A new study from the Journal of Marital & Family Therapy warns of the dramatic rise in the use of psychotropic medications for children. One in every fifty Americans is now considered permanently disabled by mental illness, and up to eight million children take one or more psychotropic drugs.

The authors, James P. Morris, Ph.D. and George Stone, LCSW, state that there is little evidence available to warrant the widespread use of psychotropic drugs for children, and little long term data regarding its long term impact on development. According to the authors the mental health field is currently designed to treat adults with psychotropic medications, but they are often misused in the case of children and adolescents, "This presents an ethical challenge to marriage and family therapists, who should be very cautious about these medications as an option for children. The long-term research on their safety for children is uncertain."

As an example, the diagnosis of early onset bipolar disorder and attention deficit hyperactivity disorder has climbed drastically in the past decade. Drugs designed to treat the above two disorders show a fair short term risk-benefit ratio, but a poor long-term benefit. Morris and Stone indicate, "If the psychiatric community has been misled by pharmaceutical companies in thinking that these drugs are safe for their children, the parents of these children have been in turn deluded into putting their children in harm's way."

The authors continue that the pharmaceutical industry is largely influenced by the desire for economic profit, and the marketing muscle behind the industry, and leniency of institutions such as the FDA, tout benefits that are not yet properly evaluated for pediatric use. Between 1994 and 2001, psychotropic prescriptions for adolescents rose more than sixty percent; the rise post-1999 was connected to the development and marketing of several new psychotropic drugs and the rebranding of several older ones.

Morris and Stone claim that family health professionals are put in the line of fire when children begin to experience the negative consequences of long-term use of these medications. They are left with the challenge of evaluating the quality of evidence-based care offered to their pediatric clients by the psychiatric community, and the negative effects of the medications without sufficient empirical evidence or information.

Children with the genetic condition known as Williams syndrome have unusually friendly natures because they lack the sense of fear that the rest of us feel in many social situations. Now, a study reported in the April 13th issue of Current Biology, a Cell Press publication, suggests that children with Williams Syndrome are missing something else the rest of us have from a very tender age: the proclivity to stereotype others based on their race.

The findings support the notion that social fear is at the root of racial stereotypes. The researchers say the results might also aid in the development of interventions designed to reduce discriminatory attitudes and behavior towards vulnerable or marginalized groups of society.

"This is the first study to report the absence of racial stereotypes in any human population," said Andreas Meyer-Lindenberg of the Central Institute of Mental Health, Mannheim/University of Heidelberg, who coauthored the paper with Andreia Santos and Christine Deruelle of the Mediterranean Institute of Cognitive Neuroscience in Marseille.

Previous studies have shown that stereotypes are found ubiquitously in typically developing children—as early as age 3—as they are in adults, Meyer-Lindenberg explained. Even children with autism display racial stereotypes, despite profound difficulties in daily social interaction and a general failure to show adapted social knowledge.

In their study, the researchers showed children a series of vignettes with people differing in race or gender and asked the children to assign positive or negative features to those pictured. Typical children made strongly stereotypical assignments both for sex roles and for race, confirming the results of previous studies. On the other hand, children with Williams syndrome showed no evidence for racial bias.

"The unique hypersociable profile of individuals with Williams syndrome often leads them to consider that everybody in the world is their friend," Meyer-Lindenberg said. "In previous work, we have shown that processing of social threat is deficient in people with the syndrome. Based on this, we suspected that they would not show a particular preference for own-race versus other-race characters. The finding that racial stereotypes in children with Williams syndrome were completely absent was nevertheless surprising in its degree."

The children with Williams syndrome did make stereotypical sex role assignments just like normal children. That finding suggests that different forms of stereotyping arise from different brain mechanisms, the researchers say, and that those mechanisms are selectively affected in some way by the genetic alteration that causes Williams syndrome (the loss of about 26 genes on chromosome 7).

Traditional treatments of cognitive behavioral therapy and pharmacotherapy don't reach everyone

Exercise is a magic drug for many people with depression and anxiety disorders, and it should be more widely prescribed by mental health care providers, according to researchers who analyzed the results of numerous published studies. "Exercise has been shown to have tremendous benefits for mental health," says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. "The more therapists who are trained in exercise therapy, the better off patients will be."

Smits and Michael Otto, psychology professor at Boston University, based their finding on an analysis of dozens of population-based studies, clinical studies and meta-analytic reviews related to exercise and mental health, including the authors' meta-analysis of exercise interventions for mental health and studies on reducing anxiety sensitivity with exercise. The researchers' review demonstrated the efficacy of exercise programs in reducing depression and anxiety.

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don't reach everyone who needs them, says Smits, an associate professor of psychology. "Exercise can fill the gap for people who can't receive traditional therapies because of cost or lack of access, or who don't want to because of the perceived social stigma associated with these treatments," he says. "Exercise also can supplement traditional treatments, helping patients become more focused and engaged."

The researchers presented their findings March 6 in Baltimore at the annual conference of the Anxiety Disorder Association of America. Their workshop was based on their therapist guide "Exercise for Mood and Anxiety Disorders," with accompanying patient workbook (Oxford University Press, September 2009). For links to more information see www.smuresearch.com. "Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger," Smits says. "Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing."

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity. At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients' exercise guides and motivators. "Rather than emphasize the long-term health benefits of an exercise program – which can be difficult to sustain – we urge providers to focus with their patients on the immediate benefits," he says. "After just 25 minutes, your mood improves, you are less stressed, you have more energy – and you'll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise."

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists. "Therapists can help their patients take specific, achievable steps," he says. "This isn't about working out five times a week for the next year. It's about exercising for 20 or 30 minutes and feeling better today."

Poisoning is now the second leading cause of unintentional injury death in the U.S. While several recent high-profile Hollywood celebrity cases have brought the problem to public attention, the rates of unintentional poisoning deaths have been on the rise for more than 15 years, and in fact, unintentional poisoning has surpassed motor vehicle crashes as the leading cause of unintentional injury death among people 35-54 years of age. In a study published in the May issue of the American Journal of Preventive Medicine, researchers found that hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers in the U.S. have increased by 65% from 1999 to 2006.

"Deaths and hospitalizations associated with prescription drug misuse have reached epidemic proportions," said the study's lead author, Jeffrey H. Coben, MD, of the West Virginia University School of Medicine. "It is essential that health care providers, pharmacists, insurance providers, state and federal agencies, and the general public all work together to address this crisis. Prescription medications are just as powerful and dangerous as other notorious street drugs, and we need to ensure people are aware of these dangers and that treatment services are available for those with substance abuse problems."

In the first comprehensive examination of nationwide hospitalizations associated with these prescription medications, researchers examined data gathered from the Nationwide Inpatient Sample (NIS), which contains records for approximately 8 million hospitalizations per year. By using standard diagnosis codes from the ICD-9-CM, the authors extracted from the NIS all poisonings by drugs, medicinal, and biological substances reported from 1999-2006, and further categorized the specific types of drugs in each case. It was also possible to determine whether the poisoning was diagnosed as intentional, unintentional or undetermined.

Dr. Coben believes that while the data reveals a fast-growing problem, there's an urgent need for more in-depth research on this wave of injuries and deaths. Writing in the article, he said, "Interviews with survivors could provide important additional details regarding the pathways to abuse of these drugs, the methods used to obtain the medications, the sequencing and combination of drugs that result in overdose, and the immediate precursors to these serious events. The association between hospitalization for prescription opioids, sedatives, and tranquilizers and subsequent morbidity and mortality is another area in need of further research."

While the majority of hospitalized poisonings are classified as unintentional, substantial increases were also demonstrated for intentional overdoses associated with these drugs, likely reflecting their widespread availability in community settings.

From 1999-2006, total estimated hospitalizations in the U.S. for poisoning by prescription opioids, sedatives, and tranquilizers increased by 65%; while unintentional poisonings by these drugs increased by 37%. In comparison, during this same period, hospitalizations for poisoning by other drugs, medicinal and biological substances increased by 33%, while all other hospitalizations increased by just over 11%. Unintentional poisonings by other substances increased by 21%. Intentional poisonings from prescription opioids, sedatives, and tranquilizers rose by a total of 130% compared to a 53% increase in intentional poisonings from other substances.

The largest percentage increase in hospitalizations for poisoning for a specific drug was observed for methadone (400%). Poisonings by benzodiazepines increased 39%. Hospitalizations for poisoning by barbiturates actually decreased 41%, as did hospitalizations for poisoning by antidepressants (a decrease of 13%).

Yet 1 in 40 are 'supertaskers' who can do both
                
A new study from University of Utah psychologists found a small group of people with an extraordinary ability to multitask: Unlike 97.5 percent of those studied, they can safely drive while chatting on a cell phone. These individuals – described by the researchers as "supertaskers" – constitute only 2.5 percent of the population. They are so named for their ability to successfully do two things at once: in this case, talk on a cell phone while operating a driving simulator without noticeable impairment. The study, conducted by psychologists Jason Watson and David Strayer, is now in press for publication later this year in the journal Psychonomic Bulletin and Review.

This finding is important not because it shows people can drive well while on the phone – the study confirms that the vast majority cannot – but because it challenges current theories of multitasking. Further research may lead eventually to new understanding of regions of the brain that are responsible for supertaskers' extraordinary performance. "According to cognitive theory, these individuals ought not to exist," says Watson. "Yet, clearly they do, so we use the supertasker term as a convenient way to describe their exceptional multitasking ability. Given the number of individuals who routinely talk on the phone while driving, one would have hoped that there would be a greater percentage of supertaskers. And while we'd probably all like to think we are the exception to the rule, the odds are overwhelmingly against it. In fact, the odds of being a supertasker are about as good as your chances of flipping a coin and getting five heads in a row."

The researchers assessed the performance of 200 participants over a single task (simulated freeway driving), and again with a second demanding activity added (a cell phone conversation that involved memorizing words and solving math problems). Performance was then measured in four areas—braking reaction time, following distance, memory, and math execution. As expected, results showed that for the group, performance suffered across the board while driving and talking on a hands-free cell phone.
                
For those who were not supertaskers and who talked on a cell phone while driving the simulators, it took 20 percent longer to hit the brakes when needed and following distances increased 30 percent as the drivers failed to keep pace with simulated traffic while driving. Memory performance declined 11 percent, and the ability to do math problems fell 3 percent. However, when supertaskers talked while driving, they displayed no change in their normal braking times, following distances or math ability, and their memory abilities actually improved 3 percent.

The results are in line with Strayer's prior studies showing that driving performance routinely declines under "dual-task conditions" – namely talking on a cell phone while driving – and is comparable to the impairment seen in drunken drivers. Yet contrary to current understanding in this area, the small number of supertaskers showed no impairment on the measurements of either driving or cell conversation when in combination. Further, researchers found that these individuals' performance even on the single tasks was markedly better than the control group. "There is clearly something special about the supertaskers," says Strayer. "Why can they do something that most of us cannot? Psychologists may need to rethink what they know about multitasking in light of this new evidence. We may learn from these very rare individuals that the multitasking regions of the brain are different and that there may be a genetic basis for this difference. That is very exciting. Stay tuned."

Watson and Strayer are now studying expert fighter pilots under the assumption that those who can pilot a jet aircraft are also likely to have extraordinary multitasking ability. The current value society puts on multitasking is relatively new, note the authors. As technology expands throughout our environment and daily lives, it may be that everyone – perhaps even supertaskers – eventually will reach the limits of their ability to divide attention across several tasks. "As technology spreads, it will be very useful to better understand the brain's processing capabilities, and perhaps to isolate potential markers that predict extraordinary ability, especially for high-performance professions," Watson concludes.