Other journals: December 2006

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

Intelligent children may be more likely to become vegetarian, according to a study out yesterday. Those recorded as having a high IQ aged ten were more likely to be vegetarian aged 30, it said. The research, published online in the British Medical Journal involved a study of 8,179 men and women. Aged 30, 366 (4.5 per cent) of them said they were vegetarian. Of those, nine (2.5 per cent) were vegan while 123 (33.6 per cent) said they were vegetarian but ate fish or chicken.

On average, vegetarians had a higher childhood IQ score than non-vegetarians. The mean childhood IQ score of vegetarians compared with non-vegetarians was 106.1 and 100.6 for men and 104 and 99 for women. It is already known that children with a high IQ have lower risk of coronary heart disease in later life - something the researchers said could be down to a vegetarian diet which is also regarded as good for the heart.

They said: "Vegetarians were more likely to be female, to be of higher social class, and to have attained higher academic or vocational qualifications, although these advantages were not reflected in their income. "Higher IQ at age ten years was associated with an increased likelihood of being vegetarian at age 30. IQ remained a statistically significant predictor of being vegetarian as an adult after adjustment for social class, academic or vocational qualifications, and sex."

The authors also noted that vegetarians were less likely to be working in the private sector.

Anti-smoking ads sponsored by tobacco companies not only fail to deter young people from smoking but in fact encourage them to take up the habit, suggests a new study published in the December issue of the American Journal of Public Health. "We suspected this the minute we saw the kind of ads the tobacco companies were creating, said author Brian Flay, a professor in the department of public health at Oregon State University. Their objective is to get customers, not to stop customers from finding them."

A new study says anti-smoking ads sponsored by tobacco companies fail to establish an anti-smoking stance. (Francois Mori/Associated Press) In Canada, Ottawa passed the Tobacco Act which prohibited tobacco companies from advertising. Ads sponsored by tobacco companies are sometimes seen in Canada on U.S. networks. The study, sponsored by the U.S. National Cancer Institute, the U.S. National Institute on Drug Abuse and the Robert Wood Johnson Foundation, surveyed 100,000 students in the U.S. in Grades 8, 10 and 12.

Researchers noted that ads geared toward youth generally did not discourage students from smoking. They also noted that on average, students were exposed to more than four youth-targeted ads per month and that there was a 12 per cent increase in the probability of Grade 10 and 12 students becoming smokers if they watched prevention ads aimed at their parents. "Among students in Grade 8, tobacco company parent-targeted advertising was related to stronger beliefs that the harms associated with smoking have been exaggerated, and among students in Grades 10 and 12, was associated with lower perceived harm of smoking, stronger approval of smoking, and a higher likelihood of having smoked in the past 30 days," the study said.

The study suggests anti-smoking ads that encourage parents to talk to their children do not clearly establish an anti-smoking stance. "The overt message of the parent-targeted campaign is that parents should talk to their children about smoking, but no reason beyond simply being a teenager is offered as to why youths should not smoke," Flay said in the study.

About one in 16 teenagers who are sexually active have had sex that has resulted in a pregnancy. The results of a study analysing sexual behaviour and teen pregnancy, involving more than 2000 teenagers at 110 schools, have raised questions about the effectiveness of sex education in schools.

Professor Marian Pitts, the director of the Australian Research Centre in Sex, Health and Society at La Trobe University, said sex education in some schools was "patchy". "Some schools and some teachers are doing it extremely well, but there's very little consistency, she said. There's been no national audit of sex education."

The survey of 2388 students in years 10 and 12 at 110 government, Catholic and independent schools, conducted in 2002, found that 35 per cent had had sex. Of those that were sexually active, 6.1 per cent said they had had sex that had resulted in a pregnancy. When teenagers who were not sexually active were included, the overall rate of pregnancy was 2.1 per cent for girls and 2.5 per cent for boys.

Professor Pitts, a co-author of the study, published in today's Australian and New Zealand Journal of Public Health, said it was too hard to say whether the rate had gone up, as there were no comparable figures for Australia. "For any given classroom, you're likely to have at least one pupil … who has experienced a pregnancy," she said. Professor Pitts said there was a need for sex education in the school curriculum early enough to prepare students for safe sex. She said about one in 10 teenagers did not use contraception the last time they had sex, a worrying rate.

Centre for Adolescent Health director Susan Sawyer said the data was concerning. "We know that the overwhelming majority of pregnancies in teenagers are unplanned, she said. It reinforces the importance of young people being encouraged to delay the onset of sexual activity to an older age."

Professor Sawyer said sex education had too much emphasis on biology and anatomy, when there should be a greater focus on relationships and decision-making. She said the study should be a wake-up call to both schools and families.

Nick Murphy, assistant principal at Northcote High School, which has a comprehensive sex education program, said a national audit of sex education was a good idea. "I think you'll find Australia-wide that often with the pressures on the curriculum, by year 10 human relations and health education and sex education are beginning to disappear," he said.

An Education Department spokeswoman said sex education was part of the health education curriculum and incorporated discussions about relationships, rights and responsibilities, sexual safety and family and society values. Individual schools developed guidelines to deal with sex education to meet the needs of their students.

Adolescents who use alcohol, cigarettes and marijuana while alone are more likely to have health and behavioral problems as young adults than their peers who consume the substances only in social settings, according to a RAND Corporation study.

Solitary alcohol, cigarette and marijuana users are less likely to graduate from college, more likely to have substance use problems as young adults, and tend to report poorer physical health by age 23 than their peers who were social substance users, according to the study by the nonprofit research organization. "While substance use is a problem in itself, these findings suggest that risk among solitary users is especially high," said Joan Tucker, a RAND psychologist and lead author of the study. Solitary use is a warning sign that youth will be less productive and have more problems as young adults -- more problems, even, than others who also used substances during childhood. The challenge is to identify these at-risk children and find out what type of assistance might benefit them."

Among the 8th graders studied, 16 percent had smoked cigarettes while alone, 17 percent had engaged in solitary drinking and 4 percent had used marijuana while alone. Prior research has found that adolescent substance users are at risk for a wide range of problems during adolescence that persist into young adulthood, such as low academic achievement, stealing and other social problems.

Researchers found that during adolescence, those who used alcohol, cigarettes and marijuana alone were at higher risk for a variety of troubling behaviors as compared with social-only users. Solitary users admitted to more delinquent behavior, such as stealing and acting out at school, and were less inclined to talk to their parents about personal problems. Solitary users also were less engaged with school. This was evidenced by their lower grades, less time spent on homework and less time devoted to school activities. However, solitary users spent significantly more time going to parties and dating than other substance-using youth. "This dispels the notion that these solitary users are lonely, socially isolated teens," Tucker said.

Consistent with their active social life, solitary substance users typically felt that substance use has positive effects on their behavior, allowing them to relax, have more fun, and get away from their problems. In contrast, they were less likely than social-only users to think substance use is harmful -- that it impairs physical and cognitive functioning, and factors into behavioral problems.

In addition, solitary users reported higher frequency and quantity of substance use compared to social-only users. On average:

Costly methadone treatment for heroin addicts could be replaced by a substitute painkiller that is half the price, safer and less toxic.

In a study spanning three and a half years, researchers found that the prescription painkiller dihydrocodeine is equally as effective as methadone to help drug users kick the habit. The research by the Universities of Edinburgh, Napier and Adelaide could have major implications for treatment programmes for drug users, which have proved controversial not least because of the high costs involved.

In contrast to methadone -which comes in liquid not tablet form - dihydrocodeine is much easier to store and comes under less stringent regulations because it is not as toxic and less likely to cause a fatal overdose. It is estimated that whereas methadone treatment can cost almost 1,500 pounds annually per patient, the cost of dihydrocodeine is 713 pounds. Dihydrocodeine has been used by GPs and specialists for many years to treat drug users . It is often preferred in situations where methadone is seen as hazardous, such as police custody or prison. Its effectiveness has, however, never been tested before.

Dr Roy Robertson, a Reader at the University of Edinburgh, who is the study's main author, said: "Heroin addiction is a chronic condition requiring long-term medication. Just as with other chronic conditions, such as diabetes or arthritis, there should be a number of treatments available so that doctors and nurses can tailor medication to the needs of each patient. "Methadone should still be used to treat the majority of patients withdrawing from heroin and requiring maintenance treatment, but dihydrocodeine offers an alternative treatment for those who can't tolerate methadone, or find it hard to deal with the stigma of having to take their dose - sometimes every day - in a pharmacy. It is also much cheaper."

The study, the first of its kind in the world, assessed 235 people requiring treatment for opiate dependency in Edinburgh and found that dihydrocodeine was just as effective as methadone.

Dr Roberston, who also works as a GP, added that while there were less restrictions attached to prescribing dihydrocodeine tablets, it is still essential that treatment regimes are controlled and tailored to the individual. "We want to engage young people in a treatment programme which stops them from injecting drugs and running the risk of infection, he said. Apart from the danger of contracting AIDS, drug users run the real risk of exposure to the potentially fatal liver disease, Hepatitis C. We face an epidemic of Hepatitis C in Scotland, with 40% of young people who have been injecting drugs for more than two years being infected with this serious illness."

People who suffer from what was once called "hysteria" show altered patterns of brain activity connected to their symptoms, researchers reported Monday.

Though hysteria is now known by the kinder name "conversion disorder," its unusual features haven't changed. Sufferers have neurological symptoms, ranging from numbness in a limb to paralysis, memory loss and seizures, that cannot be traced to any known medical problem. Conversion disorder is so named because it's thought that people "convert" a psychological distress into a physical symptom -- though it's not under their conscious control. Freud himself coined the term.

Now the new study, published in the journal Neurology, offers brain evidence that "validates" the general Freudian view of the disorder, said study co-author Dr. Anthony Feinstein of the University of Toronto in Canada. Using brain imaging called functional MRI, he and his colleagues found that three women with conversion disorder showed an unusual pattern of brain activity related to their symptoms. All of the women had sensory conversion disorder, which involves a loss of sensation in a limb. Each had numbness in one hand or foot that could not be traced to any physical problem. Normally, when a healthy limb is touched, a particular, sensation-related area of the brain on the side opposite to that limb will be activated. For the three women in Feinstein's study, stimulation of the numb limb failed to trigger activity in this sensory area of the brain. Instead, brain regions involved in emotion "lit up" on the MRI scans.

Next, the researchers stimulated both the affected and unaffected limb at the same time. This time, the sensory-related areas on both sides of the brain were activated. But so too were the same emotional regions, and the women still felt numbness in the affected limb, Feinstein said. "What these data show are that very clear brain changes are driving hysteria," he told Reuters Health.

The fact that emotional structures in the brain were activated by touch supports the general belief about conversion disorder -- that a psychological trauma or stress is at the root of the physical symptoms. For some people, the distress becomes connected to numbness in a limb, for others it's a problem with movement or memory. It seems the trauma essentially "overwhelms" the brain's normal functioning, Feinstein said. Inappropriate activity in the brain's emotional structures may inhibit normal activity in areas related to sensation and movement. Feinstein and his colleagues are now studying whether sensory problems can be improved by distracting patients' attention during limb stimulation. That is, can the brain be "fooled" into a normal pattern of activation?

Feinstein said it's unclear whether the research will yield any new therapies for conversion disorder, which is typically addressed by treating the anxiety or other psychiatric problem believed to be behind the symptoms. Meanwhile, for people who may have had their symptoms dismissed by a doctor, or who believe that they're just crazy," Feinstein noted, this brain research shows that "a very real process" is behind their problems.

Looking at changes in the structure of the brain over time could help doctors to predict whether or not a person who has a family history of schizophrenia will go on to develop the condition, new research suggests. Schizophrenia is a serious mental illness characterised by disturbances in a person's thoughts, perceptions, emotions and behaviour. Symptoms can include delusions and hallucinations. The condition affects around one in every 100 people - an estimated 41,000 people Ireland are currently affected.

A team at the University of Edinburgh discovered that the MRI (magnetic resonance imaging) scans they had carried out on a number of patients had revealed changes in the brain tissue of some of those patients before they developed schizophrenia. Over a 10-year period, the team had followed 200 young people who were at high risk of developing schizophrenia because two or more members of their family had already been diagnosed with the illness.

The researchers analysed the MRI scans of 65 of the 200 young people. The scans had been taken, on average, 18 months apart. They looked specifically for changes in the grey matter - that is brain tissue made principally of neurones, which transmit messages and help to store memories.

As members of a high risk group, each person in the study had around a 13% risk of developing schizophrenia. However the MRI scans revealed changes in brain tissue that increased this prediction to 60% risk for some, thereby increasing doctors' ability to determine if an individual has an elevated risk. Eight of the 65 people, who were all aged 16-25 at the start of the study, went on to develop schizophrenia an average of two years after their first scan. The MRI scans of each of these individuals revealed that they had changes in grey matter that occurred before they became unwell.

An amalgamation of the MRI scans of the eight people who went on to develop schizophrenia. The yellow area highlights the parts of the brain where scans revealed a reduction in grey matter density

"Although there are no preventative treatments for the illness, an accurate predictive test could help researchers to assess possibilities for prevention in the future. Current methods are good for predicting who won't develop schizophrenia, but not who will", explained lead researcher, Dr Dominic Job.

He said that by combining brain imaging with traditional clinical assessments, 'it might be possible to detect people who are at highest risk of the illness early'. He acknowledged that because the number of participants in the study was small, the test needs to be independently replicated to confirm that MRI scanning is a reliable predictor of schizophrenia among people already at high risk.

Teens who often engage in unhealthy habits on their own, rather than with peers, may be in bigger trouble, a new study finds.

Researchers at the Rand Corp. found that teens who use alcohol, cigarettes and marijuana when they are alone are less likely to graduate from college, more likely to have substance abuse problems and report poorer physical health by age 23, compared with their peers who only use these substances in groups. "We found that kids who used these substances while alone were not only at higher risk for problems during adolescences, but 10 years later when they were 23," said study author Joan Tucker, a behavioral scientist at Rand Corp. "We need to take a closer look at this group of 'solitary users, Tucker said. They are overlooked. When we think about adolescent substance users, we think of those kids who are using substances at parties or when they are hanging out with friends. But we found that there is a significant group that are using these substances by themselves."

Tucker noted that these teens are not loners but are socially active, using alcohol, tobacco or marijuana when they are with friends, but also when they are alone. Her team's report is published in the December issue of Psychology of Addictive Behaviors. In the study, Tucker's team collected data on over 6,500 teenagers from California and Oregon who were in a study to evaluate Project ALERT, a drug-prevention program developed by Rand for middle school children. Teens were asked about their substance use and a variety of other issues several times during middle school and high school, and again at age 23.

The researchers found that of the more than 3,300 people who completed the study, 16 percent of eighth graders had smoked cigarettes while alone, 17 percent drank while alone, and 4 percent had used marijuana while alone. These solitary users admitted to more delinquent behavior, such as stealing and acting out at school, and were less likely to talk to their parents about personal problems than kids who indulged in bad habits more socially. They were also less involved with school, had lower grades and spent less time on homework and school activities.

However, "these are not the loner kids," Tucker said. In fact, most of these high-risk youngsters also spent significantly more time going to parties and dating than other substance-using youth. They focus less on school and more on activities with their peers," Tucker said. Moreover, these solitary substance abusers felt that substance use had positive effects on their behavior, helping them relax, have more fun and feel better, Tucker said. Also, they were less likely to think substance use is harmful.

But at 23, more of these solitary users had developed substance abuse problems and were involved in crimes, such as selling drugs and stealing, Tucker said. They also had more physical health problems. "So, across the board, they were faring worse in young adulthood," she said.

One expert believes that a combination of addiction and existing psychological problems account for these behaviors among this subset of youth. "People who are more likely to be addicted are more likely to use solitarily as well as socially, said Bonnie Halpern-Felsher, an associate professor of pediatrics at the University of California, San Francisco. In addition, kids who are at risk are more likely to use solitarily."

Halpern-Felsher thinks it is important that health-care providers ask adolescents about their smoking and drug use behaviors - not only if they use drugs and alcohol but where. "It may be that asking these questions will help identify those teens at risk for other developmental problems, she said. It's not just the fact that they are using the substances, but what's going on behind it, Halpern-Felsher said. Either they are lonely or there is depression or there is something going on at home. It could be that this is a marker for other behavioral and social problems that are going on," she said.

Young people who smoke are much more likely to abuse alcohol and use illegal drugs than non-smoking youth, according to a new report released Wednesday by the Canadian Centre on Substance Abuse.

The research report used data from the 2004 Canadian Addiction Survey and examined the association between tobacco use by 15- to 19-year-olds and the use of alcohol, marijuana and other drugs. The study found that the association is “very strong.” For example, 31 per cent of smoking youth under 20 reported using hard drugs such as cocaine, heroin, amphetamine, ecstasy or hallucinogens compared with only 3.5 per cent of non-smoking youth. Some of the report’s other key findings include:

The report does not say whether smoking necessarily leads to other drug or alcohol use. In other words, the study did not determine whether tobacco is a “gateway drug,” but it warns parents to be aware of the link between smoking and substance abuse.

“This research clearly shows that tobacco use among youth age 15 to 19 is a powerful and effective marker of other substance use and a good indication that these youth are engaging in other risky behaviour, such as hazardous drinking,” Rita Notarandrea, CCSA’s deputy chief executive office and director of research and policy, said in a release. She recommended that parents and educators start a dialogue with young smokers about their use of other drugs and drinking.

A little more than a quarter — 26.7 per cent — age 15 to 19 reported that they has smoked cigarettes at least occasionally in the year before the survey.

Excess of up to 165 calories day - about a can of soda - creates 'energy gap,' leading to overweight

It's no secret that American kids eat too much. Now, a new study provides some specific numbers that could help fight the obesity epidemic.

Over a 10-year period, the average child consumed up to 165 calories more than he or she needed each day -- the equivalent of an entire can of soda. And the fattest teens took in as many as 1,000 calories more each day than they needed -- almost as much as two Big Macs.

Many American kids are suffering from an "energy gap," in which they take in more calories than they burn through growth and daily living. And the trend won't be easy to reverse, said the study's lead author, Dr. Y. Claire Wang, a researcher at the Harvard School of Public Health. "Closing this energy gap in order to reverse the childhood obesity epidemic will require more than one single intervention, Wang said. Just panicking or just screaming about how bad the epidemic has become is probably not going to be enough."

An estimated one in three American kids is either obese -- a step beyond overweight -- or in danger of becoming obese, Wang said. And one in eight or nine children is actually obese. "A typical U.S. teen has gained an excess of 10 pounds over the body weight that is considered normal," Wang said. At the same time, teens haven't gotten taller.

In what is apparently the first study of its kind, Wang and her colleagues tried to determine just how much excess food children are consuming. They examined several federal studies and extrapolated the "energy gap" for different age ranges. From 1988 to 1994, children aged 2 to 7 consumed between 110 and 165 calories more than they needed each day, resulting in a weight gain -- not related to growth -- of almost a pound a year, the researchers found. The researchers also found that from 1999 to 2002, obese children 12 to 17 years old took in an average of 678 to 1,017 extra calories a day, amounting to an entire excess weight gain of 58 pounds.

What can be done?
"Prevention is the most important thing,"Wang said. Children "start having a small energy gap, then it becomes bigger over time. [We] need to start early and establish healthy habits. It requires more than just one strategy -- everyone has to participate, including the government, community, schools, families, and the food and beverage industries." As for specific strategies, research suggests that cutting TV viewing by an hour a day could reduce food intake by about 160 calories, Wang said.

Karen A. Donato is coordinator of the National Heart, Lung, and Blood Institute's Obesity Education Initiative, and she's familiar with the new study findings. She said the study shows that a relatively small number of calories over time can tip the energy balance toward overweight. "Parents in particular need to be aware as their children grow that they not consume excessive calories from large portions and sugar-sweetened beverages, and that they remain physically active and not watch a lot of TV, Donato said. A relatively small number of calories over time can tip the energy balance towards overweight. Doctors need to alert parents that they need to have healthy foods in their home and stay active with their children."

Inappropriate advertising contributes to many childhood ills, from obesity to anorexia, to drinking alcohol and having sex too soon, and Congress should crack down on it, the American Academy of Pediatrics says. The influential doctors' group issued a new policy statement in response to what it calls a rising tide of advertising aimed at children. The policy appears in this month's issue of Pediatrics, scheduled for release today. "Young people view more than 40,000 ads per year on television alone and increasingly are being exposed to advertising on the Internet, in magazines, and in schools," the policy says.

The objectionable commercials include those for sugary breakfast cereals and high calorie snacks shown during children's programs as well as those for Viagra and other erectile dysfunction drugs shown during televised sporting events.

The statement also criticizes alcohol ads that feature cartoonish animal characters, fast-food ads on educational TV shown in schools, magazine ads with stick-thin models and toy and other product "tie-ins" between popular movie characters and fast-food restaurants. These pervasive ads prompt children to demand unhealthy food and to think that drinking is cool, sex is a recreational activity and anorexia is fashionable, the academy says. Interactive digital TV, expected to arrive in a few years, will spread the problem, allowing youngsters to click on-screen links to Web-based promotions, the new policy says.

The academy specifically says doctors should ask Congress and federal agencies to:

The academy also says television ads for erectile dysfunction drugs should be shown only after 10 p.m. Critics of advertising restrictions claim a threat to free speech. But the academy notes that several Western countries, including Sweden, Norway, Denmark, Belgium and Greece, limit ads directed at children. "What kind of society exploits its children and teenagers for money? This is an example of where public health really has to trump capitalism," said Dr. Victor Strasburger, lead author of the policy statement and an adolescent medicine specialist at the University of New Mexico in Albuquerque.

Advertising aimed at children has come under scrutiny in recent years, particularly because of data showing that about 17 percent of U.S. children are obese.

Marg Oaten's daughter was a happy, healthy girl who loved table tennis and drama until at the age of 10 she developed anorexia. Twelve years on she is still fighting the illness, which almost killed her. "I was absolutely distraught, said Oaten, 54. It is the worst thing in the world to know your daughter might die." At her darkest point, Oaten said her daughter existed on five flakes of cereal a day, washed down with a mouthful of water.

Children as young as seven can suffer from eating disorders. The illness also afflicts older women as well as men and boys, though it is most common in young women, health experts say. In Britain, about five to ten percent of women aged 14 to 24 suffer from some form of eating disorder. The ratio falls to 1 percent for the whole female population, said Professor Janet Treasure, head of the eating disorders service and research unit at King's College London.

Bulimia nervosa, when a person binges and vomits, is two to five times more common than anorexia nervosa, when someone restricts their intake of food and drink, she said. Both psychiatric disorders, can be fatal -- two models from Latin America died this year after becoming anorexic -- or cause permanent health defects such as brittle bones and infertility.

For Oaten's daughter, who wanted to remain anonymous, the fear of changes to her body as she approached adolescence coupled with bullying at school drove her to stop eating. Her weight plunged and she ended up in hospital where she was treated as an inpatient and eventually allowed home. Two years later, however, she developed bulimia. Now, at 22, she has had surgery for a prolapsed bowel and still makes herself sick, but she is trying to get better, said Oaten, who has used her experience with eating disorders to set up a support group in Hull, northern England, to help others.

Children as young as 7 has anorexia
Doctor Jon Goldin, a consultant child and adolescent psychiatrist at Great Ormond Street Hospital for Children in London, said: "We see children here as young as seven or eight with anorexia but that is very rare." Asked why youngsters develop a problem with food so early on, he said: "One contributing factor is that maybe children are under more pressure now than they were 10 or 20 years ago and somehow childhood is being prematurely shortened."

A perception in society that thin is glamorous, compounded by images of waif-like celebrities in magazines, is another of the many factors that triggers anorexia and bulimia. But far from being sexy, the reality of the illness is lonely and desperate.

Victims say they secretly starve their bodies or binge and then vomit until there is nothing left but the taste of stomach acid on their lips. They often exercise obsessively and feel fat even when grossly underweight. "I hated the hunger and the cold and the tiredness, but the feeling of being able to control what I ate was brilliant," said Rebecca Slack, now 23, who became anorexic when she was 15 and dropped to five stone (32 kilograms).

Alison Alden, a married mother of three from southeast England, said starvation became a way of life when she was 43, prompted by a desire to lose weight at a time when she had been under pressure running a guest house. Over three years, she dropped from 8 stone 7 (55 kilograms) to less than 6 stone (38 kilograms), but felt: "This couldn't be anorexia because I had never been ill in that way and I was too old." Alden decided to get help for the sake of her family or she would die. She went to a doctor who diagnosed her as having anorexia fueled by depression. He prescribed her some anti-depressants that helped strengthen her resolve to recover.

For most sufferers, the first port of call is the doctor, who may refer him or her to an eating disorder unit at a hospital as an outpatient to receive advice on eating healthily as well as counseling to understand why the problem started.

There is no straight answer, but research has uncovered a likely genetic aspect that triggers the disorder when coupled with factors such as the onset of puberty, pressure from society to achieve, bullying and a low self-esteem, Treasure said. Among a range of warning signs is an obsessive interest in dieting and a reluctance to eat around others, said Goldin. It may take several years, but eating disorders can be cured and the faster they are spotted the greater the chance of recovery for people of all ages, the two experts said.

"It's all about having a reason to get better and building strategies to cope,"said Alden, now 47, who has written a book, Sleeping Dragons and Poppy Seeds, about her struggle.

A biological defect in the way blood flows in the brain rather than a psychological defect could be one reason why some people become criminal psychopaths, a new study shows.

Researchers from the Institute of Psychiatry, King's College London monitored the emotional responses of six men who had committed repeat offences such as attempted murder, rape with strangulation and grievous bodily harm. "We've never been able to look directly in the brain before and what we found is that when psychopaths were exposed to frightened faces the distress cue didn't increase the psychopath's blood flow. It decreased it," Declan Murphy, a professor of psychiatry at the institute, told Reuters. He added psychopaths might not stop their attacks because they may have learned to dampen their brain's response to other peoples' distress signals.

All six subjects scored highly on the Hare Psychopathy Checklist, a test which looks for the presence of cunning, manipulative or exploitative behaviors as well as lack of guilt or remorse. The results were published on Friday in the British Journal of Psychiatry. Their scans were compared to nine healthy volunteers who were also shown images of fearful, happy and neutral faces.

Tom Fahy, professor of forensic mental health and co-author of the study, said the condition may be inherited or acquired through very deprived and abusive childhoods. He added the findings of the study opened possibilities for new treatments other than counseling therapies and could be used to identify people who had a higher risk of re-offending.

"Psychopaths currently respond pretty poorly to treatment but this biological problem could be used as a marker for people who say they have recovered but actually haven't," Murphy said.

Children who start dating before their teens are at least twice as likely as other youngsters to become smokers, researchers said on Friday.

The link was particularly strong in preteen girls who are increasingly taking up the habit. "Kids who start dating early, about 11 or 12, are two to three time more likely to take up smoking by the time they reach 16, said Robert West, a professor of health psychology at University College London. They are between six and nine times more likely to begin smoking in their teenage years," he added in an interview.

West and his team believe the findings could fill in some of the missing pieces about what motivates preteens to experiment with cigarettes and how to discourage them. The results of the study published in the journal Addiction are troubling because most adult smokers started when they were adolescents and efforts to prompt them to quit, or to prevent children from starting, have had limited success.

Girls who started dating early were nine times more likely than their contemporaries to begin smoking by 13 years old. They also had three times the risk of being a smoker by the time they left school.

The risk was lower for boys. "This is particularly interesting because recent figures show that while the number of 14 to 15 year old boys admitting to smoking has nearly halved to a quarter, the number of girls of the same age who say they smoke has risen to nearly half," Jenny Fidler said, a co-author of the study, said referring to results from a British household survey.

Even when the researchers considered other factors that influence smoking such as whether parents and peers were hooked on the habit, ethnicity and deprivation, early dating was still an influence.

They suspect smoking and dating young could result from children wanting to act like adults. A desire to be popular and impress their peers could also be a factor. "The most likely explanation is that both of these (dating and smoking) reflect a tendency to think of themselves as, and to want to be, grownup, said West. If that is the case if offers us some clues as to what we might do to prevent kids from taking up smoking at this age," he added.

The findings of the five-year study are based on a survey of more than 2,000 British children.