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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 ...
March 2007
Is there an alternative to ADHD treatment?
FIFE'S addiction to giving drugs to kids with ADHD will turn a generation into addicts hooked on presciption medication. That's the controversial view of environmental campaigner Jan Martinez, founder of the Just Rural Development Trust. Along with former GP Morag Parnell from Women's Environmental Network, she blasted alarming figures which have revealed Fife tops the chart for using drugs to treat ADHD (Attention Deficit Hyperactivity Disorder) in youngsters.
NHS Fife is the largest single user of ADHD drugs with 179.98 prescribed items per 1000 population (aged five to 14) in 2005/06 – that's more than double the Scottish average of 82.56. An NHS Fife spokesman said figures are affected because Fife accepts patients from outside their catchment area and moved to reassure parents drugs used are safe.
Consultant paediatrician at NHS Fife Dr Chris Steer, also defended their stance and said there was "no evidence" medications used are addictive.
But Jan Martinez said alternative treatments must be found before a generation of young Fifers become hooked. She said: "We are really concerned about the over use of Ritalin and other prescription drugs and the lack of investigation. There has been research and there are alternative routes to dealing with ADHD. The authorities want Drug Tsars to combat problems with cannabis, heroin and crack but what about the prescription drugs? It's just as serious. Children are so trusting and are in the hands of supposedly educated adults. When these adults are dishing out these pills they are affecting youngsters right into adulthood. If push comes to shove and there is no other available alternative there should be strong support structures and measurement but I think using Ritalin or prescription drugs to treat ADHD is like putting a corn plaster over a burst artery."
Dilemma
Morag Parnell from the Women's Environmental Network (WENS) said: "It is
a real dilemma as to how to manage these children, drug therapy is far
from satisfactory with very undesirable effects. Much more has to be
done to understand and support them and their families.
"A major concern of WENS, and one that is not being given sufficient attention, is the role of environmental toxins in the causation of this condition. Wildlife and laboratory studies have found similar problems in exposed animals, and now some research is pointing to the probability that similar exposures are responsible in humans. Governments, and researchers should be doing everything they can to find out about these environmental toxins. Eliminating them and preventing this condition occurring in the first place is the only, and surely the right way to eventually deal with it."
NHS Fife confirmed all assessments and treatments are based on SIGN and NICE guidelines.
A recent review of ADHD services across Scotland identified a significant under-diagnosis and under-treatment of ADHD rather than the opposite. Dr Steer said: "Medications used for treatment of ADHD are not stand alone measures and are often used alongside educational and psychological treatments. 'There is absolutely no evidence they are addictive, and rather they have a protective effect in reducing rates of smoking, drinking and substance misuse in young people. Medicines used have been thoroughly researched and are very safe where appropriately prescribed offering relief for many children and families."
Cara Dodson
29 March 2007
http://www.fifenow.co.uk/ViewArticle2.aspx?SectionID=1015&ArticleID=2189571
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FDA suggests anesthesia a potential risk for children
Anesthesia can be harmful to the developing brain, studies on animals suggest, raising concerns about potential risks in putting young children under for surgery.
Food and Drug Administration scientists stressed today they have no evidence that anesthesia and sedation drugs, which have been commonly administered for decades, can cause brain damage in children. But numerous animal studies find that a majority of the drugs typically used to knock out children before surgery do kill brain cells in young rats, mice and — preliminary results suggest — rhesus monkeys.
"A safety signal has been identified in animals for many drugs used to provide sedation and anesthesia. This database is growing. The relevance of the animal findings to pediatric patients is unknown," Dr. Arthur Simone, an FDA medical officer, told experts gathered by the agency to discuss the issue.
Experiments on laboratory rats and other animals have shown that the drugs can lead to subtle but prolonged changes in behavior, including memory and learning impairments, according to a study published by FDA scientists this month in the journal Anesthesia & Analgesia.
Scientists don't know if those study findings apply to children. Nor have comparable human studies been done that might provide answers. Even detecting the effect of ketamine, halothane and other anesthetics on the central nervous system is difficult if not impossible in the young, according to the FDA. Unlike, say, fetal alcohol syndrome, there is no clear-cut collection of disorders associated with anesthesia exposure, said Dr. Bob Rappaport, head of the FDA's anesthesia office and one of the study's authors.
The FDA published the study and convened a public meeting to alert other experts to its concerns, as well as to update them on research and outline tentative plans for future studies.
Some drugs appear to cause more harm to animals than others, the FDA and other experts said. Furthermore, in some drugs both dose size and duration may affect the brain differently. And some combinations of drugs — like the triple "cocktail" of isoflurane, midazolam and nitrous oxide — may be more toxic to the brain than any one used individually. Still, panel members agreed unanimously that there isn't enough information to say any one drug or drug combination is safer than any other.
The animal studies suggest young animals are most susceptible to the drugs during the period of rapid growth of the brain. In humans, that period begins before birth, in the third trimester, and extends to about age 3. An estimated 600,000 children within that age range receive general anesthesia each year in the United States, including during operations to place ear tubes, repair hernias or stitch up serious wounds, said Dr. C. Dean Kurth, anesthesiologist-in-chief at Cincinnati Children's Hospital Medical Center.
Many of the operations performed on children are to save their lives or improve their quality of life. Since they're typically not elective, skipping or even delaying such surgeries would have its own risks, according to FDA officials. "We're certainly not looking at saying anesthesia should not be used on children," Rappaport told The Associated Press, adding that it's generally considered one of medicine's greatest advances. Nor are there any good alternatives to the current menu of anesthetic drugs, experts said. And surgery ethically cannot be performed without anesthesia.
"These findings have potentially important public health implications, and pose a therapeutic dilemma for physicians," said Dr. John Olney, of Washington University School of Medicine. "You don't come in for anesthesia. You come in for something else, and you can't not have it. And not having surgery can have more far-ranging consequences than what the panel's talking about," said Kurth, who's also a spokesman for the American Society of Anesthesiologists. He pointed out that anesthesia in some heart and other surgeries can protect the brain by making it more resilient to decreased levels of oxygen in the blood.
In the short term, Olney recommended studying in animals the potential risk to the developing brain of all anesthetic drugs used singly and in combination. Only those with the widest safety margins then could be used in children. Longer term, Olney suggested developing drugs that could be given with anesthesia to blunt its cell-killing effect.
When asked how the animal findings would affect how they treat children, several panel members recommended delaying surgeries in the very young when possible, even if only for a few months. Others recommended moderation. "Once you give it, you give it, so try to get away with giving as little as you can," said Dr. Athena Zuppa of Children's Hospital of Philadelphia.
Andrew Bridges
29 March 2007
http://www.chron.com/disp/story.mpl/nation/4673065.html
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Aggressive action needed to battle child obesity
More Canadian children are overweight and for the first time the country's younger generations are expected to live shorter lives than their parents due to obesity, says a new Commons committee report released Tuesday.
Committee MPs said they were “shocked” to learn about the increase in overweight children — from 12 per cent to 18 per cent — and obese children — from three per cent to eight per cent — between 1978 and 2004. That makes about one in four Canadian children overweight or obese. The report said parents must be in denial as a Canadian Medical Association survey found only nine per cent report they have a child who is at least somewhat overweight.
The health committee called Tuesday for aggressive measures to halt child obesity, and said they share fears of experts that “today's children will be the first generation for some time to have poorer health outcomes and a shorter life expectancy than their parents.” Highlights of recommendations are a ban on trans fats as advised by a federal task force; use of a mandatory, simplified, standardized food labelling system; and designation of federal funds to build or replace aging playgrounds, sidewalks, rinks, pools and other community exercise spots across the country.
The report said most Canadian children spend too much time in front of TV and computer screens; don't get the expert-recommended 90 minutes a day of exercise; eat too much fat and junk food; consume too many sugary drinks and don't eat the recommended five daily servings of fruit and vegetables.
The committee also reported the “distressing” and “most alarming” number of 55 per cent of First Nations children living on reserves and 41 per cent off reserves are overweight or obese. There is so much poverty among First Nation and Inuit people that many people cannot afford nutritious food, especially in remote northern communities, the report said. And of more than 500 First Nations schools, only half have a gym.
The health committee proposed Canadians take up a national challenge to halt a 30-year rise in overweight children in just three years — by the 2010 Olympic games in Vancouver. Then targets to reverse the trend could kick in. “It is ambitious but it is doable,” committee chairman Rob Merrifield, an Alberta Conservative MP, told a news conference. “For the first time in recorded history, our younger generations are expected to live shorter lives than their parents due to obesity,” he said in a prepared statement. “New and aggressive action is required to address this complex, and ultimately very costly, problem.”
The report was welcomed by the Heart and Stroke Foundation, which has long warned “fat is the new tobacco,” and by the Canadian Medical Association. Foundation chief Sally Brown said overweight children are on “a fast track” to developing hypertension, heart disease and stroke.
New Democratic Party MP Penny Priddy said by chronicling links between poverty, poor diet and lack of exercise, the report busts a myth that overweight children all sit around playing on computers and watching TV. She cited the example of children in poor families being fed “Kraft Dinner” instead of going to bed hungry. Kraft Dinner is a brand of macaroni and cheese, an inexpensive food. Expressing concern that the committee would get into trouble with the Kraft corporation, Merrifield said “I love Kraft Dinner.”
The report said on average, adolescents in Canada spend almost 35 hours a week in front of a TV or computer screen — more time than in the classroom over the course of a year. Studies had shown the less time in front of a screen and the more activity, the less weight.
The committee also postponed a decision on a possible ban on food advertising to children, saying it would assess the impact of self-regulation in Quebec, Sweden and other jurisdictions in a year before deciding on the issue.
Bloc Quebecois MPs issued a dissenting report, saying the Quebec government already has a well-defined strategy to deal with juvenile obesity and that the federal government should stick to its own jurisdiction in health, which is confined to First Nations and Inuit people.
CanWest News Service
27 March, 2007
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Sex behaviour predictable from nine
Sexually risky and promiscuous behaviour in teenagers can be predicted in children as young as nine, new research shows.
A study which tracked children for the first 16 years of life has found a clear link between aggressive and delinquent behaviour in children and adolescents who have frequent, unprotected sex. "It seems you can predict very early on, as young as nine, if children are more likely to become risky and promiscuous sexually as young teenagers," said Australian researcher Melanie Zimmer-Gembeck from Griffith University. "That means there's a much longer pathway to sexual risk-taking than we thought."
The researcher was part of a US team that followed 167 young people to gauge the level of risky sexual activity, and to find out how it can be predicted.
At 16 years old, 60 per cent had had sex, with half considered "low risk" because they'd had few partners and reported always using contraception. These teens were very similar to the sexual abstainers, except they looked more physically mature, had closer bonds with their friends and were more inclined to drink alcohol, Dr Zimmer-Gembeck said.
The other half of the sexually active US teens - 25 per cent - said they had had five partners or more and rarely used protection, putting them at high risk of sexually-transmitted disease and pregnancy.
The study, published in the Journal of Research on Adolescence, found that these so-called high-risk teens had a long and clear history of family and behavioural problems. "Kids with risky sexual behaviour at 16 were already showing signs of aggression and delinquency problems at age nine," Dr Zimmer-Gembeck said. "That means that back this far we can predict whether they're likely to be an inconsistent contraceptive user and have a lot more sexual partners in adolescence."
The researcher said the same study carried out in Australia would draw very similar results for sexual activity."We've got lower rates of early pregnancy but higher rates of sexually transmitted diseases so I'd imagine the risk-taking rates are probably the same too," she said.
Source: Journal of Research on Adolescence
22 March 2007
http://www.news.com.au/dailytelegraph/story/0,22049,21422474-5006007,00.html
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Small children need to have fun
A note of caution should be sounded about government plans to improve services for primary school pupils and the under-fives. First, ministers launched the foundation stage curriculum - an attempt to ensure that childminders and nurseries are providing enough stimulation for the children in their care. Most of the newspaper headlines concentrated on the need for early years staff to look out for whether babies (aged 0 to 11 months) were communicating effectively.
However, there is a more serious point to the Government's proposals. It wants to make sure that parents can be confident that any early years setting they choose for their children is of a sufficiently high standard. The danger is that that the plans will create a tick-box mentality among staff because they will have to check children in 13 areas on a nine-point scale before their transfer to primary school. That is likely to mean less accent on fun and play for the children, possibly making their time at pre-school less enjoyable. The Government, therefore, needs to lighten up on the amount of assessment it expects from staff.
On the second announcement that the gifted and talented programme - whereby the top 10 per cent of pupils are singled out by teachers for special "master-classes" to stretch their ability - is to be extended to primary schools, a further warning is needed. Under the plans, teachers will be choosing pupils for special attention from the moment they start primary school at the age of four or five. It is true that gifted children can often become bored with the curriculum because not enough time is spent on meeting their needs.
The Government must remember that four-year-olds who fail to show talent may have been deprived of a stimulating environment at home before starting school. They are just as much deserving of special attention as those earmarked to succeed in education - if not more so. There is a danger of creating a feeling among them that they are not going to succeed, which could lead to them switching off education. Moreover, it is extraordinarily difficult to assess ability in very young children. They develop at different rates. Some learn to read young, a sign of intelligence, but others don't. Are the latter going to be written off because they were slow to learn to decode words?
Leading article
23 March 2007
http://education.independent.co.uk/schools/article2379005.ece
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Youth drug 'link to schizophrenia'
Using cannabis under the age of 18 greatly increases an individual's chance of developing psychosis, it has been claimed. According to mental health charity Rethink, at least five international studies have found cannabis use at this age doubles the risk of mental illness.
Some research suggests that those who have used cannabis more than 50 times have six times the usual risk of developing schizophrenia, the charity says.
A spokesman for Rethink said: "We now know that cannabis can be a trigger for mental health problems and smoking it under the age of 18 can double people's chances of developing psychosis. "The Government must invest in a wide-scale public health campaign so that young people know cannabis is not risk-free."
Rethink, in a recently published article, says that for those with severe mental illness, using cannabis greatly reduces your chances of getting better. It claims that smoking cannabis at any age is associated with mental health problems. And according to the charity, two studies have estimated that 13% of schizophrenia could be averted if all cannabis use were prevented.
One study suggested 50% of the most serious cases could be avoided.
Rethink are hoping the Government will launch a campaign in Britain on cannabis, similar to the current one on smoking.
PA News
21 March 2007
http://www.channel4.com/news/articles/society/health/youth+drug+link+to+schizophrenia/325077
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Secret to slim kids? Just a little running around
Just 15 minutes a day of kicking around a ball or swimming might be enough to keep children from becoming obese, British and U.S. researchers said on Monday. A study of 5,500 children who agreed to wear a motion sensor device showed that those who exercised more were less likely to be obese -- and that short bursts of intense activity seemed to be the most helpful.
Children who did 15 minutes a day of moderate exercise -- equivalent to a brisk walk -- were 50 percent less likely than inactive children to be obese, the researchers reported in the Public Library of Science journal PLoS Medicine. "Our data suggest that higher intensity physical activity may be more important than total activity," Andy Ness of the University of Bristol and colleagues wrote.
"This study provides some of the first robust evidence on the link between physical activity and obesity in children," Chris Riddoch of Britain's Bath University, who worked on the study, said in a statement. "We know that diet is important, but what this research tells us is that we mustn't forget about activity. It's been really surprising to us how even small amounts of exercise appear to have dramatic results."
Obesity is on the rise in many countries, including the United States, where 60 percent of the population is overweight or obese, Britain and elsewhere in Europe. It is clearly a matter of people eating more calories than they burn off, but experts cannot agree whether diet or exercise is more important -- and which kind of exercise might be best.
Ness' team studied 5,500 children, with an average age of 12, who with their mothers have been taking part in a larger, long-term study of health. The children agreed to wear a device called an accelerometer, which measures total activity, and they had X-ray scans for body fat. The researchers rated the children with the top 10 percent levels of fat mass as obese. The less the children exercised, the more likely they were to be obese, the study found.
"These associations suggest even a modest increase of 15 minutes moderate and vigorous physical activity might result in an important reduction in the prevalence of overweight and obesity," the researchers wrote.
The study is available on the Internet at http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040097.
20 March 2007
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Kids with mental illness often rejected socially
Research suggests that a "substantial minority" of American adults are reluctant to let their children interact with children who suffer from depression or attention deficit hyperactivity disorder. About one out of five parents would not want these children as neighbors, in their child's classroom, or as their child's friend, report Jack K. Martin and colleagues from Indiana University in the Journal of Health and Social Behavior. Older children and boys with mental conditions are most likely to be rejected.
This troubling pattern, the investigators report, appears to result from perceptions that a mentally ill child may be "dangerous."
"If, as it seems, the 'mental illness' of either children or adults signals danger to the public, this barrier must be addressed by future political, legal, and research agendas," according to Martin and colleagues.
The research stems from interviews with more than 1,100 adults as part of the General Social Survey administered by the National Opinion Research Center. The interviewees were given descriptions of children of various ages with asthma, attention deficit hyperactivity disorder, depression or "normal" ups and downs of childhood.
Levels of rejection for children with depression and ADHD were two to three times higher than those reported for children with asthma or "normal" childhood troubles.
The results showed that almost 30 percent of parents said they would not like their child to become friends with a child who was depressed and more than 18 percent wouldn't want to live next door to a family with a depressed child. Roughly 23 percent of parents said they preferred that their child not make friends with a child with behaviors consistent with ADHD and 22 percent wouldn't want to live next door to a family with a child with ADHD.
"In line with the 1999 Surgeon General's report on mental illness, our analyses point to continuing barriers to public acceptance," note the report's authors. "While not as significant an obstacle as the rejection of adults, social distance does reflect stigma surrounding children's mental health problems." They hope a greater understanding of the roots of this stigma will lead to effective efforts to confront the persistent lack of social acceptance of the mentally ill.
SOURCE: Journal of Health and Social Behavior, March 2007.
19 March 2007
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First UK study to determine how general practice professionals can tackle adolescent obesity
Academics at the University of Hertfordshire are conducting the first UK study to investigate how health professionals based in general practice can help adolescents who are obese to lose weight. The study which the University has announced during Obesity Awareness Week, and will be conducted over a three-year period, will survey GPs and practice nurses working in general practices in Hertfordshire and Bedfordshire regarding their current practice towards adolescents who are obese. It will look at their attitudes towards and potential barriers to giving weight management advice to young people and their awareness of and opinions on existing guidelines.
Ms Josefine Magnusson at the University's Centre for Primary and Community Care (CRIPACC) said: "A search of the existing literature found no UK-based studies on how this issue is managed in general practice. Much of the research on obesity and overweight young people has focused on younger children rather than adolescents and few studies have been done in the UK."
The study will go on to interview a sub-sample of the health professionals surveyed in order to gain a more in-depth perspective of the weight management services they offer to young people.
During the later stages of the study, adolescents (aged 13-16) who are obese will be interviewed about their experiences with such services and the associated potential barriers and facilitators. The parents of those adolescents will also be interviewed on their experiences of, and/ or attitudes towards, general practice as a setting for weight management advice for young people.
Ms Magnusson commented: "The outcomes of this research will illuminate what current practice of dealing with obese adolescents in general practice is; what the potential barriers for implementing general practice-based interventions might be, and a health professional and young person's perspective on how these services can best be utilised. It is unlikely that any general practice-based interventions aimed at helping obese adolescents to lose weight will be successful before these points are fully investigated."
Source: Hertfordshire University
18 March 2007
http://www.medicalnewstoday.com/medicalnews.php?newsid=65461
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Huge increase in cases of diabetes among children
The number of very young children with diabetes has risen dramatically in 20 years, research suggests. The number of children under five who have had the type 1 form of the condition diagnosed increased five-fold between 1985 and 2004, suggesting that the environment in which babies are brought up could have dire consequences for their future health.
The exact causes of type 1 diabetes are unknown, although there is evidence that it might be at least partly inherited.
But the number of under15s with the condition almost doubled during the course of the study to an average of more than four cases per thousand children. The researchers said that the rise was too steep to be linked purely to genetic factors and concluded that the environment must be playing a part. Their findings lend further weight to the “hygiene hypothesis”, which links the rise in some illnesses to the inability of children’s immune systems to cope with infection because modern environments are too sterile.
The chances of developing type 1 diabetes, formerly known as insulin-dependent diabetes, are higher if a family member has the condition. Type 1 is different from type 2 diabetes, which affects people later in life and is linked to life-style factors such as obesity. Of the estimated two million diabetics in Britain, about 250,000 suffer from type 1, including at least 20,000 children of school age, according to the charity Diabetes UK.
Lauren Shehan, 10, from Walthamstow, northeast London, had diabetes diagnosed aged 3 after she became ill without warning and lapsed into a coma while on holiday with her parents in Majorca. The only child in her school with type 1 diabetes, she now injects herself with three doses of insulin a day and attends regular clinics every three months. Her mother Ann, 39, said: “Lauren is a popular, happy girl who enjoys PE and doesn’t let her diabetes bother her. But she had a rough time with illness when she was younger, and hearing that it could be the result of the surroundings in which she was brought up is frankly shocking.”
The study, carried out by a team at the University of Bristol and funded by Diabetes UK, suggested that there was a 4.4 per cent increase each year since 1985 in the number of children in whom type 1 diabetes had been diagnosed.
Polly Bingley, who carried out the research and is due to present the findings to the Diabetes UK annual conference in Glasgow today, said: “The incidence of childhood type 1 diabetes has been shown to be increasing all over Europe, particularly in the very young. “Although the chances of developing diabetes are still low and depend on the hand of cards someone is dealt in terms of genetics, the increase is very worrying and too steep to be put down to genetic factors alone. It must also be due to changes in our environment.
“This could either mean that we are being exposed to something new, or that we now have reduced exposure to something that was previously controlling our immune responses.” If the immune systems of babies were not challenged by infections in early life they might lose the ability to regulate themselves, and attack the body’s own insulin production system instead, Dr Bingley added.
Simon O’Neill, a spokesman for Diabetes UK, said: “The evidence of a steep rise of type 1 diabetes found in the underfives indicates that the peak age for diagnosis of the condition in the UK is becoming younger. Whilst 10 to 14-year-olds remain the largest group for diagnosis, the rise in cases found in children under five is worrying.” Dr Bingley added: “The changes which cause diabetes may occur four or five years before symptoms are noticed, so the environment in which very young children are being brought up could have a serious effect on their future health.”
David Rose
16 March 2007
http://www.timesonline.co.uk/tol/news/uk/health/article1522618.ece
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Major study shows many medications given to children tested only for adults
A major study finds that 80 percent of children in U.S. hospitals receive medication that has been tested and approved only for adults. This often leaves pediatricians to a potentially dangerous assumption that if a drug works for adults, it will also be safe for children.
VOA's Carol Pearson has more on the study and its implications.
When parents entrust their sick children to a hospital staff, Dr. Daniel Benjamin of Duke University says most parents are unaware of this disturbing fact. "Most of the time when we're treating children, we don't know if we have the right drug, how safe it is, and what the right dose is."
Dr. Benjamin says he thinks about this every time he prescribes a medication for a child. "Regularly, I worry, 'Is this product going to do more damage to this child? Is this product going to do more harm than the disease is doing?' "
A study by Children's Hospital of Philadelphia concludes that nearly four out of five hospitalized children in the U.S. receive medications tested only for adults. While the study only looked at medicine prescribed in hospitals, Dr. Samir Shah, the study's lead author says outside the hospital, the same is true: children receive the same medicines adults receive.
Another pediatrician at Children's Hospital of Philadelphia, Dr. Peter Adamson, points out that children and adults can react to drugs much differently. "The changes in muscle, bone, water, protein, fat, all could impact what happens to a drug."
The study shows that the consequences can be serious or even deadly. Doctors often have no other choice but to prescribe these medications, especially for critically ill children.
The U.S. Food and Drug Administration has taken steps to encourage pharmaceutical companies to increase the number of drugs tested for children. The authors of the children's study call for even more information to be gathered on medications that are commonly prescribed for children but not tested for them.
Carol Pearson
13 March 2007
http://www.voanews.com/english/2007-03-13-voa30.cfm
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Eating-disorder education shows unintended effects
Teaching teenagers about eating disorders can make them more knowledgeable about the problem, but it may also have some inadvertent effects, a new study suggests. Yale University researchers found that when they presented female high school students with videos on eating disorders, it met the intended goal of boosting their knowledge about anorexia and bulimia. However, the team saw that the students didn't necessarily find the results of eating disorders unappealing. Teens who watched a video featuring a woman recovering from an eating disorder became more likely to view girls with eating disorders as "very pretty," and some thought it would be "nice to look like" the woman in the video.
The findings suggest that more research should go into the unintended effects of eating disorder education before such programs are widely used, the researchers conclude in their article in the International Journal of Eating Disorders. "It seems intuitively appealing to have recovered patients get up in front of high school or college-aged girls and tell the story of their eating disorder and recovery," lead study author Dr. Marlene B. Schwartz told Reuters Health.
However, she explained, there's also the argument that having an attractive, articulate woman talk about her eating disorder could inadvertently "glamorize" the condition.
To investigate the question, Schwartz and her colleagues had 376 female high school students view one of two videos on eating disorders. Both videos were the same, except for the "presenter." In one video, the presenter was a young woman identified as a doctor, who told the story of a typical eating disorder patient; in the other, the woman was a "recovered eating disorder patient" who described her personal experience.
The students completed questionnaires before and after the video.
Overall, the study found, both videos increased the girls' knowledge about anorexia and bulimia, but there were some unforeseen results as well. Regardless of which video they saw, the girls were more likely to say afterward that "it's not that hard" to recover from an eating disorder. They were also more likely to believe girls with eating disorders have "strong" personalities.
Girls who viewed the video featuring the eating disorder patient were particularly likely to see women with anorexia or bulimia in a positive light. "Depending on your point of view, that may or may not be a good thing," Schwartz said. It can be positive if it minimizes the stigma of eating disorders, she and her colleagues note, or negative if it glamorizes the problem.
Schwartz said she recommends that schools address eating disorders by promoting healthy eating, exercise and positive body image, and discouraging "weight bias" and teasing based on physical appearance. "The best way for schools to help prevent eating disorders is to create a nurturing environment that automatically promotes healthy behaviors," she said.
SOURCE: International Journal of Eating Disorders, March 2007.
Amy Norton
9 March 2007
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US scheme provides cure for tackling unruly children
The scourge of antisocial behaviour among young people could be reversed by teaching their parents how to raise their offspring, researchers claim.
Psychologists in Wales have shown that helping parents to build relationships with children who are overly aggressive, demanding and disobedient, significantly reduces the risk of their developing behavioural disorders and falling into crime, drug abuse and violence as teenagers. As many as one in 10 children aged from five to 15 has clinically significant behavioural problems and if left untreated, 40 per cent will end up as delinquent teenagers.
The scheme, imported from America, has been so successful it is being rolled out across Wales and to six authorities in England. Called Incredible Years, it involves teaching parents to listen to their children, praise and reward good behaviour, set rules and impose discipline.
The finding is an embarrassment to ministers whose Sure Start programme launched in 2001, which has cost more than £3bn, has failed to show any effect on reducing behavioural problems in children. Sure Start offered help to parents in socially disadvantaged areas but much of it had not been tested in trials and an interim report last year found " no significant effect in preventing or reducing conduct disorder.
The Incredible Years programme, developed in Seattle 30 years ago, was implemented by Sure Start staff in 11 centres in North Wales over two and half years. More than 150 parents took part who had been identified by health visitors as having problem children aged between three and four.
Judy Hutchings of the University of Wales psychology department, who led the study, published on BMJ Journals Online, said: "The Government must deliver programmes known to work and resource them."
Jeremy Laurance
9 March 2007
http://news.independent.co.uk/uk/health_medical/article2341340.ece
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Stress may 'damage child brains'
Extreme stress can trigger PTSD High levels of stress may physically scar a child's brain, a study suggests. US scientists discovered a brain structure involved with memory and emotion had shrunk in children with post-traumatic stress disorder (PTSD).
A withered hippocampus may make a child less able to deal with stress and raise anxiety, Pediatrics journal reports.
The children in the study also had higher blood levels of a stress hormone called cortisol, which has been shown to kill hippocampal cells in animals. This could set up a vicious cycle, where high cortisol causes more hippocampal damage, which in turn raises the anxiety.
The Stanford University Medical Center scientists speculate that the ensuing damage could prolong the stress symptoms and also interfere with therapy. Lead researcher Victor Carrion explained: "One common treatment for PTSD is to help a sufferer develop a narrative of the traumatic experience. But if the stress of the event is affecting areas of the brain responsible for processing information and incorporating it into a story, that treatment may not be as effective."
Extreme stress
He said stress had to be extreme to cause the damage. "We are not
talking about the stress of doing your homework or fighting with your
dad," Dr Carrion said. The 15 children he and his team studied all had
PTSD as a result of physical, emotional or sexual abuse, witnessing
violence or experiencing lasting separation and loss. Dr Carrion said it
would now be important to understand why some children appear to be more
resilient to stress than others, and what the long-term effects of
extreme stress are.
Experts already know a person's genes and environment play a role, and that having PTSD as a child increases the risk of depression and anxiety in adulthood. It is estimated that up to 1 in 10 people may develop PTSD at some stage in life.
Professor Joe Herbert, professor of neuroscience at Cambridge University, said: "There is increasing evidence that adversity in early life can have long-lasting results on subsequent mental and physical health, and that at least some of these associations are the result of changes in the secretion of cortisol. "The major question is whether the smaller hippocampus is a predictor of PTSD or a consequence."
He said a study in war veterans with PTSD suggested a smaller hippocampus predisposes to PTSD, not the other way round.
http://news.bbc.co.uk/2/hi/health/6411351.stm
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"Dissonance" therapy aids eating disorder symptoms
Group therapy using a technique based on the theory of "cognitive dissonance" may help young women at risk of eating disorders, new research suggests. The study included 93 college women who responded to a call for women who were not satisfied with their bodies. Both interventions lasted about 6 weeks.
The researchers found that group therapy, once-weekly for 6 weeks, relieved some of the students' body dissatisfaction, unhealthy eating habits and symptoms of anxiety.
The other approach that was used -- yoga -- failed to spur any improvements, according to findings published in the International Journal of Eating Disorders. However, the researchers note that 6 weeks was a relatively short period to learn yoga, and previous studies that found a relationship between yoga and a reduction in eating disorder symptoms included women who practiced yoga for about six years.
The problem of "disordered eating" is common among college women. Though they fall short of an official eating disorder diagnosis, these women suffer from body dissatisfaction and fear of gaining weight, and often use unhealthy weight control measures like fasting, vomiting and laxative and diuretic abuse. Many go through cycles of binge-eating.
The idea of dissonance-based therapy is to address a person's "competing ideas," explained lead study author Karen S. Mitchell of Virginia Commonwealth University in Richmond. An example would be women who are unhappy with their body size, but know that society's "ideal" for the female body is unhealthy. The therapy involved group discussions that focused on topics like the negative consequences of the "thin-ideal" and media images of women. At the end of the study, the women showed improvements in measures of body image, unhealthy eating and weight-control habits, and anxiety.
The results are encouraging, Mitchell told Reuters Health. Similar group meetings, she said, could be offered on college campuses to help female students with body-image and eating issues. Women with full-blown eating disorders would need more intensive therapy, however, Mitchell noted.
Unlike the dissonance-based therapy, she noted, the yoga classes were not specifically geared toward body image and unhealthy dieting. Among the goals of yoga are a calmer mind and self-acceptance, but that addresses disordered eating in a much more "indirect" way than the dissonance-based therapy did, Mitchell and her colleagues point out.
More research, Mitchell said, should continue to look at the effects of yoga on body dissatisfaction.
SOURCE: International Journal of Eating Disorders, February 2007.
2 March 2007
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Schizophrenia may block the music in speech: study
Maggie Fox People with schizophrenia cannot hear false notes in music as well as healthy people do, and often cannot make out important tones that convey meaning in speech, U.S. researchers reported on Thursday. They now want to see if their findings could lead to new ways to treat the disease, either with drugs, therapy or both.
"People have been assuming that patients are experiencing the world normally and not processing the information correctly," Dr. Daniel Javitt, a psychiatrist and neuroscientist at the New York University School of Medicine in Orangeburg, New York, said in a telephone interview. "We show they are not experiencing the world normally. They don't read social cues. They can't read facial expressions. They can't tell by tone of voice what emotion a person is showing."
Their tests on 19 adults with schizophrenia and 19 similar people without the condition showed clear differences, both when assessed using quizzes and looking inside the brain using magnetic resonance imaging, or MRI. "They can't use pitch -- they just don't hear those pitch changes. Not only do they not get emotion, they don't get whether it is a question or a statement. And what we show in the paper is that these sensory abnormalities are driven by structures in the brain, in the connections between the brain stem and the auditory cortex," Javitt said.
Javitt said the findings, published in the March issue of the American Journal of Psychiatry, might help explain why people with schizophrenia often have poor social skills even before they begin to show symptoms of the disease. "If we could detect it early and start remediating and start having patients practice, we could hopefully preserve and restore these pathways," Javitt said.
Schizophrenia occurs in about 1 percent of the population everywhere. It is far more common in men than in women and is usually diagnosed in late adolescence or early adulthood. But some studies have shown that when the school records of adults with schizophrenia are examined, they showed poor social skills early on. "They do tend to have been the most socially disturbed," Javitt said. His study may help explain it.
"In our behavioral battery, we did a range of tests including the distorted tunes test. You take a common tune and change a note to see if people can tell you if the note has been changed," Javitt said. "Then we did another test where we played recorded voices from actors that express different emotions and we asked people to identify the different emotions. We showed that people who had the worst musical abilities were the ones that did worst on the emotions test."
Javitt wants to find out if there is data on whether professional musicians might be protected from schizophrenia, and would like to see if musical training might be protective.
Another important study would be to see how schizophrenia affects people who speak languages in which tone is even more important than it is in English, such as Chinese or Vietnamese.
Schizophrenia affects 3.2 million Americans. It is characterized by hallucinations, delusions and disordered thinking. While antipsychotic drugs can help, they do not cure the mental illness and cause unpleasant side-effects, including sometimes dangerous weight gain.
Source: American Journal of Psychiatry
Maggie Fox
1 March 2007
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Overuse sports injuries often seen in kids
Today's overachieving kids are starting sports earlier and training longer and harder, often before they enter Kindergarten, and many of them are suffering overuse injuries as a result, according to Dr. Lyle Micheli.
Micheli is director and co-founder of the world's first sports medicine clinic for children located at Children's Hospital Boston. "Overuse injuries result from overtraining," Micheli said. "Certainly, as the volume of training increases, the risk of injury increases." Twenty years ago, he noted in an interview with Reuters Health, "we didn't see overuse injuries in kids, but today we do."
Micheli said he sees about 300 kids each week in his sports medicine clinic and "60 to 70 percent of the injuries are overuse injuries. Twenty-years ago, it was quite the opposite. It was mostly acute injuries, not overuse injuries."
Children who participate in individual sports like gymnastics, tennis, and swimming, where they typically put in more hours of training, are particularly at risk, Micheli said. For children in these sports, "we see stress fractures and even tendonitis, which is unusual in children."
Young baseball pitchers with injuries to their pitching arm are also seen. "Today's young pitchers are throwing harder and earlier and some may 'just play through it' when the arm is sore, which makes it worse and may lead to permanent damage," Micheli warned. He urges parents and coaches to be sensitive to changes in performance and attitude in young athletes -- changes that may signal overtraining and burn out and may come before the actual physical injury.
Often a young athlete will push himself or herself to train harder and longer for the coach. "To a 10-year-old, their coach is God," Micheli noted.
Micheli thinks it's time for "mandatory safety education and maybe even certification" for coaches of school-age children. "We have a whole cadre of well-meaning volunteer coaches out there and they have variable levels of knowledge including the sports they are dealing with," he said. "If we were to do one thing to have an impact and improve the safety of kids' sports," Micheli said, "it would be coaching education and certification. Some sports are moving toward this, like soccer, where in some places you can coach for one year and after that you have to take the coaching course."
Megan Rauscher
1 March 2007
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