October 20, 2014

Mental Rest and Reflection Boost Learning, Study Suggests

What do you think of this article supported by the NIH and published by University of Texas at Austin?: "The patterns of brain activity recorded in this fMRI scanner revealed how mental rest and reflection on past learning activities can boost future learning. Photo credit: Jeff Luci. AUSTIN, Texas — A new study, which may have implications for approaches to education, finds that brain mechanisms engaged when people allow their minds to rest and reflect on things they've learned before may boost later learning. Scientists have already established that resting the mind, as in daydreaming, helps strengthen memories of events and retention of information. In a new twist, researchers at The University of Texas at Austin have shown that the right kind of mental rest, which strengthens and consolidates memories from recent learning tasks, helps boost future learning. The results appear online this week in the journal Proceedings of the National Academy of Sciences. Margaret Schlichting, a graduate student researcher, and Alison Preston, an associate professor of psychology and neuroscience, gave participants in the study two learning tasks in which participants were asked to memorize different series of associated photo pairs. Between the tasks, participants rested and could think about anything they chose, but brain scans found that the ones who used that time to reflect on what they had learned earlier in the day fared better on tests pertaining to what they learned later, especially where small threads of information between the two tasks overlapped. Participants seemed to be making connections that helped them absorb information later on, even if it was only loosely related to something they learned before. "We've shown for the first time that how the brain processes information during rest can improve future learning," says Preston. "We think replaying memories during rest makes those earlier memories stronger, not just impacting the original content, but impacting the memories to come. Until now, many scientists assumed that prior memories are more likely to interfere with new learning. This new study shows that at least in some situations, the opposite is true. "Nothing happens in isolation," says Preston. "When you are learning something new, you bring to mind all of the things you know that are related to that new information. In doing so, you embed the new information into your existing knowledge." Preston described how this new understanding might help teachers design more effective ways of teaching. Imagine a college professor is teaching students about how neurons communicate in the human brain, a process that shares some common features with an electric power grid. The professor might first cue the students to remember things they learned in a high school physics class about how electricity is conducted by wires. "A professor might first get them thinking about the properties of electricity," says Preston. "Not necessarily in lecture form, but by asking questions to get students to recall what they already know. Then, the professor might begin the lecture on neuronal communication. By prompting them beforehand, the professor might help them reactivate relevant knowledge and make the new material more digestible for them." This research was conducted with adult participants. The researchers will next study whether a similar dynamic is at work with children. This work was supported by the National Institute of Mental Health of the National Institutes of Health, the National Science Foundation (NSF) through the NSF CAREER Award and the Department of Defense through the National Defense Science and Engineering Graduate Fellowship Program." For more information on mental health topics, please visit CEUs for Counselors

October 17, 2014

Public feels more negative toward drug addicts than mentally ill

What do you think about this article from NIH? "While both are treatable health conditions, stigma of drug addiction much more pronounced, seen as 'moral failing' People are significantly more likely to have negative attitudes toward those suffering from drug addiction than those with mental illness, and don't support insurance, housing, and employment policies that benefit those dependent on drugs, new Johns Hopkins Bloomberg School of Public Health research suggests. A report on the findings, which appears in the October issue of the journal Psychiatric Services, suggests that society seems not to know whether to regard substance abuse as a treatable medical condition akin to diabetes or heart disease, or as a personal failing to be overcome. "While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition," says study leader Colleen L. Barry, PhD, MPP, an associate professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. "In recent years, it has become more socially acceptable to talk publicly about one's struggles with mental illness. But with addiction, the feeling is that the addict is a bad or weak person, especially because much drug use is illegal." Between Oct. 30 and Dec. 2, 2013, Barry and her colleagues surveyed a nationally representative sample of 709 participants about their attitudes toward either mental illness or drug addition. The questions centered on stigma, discrimination, treatment and public policy. Not only did they find that respondents had significantly more negative opinions about those with drug addiction than those with mental illness, the researchers found much higher levels of public opposition to policies that might help drug addicts in their recovery. Only 22 percent of respondents said they would be willing to work closely on a job with a person with drug addiction compared to 62 percent who said they would be willing to work with someone with mental illness. Sixty-four percent said that employers should be able to deny employment to people with a drug addiction compared to 25 percent with a mental illness. Forty-three percent were opposed to giving individuals addicted to drugs equivalent health insurance benefits to the public at-large, while only 21 percent were opposed to giving the same benefits to those with mental illness. Respondents agreed on one question: Roughly three in 10 believe that recovery from either mental illness or drug addiction is impossible. The researchers say that the stories of drug addiction portrayed in the media are often of street drug users in bad economic conditions rather than of those in the suburbs who have become addicted to prescription painkillers after struggling with chronic pain. Drug addicts who fail treatment are seen as "falling off the wagon," as opposed to people grappling with a chronic health condition that is hard to bring under control, they say. Missing, they say, are inspiring stories of people who, with effective treatment, are able to overcome addiction and live drug-free for many years. Barry says once it would have been taboo for people to casually discuss the antidepressants they are taking, which is often the norm today. That kind of frank talk can do wonders in shaping public opinion, she says. "The more shame associated with drug addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need," says another study author, Beth McGinty, PhD, MS, an assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. "If you can educate the public that these are treatable conditions, we will see higher levels of support for policy changes that benefit people with mental illness and drug addiction." ### "Stigma, Discrimination, Treatment Effectiveness, and Policy: Public Views About Drug Addiction and Mental Illness," was written by Colleen L. Barry, PhD, MPP; Emma E. McGinty, PHD, MS; Bernice A. Pescosolido, PhD; and Howard H. Goldman, MD, PhD. The study was supported by grants from AIG Inc.; the National Institutes of Health's National Institute on Drug Abuse (R01 DA026414); the NIH's National Institute of Mental Health (1R01MH093414-01A1); the National Science Foundation and the College of Arts and Sciences, Indiana University." For more information on mental health topics, please visit Continuing Education for Counselors

October 15, 2014

Teenage Girls Are Exposed to More Stressors that Increase Depression Risk

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"Adolescence is often a turbulent time, and it is marked by substantially increased rates of depressive symptoms, especially among girls. New research indicates that this gender difference may be the result of girls’ greater exposure to stressful interpersonal events, making them more likely to ruminate, and contributing to their risk of depression. The findings are published in Clinical Psychological Science, a journal of the Association for Psychological Science. This is a photo of a pensive looking girl sitting on steps.“These findings draw our focus to the important role of stress as a potential causal factor in the development of vulnerabilities to depression, particularly among girls, and could change the way that we target risk for adolescent depression,” says psychology researcher and lead author on the study, Jessica Hamilton of Temple University. “Although there is a range of other vulnerabilities that contribute to the emergence of girls’ higher rates of depression during adolescence, our study highlights an important malleable pathway that explains girls’ greater risk of depression.” Research has shown that cognitive vulnerabilities associated with depression, such as negative cognitive style and rumination, emerge during adolescence. Teens who tend to interpret events in negative ways (negative cognitive style) and who tend to focus on their depressed mood following such events (rumination) are at greater risk of depression. Hamilton, a doctoral student in the Mood and Cognition Laboratory of Lauren Alloy at Temple University, hypothesized that life stressors, especially those related to adolescents’ interpersonal relationships and that adolescents themselves contribute to (such as a fight with a family member or friend), would facilitate these vulnerabilities and, ultimately, increase teens’ risk of depression. The researchers examined data from 382 Caucasian and African American adolescents participating in an ongoing longitudinal study. The adolescents completed self-report measures evaluating cognitive vulnerabilities and depressive symptoms at an initial assessment, and then completed three follow-up assessments, each spaced about 7 months apart. As expected, teens who reported higher levels of interpersonal dependent stress showed higher levels of negative cognitive style and rumination at later assessments, even after the researchers took initial levels of the cognitive vulnerabilities, depressive symptoms, and sex into account. Girls tended to show more depressive symptoms at follow-up assessments than did boys — while boys’ symptoms seemed to decline from the initial assessment to follow-up, girls’ symptoms did not. Girls also were exposed to a greater number of interpersonal dependent stressors during that time, and analyses suggest that it is this exposure to stressors that maintained girls’ higher levels of rumination and, thus, their risk for depression over time. The researchers emphasize that the link is not driven by reactivity to stress — girls were not any more reactive to the stressors that they experienced than were boys. “Simply put, if boys and girls had been exposed to the same number of stressors, both would have been likely to develop rumination and negative cognitive styles,” Hamilton explains. Importantly, other types of stress — including interpersonal stress that is not dependent on the teen (such as a death in the family) and achievement-related stress — were not associated with later levels of rumination or negative cognitive style. “Parents, educators, and clinicians should understand that girls’ greater exposure to interpersonal stressors places them at risk for vulnerability to depression and ultimately, depression itself,” says Hamilton. “Thus, finding ways to reduce exposure to these stressors or developing more effective ways of responding to these stressors may be beneficial for adolescents, especially girls.” According to Hamilton, the next step will be to figure out why girls are exposed to more interpersonal stressors: “Is it something specific to adolescent female relationships? Is it the societal expectations for young adolescent girls or the way in which young girls are socialized that places them at risk for interpersonal stressors? These are questions to which we need to find answers!” Co-authors on the study include Jonathan P. Stange and Lauren B. Alloy of Temple University and Lyn Y. Abramson of the University of Wisconsin-Madison. This work was supported by NIMH Grants MH79369 and MH101168 to Lauren B. Alloy. Jonathan P. Stange was supported by National Research Service Award F31MH099761 from NIMH." For more information on mental health topics, please visit CEUs for MFTs

September 30, 2014

How Career Dreams are Born: Study shows how to convince those with low self-confidence to pursue their career choice

What do you think of this article by Jeff Grabmeier? Published on September 29, 2014 "COLUMBUS, Ohio – A new study shows just what it takes to convince a person that she is qualified to achieve the career of her dreams. Researchers found that it’s not enough to tell people they have the skills or the grades to make their goal a reality. Instead, many people need a more vivid and detailed description of just how pursuing their dream career will help make them successful. This is especially important for people who have the skills and potential to pursue a particular career, but lack the self-confidence, said Patrick Carroll, author of the study and associate professor of psychology at The Ohio State University’s Lima campus. Students who have chronic self-doubt may need an extra boost to pursue the dreams they are certainly able to achieve,” Carroll said. Dr. Patrick J. Carroll Patrick Carroll “This study finds that what they really need is a vivid picture of what will happen if they succeed.” The study was published online this week in the journal Basic and Applied Social Psychology. The study involved 67 undergraduate business and psychology students at Ohio State. The students signed up to meet with a career adviser to learn about a supposedly new master’s degree program in business psychology that would train them for “high-paying consulting positions as business psychologists.” However, the program didn’t actually exist. The goal was to get the students interested in the program, and see how they reacted when faced with varying levels of validation to their new dreams of becoming a business psychologist. (The researchers followed a protocol to help students who may have been disappointed that there wasn’t a real program. More on that below.) All the students read a brochure about the program and then filled out several questionnaires. They were asked to rate their self-confidence that they could become a business psychologist, whether they were excited about the possibility of becoming a business psychologist, whether they thought they could be admitted to the business psychology program and whether they intended to apply. They also reported their overall GPA. The students were then separated into four groups. Students in the control group were given an information sheet indicating no GPA requirement for the program. The other three groups were given sheets indicating the GPA requirement was .10 below whatever they had listed as their own GPA. In one of these groups, the “career adviser” –- who actually worked with the researchers -- simply pointed out that the students’ GPA was higher than the requirement. In another group, the validation was raised slightly: The adviser told the participants that they were exactly what the program was looking for and that it was unlikely they would be rejected if they applied. The last group received the strongest validation to their hopes of becoming a business psychologist: They were also told they were qualified and were unlikely to be rejected if they applied. But the adviser added that it was likely that the student would be accepted with full funding and excel in the program and would graduate with numerous job offers in business psychology. Afterward, the participants once again filled out forms asking how confident and excited they were about becoming a business psychologist and whether they expected they would be admitted. In addition, the students were given the opportunity to actually apply to the program. The results were striking. The students in the control group and those who were simply told their GPA exceeded the program requirements didn’t embrace the possible new goal of becoming a business psychologist. These participants did not show any elevations in self-confidence related to becoming a business psychologist and were unlikely to apply to the program or even ask for more information. Even when students learn that they exceed some external admissions requirement to become a business psychologist, they still have to decide whether that means they should pursue that career dream instead of any others,” Carroll said. “They may need more validation than that to pursue this career goal.” However, when the adviser clearly detailed the vivid prospect of success, the students were willing to embrace the pursuit of that new business psychology goal. Specifically, students given the most vivid validation had higher levels of self-confidence immediately after meeting with the adviser and were more likely to actually apply to the business psychology program. “Self-confidence played a key role here. Students felt more confident that they could really be successful as a business psychologist when they received a detailed picture from their adviser,” Carroll said. Following the study, the researchers thoroughly debriefed all participants on why it was necessary to use deception to study how students, like them, naturally respond to social validation to pursue new career goals. In addition, researchers provided all participants with detailed information on career counseling services that they could utilize on campus for help in making future career choices. This extensive debriefing was designed to remove any adverse influence of the study feedback on participants before they left, Carroll said. After the purpose of the study was explained to them, many participants were enthusiastic about the research and its relevance in revealing how others can shape their own career decisions, he said. Carroll said he sees the relevance of this research nearly every day, as students seek his input about career plans or the possibility of graduate school. “Sometimes students have the grades, the motivation and the ability but simply lack the necessary self-confidence to whole-heartedly invest in the pursuit of a realistic new goal,” he said. “This work shows how parents, teachers and counselors can steer students into the right direction to achieve their dreams.” The findings are especially relevant now as students prepare for an uncertain job market and they, along with their teachers and guidance counselors, try to find the best career choices for them. “Educators are trying to lead students to the most realistic career options,” Carroll said. “This research is important to understanding how students make revisions in their career goals and decide which career possibilities they should embrace.” This research was supported by a grant from the National Institute of Mental Health." For more informatio0n on mental health and social work topics, please visit Aspira Continuing Education and LPC Continuing Education

September 24, 2014

To curb violent tendencies, start young Working with aggressive children prevents some from becoming violent, criminal adults

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DURHAM, N.C. -- Aggressive children are less likely to become violent criminals or psychiatrically troubled adults if they receive early intervention, says a new study based on more than two decades of research. "These findings from researchers at Duke, Pennsylvania State and Vanderbilt universities and the University of Washington are based on the Fast Track Project, a multi-faceted program that is one of the largest violence-prevention trials ever funded by the federal government. Beginning in 1991, the researchers screened nearly 10,000 5-year-old children in Durham, Nashville, Seattle and rural Pennsylvania for aggressive behavior problems, identifying those who were at highest risk of growing up to become violent, antisocial adults. Nearly 900 children were deemed at high risk, and of those, half were randomly assigned to receive the Fast Track intervention, while the other half were assigned to a control group. Participating children and their families received an array of interventions at school and at home. Nineteen years later, the authors found that Fast Track participants at age 25 had fewer convictions for violent and drug-related crimes, lower rates of serious substance abuse, lower rates of risky sexual behavior and fewer psychiatric problems than the control group. "We can prevent serious violence and psychopathology among the group of children who are highest-risk," said Duke's Kenneth Dodge. "That's the essential finding from this study. It provides the strongest evidence yet that, far from being doomed from an early age, at-risk children can be helped to live productive lives." Dodge directs the Duke Center for Child and Family Policy and is the William McDougall Professor of Public Policy at Duke's Sanford School of Public Policy. The program's positive effects held true across four different sites around the country, among both males and females and among both white and African-American children. The study appears online Sept. 15 in the American Journal of Psychiatry. From first through 10th grade, the Fast Track children received reading tutoring and specialized intervention aimed at improving self-control and social-cognitive skills. Parents learned problem-solving skills through home visits and parent training groups. When program participants turned 25, researchers reviewed court records and conducted interviews with participants and control group members, as well as individuals who knew the participants well. Along with fewer criminal convictions, Fast Track participants had lower rates of antisocial personality disorder and avoidant personality disorder, lower rates of risky sexual behavior and lower rates of harsh parenting. The latter finding suggests that the intervention may interrupt the inter-generational cycle of problem behavior. Fast Track is among very few studies to test the long-term effect of environment on children's development through a clinical trial. It provides strong evidence for the critical role environment plays in shaping a child's development. "This study adds to the experimental evidence for the important role that environment plays," Dodge said. "Genes do not write an inalterable script for a child's life. And not only does the environment matter greatly in a child's development, we've shown that you can intervene and help that child succeed in life." Fast Track's positive effects do not come cheap. The 10-year intervention costs $58,000 per child. However, that cost should be weighed against the millions of dollars that each chronic criminal costs society in imprisonment and harm to others, Dodge said. "Prevention takes a considerable investment, but that investment is worth it," Dodge said. "Our policies and practices should reflect the fact that these children can have productive lives." In future studies, Dodge and his colleagues plan to examine the cost-benefit question more closely. ### The research was supported by grants from the National Institute of Mental Health (NIMH R18 MH48043, R18 MH50951, R18 MH50952, R18 MH50953, K05MH00797 and K05MH01027), the Department of Education (grant S184U30002) and the National Institute on Drug Abuse (NIDA grants DA16903, DA017589, K05DA015226, and P30DA023026). The Center for Substance Abuse Prevention and the National Institute on Drug Abuse also provided support through a memorandum of agreement with the NIMH. Financial disclosure: Study authors Kenneth Dodge, Karen Bierman, John Coie, Mark Greenberg, John Lochman and Robert McMahon are the developers of the Fast Track curriculum and have a publishing agreement with Guilford Press. Greenberg is also an author of the PATHS curriculum, which is used in the Fast Track program. McMahon is a co-author of Helping the Noncompliant Child and has a royalty agreement with Guilford Publications. He is also a member of the Treatments that Work Scientific Advisory Board with Oxford University Press. The other authors have no financial relationships to disclose." CITATION: "Impact of Early Intervention on Psychopathology, Crime and Well-Being at Age 25," Kenneth A. Dodge and the Conduct Problems Prevention Research Group. American Journal of Psychiatry, September 15, 2014. DOI: 10.1176/appi.ajp.2014.13060786. For more information on mental health topis, please visit CEUs for Counselors

September 10, 2014

Intervention in 6-month-olds with autism eliminates symptoms, developmental delay

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'Infant Start' therapy removes disabling delay before most children are diagnosed "Treatment at the earliest age when symptoms of autism spectrum disorder (ASD) appear – sometimes in infants as young as 6 months old – significantly reduces symptoms so that, by age 3, most who received the therapy had neither ASD nor developmental delay, a UC Davis MIND Institute research study has found. The treatment, known as Infant Start, was administered over a six-month period to 6- to 15-month-old infants who exhibited marked autism symptoms, such as decreased eye contact, social interest or engagement, repetitive movement patterns, and a lack of intentional communication. It was delivered by the people who were most in tune with and spent the most time with the babies: their parents. “Autism treatment in the first year of life: A pilot study of Infant Start, a parent-implemented intervention for symptomatic infants,” is co-authored by UC Davis professors of Psychiatry and Behavioral Sciences Sally J. Rogers and Sally Ozonoff. It is published online today in the Journal of Autism and Developmental Disorders. "Most of the children in the study, six out of seven, caught up in all of their learning skills and their language by the time they were 2 to 3," said Rogers, the study's lead author and the developer of the Infant Start therapy. "Most children with ASD are barely even getting diagnosed by then." "For the children who are achieving typical developmental rates, we are essentially ameliorating their developmental delays," Rogers said. "We have speeded up their developmental rates and profiles, not for every child in our sample, but for six of the seven." Rogers credited the parents in the small, pilot study with making the difference. "It was the parents – not therapists – who did that," she said. "Parents are there every day with their babies. It's the little moments of diapering, feeding, playing on the floor, going for a walk, being on a swing, that are the critical learning moments for babies. Those moments are what parents can capitalize on in a way that nobody else really can." Early identification crucial Children diagnosed with autism typically receive early intervention beginning at 3 to 4 years, six to eight times later than the children who participated in the study. But the earliest symptoms of autism may be present before the child’s first birthday. Infancy is the time when children first learn social interaction and communication, so autism researchers and parents of children with the condition have been working to identify autism and begin intervention sooner. Effective autism treatment relies on early detection so that a child can begin therapy as soon as possible, to prevent or mitigate the full onset of symptoms and sometimes severe and lifelong disability. "We were very fortunate to have this treatment available for the affected infants identified through our study," said Ozonoff, who directs the MIND Institute's Infant Sibling Study, an early detection project that follows babies at risk for autism or ADHD from birth through age 3. "We want to make referrals for early intervention as soon as there are signs that a baby might be developing autism," Ozonoff said. "In most parts of the country and the world, services that address autism-specific developmental skills are just not available for infants this young." Of the seven babies in the study, four were part of the Infant Sibling Study. In addition to these four, the other three children were referred by community parents. The treatment group was compared with four other groups of children that included: High-risk children with older siblings with autism who did not develop autism Low-risk children who were the younger siblings of typically developing children Infants who developed autism by the age of 3 Children who also had early autism symptoms but chose to receive treatment at an older age Treatment based on Early Start Denver Model The treatment was based on the highly successful Early Start Denver Model (ESDM) intervention developed by Rogers and her colleague, Geraldine Dawson, professor of psychiatry, psychology and pediatrics at Duke University in North Carolina. ESDM is usually provided in the home by trained therapists and parents during natural play and daily routines. Parents were coached to concentrate their interactions on supporting their infants’ individualized developmental needs and interests, and embedded these practices into all of their play and caretaking, focusing on creating pleasurable social routines to increase their children’s opportunities for learning. Parents were encouraged to follow their infants’ interests and subtle cues and gauge activities in ways that optimized their child's attention and engagement. The intervention focused on increasing: Infant attention to parent faces and voices Parent-child interactions that attract infants' attention, bringing smiles and delight to both Parent imitation of infant sounds and intentional actions Parent use of toys to support, rather than compete with, the child's social attention The treatment sessions included: Greeting and parent progress sharing A warm-up period of parent play, followed by discussion of the activity and intervention goals Discussion of a new topic, using a parent manual Parents interacting in a typical daily routine with their child while fostering social engagement, communication and appropriate play, with coaching from therapists Parents practicing the approach with their child across one or two additional home routines with toys or caregiving activities Autism scores lowered by 18 to 36 months All of the participants who received treatment were between 6 and 15 months old, lived within a one-hour drive of the MIND Institute, and came from families where English was the primary language. They had normal vision and hearing and no significant medical conditions. All received assessments prior to their participation and at multiple points throughout the study. The treatment group of seven children received scores on the Autism Observation Scale for Infants (AOSI) and the Infant-Toddler Checklist that indicated they were highly symptomatic and at risk of developing ASD. Their symptoms also elicited clinical concern from professors Rogers and Ozonoff. The study measured the children’s and parents’ responses to the intervention. Treatment began immediately after enrollment and consisted of 12 one-hour sessions with infant and parent. It was followed by a six-week maintenance period with biweekly visits, and follow-up assessments at 24 and 36 months. The treatment sessions focused on parent–child interactions during typical daily life and provided parent coaching as needed to increase infant attention, communication, early language development, play and social engagement. The children who received the intervention had significantly more autism symptoms at 9 months, but significantly lower autism severity scores at 18- to 36-months of age, when compared with a small group of similarly symptomatic infants who did not receive the therapy. Overall, the children who received the intervention had less impairment in terms of autism diagnosis, and language and development delays than either of the other affected groups. Treating severe disability Given the preliminary nature of the findings, the study only suggests that treating these symptoms so early may lessen problems later. Larger, well controlled studies are needed to test the treatment for general use. However, the researchers said that this initial study is significant because of the very young ages of the infants, the number of symptoms and delays they exhibited early in life, the number of comparison groups involved, and because the intervention was low intensity and could be carried out by the parents in everyday routines. “I am not trying to change the strengths that people with ASD bring to this world," Rogers said when asked whether she is seeking to "cure" autism. "People with ASD contribute greatly to our culture," she said. "The diversity of human nature is what makes us a powerful and strong species. We are trying to reduce the disability associated with ASD." “My goal is for children and adults with autism symptoms to be able to participate successfully in everyday life and in all aspects of the community in which they want to participate: to have satisfying work, recreation, and relationships, education that meets their needs and goals, a circle of people they love, and to be generally happy with their lives.” ### Other study authors are Laurie Vismara of UC Davis and York University, Toronto; and A.L. Wagner, C. McCormick and Gregory Young, all of UC Davis. The study was funded by grants from the National Institute of Child Health and Human Development R21 HD 065275 to Sally Rogers and National Institute of Mental Health grant MH068398 to Ozonoff. At the UC Davis MIND Institute, world-renowned scientists engage in collaborative, interdisciplinary research to find the causes of and develop treatments and cures for autism, attention-deficit/hyperactivity disorder (ADHD), fragile X syndrome, 22q11.2 deletion syndrome, Down syndrome and other neurodevelopmental disorders. For more information, visit mindinstitute.ucdavis.edu." For more informationon this topic and other related subjects, please visit Counselor CEUs

August 27, 2014

Combined drugs and therapy most effective for severe nonchronic depression

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"The odds that a person who suffers from severe, nonchronic depression will recover are improved by as much as 30 percent if they are treated with a combination of cognitive therapy and antidepressant medicine rather than by antidepressants alone. However, a person with chronic or less severe depression does not receive the same additional benefit from combining the two. That is the result of a major new clinical trial published online by the journal JAMA Psychiatry on Aug. 20. In North America, about one in five women and one in 10 men suffer from major depression in her or his lifetime. "Our results indicate that combining cognitive therapy with antidepressant medicine can make a much bigger difference than we had thought to about one-third of patients suffering from major depressive disorder," said Steven Hollon, the Gertrude Conaway Professor of Psychology at Vanderbilt University, who directed the study. "On the other hand, it does not appear to provide any additional benefit for the other two-thirds." Previous studies have found that about two-thirds of all patients with major depressive disorder will improve on antidepressant medications and about one-third of patients will achieve full remission, but half then relapse before fully recovering. Cognitive therapy has proven to be about as effective as medication alone but its effects tend to be longer lasting. Combining the two has been estimated to improve recovery rates by 6 to 33 percent. "Now, we have to reconsider our general rule of thumb that combining the two treatments keeps the benefits of both," said Hollon. The new study was a randomized clinical trial involving 452 adult outpatients with chronic or recurrent major depressive disorder. Unlike previous studies that followed subjects for a set period of time, this study treated them for as long as it took first to remission (full normalization of symptoms) and then to recovery (six months without relapse), which in some cases took as long as three years. "This provided us with enough data so that we could drill down and see how the combined treatment was working for patients with different types and severity of depression: chronic, recurrent, severe and moderate," Hollon said. According to the psychologist, the results could have a major impact on how major depressive disorder is treated. The most immediate effect is likely to be in the United Kingdom, which, he said, is 10 years ahead of the United States in treatment of depression. The use of combined cognitive therapy and antidepressive medicine is standard for severe cases in the UK, and the English National Health Service is actively training its therapists in cognitive therapy and other empirically supported psychotherapies." ### Collaborators in the study were Robert DeRubeis and Jay Amsterdam from the University of Pennsylvania; Jan Fawcett from the University of New Mexico, Albuquerque; Richard Shelton from the University of Alabama, Birmingham; John Zajecka and Paula Young from Rush University; and Robert Gallop from West Chester University. The study was supported by grants MH60713, MH01697, MH60998 and MH060768 from the National Institute of Mental Health. For more information on mental health and counseling related topics, please visit Counselor CEUs