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Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users

April 23, 2014 Comments off

Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users (PDF)
Source: Neurobiology of Disease

Marijuana is the most commonly used illicit drug in the United States, but little is known about its effects on the human brain, particularly on reward/aversion regions implicated in addiction, such as the nucleus accumbens and amygdala. Animal studies show structural changes in brain regions such as the nucleus accumbens after exposure to9-tetrahydrocannabinol, but less is known about cannabis use and brain morphometry in these regions in humans. We collected high-resolution MRI scans on young adult recreational marijuana users and nonusing controls and conducted three independent analyses of morphometry in these structures: (1) gray matter density using voxel-based morphometry, (2) volume (total brain and regional volumes), and (3) shape (surface morphometry). Gray matter density analyses revealed greater gray matter density in marijuana users than in control participants in the left nucleus accumbens extending to subcallosal cortex, hypothalamus, sublenticular extended amygdala, and left amygdala, even after controlling for age, sex, alcohol use, and cigarette smoking. Trend-level effects were observed for a volume increase in the left nucleus accumbens only. Significant shape differences were detected in the left nucleus accumbens and right amygdala. The left nucleus accumbens showed salient exposure dependent alterations across all three measures and an altered multimodal relationship across measures in the marijuana group. These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix of core reward structures and is consistent with animal studies of changes in dendritic arborization.

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Pet Dog Ownership Decisions for Parents of Children With Autism Spectrum Disorder

April 23, 2014 Comments off

Pet Dog Ownership Decisions for Parents of Children With Autism Spectrum Disorder (PDF)
Source: Journal of Pediatric Nursing (pre-publication dissertation)

This study compared the social skills of children wit h Autism Spectrum Disorder who lived with dogs and those who did not live with dogs. Interaction with dogs was investigated in this population, along with the attachment of those children who lived with dogs. This cross – sectional, descriptive study was conducted using a telephone survey. Seventy caregivers rated their child using the Social Skills Improvement System Rating Scale, and responded to open – ended questions regarding their child’s interaction with dogs. Children living with dogs completed the Companion A nimal Bonding Scale . Two – sample t – tests were used for comparison of children with and without dogs. Thematic analysis was used to evaluate the qualitative data. In seven of eight social skill areas, the mean social skill scores of children with dogs were greater than for those without dogs . Eighty – nine percent of parents with dogs described their child as “ very attached ” and children reported high bonding to their dogs using the CABS. Parents indicat ed the benefits of dog ownership for their child with ASD were companionship, unconditional love and responsibility opportunities. The findings suggest that dog ownership may be beneficial for some children with ASD.

The Association for University and College Counseling Center Directors Annual Survey (Reporting period: September 1, 2012 through August 31, 2013)

April 22, 2014 Comments off

The Association for University and College Counseling Center Directors Annual Survey (PDF)
Source: Association for University and College Counseling Center Directors

Anxiety continues to be the most predominant presenting concern among college students ( 46.2%; up from 41.6% in 2012 ), followed by depression ( 39.3%, up from 36.4% in 2012 ), and relationship problems (35.8% , unchanged from 2012 ). Other commo n concerns are suicidal ideation ( 17.9%, up from 16.1% in 2012 ), alcohol abuse (9.9% , down from 11% in 2012 ), and sexual assault ( 7.4%, down from 9.2 % in 2012 ).

Recent Declines in Adolescent Inhalant Use

April 18, 2014 Comments off

Recent Declines in Adolescent Inhalant Use (PDF)
Source: Substance Abuse and Mental Health Services Administration

+ In 2012, almost 650,000 adolescents aged 12 to 17 used inhalants in the past year.

+ Past year inhalant use among adolescents generally has been declining since about 2006; most recently, rates decreased from 3.3 percent in 2011 to 2.6 percent in 2012.

+ Rates of past year inhalant use among adolescents decreased between 2011 and 2012 for several demographic groups, including males, whites, those living in the Northeast and West, and those living in metropolitan areas.

Barriers to Psychiatric Care among Military and Veteran Populations in the US: The Effect of Stigma and Prejudice on Psychological and Pharmacological Treatment

April 18, 2014 Comments off

Barriers to Psychiatric Care among Military and Veteran Populations in the US: The Effect of Stigma and Prejudice on Psychological and Pharmacological Treatment
Source: International Journal of Advances in Psychology

This paper addresses the importance of understanding veterans’ individual beliefs and the effects of stigma on pharmacological and psychological treatment among active military personnel and veterans. The discussion can assist treating clinicians in reducing barriers to treatment and increasing compliance with effective psychological and pharmacological interventions for this population. The author has conducted more than 3000 interviews with veterans from World War II (WWII), the Korean War, the Vietnam War, Gulf War, and the wars in Iraq and Afghanistan who applied for service connected Veterans Administration compensation due to mental health conditions. A summary of the responses from veterans regarding their reaction to psychiatric treatment is given and compared to the findings of other provided preliminary studies regarding the effect of individual beliefs and stigma on treatment compliance.

Understanding the acceptability of e-mental health – attitudes and expectations towards computerised self-help treatments for mental health problems

April 18, 2014 Comments off

Understanding the acceptability of e-mental health – attitudes and expectations towards computerised self-help treatments for mental health problems
Source: BMC Psychiatry

Background
E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population.

Methods
An advisory group of service users identified dimensions that potentially influence an individual’s decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA.

Results
Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants’ expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future.

Conclusions
Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such interventions.

Social Host Liability for Underage Drinking Statutes

April 16, 2014 Comments off

Social Host Liability for Underage Drinking Statutes
Source: National Conference of State Legislatures

Enacted in 1984, the National Minimum Drinking Age Act set the minimum drinking age at 21. To comply with federal law, states prohibit persons under 21 years of age from purchasing or publicly possessing alcoholic beverages.

According to the 2012 National Survey on Drug Use and Health, about 9.3 million persons aged 12 to 20 (24.3 percent of this age group) reported drinking alcohol in the past month and an estimated 11.2 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year.

In an effort to combat underage drinking, state legislators have enacted laws that assign responsibility to adults who allow minors to drink alcohol at social gatherings. Thirty-one states allow social hosts to be civilly liable for injuries or damages caused by underage drinkers. Twenty-six states and the Virgin Islands have criminal penalties for adults who host or permit parties with underage drinking to occur in the adults’ homes or in premises under the adults’ control. These social host statutory provisions do not apply to licensed establishments such as restaurants, bars, and liquor stores, which are covered by dram shop laws.

New Directions in Child Abuse and Neglect Research (2014)

April 16, 2014 Comments off

New Directions in Child Abuse and Neglect Research (2014)
Source: National Research Council

Each year, child protective services receive reports of child abuse and neglect involving six million children, and many more go unreported. The long-term human and fiscal consequences of child abuse and neglect are not relegated to the victims themselves — they also impact their families, future relationships, and society. In 1993, the National Research Council (NRC) issued the report, Understanding Child Abuse and Neglect, which provided an overview of the research on child abuse and neglect. New Directions in Child Abuse and Neglect Research updates the 1993 report and provides new recommendations to respond to this public health challenge. According to this report, while there has been great progress in child abuse and neglect research, a coordinated, national research infrastructure with high-level federal support needs to be established and implemented immediately.

New Directions in Child Abuse and Neglect Research recommends an actionable framework to guide and support future child abuse and neglect research. This report calls for a comprehensive, multidisciplinary approach to child abuse and neglect research that examines factors related to both children and adults across physical, mental, and behavioral health domains–including those in child welfare, economic support, criminal justice, education, and health care systems–and assesses the needs of a variety of subpopulations. It should also clarify the causal pathways related to child abuse and neglect and, more importantly, assess efforts to interrupt these pathways. New Directions in Child Abuse and Neglect Research identifies four areas to look to in developing a coordinated research enterprise: a national strategic plan, a national surveillance system, a new generation of researchers, and changes in the federal and state programmatic and policy response.

Mental Health Professionals’ Attitudes and Expectations About Adoption and Adopted Children

April 16, 2014 Comments off

Mental Health Professionals’ Attitudes and Expectations About Adoption and Adopted Children
Source: National Council for Adoption

Many researchers have documented heavy use of clinical services by adoptees, but little is known about how much training mental health professionals actually receive about adoption, or their beliefs about adoption and adopted people. It is important to understand mental health professionals’ expectations for their adopted clients.

Previous research has shown that teachers treat students differently if they have high expectations for those students. In other studies, some adoptive parents have told us it was necessary to educate their child’s counselor about issues related to adoption. We have therefore investigated adoption-related expectations and training on adoption issues among mental health professionals. In this article, we will review some of the most current published information about the adjustment of adopted children, and present our own findings regarding clinicians’ beliefs and expectations for their adopted clients.

Gender Differences in Primary Substance of Abuse across Age Groups

April 16, 2014 Comments off

Gender Differences in Primary Substance of Abuse across Age Groups
Source: Substance Abuse and Mental Health Services Administration

+ In 2011, about 609,000 of the 1.84 million admissions to substance abuse treatment were female (33.1 percent), and 1.23 million were male (66.9 percent)
+ Compared with their male counterparts, a larger proportion of female admissions aged 12 to 17 reported alcohol as their primary substance of abuse (21.7 vs. 10.5 percent)
+ Marijuana as the primary substance of abuse was less common among female than male admissions aged 12 to 17 (60.8 vs. 80.7 percent) and 18 to 24 (22.1 vs. 33.4 percent)
+ Within the 65 or older age group, the proportion of female admissions reporting primary abuse of prescription pain relievers (e.g., oxycodone) was nearly 3 times that of their male counterparts (7.2 vs. 2.8 percent)

Daytime sleepiness: associations with alcohol use and sleep duration in americans

April 15, 2014 Comments off

Daytime sleepiness: associations with alcohol use and sleep duration in americans
Source: Sleep Disorders

The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES) 2007-2008 (N = 2919) using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use). A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58–0.95)], a decreased log drinking frequency [0.90 (95% CI, 0.83–0.98)], and lower sleep duration [OR = 0.75 (95% CI, 0.67–0.84)]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P = 0.004). Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System

April 14, 2014 Comments off

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System
Source: PLoS ONE

Background
With increased life expectancy for HIV-infected persons, there is concern regarding comorbid depression because of its common occurrence and association with behaviors that may facilitate HIV transmission. Our objectives were to estimate the prevalence of current depression among HIV-infected persons receiving care and assess the burden of major depression, relative to that in the general population.

Methods and Findings
We used data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS). The eight-item Patient Health Questionnaire was used to identify depression. To assess the burden of major depression among HIV-infected persons receiving care, we compared the prevalence of current major depression between the MMP and BRFSS populations using stratified analyses that simultaneously controlled for gender and, in turn, each of the potentially confounding demographic factors of age, race/ethnicity, education, and income. Each unadjusted comparison was summarized as a prevalence ratio (PR), and each of the adjusted comparisons was summarized as a standardized prevalence ratio (SPR). Among HIV-infected persons receiving care, the prevalence of a current episode of major depression and other depression, respectively, was 12.4% (95% CI: 11.2, 13.7) and 13.2% (95% CI: 12.0%, 14.4%). Overall, the PR comparing the prevalence of current major depression between HIV-infected persons receiving care and the general population was 3.1. When controlling for gender and each of the factors age, race/ethnicity, and education, the SPR (3.3, 3.0, and 2.9, respectively) was similar to the PR. However, when controlling for gender and annual household income, the SPR decreased to 1.5.

Conclusions
Depression remains a common comorbidity among HIV-infected persons. The overall excess burden among HIV-infected persons receiving care is about three-times that among the general population and is associated with differences in annual household income between the two populations. Relevant efforts are needed to reduce this burden.

The Treatment of Persons with Mental Illness in Prisons and Jails

April 14, 2014 Comments off

The Treatment of Persons with Mental Illness in Prisons and Jails
Source: Treatment Advocacy Center
From Executive Summary:

Prisons and jails have become America’s “new asylums”: The number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold. Most of the mentally ill individuals in prisons and jails would have been treated in state psychiatric hospitals in the years before the deinstitutionalization movement led to closing the hospitals, a trend that continues even today.

The treatment of mentally ill individuals in prisons and jails is critical, especially since such individuals are vulnerable and often abused while incarcerated. Untreated, their psychiatric illness often gets worse, and they leave prison or jail sicker than when they entered. Individuals in prison and jails have a right to receive medical care, and this right pertains to serious mental illness just as it pertains to tuberculosis, diabetes, or hypertension. This right to treatment has been affirmed by the US Supreme Court.

“The Treatment of Persons with Mental Illness in Prisons and Jails” is the first national survey of such treatment practices. It focuses on the problem of treating seriously mentally ill inmates who refuse treatment, usually because they lack awareness of their own illness and do not think they are sick. What are the treatment practices for these individuals in prisons and jails in each state? What are the consequences if such individuals are not treated?

To address these questions, an extensive survey of professionals in state and county corrections systems was undertaken. Sheriffs, jail administrators, and others who were interviewed for the survey expressed compassion for inmates with mental illness and frustration with the mental health system that is failing them. There were several other points of consensus among those interviewed:

  • Not only are the numbers of mentally ill in prisons and jails continuing to climb, the severity of inmates’ illnesses is on the rise as well.
  • Many inmates with mental illness need intensive treatment, and officials in the prisons and jails feel compelled to provide the hospital-level care these inmates need.
  • The root cause of the problem is the continuing closure of state psychiatric hospitals and the failure of mental health officials to provide appropriate aftercare for the released patients.

Is Violent Radicalisation Associated with Poverty, Migration, Poor Self-Reported Health and Common Mental Disorders?

April 14, 2014 Comments off

Is Violent Radicalisation Associated with Poverty, Migration, Poor Self-Reported Health and Common Mental Disorders?
Source: PLoS ONE

Background
Doctors, lawyers and criminal justice agencies need methods to assess vulnerability to violent radicalization. In synergy, public health interventions aim to prevent the emergence of risk behaviours as well as prevent and treat new illness events. This paper describes a new method of assessing vulnerability to violent radicalization, and then investigates the role of previously reported causes, including poor self-reported health, anxiety and depression, adverse life events, poverty, and migration and socio-political factors. The aim is to identify foci for preventive intervention.

Methods
A cross-sectional survey of a representative population sample of men and women aged 18–45, of Muslim heritage and recruited by quota sampling by age, gender, working status, in two English cities. The main outcomes include self-reported health, symptoms of anxiety and depression (common mental disorders), and vulnerability to violent radicalization assessed by sympathies for violent protest and terrorist acts.

Results
2.4% of people showed some sympathy for violent protest and terrorist acts. Sympathy was more likely to be articulated by the under 20s, those in full time education rather than employment, those born in the UK, those speaking English at home, and high earners (>£75,000 a year). People with poor self-reported health were less likely to show sympathies for violent protest and terrorism. Anxiety and depressive symptoms, adverse life events and socio-political attitudes showed no associations.

Conclusions
Sympathies for violent protest and terrorism were uncommon among men and women, aged 18–45, of Muslim heritage living in two English cities. Youth, wealth, and being in education rather than employment were risk factors.

Effect of Drinking on All-Cause Mortality in Women Compared with Men: A Meta-Analysis

April 11, 2014 Comments off

Effect of Drinking on All-Cause Mortality in Women Compared with Men: A Meta-Analysis
Source: Journal of Women’s Health

Background:
Alcoholic beverages are consumed by humans for a variety of dietary, recreational, and other reasons. It is uncertain whether the drinking effect on risk of all-cause mortality is different between women and men. We conducted a meta-analysis to evaluate the effect of drinking on the risk of all-cause mortality in women compared with men.

Methods:
We selected cohort studies with measures of relative risk (RR) and 95% confidence interval (CI) for all-cause mortality for drinkers versus nondrinkers by sex. Sex-specific RR and 95% CI were used to estimate the female-to-male ratio of RR (RRR) and 95% CI. Pooled estimates of RRR across studies were obtained by the fixed-effects model or the random-effects model (if heterogeneity was detected). Second-order fractional polynomials and random effects meta-regression models were used for modeling the dose-risk relationship.

Results:
Twenty-four studies were considered eligible. A total of 2,424,964 participants (male: 1,473,899; female: 951,065) were enrolled and 123,878 deaths (male: 76,362; female: 47,516) were observed. Compared with nondrinkers, the pooled female-to-male RRR for drinkers was 1.07 (95% CI: 1.02, 1.12). Subgroup analyses showed that the increased risk among female drinkers appeared to be consistent. J-shaped dose–response relationship was confirmed between alcohol and all-cause mortality in men and women, respectively. Moreover, the female-to-male RRR of all-cause mortality were 1.52 (95% CI: 1.01, 2.29), 1.95 (95% CI: 1.08, 3.49), and 2.36 (95% CI: 1.15, 4.88), respectively, for those who consumed 75, 90, and 100 g/day of alcohol.

Conclusions:
Females had an increased risk for all-cause mortality conferred by drinking compared with males, especially in heavy drinkers. The present study suggested that female drinkers, particularly heavy drinkers, should moderate or completely reduce their level of consumption to have a health benefit.

Current Issues in Mental Health in Canada

April 10, 2014 Comments off

Current Issues in Mental Health in Canada
Source: Library of Parliament

Mental health problems and mental illness exact a huge human, social and economic toll.

In Canada, roughly one in every five people will experience a mental illness in his or her lifetime. Individuals with mental health problems or mental illness may suffer from such consequences as stigmatization, discrimination, lost income, homelessness and substance abuse, among others. Left untreated, some mental health disorders may even lead to suicide.

The Library of Parliament recently published a series of papers on mental health in Canada and the involvement of the federal government in this area; this HillNote introduces the series and highlights some of the issues addressed in the papers.

NZ — Suicide Reporting

April 10, 2014 Comments off

Suicide Reporting
Source: Law Commission

The Report recommends that sections 71 to 73 of the Coroners Act 2006 that restrict the reporting of suicide be repealed and replaced by new provisions. Those provisions should only prohibit the reporting of the method of suicide and the fact that a death is a suicide. A person should be able to apply to the Chief Coroner for an exemption from those prohibitions. It also recommends that the Coroners Act requires the Minister of Health to prepare, in consultation with media and mental health experts, a new set of standards for reporting suicide, and to implement an ongoing programme to disseminate, promote, support and evaluate the implementation of those standards.

40% of Children Miss Out on the Parenting Needed to Succeed in Life

April 10, 2014 Comments off

40% of Children Miss Out on the Parenting Needed to Succeed in Life
Source> Sutton Trust

Four in ten babies don’t develop the strong emotional bonds – what psychologists call “secure attachment” – with their parents that are crucial to success later in life. Disadvantaged children are more likely to face educational and behavioural problems when they grow older as a result, new Sutton Trust research finds today.

The review of international studies of attachment, Baby Bonds, by Sophie Moullin (Princeton University), Professor Jane Waldfogel (Colombia University and the London School of Economics) and Dr Liz Washbrook (University of Bristol), finds infants aged under three who do not form strong bonds with their mother or father are more likely to suffer from aggression, defiance and hyperactivity when they get older.

CBO — Presentation on Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget

April 9, 2014 Comments off

Presentation on Raising the Excise Tax on Cigarettes: Effects on Health and the Federal Budget
Source: Congressional Budget Office

Presentation by James Baumgardner, CBO’s Deputy Assistant Director for Health, Retirement, and Long-Term Analysis, to the 30th International Congress of Actuaries

Identifying Personality Disorders that are Security Risks: Field Test Results

April 9, 2014 Comments off

Identifying Personality Disorders that are Security Risks: Field Test Results (PDF)
Source: Defense Personnel Security Research Center

Accurate identification and assessment of employees with risky personality disorders is imperative for programs that involve access to nuclear materials, weapons, and biological select agents which depend on personnel maintaining mental health and reliable behavior. Certain risky personality disorders, however, are especially difficult to diagnose with routine assessment tools that rely on the subject’s self-report. To combat this issue, PERSEREC, in collaboration with Department of Energy, initiated a field test that examined whether an improved screening tool has utility for clinicians who routinely evaluate personnel in a high-risk program. Five clinicians used the Shedler-Westen Assessment Procedure (SWAP), along with its Dispositional Indicators of Risk Exposure (DIRE) subscale developed earlier, for a period of 4 months to evaluate 26 new candidates and current employees of concern. Debriefing interviews indicated that SWAP/DIRE was more effective than clinicians’ existing tools for establishing a positive rapport with the subject, assessing personality disorders, and making legally-defensible recommendations. Findings also include recommendations for using SWAP/DIRE methodology for identifying risky personnel.

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