes in such a short amount of time," said Gentile. "Children's aggression in school did increase with greater exposure to violent video games, and this effect was big enough to be noticed by their teachers and peers within five months."

The study additionally found an apparent lack of "immunity" to the effects of media violence exposure. TV and video game screen time was also found to be a significant negative predictor of grades.

The book's final chapter offers "Helpful Advice for Parents and Other Caregivers on Choosing and Using Video Games." The authors say that providing clear, science-based information to parents and caregivers about the harmful effects of exposure to violent video games is the first step in helping educate the people who are best able to use the information. The advice includes links to Web sites about entertainment media and parenting issues, including Anderson's and Gentile's Web pages at http://www.psychology.iastate.edu/faculty/caa/ and http://www.psychology.iastate.edu/faculty/dgentile/.

Although intelligence is generally thought to play a key role in children's early academic achievement, aspects of children's self-regulation abilities—including the ability to alternately shift and focus attention and to inhibit impulsive responding--are uniquely related to early academic success and account for greater variation in early academic progress than do measures of intelligence. Therefore, in order to help children from low-income families succeed in school, early school-age programs may need to include curricula designed specifically to promote children's self-regulation skills as a means of enhancing their early academic progress.

Those are the findings of a new study conducted by researchers at the Pennsylvania State University and published in the March-April 2007 issue of the journal Child Development.

Although there is currently a focus on teaching specific content and factual information in pre-kindergarten and early elementary education, these findings indicate that without a simultaneous focus on promoting self-regulation skills, many children are likely to struggle to keep pace with the academic demands of the early elementary classroom.

The study examined the role of self-regulation in emerging academic ability in 141 3- to 5-year-old children from low-income homes who attended Head Start, the federal preschool program for children living in poverty. The researchers sought to determine the extent to which distinct but overlapping aspects of children's developing self-regulation (cognitive, social-emotional, and temperament-based) are associated with emerging math and literacy ability in kindergarten.

The researchers found that all aspects of children's self-regulation are uniquely related to their academic abilities, over and above their intelligence. They also found that one particular aspect of self-regulation—termed the inhibitory control aspect of brain function used in planning, problem solving, and goal-directed activity—is predictive of all academic outcomes but was particularly associated with early ability in math.

"Children's ability to regulate their thinking and behavior develops rapidly in the preschool years," according to Clancy Blair, associate professor of human development and family studies at the Pennsylvania State University and lead author of the study. "By the time children start school, they are expected to be able to sufficiently regulate attention, impulsivity, and emotion so as to communicate effectively and to jointly engage in learning experiences with teachers and classmates.

"For some children, however, particularly children from low-income homes or facing early adversity, self-regulation abilities may be slow in developing, leading to problems in the transition to school and increased risk for early school failure. In the attempt to improve educational achievement and decrease inequities in educational progress associated with socioeconomic status, it is important to understand the nature of multiple influences on early progress in school."

Alcohol and tobacco more harmful than cannabis and ecstacy.

A new study published in the Lancet proposes that drugs should be classified by the amount of harm that they do, rather than the sharp A, B, and C divisions in the UK Misuse of Drugs Act. The new ranking places alcohol and tobacco in the upper half of the league table. These socially accepted drugs were judged more harmful than cannabis, and substantially more dangerous than the Class A drugs LSD, 4-methylthioamphetamine and ecstasy.

Harmful drugs are currently regulated according to classification systems that purport to relate to the harms and risks of each drug. However, these are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages.

Professor David Nutt from the University of Bristol, Professor Colin Blakemore, Chief Executive of the Medical Research Council, and colleagues, identified three main factors that together determine the harm associated with any drug of potential abuse:

   1. the physical harm to the individual user caused by the drug
   2. the tendency of the drug to induce dependence
   3. the effect of drug use on families, communities, and society

Within each of these categories, they recognized three components, leading to a comprehensive 9-category matrix of harm. Expert panels gave scores, from zero to three, for each category of harm for 20 different drugs. All the scores for each drug were combined to produce an overall estimate of its harm. In order to provide familiar benchmarks, for comparison with illicit drugs, five legal drugs of potential misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) were included in the assessment. The process proved simple, and yielded roughly similar scores for drug harm when used by two separate groups of experts.

Professor David Nutt, lead author on the paper, said: “Drug misuse and abuse are major health problems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.”

Professor Colin Blakemore added: “Drug policy is primarily aimed at reducing the harm to individual users, their families and society. But at present there is no rational, evidence-based method for assessing the harm of drugs. We have tried to develop such a method. We hope that policy makers will take note of the fact that the resulting ranking of drugs differs substantially from their classification in the Misuse of Drugs Act and that alcohol and tobacco are judged more harmful than many illegal substances.”

Press release: 23 March 2007
University of Bristol