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WSU researchers find the missing link between mental health disorders and chronic diseases in Iraq war refugees
October 15, 2012Subjects who fled Iraq after Gulf War were 43 times more likely to suffer from obstructive sleep apneaDETROIT – Wayne State University School of Medicine researchers may have discovered why people exposed to war are at increased risk to develop chronic problems like heart disease years later. And the culprit that links the two is surprising.Beginning in the mid-2000s, WSU researchers interviewed a random sample of 145 American immigrants who left Iraq before the 1991 Gulf War, and 205 who fled Iraq after the Gulf War began. All were residing in metropolitan Detroit at the time of the study. Study subjects were asked about socio-demographics, pre-migration trauma, how they rated their current health, physician-diagnosed and physician-treated obstructive sleep apnea, somatic disorders and psychosomatic disorders. Those who left Iraq after the war began and suffered from mental disorders such as post-traumatic stress disorder (PTSD) and depression, and self-rated their physical health as worse than their actual health, were 43 times more likely than pre-Gulf War immigrants to report obstructive sleep apnea (30.2 percent versus 0.7 percent) and later develop major chronic health issues such as cardiovascular disease.“I was surprised, but we had a specific theory we wanted to test. Changes in the stress system would contribute to sleep apnea. What happens? Maybe it’s the stress that leads to this fractured sleep,” said Bengt Arnetz, M.D., Ph.D., M.P.H., School of Medicine professor of occupational and environmental health, deputy director of the Institute of Environmental Health Sciences at Wayne State, and the study’s principal investigator and first author. “No one had explored this possible link before, although basic research suggests it as plausible.”The results are featured in the October 2012 issue of Psychosomatic Medicine, the peer-reviewed journal of the American Psychosomatic Society.According to the article, “Obstructive Sleep Apnea, Post-traumatic Stress Disorder, and Health in Immigrants,” obstructive sleep apnea occurs when the muscles supporting the soft palate at the back of the throat relax, but less is known about the reasons behind this neuromuscular malfunctioning.“It’s a known fact that the more exposure to violence you have, the more likely you are to report PTSD and depression, and the worse your self-rated health is, the more likely your actual health will suffer in five to 10 years,” Arnetz said.Hikmet Jamil, M.D., Ph.D., professor of occupational and environmental health in WSU’s School of Medicine, and Thomas Templin, Ph.D., research professor in WSU’s College of Nursing, also contributed to the article.The obstructive sleep apnea and chronic disase link has been observed among many trauma-exposed populations, including refugees, Arnetz said.“Iraqis were exposed to harsh conditions during the entirety of Saddam Hussein’s more than 20 years of reign. However, trauma and environmental exposures increased measurably and dramatically after the initiation of the 1991 Gulf War,” the article states.The study can now be used as a model for other populations, including U.S. soldiers returning home from battle.The multidisciplinary study brought together mental health research, sleep research and chronic disease research, Arnetz said.He and Jamil were partially supported by the National Institute of Mental Health of the National Institutes of Health (award number R01MH085793).To further test their ideas, the researchers plan to apply for funding from the National Institutes of Health to collaborate with Safwan Badr, M.D., professor and chief of the School of Medicine’s Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, and Thomas Roth, Ph.D., director of the Henry Ford Sleep Disorders and Research Center.###Wayne State University is one of the nation’s pre-eminent public research universities in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, state of Michigan and throughout the world. For more information about research at Wayne State University, visit http://www.research.wayne.edu.Founded in 1868, the Wayne State University School of Medicine is the largest single-campus medical school in the nation, with more than 1,000 medical students. In addition to undergraduate medical education, the school offers master’s degree, Ph.D. and M.D.-Ph.D. programs in 14 areas of basic science to about 400 students annually Professional Counselor Continuing Education
October 23, 2012
An analysis of a school behavior strategy—known as School-Wide Positive Behavioral Interventions and Supports (SWPBIS)—found that these types of programs significantly reduced children's aggressive behaviors and office discipline referrals, as well as improved problems with concentration and emotional regulation. The study, conducted by researchers from the Johns Hopkins Bloomberg School of Public Health, is the first randomized control trial to examine the impact of SWPBIS programs over multiple school years. The results were published October 15 in the journal Pediatrics as an eFirst publication.SWPBIS is a prevention strategy that aims to alter student behavior by setting universal, positively stated expectations for student behavior that are implemented across the entire school. Policies and decisions related to student behaviors are based on data analysis. SWPBIS programs are used in more than 16,000 schools in the U.S."These findings are very exciting, given the wide use of SWPBIS across the country. These results are among the first to document significant impacts of the program on children's problem behaviors, as well as positive behaviors, across multiple years as a result of SWPBIS," said Catherine P. Bradshaw, PhD, MEd, lead author of the study and associate professor in the Bloomberg School's Department of Mental Health.The randomized trial included a representative sample of 12,344 elementary school children from 37 schools. Approximately half of the students received free or reduced-priced meals, and nearly 13 percent received special education services. The researchers analyzed teachers' ratings of students' behavior and concentration problems, social-emotional functioning, pro-social behavior, office discipline referrals, and suspension over 4 school years.Overall, the study found significant improvement in children's behavior problems, concentration problems, social-emotional functioning, and pro-social behavior in schools using SWPBIS. Children in SWPBIS schools also were 33 percent less likely to receive an office discipline referral than those in the comparison schools. The effects tended to be strongest among children who were first exposed to SWPBIS in kindergarten."A unique feature of the model is the overall structure that is formed in schools to support sustainable services for students across a range of behavioral needs LCSW Continuing Education Using this framework, school staff can identify students at greatest need of services and efficiently target programs and resources to them," said Bradshaw.###The author of "Effects of School-Wide Positive Behavioral Interventions and Supports on Child Behavior Problems" include Catherine Bradshaw, PhD, MEd; Tracy E. Waasdorp, PhD, MEd; and Philip J. Leaf, PhD.
October 21, 2012
HomeScience NewsScience News from 2012Science Update • October 12, 2012
Many Teens Considering Suicide Do Not Receive Specialized Mental Health Care
Source: iStockPhotoMost adolescents who are considering suicide or who have attempted suicide do not receive specialized mental health services, according to an analysis published online August 15, 2012, in Psychiatric Services, a journal of the American Psychiatric Association.
National survey data from the Centers for Disease Control and Prevention (CDC) notes that approximately 14 percent of high school students seriously consider suicide each year, 11 percent have a suicide plan, and 6 percent attempt suicide. Other research has suggested that less than half of teens who attempt suicide received mental health services in the year prior to their attempt.Kathleen Merikangas, Ph.D., of NIMH and colleagues analyzed data from the National Comorbidity Survey-Adolescent Supplement (NCS-A), a nationally representative, face-to-face survey of more than 10,000 teens ages 13 to 18. They asked teens whether they had any suicidal thoughts, plans, or actions (ideation) over a one-year period prior to the survey. They also completed a structured diagnostic interview regarding the full range of mental disorders including mood, anxiety, eating and anxiety disorders and whether they had received treatment for emotional or behavioral problems in the past 12 months. Respondents were asked to differentiate between receiving care from a mental health specialist such as a social worker, psychiatrist or other mental health professional, and receiving care from a general service provider, such as a primary care physician.
Results of the study
The survey revealed that, within the past year, 3.6 percent of adolescents had suicidal thoughts, but did not make a specific plan or suicide attempt. In addition, 0.6 percent reported having a plan, and 1.9 percent reported having made a suicide attempt within the past year.Suicidal behavior among youth was not only associated with major depression, but also with a range of other mental health problems including eating, anxiety, substance use and behavior disorders, as well as physical health problems. Between 50 and 75 percent of those teens who reported having suicidal ideation had recent contact with a service provider. However, most only had three or fewer visits, suggesting that treatment tends to be terminated prematurely. Moreover, most teens with suicidal ideation did not receive specialized mental health care.
The results of this study suggest that depression and other mood disorders are not the only pathways to suicide. They also highlight the importance of integrating risk assessment for suicide into routine physical and mental health care for teens. Even if adolescents are in treatment, they should continue to be monitored for suicidal ideation and behaviors, the researchers concluded.
Husky M, Olfson M, He J, Nock M, Swanson S, Merikangas K. Twelve-month suicidal symptoms and use of services among adolescents: results from the National Comorbidity Survey. Psychiatric Services in Advance, Aug 15, 2012.
Colleen LabbeNIMH Press Office301-443-4536NIMHPress@nih.gov
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