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In the news ... what the editors are researching ...

Alcohol and tobacco are by far the biggest threat to human welfare of all addictive drugs. A review shows that alcohol and tobacco use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing a further tens of millions. Global estimates suggest that nearly one in seven adults (15.2%) smoke tobacco and one in five adults report at least one occasion of heavy alcohol use in the past month. Society for the Study of Addiction. Addiction

Developmental psychotherapy. Antisocial behavior is common during adolescence and incurs significant costs both for society and for the young people themselves. While most adolescents will not continue on a trajectory of antisocial behavior as they age, they may still be affected years later in terms of educational and employment opportunities. Developmental psychotherapy for antisocial adolescents goes beyond rehabilitation and behavioral control and aims at helping antisocial young people and young offenders become responsible adults, as the intervention takes into account the values and goals of the individual. Understanding behavioral problems as a result of intentions, values and goals, rather than as a "lack of something" is at the core of a treatment approach that incorporates a developmental understanding of delinquent youth with a psychoanalytically informed perspective on treatment. This kind of therapeutic alliance is rooted in a shared understanding of the meanings and symbolic motives of behavior, within a developmental frame that puts young people's needs, values and goals first. Dr. Alfio Maggiolini and Dr. Virginia Suigo. Adolescent Psychiatry

Replacing diet beverages with water, lose weight. In a study of 81 overweight and obese women with type 2 diabetes who usually consumed diet beverages and were on a weight loss program, those who substituted water for diet beverages after their lunch for 24 weeks had a greater decrease in weight and body mass index compared with those who continued to consume diet beverages. Participants who switched to water also experienced greater improvements in fasting blood sugar levels and insulin sensitivity. Diabetes, Obesity and Metabolism

Link between food allergies and childhood anxiety.  Researchers studied the link between food allergy and childhood anxiety and depression among a sample of predominantly low socioeconomic status minority children. The results showed that children with a food allergy had a significantly higher prevalence of childhood anxiety. Food allergies were not associated with symptoms of childhood depression or with symptoms of anxiety or depression among their caregivers. Columbia University's Mailman School of Public Health and Albert Einstein College of Medicine. Journal of Pediatrics

Fashion mannequins communicate 'dangerously thin' body ideals. Research shows that the body size of mannequins used to advertise female fashion in the UK are too thin and may be promoting unrealistic body ideals. The study found that the average female mannequin body size was representative of a severely underweight woman. The average male mannequin body size was significantly larger than the average female mannequin body size and only a small proportion of male mannequins represented an underweight body size. "We of course are not saying that altering the size of high street fashion mannequins will on its own 'solve' body image problems. What we are instead saying is that presentation of ultra-thin female bodies is likely to reinforce inappropriate and unobtainable body ideals, so as a society we should be taking measures to stop this type of reinforcement." "Given that the prevalence of body image problems and disordered eating in young people is worryingly high, positive action that challenges communication of ultra-thin ideal may be of particular benefit to children, adolescents and young adult females." University of Liverpool. Journal of Eating Disorders

What do you fear? Fears and Phobias - A survey asked respondents about 65 fears across a broad range of categories including fears about the government, crime, the environment, the future, technology, health, natural disasters, as well as fears of public speaking, spiders, heights, ghosts and many other personal anxieties.

The survey shows that the top 10 things Americans fear the most are:
1)    Corruption of government officials (same top fear as 2015)
2)    Terrorist attacks
3)    Not having enough money for the future
4)    Being a victim of terror
5)    Government restrictions on firearms and ammunition (new)
6)    People I love dying
7)    Economic or financial collapse
8)    Identity theft
9)    People I love becoming seriously ill
10)  The Affordable Health Care Act/"Obamacare"
Chapman University

Psychotherapy sessions for anxiety, phobias and fears - Patients make more progress toward overcoming anxiety, fears and phobias when their therapy sessions are scheduled in the morning. The study found that morning sessions helped psychotherapy patients overcome their panic and anxiety and phobic avoidance better, in part, because levels of cortisol -- a naturally occurring hormone -- are at their highest then, said clinical psychologist Alicia E. Meuret. "The hormone cortisol is thought to facilitate fear extinction in certain therapeutic situations," said Meuret, lead author on the research. "Drugs to enhance fear extinction are being investigated, but they can be difficult to administer and have yielded mixed results. The findings of our study promote taking advantage of two simple and naturally occurring agents - our own cortisol and time of day." However, Meuret cautioned that the precise mechanism by which cortisol enhances the effectiveness of morning exposure sessions remains unclear and can't be directly addressed from the data in this study. The sample size of the study was small and findings need to be confirmed independently in larger studies, she said. Southern Methodist University, Dallas, University of Michigan. Psychoneuroendocrinology

Expecting the worst increases side-effects in breast cancer patients on hormone therapies - Women receiving hormone therapies such as tamoxifen as part of their treatment for breast cancer has found that the number and seriousness of side-effects they experienced were influenced by their expectations. The study found that women who had higher expectations of suffering more and worse side-effects before their treatment began did, in fact, experience more after two years of adjuvant hormone therapy. They experienced nearly twice the number of side-effects than did women with positive expectations or who thought the effects would not be too bad. The researchers say that their findings are important because women may stop taking their adjuvant hormone treatment if they experience too many side-effects and worse health-related quality of life; this, in turn, can affect the success of treatment and survival. However, if expectations can predict the risk of experiencing side-effects, then interventions such as counselling could lower the risk and, therefore, improve adherence to medication. Professor Yvonne Nestoriuc, of the Department of Psychosomatic Medicine and Psychotherapy at the University Medical Centre, Hamburg, Germany, said: "Our results show that expectations constitute a clinically relevant factor that influences the long-term outcome of hormone therapy. Expectations can be modified so as to decrease the burden of long-term side-effects and optimise adherence to preventive anti-cancer treatments in breast cancer survivors." "Is it best to expect the worst? Influence of patients' side-effect expectations on endocrine treatment outcome in a two-year prospective clinical cohort study", by Y. Nestoriuc et al. Annals of Oncology.

Depressed, out of work? Skills help - Unemployed people were more likely to land a job if they used skills commonly taught as part of cognitive therapy for depression. These skills included identifying negative thoughts and countering them with more positive responses and planning enjoyable activities to improve mood. The study shows that cognitive behavioral (CB) skills not only predict changes in depression symptoms, but also real-life functioning, said Daniel Strunk, associate professor of psychology. "Searching for a job is difficult in any circumstance, but it may be even more difficult for people who are depressed," Strunk said. "But we found that there are specific skills that can help not only manage the symptoms of depression but also make it more likely that a person will receive a job offer." "The people who got jobs in our study were more likely to be putting into practice the skills that we try to teach people in cognitive therapy," Strunk said. Ohio State University. Journal of Clinical Psychology

Integrative Pain Management - The American Academy of Pain Management, now the Academy of Integrative Pain Management, invites all clinicians who care for people with pain to attend its 27th Annual Meeting in San Antonio, Texas, September 21-25, 2016. "Given the national furor over opioid prescribing, this meeting provides a timely opportunity for practitioners to learn how to deliver effective, safe, and sane pain care as outlined by the NIH National Pain Strategy," says Academy executive director and national pain management leader Robert K Twillman, PhD.

Pain management is not a "one-size-fits-all" proposition but it is a "team sport" according to Twillman. The conference planners have built a program to advance the best and most current methods covering the full spectrum of pain treatment modalities, including best practices in Pain Medication Use, Dynamic Psychotherapy, Biopsychosocial Approaches, Massage Therapy, Guided Imagery, Yoga, Physical Therapy, Nutrition Therapy, Acupuncture and more. The most challenging painful conditions will be addressed from the multidisciplinary treatment perspective including Back Pain, Chronic Regional Pain Syndrome, Trauma and Pain, Myofascial Pain, Migraine, Comorbid CRPS and PTSD, Fibromyalgia, Cancer Pain, Orofacial Pain, Pediatric Pain, and Phantom Limb Pain.

Higher potato consumption associated with increased risk of high blood pressure - Higher intakes of boiled, baked, or mashed potatoes, and French fries is associated with an increased risk of developing high blood pressure (hypertension) in adult women and men. Researchers suggest that replacing one serving a day of boiled, baked, or mashed potatoes with one serving of a non-starchy vegetable is associated with a lower risk of developing hypertension. The authors point out that potatoes have a high glycaemic index compared with other vegetables, so can trigger a sharp rise in blood sugar levels. They also acknowledge some study limitations and say that, as with any observational study, no firm conclusions can be drawn about cause and effect. Nevertheless, they say their findings "have potentially important public health ramifications, as they do not support a potential benefit from the inclusion of potatoes as vegetables in government food programs but instead support a harmful effect that is consistent with adverse effects of high carbohydrate intakes seen in controlled feeding studies." Brigham and Women's Hospital and Harvard Medical School. BMJ

Mental practice and physical therapy effective treatment for stroke - A combination of mental practice and physical therapy is an effective treatment for people recovering from a stroke. Mental practice and physical therapy are interventions used to improve impaired motor movement, coordination and balance following stroke. Mental practice, also known as motor imagery, is the mental rehearsal of a motor action without an overt action. Physical therapy consists of repetitive, task-oriented training of the impaired extremity. "When people have a stroke, there's damage to brain cells and it takes a long time for neurons to grow back, if at all. You can use certain treatments to make the brain adapt or compensate in order to recruit new neurons and make you move again," said Dr. Andrew Butler, interim dean in the Byrdine F. Lewis School of Nursing and Health Professions and associate faculty in the Neuroscience Institute at Georgia State. Dr. Butler, a neuroscientist and physical therapist, and Dr. Mukesh Dhamala, a physicist and associate professor in the Department of Physics and Astronomy at Georgia State, partnered for the study. Study funded by the National Center for Complementary and Integrative Health. Georgia State University. Frontiers in Human Neuroscience

Treating seasonal affective disorder (SAD) - A study casts a shadow on light therapy's status as the gold standard for treating SAD, or seasonal affective disorder. While the treatment was effective at addressing acute episodes of SAD, a SAD-tailored version of cognitive-behavioral therapy (CBT) was significantly better at preventing relapse in future winters. Research subjects were treated with six weeks of either light therapy - timed, daily exposure to bright artificial light of specific wavelengths using a light box - or a special form of CBT that taught them to challenge negative thoughts about dark winter months and resist behaviors, like social isolation, that effect mood. "Light therapy is a palliative treatment, like blood pressure medication, that requires you to keep using the treatment for it to be effective," said psychology professor Kelly Rohan. "Adhering to the light therapy prescription upon waking for 30 minutes to an hour every day for up to five months in dark states can be burdensome," she said. Cognitive-behavior therapy, by contrast, is a preventive treatment, Rohan said. Once SAD sufferers learn its basic skills it has enduring impact, giving the person a sense of control over their symptoms.
"The degree of improvement was substantial," Rohan said. "Both treatments showed large, clinically significant improvements in depressive symptoms over six weeks in the winter." But given the difficulty in persisting with light therapy and large numbers suffering from the recurrent disorder, CBT may be the better treatment option in the long term, Rohan said. University of Vermont. American Journal of Psychiatry

Health care providers should counsel high-risk patients - More than half of patients with symptoms of mental illness - and nearly one-third of those who also had diabetes - said their health care providers had never told them to exercise or reduce their intake of dietary fat. The American Diabetes Association recommends that health care providers counsel all patients with diabetes or at high risk of diabetes about physical activity and healthy dietary choices. People with mental illness have significantly higher rates of health problems such as cardiovascular disease, diabetes, hypertension and high cholesterol that could be prevented or alleviated with lifestyle modifications. University of Illinois. Diabetes Educator

Dietary supplements increase cancer risk - While dietary supplements may be advertised to promote health, University of Colorado Cancer Center investigator Tim Byers, MD, MPH, describes research showing that over-the-counter supplements may actually increase cancer risk if taken in excess of the recommended daily amount. "This is not to say that people need to be afraid of taking vitamins and minerals," says Byers. "If taken at the correct dosage, multivitamins can be good for you. But there is no substitute for good, nutritional food." Byers says that people can get the daily recommended doses of vitamins and minerals in their diets by eating healthy meal and that many adults who take vitamin supplements may not need them. University of Colorado Denver

Cancer diagnosis leads to higher quit rates among smokers - The largest study of its kind to date finds smokers diagnosed with cancer were more likely to quit than other smokers, supporting the hypothesis that a cancer diagnosis is a "teachable moment" that can be used to promote cessation. Smoking increases the risk of second primary smoking-associated cancers; has been associated with poorer response to cancer treatment and cancer recurrence; and has many adverse health effects other than cancer. American Cancer Society. Journal of Clinical Oncology

Cardiorespiratory fitness contributes to successful brain aging - Cardiorespiratory fitness may positively impact the structure of white matter in the brains of older adults. These results suggest that exercise could be prescribed to lessen age-related declines in brain structure. "We found that higher levels of cardiorespiratory fitness were associated with enhanced brain structure in older adults," explained corresponding author Scott Hayes, PhD, assistant professor of psychiatry at Boston University School of Medicine and the associate director of the Neuroimaging Research for Veterans Center at the VA Boston Healthcare System. "We found that physical activities that enhance cardiorespiratory fitness, such as walking, are inexpensive, accessible and could potentially improve quality of life by delaying cognitive decline and prolonging independent function," he added. Annals of Clinical and Translational Neurology

Depression, anxiety and stress - Is it possible to prevent mental health problems in higher education students? The answer is "yes" according to a team of psychologists. The programs helped in enhancing not only students' social-emotional skills, self-perceptions, and interpersonal relationships, but also their academic adjustment. The authors discuss the value of skill-training programs with a preventive mental health focus and their application within higher educational settings. They conclude that effective programs to prevent emotional distress and promote psychosocial assets warrant more widespread use. Loyola University Chicago. Prevention Science

Three secrets to healthier eating - If you want to know the secrets of healthier eating, think of the kitchen fruit bowl. A fruit bowl makes fruit more convenient, attractive, and normal to eat than if the same fruit were in the bottom of the refrigerator. A study about healthy eating behaviors and found that most healthy eaters did so because a restaurant, grocery store, school cafeteria, or spouse made foods like fruits and vegetables visible and easy to reach (convenient), enticingly displayed (attractive), and appear like an obvious choice (normal). "A healthy diet can be as easy as making the healthiest choice the most convenient, attractive, and normal," said Brian Wansink, Ph.D. Cornell Food and Brand Lab. Psychology and Marketing

Complementary Medicine use among patients with cancer - The findings of a study may help hospitals develop more effective and accessible integrative oncology services for patients. "We found that specific attitudes and beliefs -- such as expectation of therapeutic benefits, patient-perceived barriers regarding cost and access, and opinions of patients' physician and family members -- may predict patients' use of complementary and alternative medicine following cancer diagnoses," said Dr. Jun Mao.

The field of integrative oncology is emerging to bring complementary medicine together with conventional care to improve patient outcomes. "Our findings emphasize the importance of patients' attitudes and beliefs about complementary and alternative medicine as we seek to develop integrative oncology programs in academic medical centers and community hospitals," said Dr. Joshua Bauml. "By aligning with patients' expectations, removing unnecessary structural barriers, and engaging patients' social and support networks, we can develop patient-centered clinical programs that better serve diverse groups of cancer patients." Abramson Cancer Center at the University of Pennsylvania's Perelman School of Medicine. American Cancer Society, Cancer

Impulse and binge eating - Do you get impulsive when you're upset? If so, this could be putting you at risk for binge eating. the more impulsive you are, the more likely it is you'll binge eat when experiencing negative feelings. 

'It's human nature to want to turn to something for comfort after a bad day, but what our research found is that the tendency to act rashly when faced with negative emotions is a personality trait that can lead to binge eating,' said Kelly Klump, professor of psychology.  'If we can treat the underlying tendency to jump to eating when feeling negative emotions like stress, we may be able to help thousands of individuals who suffer from a range of eating disorders.'

'It is possible that relationships between binge eating and negative urgency reflect impairments in behavioral control over eating when upset,' said Sarah Racine, assistant professor of psychology. 'Overeating may instead represent increased sensitivity to rewarding effects of food in the context of negative emotions.' Michigan State University, Ohio University. International Journal of Eating Disorders

Cardiovascular risk factors extremely high in people with psychosis - Extremely high levels of cardiovascular risk factors have been found in people with established psychosis, with central obesity evident in over 80 per cent of participants. The study also identified lifestyle choices likely to add to cardiovascular risk, with 62 per cent of the sample reported to be smokers, greatly in excess of the general UK population smoking rates of 20 per cent. Lack of exercise was also commonplace, with only 12 per cent of participants engaging in high intensity physical activity. Dr Fiona Gaughran, senior author from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, and the National Psychosis Unit at SLaM, said: 'We already know that diagnosis of a psychotic illness such as schizophrenia or bipolar disorder is associated with a reduced life expectancy of between 10 to 25 years. This mortality gap is largely due to natural causes, including cardiac disease. The worryingly high levels of cardiovascular risk shown in our study indicate that a much greater emphasis on physical activity is needed for those with severe mental illnesses, as well as a more significant focus on supporting attempts to quit smoking. NIHR Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust (SLaM) and King's College London. Psychological Medicine

Smoking linked to worse outcomes after surgery - Patients who smoke, as well as those who once had the habit, are more likely to develop complications during and after major urologic cancer surgery. The study also found that quitting smoking for even a year "significantly" improves surgical outcomes. "Besides demonstrating negative effects of smoking on surgical outcomes, our research found that those effects differed according to the procedure performed," says Akshay Sood, M.D., urologist and researcher at Henry Ford Hospital's Vattikuti Urology Institute. "These findings should provide motivation for all patients to quit smoking before undergoing major surgery," Dr. Sood says. "It's clear that they can expect better results with fewer complications if they do." Henry Ford Health System

Long-term depression may double stroke risk - Adults over 50 who have persistent symptoms of depression may have twice the risk of stroke as those who do not. "This is the first study evaluating how changes in depressive symptoms predict changes in stroke risk," said lead author Paola Gilsanz, Yerby Postdoctoral Research Fellow at Harvard Chan School. "If replicated, these findings suggest that clinicians should seek to identify and treat depressive symptoms as close to onset as possible, before harmful effects on stroke risk start to accumulate." The researchers suggest that depression may influence stroke risk through physiological changes involving accumulation of vascular damage over the long term. Damage may also be incurred indirectly through depression's effect on health behaviors, including increased risk of smoking and physical inactivity. Harvard School of Public Health. Journal of the American Heart Association

'Thinspiration' and eating disorders - Some of the most popular social media sites are filled with images of extremely thin women that might be harmful to those who view them -- whether they are seeking them or not. The images were often cropped to remove heads or focus on just a few body parts. Researchers point to studies that have shown repeated exposure to such content can result in body dissatisfaction and disordered eating attitudes. "A young woman looking at these image may think that's what she should look like," Jannath Ghaznavi said. "That could prompt these girls and women to resort to extreme dieting, excessive exercise or other harmful behaviors in order to achieve this thin ideal." University of California, Davis. Body Image: An International Journal of Research

Psychotherapy evidence-based treatments - Employing online training programs to teach psychotherapists how to use newer evidence-based treatments can be as successful as in-person instruction. Psychotherapy treatments can lag years behind what research has shown to be effective because there simply are not enough clinicians trained in new methods. That means that many people with mental health disorders are not getting the most effective nonpharmacological treatments. For one such treatment, Interpersonal and Social Rhythm Therapy to treat bipolar disorder, a study compared face-to-face training with online training and found e-learning to be as effective as traditional in-person instruction. In addition, e-learning enhanced clinician use of the skills just as well as traditional instruction. RAND Corporation. Psychiatric Services

Low vitamin D levels and depression - A study suggests there is a relationship between low levels of vitamin D and depression in otherwise healthy young women. Oregon State University. Psychiatry Research

ADHD advice misguided - For decades, frustrated parents and teachers have barked at fidgety children with ADHD to "Sit still and concentrate!" The findings show the longtime prevailing methods for helping children with ADHD may be misguided. The foot-tapping, leg-swinging and chair-scooting movements of children with attention-deficit/hyperactivity disorder are actually vital to how they remember information and work out complex cognitive tasks. "The typical interventions target reducing hyperactivity. It's exactly the opposite of what we should be doing for a majority of children with ADHD," said one of the study's authors, Mark Rapport, head of the Children's Learning Clinic at the University of Central Florida. "The message isn't 'Let them run around the room,' but you need to be able to facilitate their movement so they can maintain the level of alertness necessary for cognitive activities." Journal of Abnormal Child Psychology

Can exercise help people with Parkinson's disease? Exercise may help people with Parkinson's disease improve their balance, ability to move around and quality of life, even if it does not reduce their risk of falling. Overall, those who took part in the exercise program performed better on tests of ability to move around and balance, had a lower fear of falls and reported better overall mood and quality of life. Neurology®, the journal of the American Academy of Neurology.

Physical activity, vascular health - Researchers found that reducing daily physical activity for even a few days leads to decreases in the function of the inner lining of blood vessels in the legs of young, healthy subjects causing vascular dysfunction that can have prolonged effects. "Inactivity is typically going to lead to people being overweight and obese," Paul Fadel, associate professor of medical pharmacology and physiology. "The next step after that is insulin resistance which leads to Type 2 diabetes and cardiovascular disease." University of Missouri School of Medicine

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