Researchers from Harvard, Tulane, the University of Maryland and Boston Children’s hospital compared MRI and EEG scans of 20 normally developing Romanian children with scans of 29 exposed to institutional rearing as well as 25 previously exposed to institutional rearing but then moved to high-quality foster care. They found that neurodevelopmental deficits associated with institutional care were improved in children moved to high-quality care, suggesting “the potential for developmental ‘catch-up’ … even following extreme environmental deprivation.”
This month’s Neuropsychobiology reviews, in two articles, the continued legacy of Eugen Bleuler – originator of the term “schizophrenia.” An article from Switzerland states that Bleuler’s conception of schizophrenia was “markedly broader and, as for prognosis, much less pessimistic” than Kraepelin’s dementia praecox, and calls “a continuous reflection upon psychiatry’s historical and epistemological basis … an indispensable component of psychiatry, clinically and scientifically.” emphasized the potential of therapeutic communities in providing care, the drawbacks of extended hospitalization and the therapeutic potential of planned ‘early discharge’ and job integration.” An article by German researchers shows that current evidence confirms Bleuler’s emphasis on therapeutic communities, early discharge, and supported employment.
A review in Current Opinion in Psychiatry (as of July 13, 2012) finds that the United Nations Convention on the Rights of Persons with Disabilities “has ushered in a new era of discourse that moves beyond a consideration of individual impairments, to focus on the social and environmental barriers that prevent full and effective social participation of people with disabilities.” The Convention can be used, the article states, “to shift current mental health discourse from a discussion emphasizing the protection of negative rights, such as from involuntary detention or coerced treatment, to one emphasizing social rights and civic participation.”
Research from England explores the unique capacities of therapeutic communities (TCs) in an article published online July 20, 2012 by the International Journal of Social Psychiatry. Drawing on research from social and experimental psychology, the article proposes that “a sense of belongingness is correlated with improved self-esteem and overall well-being. The capacity for responsible agency is central to behavioural change … We suggest that TCs are uniquely placed to demand such growth and change of their members because the sense of belongingness engendered by TC methods protects against the risks engendered by this demand.”
Findings from a survey of 6,082 individuals, designed to explore racial and ethnic differences in mental disorders, reinforce the relationship between social support and depression. The authors suggest a re-examination of “the individualistic models of treatment that are most evaluated in the United States. The lack of evidence-based data on support groups, peer counseling, family therapy, or other social support interventions may reflect a majority-culture bias toward individualism, which belies the extensive body of research on social support deficits as a major risk factor for depression.” The study appears in Ethnicity & Disease.
I was invited to give a Keynote Address at the 2012 Alternatives Conference in Portland Oregon, and I’m collecting your input on what I should say — I’m crowd sourcing my Keynote! Alternatives is a federally funded annual SAMHSA conference that brings … Full Article →
Researchers in Denmark found, in a study of 49 remitted bipolar patients published in the Journal of Behavior Therapy and Experimental Psychiatry, that beliefs about the self having to do with things such as “Social Isolation, Failure to Achieve, Dependence, Vulnerability to Harm and Illness, Emotional Inhibition, Insufficient Self-Control, and Pessimism accounted for 28% of the variance in functional impairment when controlling for length of remission and subsyndromal depressive symptoms.”
Researchers in the Netherlands and the U.K. explored the relationship between symptom reduction in schizophrenia (according to Andreason’s 2005 criteria for remission) and social function in daily life. They found that of 177 patients, 70 met criteria for symptomatic remission, but that remission was not related to functional recovery. The results appeared online in the British Journal of Psychiatry June 28, 2012.
Researchers from Japan found, in a study of 27 persons with a schizophrenia diagnosis, 17 with major depressive disorder, and 27 controls, that negative symptoms of schizophrenia were associated with a lower level of oxytocin in cerebrospinal fluid. They also found lower levels of oxytocin were associated with use of second-generation antipsychotics. The article, published online today in Schizophrenia Research, discusses the role of oxytocin in social behavior and psychopathology.
The Seroxat & SSRI User Group was founded to support and advise patients experiencing problems with Seroxat (Paxil). This English-based group offers information, forums, book reviews and articles on withdrawal from SSRIs.
“Like a hundred little blackmails a day” is how British Member of Parliament Charles Walker described his struggle with obsessive compulsive disorder. He, along with several other MPs disclosed their personal struggles during debate about a bill on mental illness.
This paper in Transcultural Psychiatry states that global mental health (GMH) research “appears to be using a monocultural model that is individualistic, illness-oriented, and focused on intrapsychic processes. Ironically, issues of culture are prominently absent in many discussions of global mental health. This paper highlights some issues and concerns considered key to conducting ecologically valid and socially responsible GMH research. The concerns are particularly directed at researchers from dominant cultures who are working in low-income countries.”
An anthropological study of mental health service use in Ghana, published online June 21 in Transcultural Psychiatry, finds that counter to expectations almost all those interviewed had accessed biomedical treatment but many had discontinued antipsychotics. Despite perceived beneficial effects such as controlling aggression or inducing sleep, “unpleasant side effects such as feelings of weakness and prolonged drowsiness conflicted with notions of health as strength and were seen to reduce the ability to work. The reduction of perceptual experiences such as visions was less valued than a return to social functioning. The failure of antipsychotics to achieve a permanent cure also cast doubt on their efficacy and strengthened suspicions of a spiritual illness which would resist medical treatment”
A touching article in the Las Vegas Sun follows one child from abandonment through foster placements, polypharmacy, suicidality, delinquency and homelessness to stability off medication and with close support. The article weaves this story together with recent efforts to curb the use of medications in foster care.
Consistent with evolutionary theories of altruism, toddlers exhibit more happiness when giving than when receiving, say researchers from Canada, and even more if the giving comes at a cost to themselves. Writing in PLoS One, the authors claim that the study provides initial support for the claim that experiencing positive emotions when giving to others is evidence of an innate mechanism for human cooperation.
Writing in Frontiers in Human Neuroscience, researchers from the University of Cambridge and University College in London review the evidence that both attention and prior expectations modulate social perception. They find that for people with schizophrenia diagnoses this influence of prior expectations is atypically strong, while people with autism-spectrum disorders demonstrate abnormally weak top-down modulation of social perception. The authors review some putative functional connectivity in the brain related to these phenomena.
A study of 325 Chicago-area patients with major depression, published today in the Journal of American Medical Association, finds that cognitive behavioral therapy administered via telephone is not only effective, but that significantly fewer participants discontinued therapy compared to those receiving treatment face-to-face (21% vs. 33%). At a 6-month post-treatment follow-up, however, improvement was significantly better among those who received face-to-face treatment. An interview with David Mohr, the principle author, can be heard here.
In a study of 86 individuals experiencing at least mild depressive symptoms, a person’s willingness to seek support from a friend was not related to his or her personal attributions of these symptoms to biological or psychological factors. However, participants were more likely to seek support from a friend whom they perceived as attributing the depression to biology rather than psychology. The study was released online by Behavioural and Cognitive Psychotherapy on May 29, 2012.
Locus of Control (LOC), a measure of the degree to which one perceives control of one’s life to be internally- vs. externally-determined, was reviewed in 33,224 adults across 18 cultural regions in literature spanning 40 years. Researchers found that the relationship between LOC and psychological symptoms differed between cultures with distinct individualistic vs. collectivist orientations. The the study found that the link between external LOC and and anxiety was weaker in collectivist societies, and notes that external LOC does not carry the same negative connotations in these cultures. The study was released online on May 31, 2012 by Psychological Bulletin.