More money more problems? Rich teens, drugs, and other mental health issues

From allaboutaddiction.com:

Teens raised in affluent homes display the highest rates of depression, anxiety, and substance abuse according to a recent article in Monitor on Psychology, the APA’s monthly magazine.

One of our recent posts dealt with some of the issues unique to teens and drugs. In addition to the issues we’d already mentioned, the article named a number of reasons for the high prevalence of mental-health issues among affluent teens. Among them were an increasingly narcissistic society, overbearing parents, and an common attitude of perfectionism.

Each of these reasons are likely contributors to the prevalence of mental health issues among upper-middle-class (and above) teens. Still, as far as I’m concerned, the main take home message of the article is this:

Money truly doesn’t buy happiness.

While we often focus on the lower socioeconomic strata, these recent findings, indicate that being financially stable offers little in the way of protection from some of the most common psychological difficulties.

Thankfully, the researchers cited in the article made some very simple suggestions to parents:

• Give children clear responsibilities to help around the house.
• Take part in community service (to unite the family and reduce narcissism).
• Reduce TV watching (especially of reality TV shows that glorify celebrity and excess).
• Monitor internet use.
• Stop obsessing about perfect grades and focus instead on the joy of learning for its own sake.

I couldn’t agree more with these recommnedations. Having taught a number of classes myself, I have withnessed the ridiculous inflation in students’ expectations of top grades. I think it’s time we turned attention back to the family and reintroduce some of the basic skills that many addicts find themselves learning much too late… Often in recovery.

The Ethics of Neuroenhancement

A recent issue of the New Yorker featured a wide-ranging and engagingly written review of the current controversy over the ethics of neuroenhancement. Neuroenhancement refers to the growing trend of off-label use of psychiatric drugs by men and women of all ages and backgrounds for the purpose of boosting their brain power and ability to get things done. In an anonymous survey of scientists and academics that appeared in the journal Nature in 2007, about one in every five of respondents reported off-label use of Ritalin, Adderall, or the anti-narcoleptic drug Provigil (known generically as modafinil) to increase their productivity and focus. The New Yorker article, written by Margaret Talbot, is one of the most comprehensive reports on this trend to appear in a major news publication, and I strongly encourage readers with interest in this subject to read the original article in full.

Prior to reading Talbot’s article, I was unaware of the possibility that neuroenhancers are most often used to overcome cognitive or motivational deficits, but the more I think about it the more sense it seems to make. Support for this claim can be found in the New Yorker article, which argues that most neuroenhancers in college are underachievers (note, however, that this is based mainly on anecdotal evidence). So it may be true that students who take Adderall in college are gaining an unfair advantage, but this advantage may only be relative to other underachievers. Specifically, non-enhancing underachievers may receive sub-normal grades while those who take neuroenhancers may obtain grades that are closer to average. Further, recent empirical findings suggest that drugs such as Adderall and Ritalin may benefit less cognitively sharp people to a greater extent than they benefit more intelligent folks.

One interviewee in the New Yorker article raises the specter of parents who might force their children to take neuroenhancers so as to increase their competitive advantage in the academic arena and therefore their ability to get into the best colleges. This is a valid and important concern, but there is a world of difference between parents forcing their children to take neuroenhancers for non-clinical purposes and adults choosing to do so of their own free will. In any case, such abuses are already possible, as parents may push for psychiatrists to diagnose their children with ADHD so that a prescription for a neuroenhancer may be obtained.

As technology and culture continue to co-evolve in the new millennium, the public debate over the benefits and drawbacks of neuroenhancement will likely become increasingly central to how we view ourselves as individuals and as a society. Neuroenhancement offers the potential for tremendous increases in productivity across occupational and professional domains, but it also raises questions about our core ethical values and what it means to be truly meritocratic. The jury is still out on many of these questions. What do you think?

Self-Control is important, and teachable to some extent

Self-control or behavioral disinhibition has been implicated in a number of psychiatric disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD). It may be a mediating factor responsible for the lowered academic performance found among many children with ADHD.

The ability to inhibit responses may predict academic performance even better than IQ. This New Yorker article reviews studies of self-regulation and how “will power” may be a trainable trait that makes a difference in our social, academic, and financial domains.

One example of how animal research can help humans

Human and animal studies have found that brains go through substantial
synaptic pruning during childhood, removing approximately half of all synapses until puberty. While the pruning of synapses is a natural process, some researchers have theorized that schizophrenia arises from excessive pruning (Siekmeier & Hoffman, 2002). Presuming schizophrenia is a disorder of disruptions in neural connectivity caused by excessive pruning, then efforts to prevent the onset of psychosis and other symptoms of schizophrenia should being prior to adolescence. Identification of likely prodromes should therefore occur as early as possible in development.

Identifying the areas of the brain and specific neurotransmitters that play a role in pruning, in particular pruning likely specific to schizophrenia is an important step to keep those areas from being pruned unnecessarily. One possible prevention strategy could be to stimulate glutamate receptors on pyramidal neurons during childhood or before the heightened rate of pruning. Great care would need to be taken to be sure that only areas with excessive synaptic pruning be targeted. Animal studies could help to locate which agonist will bind to the correct receptors. Some early research is encouraging, as a study on amphibians found that after chronic NMDA treatment, changes in the magnitude of NMDA currents were detected in glutamatergic synaptic currents (Hickmott & Constantive-Paton, 1997). It will likely take many years to be confident that the introduction of pharmacological treatments to prevent unnecessary pruning will have benefits that outweigh the risks.

Animal research can and has helped to identify novel treatments for a number of diseases. For more information on how to support humane animal research go to http://www.ucla-pro-test.org/

References

Hickmott, P. W., & Constantine-Paton, M. (1997). Experimental down-regulation of the NMDA channel associated with synapse pruning. The Journal of Neurophysiology, 78, 1096-1107.

Siekmeier, P. J., Hoffman, R. E. (2002). Enhanced semantic priming in schizophrenia: a computer model based on excessive pruning of local connections in association cortex. British Journal of Psychiatry, 180, 345-350.

Disclose or not? The catch 22 of mental illness

A recent report published by SAMHSA addresses the issue of self-disclosure regarding mental illness.

Research has already shown that the more familiar people are with others who have different form of mental illness, the more their attitudes regarding mental illness will improve.

The problem is that in the process, those who self-disclose fear being ostracized, losing their jobs, and suffering other similar consequences.

Still, the report found that those who do self-disclose often experience relief and find that it improves their relationships.

Obviously, the process requires careful timing. Also, a progression of self-disclosure, from a small group of trusted friends on, is suggested.

For the full report, go here: “Self-disclosure and its impact on individuals who receive mental health services.”

Social Defeat may play a causal role in schizophrenia

Some ethnic minority groups have higher rates of schizophrenia than the general population. My first thought was that the differences were genetic. Current research has found a strong genetic component to schizophrenia, and given that different ethnic groups may have different rates of high risk genotypes, the genetic variation between groups may be in part responsible for the different rates. However, when these groups (often recent immigrants) were compared with those from the broader population of their own national/ethnic origin, there was no evidence of these groups being more genetically “at-risk.” Additional work found that those who had chosen to migrate were not likely different in the degree to which they were genetically predisposed to schizophrenia. There are separate fronts in the battle to understand mental disorder, with many pushing to further ‘biologize’ psychiatric disorders. One danger of over-biologizing is the removal of consideration of other causal explanations. While it may not be the schizophregenic mother that is responsible for the development of schizophrenia in her child, the social environment in which we live and interact likely plays at least a partial role in the development of serious psychopathology, even one as genetically-influenced as schizophrenia.

Research on the epidemiology of schizophrenia has found that risk for the disorder increases among nonwhites as their neighborhood composition becomes more white (Halpern, 1993). The repeated findings that minority members are at greater risk depending on the social environment in which they live means that environment may influence the onset, course, and possible origin of schizophrenia (Luhrmann, 2007). This effect has been explained by the experience of “social defeat,” which had been used in animal research to term the effect when one animal becomes physically dominant over another. In rats, social defeat appears to increase dopaminergic activity in the mesolimbic dopamine system pathway, which has been found to be associated with positive symptoms in schizophrenia in humans (Tidey & Miczek, 1996).

Most gene x environment research in psychological research has focused on objectively traumatic events (e.g. combat exposure, child sexual or physical abuse), yet the introduction of more subtle environmental “events,” such as discrimination, provides a new avenue of analysis that should be incorporated in the integrative models of psychopathology.

References

Halpern, D. (1993). Minorities and Mental Health. Social Science and Medicine, 36, 597–607.

Luhrmann, T. M. (2007). Social defeat and the culture of chronicity: Or, why does schizophrenia do so well over there and so badly over here? Culture, Medicine and Psychiatry, 31, 135–172.

Tidey, J., & Miczek, K. (1996). Social defeat stress selectively alters mesocorticolimbic dopamine release: An in vivo microdialysis study. Brain Research, 721, 140-149.

Beta blockers, addiction, and craving help: The new holy grail?

From all-about-addiction:

Okay, maybe I’m getting a little ahead of myself here, but I’m pretty excited about one study in particular that I heard about while in DC (for a Society For Neuroscience conference).

I’ve already written about a study by the renowned addiction researcher Barry Everitt showing that medications could be used in treatment to help addicts who are struggling with strong cravings and the effect of triggers (see it here). Still, my original idea had to do with using very common pharmacological interventions, ones being used every day for hypertension, and more recently, in the treatment of PTSD.

Well, a study recently completed revealed that indeed, propranolol, a common beta-blocker, may be useful in greatly reducing the amount of time needed to overcome the sometimes crippling effect of triggers on behavior.

The researchers trained rats to take cocaine, and after they were well trained, allowed them to press a lever for a light that had previously been associated with the drug. Animals given propranolol took half as long to stop pressing for the drug-associated light. It took multiple administrations of propranolol (seven to be exact), but the effect was clear. The next step is to see if the same effect can be observed in people.

I’ve been claiming for the past few years that if we look in the right places, we can find many ways to help struggling addicts who are having a hard time quitting using currently available methods. I think that the notion that sticking to the “best method we have right now” (a dubious claim that most 12 step followers ascribe to) is unwise given the fact that science has progressed quite a bit since the 1930s, when the group formed. I agree, and am thankful, that the system works for some, but many others leave the rooms without finding a solution, a fact that AA members see as a moral failing.

I’ve been studying addiction for the past 7 years; It’s time to quash the moral view of addiction once and for all and seek solutions that work. I think we’re well on our way…

Citation:

Ashley N. Fricks-Gleason & John F. Marshall (2008). Post-retrieval β-adrenergic receptor blockade: Effects on extinction and reconsolidation of cocaine-cue memories. Memory & Learning, 15, 643-648

It’s drug time – Circadian rhythms and addiction

From: all-about-addiction.com

Like most living creatures, humans have internal biological clocks known as circadian rhythms. These internal cycles synchronize our bodies with the Earth’s 24-hour day/night cycle and prepare us for predictable daily events (1). Circadian rhythms regulate a number of bodily functions including temperature, hormone secretion, bowel movements, and sleep (2). Well, recent research suggests that drugs may alter our circadian rhythms, possibly influencing our decisions to take drugs.

Our biological clocks are set by external cues from the environment, called zeitgebers (3). The most familiar to us are light and food. However, research on rats has shown that opiates, nicotine, stimulants, and alcohol also have the ability to alter the phase of circadian rhythms independent of light or food (1). Drug use has long been associated with major disruptions in the human sleep cycle. Cocaine, meth, and MDMA users often go without sleep for days, and these sleep disruptions can continue long after people stop using drugs. In fact, sleep disturbance outlasts most withdrawal symptoms and places recovering addicts at greater risk for relapse (3).

Circadian rhythms could also be the reason why people show 24-hour patterns of drug use. Fluctuations in drug sensitivity, effect, and reward value are believed to be regulated by genes that control circadian rhythms. In fact, a study of urban hospitals found that overdose victims are admitted to hospitals more around 6:30PM than any other time of the day (2).

Researchers are just beginning to explore the relationship between circadian rhythms and drug use. Future understanding of this relationship will help us explain how drug addiction develops and develop better ways to treat it. It’s possible that offering specific aspects of treatment as certain point in the circadian rhythm can improve the probability of success.

Citations:

1. Kosobud, A. E. K., Gillman, A. G., Leffel, J. K., Pecoraro, N.C., Rebec, G.V., Timberlake, W. (2007) Drugs of abuse can entrain circadian rhythms, The Scientific World Journal, 7(S2), 203-212

2. McClung, C.A. (2007) Circadian rhythms, the mesolimbic dopaminergic circuit, and drug addiction, The Scientific World Journal, 7(S2), 194-202

3. Gordon, H.W. (2007) Sleep, circadian rhythm, and drug abuse, The Scientific World Journal, 7(S2), 191-193

Teasing: Bullying or Playful Fun?

Dacher Keltner over at UC Berkeley recently wrote this interesting piece on teasing for the New York Times magazine. Citing examples of recent attempts to curb teasing in schools and in the workplace, Keltner argues that society is going too far in its opposition to teasing. He points out that teasing behavior is central to many human relationships, especially those of the flirtatious and romantic persuasion, and worries that the crucial distinction between mean-spirited and prosocial teasing is overlooked at our peril.

Some of Keltner’s contentions are likely to be controversial. In particular, he appears to oppose overly strict regulation of bullying in the schools and of sexual harrassment in the workplace. I invite debate on this issue in the comments section, but please be sure to read the article first…

Addendum:
This article also generated some pretty interesting letters to NYT in response. Check them out here.

Social Cognitive Neuroscience under attack!

As one of the bloggers who tends to be a bit more skeptical of work in social cognitive neuroscience, I’m posting this article w/out really investigating it closely.  I do this for three reasons.  1) As I said, I’m biased toward believing its true anyway 2)  Even if I was objective, I’m not really qualified to evaluate it properly, and 3) I want to give our neuroscience blogger the best chance possible to defend her area and stomp me intellectually.

So what’s the article already?  Vu et al. (in press) have written an article that calls into question the statistical analyses of many of the most widely cited articles in the currently ‘hot’ field of Social Cognitive Neuroscience which examines the neural correlates of topics such as personality, social pain, virtue, free will, consciousness, etc.  They argue that some of the correlations are not only inflated, they are practically impossible, and occasionally spurious.  The authors surveyed the researchers involved and found that they were using inappropriate statistical techniques, many of which might have lead the papers to be rejected if they were purely behavioral.  According to the authors, we need to reevaluate many of the big findings in social neuroscience, many of which appear to have originated from my institution.  See the article here-

http://www.pashler.com/Articles/Vul_etal_2008inpress.pdf