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EXTRACTS FROM OTHER JOURNALS RELATING TO CHILDREN, YOUTH AND FAMILIES — IN THE FIELDS OF HEALTH, SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE

December 2001

Dad's Love Influences Child as Much as Mom's Love
A father's love--or the lack of it--contributes as much to the development of a child's personality and behavior as the love of a mother, according to researchers. In some respects, they add, a father's love is even more influential.
``Probably the most important and most surprising finding of all is that the importance of mother love seems to drop out altogether in some of the analyses we have done,'' said study co-author Dr. Ronald P. Rohner of the University of Connecticut. ``It's pretty remarkable.''
Rohner and his colleague Robert A. Veneziano reviewed almost 100 US and European studies investigating the effects of parenting on the psychology and behavior of children as they grew older. The earliest study was conducted in 1949, and the most recent was completed in 2001.
In the current issue of the Review of General Psychology, the researchers report that the degree of acceptance or rejection a child receives--and perceives--from his or her father appears to affect his or her development as deeply as the presence or absence of a mother's love.
Rohner and Veneziano noted that the withholding of love by either the mother or the father is equally connected to a child's lack of self-esteem, emotional instability, withdrawal, depression and anxiety. And the risk of developing problems with aggression, drug and alcohol abuse, and delinquency was equally related to a child's rejection or acceptance by either parent.
The investigators also found that having the love and nurturing of either parent has an equally positive effect on a child's happiness, well-being and social and academic success from early childhood through young adulthood.
The team further found that in certain instances, the love of a father plays an even more important role than that of the mother. Many studies found a father's love to be the sole determining factor when it came to a child's problems with personality, conduct, delinquency or substance abuse. They said future research is needed to explain this observation.
Rohner told Reuters Health that he doesn't want to suggest that a mother's love is less important than the love of a father. Instead, he said, his research reveals an American cultural bias to overemphasize the role the mother plays in raising her children, at the expense of understanding and appreciating the equally crucial role of the father.
``In certain aspects, father's love seems to have a particularly strong influence,'' he said. ``So it seems clear that we have to move away from mother-bashing: assuming somehow that the mother is completely at fault for all the problems of her kids.... And, hopefully, this information will encourage fathers all over the country to become more involved with their kids.''
SOURCE: Review of General Psychology 2001;5:382-405.


Could People Less Receptive to Pleasure Turn To Drugs?
Many addicts wish they could say no to drugs, but a new study suggests that some can't help but say yes. Peering into the brains of several methamphetamine abusers, researchers at Brookhaven National Laboratory found that the group was short on receptors needed to store dopamine, a brain chemical tied to feelings of motivation and reward. Such deficiencies, says lead author Nora Volkow, MD, make it likely that some will turn to illicit drugs for a good time.
"All drugs of abuse increase dopamine," says Volkow, adding that sex and food can do the same sort of thing. For those who already have enough dopamine, such pleasure-seeking activities simply supply an added dopamine bonus that can be enjoyed from time to time. People stuck with a natural downer, however, seem to make pleasure a real mission.
"A low level of receptors will drive them to where nothing else matters," she says.
Volkow admits that the drug may have destroyed dopamine storage spots in the first place, since methamphetamine, better known as crank or speed, is toxic to brain cells.
But the research adds yet another clue to what may prove to be an underlying addiction theme. When given stimulants, people who have fewer dopamine receptors say the drugs are pleasurable while those with higher amounts find them unappealing.
Researchers at Brookhaven have also discovered lower-than-normal dopamine receptor levels in alcoholics, cocaine and heroin abusers, and even those who are severely obese.
"Overeating can be like a drug for some," Volkow says.
In their most recent study, Volkow and colleagues used position emission tomography (PET) to see if methamphetamine users had a lower reward threshold. Compared to 20 subjects who never used drugs, 15 recovering speed addicts had roughly 10-16% fewer dopamine receptors in two different parts of the brain.
Moreover, fewer receptors were linked to less brain activity in the orbitofrontal cortex. This region is linked to obsessive and compulsive behavior, which could explain why "speed" users have less control over their actions than others, Volkow says.
All told, methamphetamine addicts appear hard to please.
"Ordinary stimuli are not strong enough to activate a reward response," she says.
Illicit stimulants, of course, are a poor way to get your pleasure fix, regardless of whether you are naturally deficient in dopamine or not. The drug will eat away at the receptors, and if this happens over a long enough time, the losses might result in Parkinson's disease.
But the damage doesn't seem to be permanent, according to a separate study also led by Volkow.
Following five methamphetamine users who quit the drug for at least a year, the Brookhaven team found the former speed users were able to recover a significant amount of lost dopamine receptors. Even so, this surprising rejuvenation did not lead to any serious improvements on memory or physical dexterity tests.
Dr. Una Mcann, who studies varies illicit drugs at Johns Hopkins, says that it's too soon to blame low dopamine receptors for addictive behavior.
"It's highly speculative," she says.
Still, Mcann and many others are following the work closely.
"It's an interesting hypothesis," she adds. "It makes some sense."
The studies appear in the American Journal of Psychiatry and the Journal of Neuroscience.


Study implicates movies in child, teen smoking
Watching movie stars light up on screen may increase the odds a child or young teen will try smoking, study findings suggest.
Researchers say that while their findings do not mean tobacco use in movies causes kids to smoke, they are "the first step" toward showing it is possible.
The role of the media in children's behavior--particularly violence--has received much recent attention. But proving that media images can directly lead to a behavior is tough, as so many factors influence a child's beliefs and actions.
In this latest study, researchers at Dartmouth Medical School in Lebanon, New Hampshire found that the odds of a child smoking increased in tandem with the number of films with smoking scenes he or she had seen.
This pattern remained regardless of other smoking risk factors such as having parents or friends who smoked, poor school performance or a self-reported "rebellious" nature.
Dr. James D. Sargent and his colleagues report the findings in the December 15th issue of the British Medical Journal.
In response to the findings, the British Medical Association (BMA) called on the UK film industry to "stub out" on-screen smoking.
"When smoking is glamorised in movies, young people are encouraged to experiment with a lethal habit," the BMA's Dr. Vivienne Nathanson said in a statement.
And an editorial accompanying the journal report made the same challenge to Hollywood. "It is time for the entertainment industry to accept responsibility for its actions and stop serving the interests of tobacco companies," writes Dr. Stanton A. Glantz of the University of California, San Francisco.
Sargent's team based the findings on a survey of nearly 5,000 Vermont and New Hampshire students aged 9 to 15. Students were asked whether they had seen any of 50 recent movies that the researchers had screened for the number of smoking scenes. They also answered questions about environmental risk factors for smoking, their personality traits and perceptions of their parents' views on smoking.
The investigators found that the number of smoking instances students had seen in the movies was correlated with their odds of having tried smoking. Kids who had seen 51 to 100 smoking occurrences were 70% more likely than those who had seen fewer to have smoked. And the odds were nearly three times greater among those who had seen 150-plus smoking scenes.
According to the researchers, the effects of on-screen smoking were similar to those of having parent or sibling who smoked.
The films in the survey had been pulled from a group of more than 600. Of these, smoking was most common in "R"-rated films, but only 10% of "PG" and "PG-13" movies--which children can see without an accompanying adult--were smoke-free.
"The results indicate that exposure to tobacco use in films is pervasive," Sargent's team writes. "More importantly, such exposure is associated with trying smoking, which supports the hypothesis that films have a role in the initiation of smoking."
In his editorial, Glantz agrees, writing that the study "provides powerful new evidence" that smoking in movies does contribute to adolescent smoking.
SOURCE: British Medical Journal 2001;323:1394-1397, 1378-1379.
 

Moms May Underestimate Kids' Exposure to Violence
Mothers often underestimate the amount of violence their children experience and are exposed to in inner-city neighborhoods, results of a recent study suggest.
``If parents assume that their children do not encounter violence in poor inner-city neighborhoods and do not talk with their children about such events, they will miss important opportunities to counsel their children about community violence,'' Dr. Rosario Ceballo, of the University of Michigan in Ann Arbor, told Reuters Health.
For their study, Ceballo and her colleagues interviewed 104 fourth- and fifth-grade students and their mothers to determine the degree of violence that the children were exposed to, the mothers' knowledge of the exposure, and the psychological impact of violence on the children.
The investigators found that 44% of the children reported that they had been threatened with serious physical harm at some point in their lives, and two thirds of the children said they had seen someone else being threatened with physical harm.
But fewer than half of the mothers said that their child had seen someone else threatened with physical violence, and only 18% thought that their child had ever been threatened with serious harm, according to the report in the November issue of the Journal of Marriage and Family.
What's more, 13% of children reported that they had been attacked or stabbed with a knife and 11% said they had been shot at, but only 2% of the mothers said that their child had ever been shot at, and none reported that their child had ever been attacked with a knife.
It is possible that some kids may have exaggerated their exposure to such violence, but in general, ``this is what kids are reporting,'' Ceballo said. And these ``shocking'' statistics are consistent with previous study findings, she explained.
Boys were reportedly more likely than girls to experience some type of violent act. However, mother-child agreement about violence exposure was higher for girls than for boys. Mother-child agreement was also higher for 9-year-old children than for 10- and 11-year-olds.
This may be because girls and younger children are less involved in ``street-culture activities,'' and therefore more easily monitored by their mothers compared with boys and older children, the report indicates.
Children who reported regular exposure to inner-city violence also reported high levels of psychological distress, Ceballo's team notes. Again, however, ``mothers also underestimated children's feelings of psychological distress,'' Ceballo said.
For example, more than 80% of the children reported potential symptoms of post-traumatic stress disorder such as having bad dreams and ``sick feelings'' including headache and stomach pain. But only about half of the mothers said their child had such problems.
When the child's reports of violence exposure agreed with their mother's reports, however, the child exhibited fewer signs and symptoms of psychological distress, the findings show.
``(This) suggests that there is a beneficial impact for children who have the opportunity to talk about community violence with their parents,'' Ceballo said. ``Children may be reluctant to bring these experiences up on their own, and parents must take the lead in providing a safe and comfortable atmosphere in which to talk about difficult issues, like community violence.
``Specifically, parents can...(let) children know that it is okay to feel scared and upset by violence and that most people would have similar reactions to violence,'' Ceballo advised.
In addition, she said, parents should ``help children think about concrete ways to stay safe in dangerous situations.''
SOURCE: Journal of Marriage and Family 2001;63:927-940.

Parental Disapproval May Help Teens Say No to Cigs
Contrary to the notion of the rebellious teenager who spurns parental guidance in favor of peer influence, new study findings suggest that adolescents who think their parents disapprove of smoking are less likely to pick up the habit.
``Parents often perceive there is little they can do about adolescent smoking, (and) researchers have contributed to this by emphasizing the effects of peers on adolescent smoking,'' study author Dr. James D. Sargent of Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, told Reuters Health.
``This study offers hope by suggesting that parents can decrease the chances their children will smoke by communicating that they feel strongly their children should not smoke and doing this consistently over time,'' he said.
To investigate the influence of perceived parental disapproval of smoking on adolescent smoking, Sargent and co-author Dr. Madeline Dalton of Dartmouth Medical School in Hanover, New Hampshire, performed three annual surveys of students in grades 4 through 11.
About 57% of the adolescents in all three surveys indicated that they were both never-smokers and weren't susceptible to smoking. Approximately one in five of these students said that neither parent would strongly disapprove of their smoking, while about 60% to 65% said that both their mother and father would strongly disapprove.
In general, teens who believed that their parents would strongly disapprove of smoking were 60% less likely to become smokers than their peers who believed that neither parent would disapprove, Sargent and Dalton report in the December issue of Pediatrics. And the effect of parental disapproval remained significant even if the parents were smokers themselves, the report indicates.
Slightly more than three quarters of the never-smokers initially reported that their parents would strongly disapprove of smoking, but by the second and third surveys, 15% and 18%, respectively, believed that their parents had become more lenient, the researchers note. Further, nearly 15% of the never-smokers, particularly those who believed their parents had become more lenient, reported that they were established smokers by the third survey.
Adolescents who had a sibling or friend who smoked and those who performed poorly in school were more likely to become smokers than their peers, the report indicates. Females, particularly in the last two surveys, reported more smoking than males. What's more, adolescents who owned or were willing to use an item that promoted cigarettes were 2.5 times more likely to become established smokers than their peers.
``Interventions that enhance parental self-efficacy in conveying and enforcing no-smoking policies for their children could reduce adolescent smoking,'' Sargent and Dalton conclude.
``Start communicating about smoking at an early age--minimally age 10,'' Sargent advised. Emphasize key points, he suggested, such as: ``Smoking is really bad for your health; I will not allow you to do it in my household; and if I find out that you are smoking I will be very upset and there will be consequences.''
The study was supported by grants from the National Cancer Institute (news - web sites).
SOURCE: Pediatrics 2001;108:1256-1262.

Proactive Screening and Treatment Recommended for Primary Nocturnal Enuresis
Physicians need to be proactive in screening and treating school-aged children for primary nocturnal enuresis, according to a monograph produced by a symposium of pediatricians, pediatric nephrologists and pediatric urologists.
Their discussion is published in "Taking a Closer Look at Primary Nocturnal Enuresis," which appears in the October 17th issue of Infectious Diseases in Children. The symposium was sponsored by Aventis Pasteur.
Dr. Alan R. Greene, of Stanford University School of Medicine in California, and the other panel members agree that, unless underlying complications are present, most children with nocturnal enuresis can be managed safely and effectively by a general pediatrician.
"Once a simple screening urinalysis is performed, it's generally safe to go ahead and start treatment," Dr. Greene told Reuters Health. "I'll also observe the urine stream or make sure the parents have observed a good stream."
Dr. Greene may also measure children's bladder capacity by having them drink as much water as they can, then measure the amount they urinate. "If the amount is less than the child's age plus 2 ounces, then the bladder is smaller than average," he noted.
So for an 8-year-old, the capacity should be approximately 10 ounces. If it is less than that, bladder-stretching exercises may be needed. However, Dr. Greene noted, small bladders are responsible for only a very small percentage of bed-wetters.
What doctors are more likely to see are children who are difficult to arouse from sleep. If parents choose to treat their child with a conditioning alarm, which goes off when it senses moisture, the child is unlikely to wake up on his own, and parents will have to at least partially wake the child and walk him to the bathroom. The panelists disagreed as to whether the child must be fully awake when he is brought to the toilet to void.
Another option, often used in concert with the alarm, is oral desmopressin. "The most current research shows that desmopressin can be used as a 'bridge to maturity,' " Dr. Greene said.
He explained that up until recently, physicians have been concerned about using desmopressin for long periods of time. Evidence now shows that it is safe and effective, even when used for years.
"What I do in my practice is have the child take a drug holiday every 3 to 6 months, or taper the dose, to see if they still need it," he added.
However, what Dr. Green emphasized most was that even though approximately 5 million children have nocturnal enuresis, only about a third of patients or their parents will bring the subject up with their doctor.
"So once kids start school, physicians need to ask about it every year until patients report that they are consistently waking up dry," he concluded.
Infect Dis Child 2001;1:1-17.

Women More Susceptible to Ecstasy Brain Damage
A preliminary study finds that women may suffer more brain damage than men from taking the drug ecstasy, the Associated Press reported Nov. 29.
For the study, Dutch researchers compared brain scans of people who had taken 50 or more ecstasy tablets in their lifetimes with a group that had never taken the drug. The study showed that ecstasy -- also known by the chemical moniker MDMA -- caused more damage to certain brain cells in women, even though the men had taken more ecstasy over the years.
|Researchers said more studies are needed to confirm the results.
Kathryn Cunningham, professor of pharmacology and toxicology at the University of Texas Medical Branch in Galveston, said it's not surprising that men and women respond differently to ecstasy. She pointed out that amphetamines leave the body more quickly in the presence of testosterone.
"Estrogen-dependent changes in the serotonin transporter might regulate the brain response, and thus toxicity, to MDMA. And it's conceivable that women may be more vulnerable to brain damage at certain times of the month," Cunningham said.
The research is published in The Lancet medical journal.

Children of divorce less committed to marriage
Children of divorced parents are known to be at increased risk for later problems in their own marriages, including divorce. This may be because their parents' divorce undermined their thoughts and feelings about the permanence of marriage, recent study findings suggest.
"Children who grow up with divorced parents tend to reach adulthood with a relatively weak commitment to the norm of lifelong marriage," study author Dr. Paul R. Amato, of Pennsylvania State University in University Park, told Reuters Health. "When their own marriages become troubled, they tend to leave the relationship rather than stick it out or work on it."
This may be particularly true among children of parents who divorced after only minimal levels of conflict, his study found.
To investigate marital instability across generations, Amato and co-author Dr. Danelle D. DeBoer, now of Doane College in Nebraska, performed a 17-year study of more than 2,000 married individuals and 335 of their offspring who married during the study period.
Overall, divorces were more common among children whose parents had divorced than among those whose parents remained married--a finding consistent with previous study results, Amato and DeBoer report in the November issue of the Journal of Marriage and Family.
Children were also more likely to think of divorcing their spouse if their parents divorced or if their parents remained married but reported a high level of discord in the relationship, the report indicates.
"Adult children of divorce have a tendency to jettison relationships that may be salvageable," Amato said.
Children of divorced parents were more than twice as likely to report experiencing a disruption in their own marriage than were their peers whose parents remained married with a low level of discord. On the other hand, children whose parents divorced after reporting a low level of discord were at an extremely high risk of divorce in comparison to those whose parents reported a medium or high level of discord prior to divorce.
"If divorce is preceded by a long period of chronic, overt discord, children learn that divorce is a reasonable solution to an unhappy marriage," Amato noted. "But if there is little overt conflict, then children learn that marriage is an unpredictable relationship, and that love and commitment are often here today and gone tomorrow."
The risk of divorce among the offspring decreased with increasing age, and the risk of thinking about divorce was lower among those with well-educated parents, the researchers note.
In addition, offspring who reported a high level of happiness in their marriage were less likely to think about divorcing their spouse than were their less happy peers, regardless of whether or not their parents divorced, the report indicates.
"Growing up in a divorced family does not doom a person to have an unsuccessful marriage," Amato explained. "But adults with divorced parents may have to work a little harder to keep their marriages strong."
He added, "All marriages go through difficult times. Adult children of divorce, along with all (other) adults, need to be careful not to rush into a divorce, especially when there are children in the household."
SOURCE: Journal of Marriage and Family 2001;63:1038-1051.

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