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Early childhood depression alters brain development

What do you think about this article by WASHINGTON UNIVERSITY SCHOOL OF MEDICINE?

"The brains of children who suffer clinical depression as preschoolers develop abnormally, compared with the brains of preschoolers unaffected by the disorder, according to new research at Washington University School of Medicine in St. Louis. Their gray matter -- tissue that connects brain cells and carries signals between those cells and is involved in seeing, hearing, memory, decision-making and emotion -- is lower in volume and thinner in the cortex, a part of the brain important in the processing of emotions. The new study is published Dec. 16 in JAMA Psychiatry. "What is noteworthy about these findings is that we are able to see how a life experience -- such as an episode of depression -- can change the brain's anatomy," said first author Joan L. Luby, MD, whose research established that children as young as 3 can experience depression. "Traditionally, we have thought about the brain as an organ that develops in a predetermined way, but our research is showing that actual experience -- including negative moods, exposure to poverty, and a lack of parental support and nurturing -- have a material impact on brain growth and development." The findings may help explain why children and others who are depressed have difficulty regulating their moods and emotions. The research builds on earlier work by Luby's group that detailed other differences in the brains of depressed children. Luby, the Samuel and Mae S. Ludwig Professor of Child Psychiatry, and her team studied 193 children, 90 of whom had been diagnosed with depression as preschoolers. They performed clinical evaluations on the children several times as they aged. The researchers also conducted MRI scans at three points in time as each child got older. The first scans were performed when the kids were ages 6 to 8, and the final scans were taken when they were ages 12 to 15. A total of 116 children in the study received all three brain scans. "If we had only scanned them at one age or stage, we wouldn't know whether these effects simply were present from birth or reflected an actual change in brain development," said co-investigator Deanna M. Barch, PhD, head of Washington University's Department of Psychological and Brain Sciences in Arts & Sciences. "By scanning them multiple times, we were able to see that the changes reflect an actual difference in brain maturation that emerges over the course of development." The gray matter is made up mainly of neurons, along with axons that extend from brain cells to carry signals. The gray matter processes information, and as children get older, they develop more of it. Beginning around puberty, the amount of gray matter begins to decline as communication between neurons gets more efficient and redundant processes are eliminated. "Gray matter development follows an inverted U-shaped curve," Luby said. "As children develop normally, they get more and more gray matter until puberty, but then a process called pruning begins, and unnecessary cells die off. But our study showed a much steeper drop-off, possibly due to pruning, in the kids who had been depressed than in healthy children." Further, the steepness of the drop-off in the volume and thickness of the brain tissue correlated with the severity of depression: The more depressed a child was, the more severe the loss in volume and thickness. The researchers determined that having depression was a key factor in gray matter development. In scans of children whose parents had suffered from depression -- meaning the kids would be at higher risk -- gray matter appeared normal unless the kids had suffered from depression, too. Interestingly, the differences in gray matter volume and thickness typically were more pronounced than differences in other parts of the brain linked to emotions. Luby explained that because gray matter is involved in emotion processing, it is possible some of the structures involved in emotion, such as the brain's amygdala, may function normally, but when the amygdala sends signals to the cortex -- where gray matter is thinner -- the cortex may be unable to regulate those signals properly. Luby and Barch are planning to conduct brain scans on even younger children to learn whether depression may cause pruning in the brain's gray matter to begin earlier than normal, changing the course of brain development as a child grows. "A next important step will involve determining whether early intervention might shift the trajectory of brain development for these kids so that they revert to more typical and healthy development," said Barch, also the Gregory B. Couch Professor of Psychiatry. Luby said that is the main challenge facing those who treat kids with depression. "The experience of early childhood depression is not only uncomfortable for the child during those early years," she said. "It also appears to have long-lasting effects on brain development and to make that child vulnerable to future problems. If we can intervene, however, the benefits might be just as long-lasting." ### Funding from the National Institute of Mental Health and the National Institutes of Health Blueprint of the National Institutes of Health (NIH), grant numbers R01 MH66031, R01 MH084840, R01 MH090786, R01 MH098454-S, U54 MH091657, 2R01 MH064769-06A1, PA-07-070 NIMH R01 5K01MH090515-04 and T32 MH100019. Luby JL, Belden AC, Jackson JL, Lessov-Schlaggar CN, Harms MP, Tillman R, Botteron K, Whalen D, Barch DM. Early childhood depression and alterations in the trajectory of gray matter maturation in middle childhood and early adolescence?. JAMA Psychiatry, published online Dec. 16, 2015. http://jamapsychiatry.com doi:10.1001/jamapsychiatry.2015.2356 Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare." For more information on depression and other mental health related topics,please visit Aspira Continuing Education Online Courses

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Study finds surprising links between bullying and eating disorders

What do you think of this NIMH article?: "DUKE UNIVERSITY MEDICAL CENTER IMAGE: ILLUSTRATION BY MARK DUBOWSKI FOR DUKE MEDICINE. CREDIT: ILLUSTRATION BY MARK DUBOWSKI FOR DUKE MEDICINE Being bullied in childhood has been associated with increased risk for anxiety, depression and even eating disorders. But according to new research, it's not only the victims who could be at risk psychologically, but also the bullies themselves. Researchers at Duke Medicine and the University of North Carolina School of Medicine were surprised to find that in a study of 1,420 children, those who bullied others were twice as likely to display symptoms of bulimia, such as bingeing and purging, when compared to children who are not involved in bullying. The findings are published in the December issue of International Journal of Eating Disorders. "For a long time, there's been this story about bullies that they're a little more hale and hearty," said lead author William Copeland, Ph.D., associate professor of psychiatry and behavioral sciences at Duke University School of Medicine. "Maybe they're good at manipulating social situations or getting out of trouble, but in this one area it seems that's not the case at all. Maybe teasing others may sensitize them to their own body image issues, or afterward, they have regret for their actions that results in these symptoms like binge eating followed by purging or excess exercise." The findings come from an analysis of interviews from the Great Smoky Mountains Study, a database with more than two decades of health information on participants who enrolled at age 9. The data is considered a community sample and not representative of the U.S. population, but offers clues to how children ages 9 to 16 could be affected. Participants were divided into four categories - children who were not at all involved in bullying; victims of bullying; children who sometimes were victims and sometimes were instigators; and children who were solely bullies, repeatedly abusing other children verbally and physically, socially excluding others, and rumor mongering, without ever becoming a victim themselves. The researchers were not surprised to find that victims of peer abuse were generally at increased risk for eating disorders. Children who were victims of bullying were at nearly twice the risk of displaying symptoms of anorexia (11.2 percent prevalence compared to 5.6 percent of children who were not involved in bullying) and bulimia (27.9 percent prevalence compared to 17.6 percent of children not involved in bullying). Children who were both bullies and victims had the highest prevalence of anorexia symptoms (22.8 percent compared to 5.6 percent of the children not involved in bullying) and also the highest prevalence of binge eating (4.8 percent of children as compared to less than 1 percent of uninvolved children) and vomiting as a way to maintain their weight. But the impact of bullying behavior on those who were bullies was also significant, with 30.8 percent of bullies having symptoms of bulimia compared to 17.6 percent of children not involved in bullying. All of these behaviors can have devastating effects on the long-term health of children, said Cynthia M. Bulik, Ph.D., a distinguished professor of eating disorders at the UNC School of Medicine and a co-author on the findings. "Sadly, humans do tend to be most critical about features in other people that they dislike most in themselves," Bulik said. "The bullies' own body dissatisfaction could fuel their taunting of others. Our findings tell us to raise our vigilance for eating disorders in anyone involved in bullying exchanges -- regardless of whether they are the aggressor, the victim, or both." Although many children experience lifelong effects, many appear to cope and succeed after such experiences, Copeland said. He and colleagues are examining myriad factors, including looking at financial and educational outcomes, and even if bullying or being victimized is associated with genetic biomarkers. "We want to do a better job of understanding why some people are able to experience the same things as others and be able to get through them without the same consequences," Copeland said. "We really need to understand the resilience in those who have been bullied. That can help us determine the children who are going to need the most attention, and how we can promote those traits in others to increase their resilience." ### In addition to Copeland and Bulik, study authors include Nancy Zucker; Dieter Wolke; Suzet Tanya Lereya; and Elizabeth Jane Costello. The study was sponsored by the National Institute of Mental Health (MH63970, MH63671, MH48085, MH080230); the National Institute on Drug Abuse (DA/MH11301); the William T. Grant Foundation; and the Economic and Social Research Council in the United Kingdom (ES/K003593/1). Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system" For more information mental health topics, please visit our course listing mental health continuing education

Happy head, happy heart: Positive emotions may promote heart-healthy behaviors

What do you think of this article by NIMH? "People with heart disease may benefit from maintaining positive emotions, according to health researchers. Over the course of five years the researchers tracked more than 1,000 patients with coronary heart disease. Patients who reported higher positive psychological states were more likely to be physically active, sleep better and take their heart medications and were also less likely to smoke, compared to patients with lower levels of positive states. "Negative emotions and depression are known to have harmful effects on health, but it is less clear how positive emotions might be health-protective," said Nancy L. Sin, postdoctoral fellow in the Center for Healthy Aging and in the department of biobehavioral health at Penn State. "We found that positive emotions are associated with a range of long-term health habits, which are important for reducing the risk of future heart problems and death." The researchers assessed psychological well-being of participants at baseline and again at a five-year follow-up by asking the participants to rate the extent that they had felt 10 specified positive emotions, including "interested," "proud," "enthusiastic" and "inspired." Physical activity, sleep quality, medication adherence and alcohol and cigarette use were also measured at baseline and again five years later. The researchers report their findings in the today's (Oct. 2) issue of the journal Psychosomatic Medicine. "Higher levels of positive emotions were associated with less smoking, greater physical activity, better sleep quality and more adherence to medications" at baseline, said the researchers. They found no correlation between positive emotions and alcohol use. The results took into account patients' demographic factors, depressive symptoms and the severity of their heart conditions. Though positive emotions at baseline did not predict changes in health behaviors five years later, increases in positive emotions across the five-year period were associated with improvements in physical activity, sleep quality and medication adherence. There are a number of reasons why positive emotions are linked to optimal health habits, the researchers suggest. People with greater positive well-being may be more motivated and persistent in engaging in healthy behaviors. They might have more confidence in their abilities to maintain routines such as physical activity and sleep hygiene. Positive emotions may also enable people to better adjust their health goals and to proactively cope with stress and setbacks. "Efforts to sustain or enhance positive emotions may be promising for promoting better health behaviors," said the researchers. This research sets the stage for future work on interventions to improve health habits, Sin noted. Further research with other chronic disease populations and with electronic tracking of health behaviors should be conducted, she said. ### Judith Tedlie Moskowitz, professor, medical social sciences at the Feinberg School of Medicine, Northwestern University, and Mary A. Whooley, professor, medicine, epidemiology and biostatistics at the University of California San Francisco and physician at the San Francisco Veterans Affairs Medical Center, also worked on this research. The National Institute on Aging, the National Institute of Mental Health, the department of Veterans Affairs, the National Heart, Lung and Blood Institute, the Robert Wood Johnson Foundation and the American Federation for Aging Research supported this work. Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system." For more on this and other mental health subjects, please visit our course listing page Continuing Education Online Courses

Long-term memory formation

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NYU scientists find that growth factors that build brains also build memories New York University "A team of New York University neuroscientists has determined how a pair of growth factor molecules contributes to long-term memory formation, a finding that appears in the journal Neuron. "These results give us a better understanding of memory's architecture and, specifically, how molecules act as a network in creating long-term memories," explains the paper's senior author, Thomas Carew, a professor in NYU's Center for Neural Science and dean of NYU's Faculty of Arts and Science. "More importantly, this marks another step toward elucidating the intricacies of memory function, which is vital in the development of cognitive therapies to address related afflictions." The importance of growth factor molecules (GFs) has long been known. They are critical in building brains beginning in utero and until adulthood. Moreover, over time, it's been established that GFs are "recycled" from brain builders to engineers of long-term memories. Less clear, however, is how the wide range of GF families, as well as different members within each family, act to help us create these memories. In working to address this question, the NYU research team, which also included graduate student Ashley Kopec, the study's lead author, and research scientist Gary Philips, focused on two GF families: TrkB and TGFβr-II, which represent two distinct classes of GFs that utilize different types of receptors to exert their actions in the brain. In their study, the researchers examined GFs in Aplysia californica, the California sea slug. Aplysia is a model organism that is quite powerful for this type of research because its neurons are 10 to 50 times larger than those of higher organisms, such as vertebrates, and it possesses a relatively small network of neurons--characteristics that readily allow for the examination of molecular signaling during memory formation. Specifically, to produce a form of "threat memory" called sensitization in a simple reflex system of Aplysia, the researchers presented the sea slugs with a pair of mild tail shocks delivered 45 minutes apart--the first to instill a "molecular context" in the neurons of the reflex and the second to use that context to drive molecular mechanisms that are required to form a long-term memory -- and then examined GF activity at both periods, Time 1 and Time 2. Their results showed differences in the role of these two GF families across two dimensions: time and space. At Time 1, when the context for the memory is first created, TrkB plays a critical role while TGFβr-II is irrelevant. However, at Time 2, when a long-term memory is actually formed, the roles are reversed: TGFβr-II is active, but TrkB is insignificant. In addition, the results showed spatial differences. In Aplysia, the simple neural circuit that mediates the reflex modified by learning is made up of unique sensory neurons and motor neurons. The sensory neurons' cell bodies live in one compartment of the brain while their companion synapses, which pass along signals to other cells, reside in another. In the Neuron study, the researchers found that the TrkB effects are exerted only at synapses while TGFβr-II functions only at the cell body. Overall the study provides new insights into how different GF families play unique roles both in time and in space, thus helping to elucidate the "when," "where," and "how" of memory formation." ### The research was supported by grants from the National Institute of Mental Health (RO1 MH 041083, F31 MH 100889). For more information on memory, please visit Aging and Long Term Care CE Course