Findings

Depressing

Kevin Lewis

March 06, 2011

When self-destructive thoughts flash through the mind: Failure to meet standards affects the accessibility of suicide-related thoughts

Armand Chatard & Leila Selimbegović
Journal of Personality and Social Psychology, forthcoming

Abstract:
When individuals realize that they fail to attain important standards or expectations, they may be motivated to escape the self, which could lead thoughts of suicide to become more accessible. Six studies examined this hypothesis, mainly derived from escape theory (Baumeister, 1990). The results indicated that whenever individuals realize that they fail to attain an important standard, they experience increased accessibility of suicide-related thoughts (Studies 1-6). In line with the idea that such effects reflect motivations to escape from negative self-awareness, they were especially pronounced when associated with high levels of self-consciousness and escapist motivations (Study 1) and with a large discrepancy between self and standards (Studies 2-4). Moreover, failure to attain standards increased suicide-thought accessibility along with the desire for an altered state of consciousness (Study 5). Finally, increases in suicide-thought accessibility after failure were associated with simultaneous increases in accessibility of general concepts related to escape (Study 6). Implications of these findings for escape and terror management theories are discussed.

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Suicide among Arab-Americans

Abdulrahman El-Sayed, Melissa Tracy, Peter Scarborough & Sandro Galea
PLoS ONE, February 2011, e14704

Background: Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.

Methodology/Principal Findings: ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%).

Conclusions/Significance: Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

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Does victimization reduce self-control? A longitudinal analysis

Robert Agnew et al.
Journal of Criminal Justice, forthcoming

Purpose: To examine the effect of victimization on self-control.

Method: Five waves of data from the GREAT survey are analyzed; the effect of prior victimization on subsequent self-control is estimated using the dynamic panel generalized-method of moments.

Results: Victimization reduces subsequent self-control in the near term.

Conclusions: The findings point to another source of low self-control, help to explain why prior victimization is linked to subsequent victimization, and provide support for general strain theory - which predicts that strains such as victimization will reduce self-control.

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Elevated amygdala response to faces following early deprivation

N. Tottenham et al.
Developmental Science, March 2011, Pages 190-204

Abstract:
A functional neuroimaging study examined the long-term neural correlates of early adverse rearing conditions in humans as they relate to socio-emotional development. Previously institutionalized (PI) children and a same-aged comparison group were scanned using functional magnetic resonance imaging (fMRI) while performing an Emotional Face Go/Nogo task. PI children showed heightened activity of the amygdala, a region that supports emotional learning and reactivity to emotional stimuli, and corresponding decreases in cortical regions that support perceptual and cognitive functions. Amygdala activity was associated with decreased eye-contact as measured by eye-tracking methods and during a live dyadic interaction. The association between early rearing environment and subsequent eye-contact was mediated by amygdala activity. These data support the hypothesis that early adversity alters human brain development in a way that can persist into childhood, and they offer insight into the socio-emotional disturbances in human behavior following early adversity.

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The structure of past and future lives in depression

Tim Dalgleish et al.
Journal of Abnormal Psychology, February 2011, Pages 1-15

Abstract:
This study assessed the organization of past autobiographical knowledge in individuals with either current major depressive disorder (MDD), MDD in remission, or no history of MDD (the control group). Participants generated personal lists of "life chapters," dividing both their past and potential future into subjectively meaningful episodes or themes (e.g., "married life"). They were then given a list of potentially chapter-descriptive positive or negative attributes and sorted them according to the different chapters. Results revealed that, relative to the control group, MDD participants selected more negative attributes overall, showed greater redundancy for negative attributes (i.e., using the same ones repeatedly across chapters) and reduced redundancy for positive attributes, and exhibited greater compartmentalization (i.e., the negative and positive attributes were clustered separately across different chapters). A similar pattern emerged for the remitted MDD group relative to controls, with the exception of negative redundancy, which was not elevated. For future chapters, there were no group differences. Finally, a greater number of past depressive episodes was associated with increasingly reduced positive redundancy. These data reveal a "depressogenic" structuring of past (but not future) knowledge in MDD that is also evident in a remitted MDD group, with the exception of negative redundancy, which appears to be a marker of the acute state. These findings shed light on important aspects of the organization of past knowledge that are likely to be linked to maladaptive processing biases in those with a depression history.

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Killing versus witnessing in combat trauma and reports of PTSD symptoms and domestic violence

Elizabeth Van Winkle & Martin Safer
Journal of Traumatic Stress, February 2011, Pages 107-110

Abstract:
Active participation in combat trauma increased reports of posttraumatic stress disorder (PTSD) symptoms over passive witnessing of trauma. Using archival data from 376 U.S. soldiers who took part in the family interview component of the 1988 National Vietnam Veteran Readjustment Study (NVVRS), findings are that even after statistically accounting for witnessing combat trauma, U.S. soldiers who likely killed enemy soldiers in combat reported elevated levels of PTSD symptoms. Both inference and direct self-reports were used to measure killing in combat, and both measures accounted equally well for variance in PTSD symptoms. The likelihood of a soldier killing enemy combatants was also weakly related to his spouse's report of physical domestic violence in the past year. Diagnosing the mental health symptoms of combat soldiers should specifically assess whether they actively participated in wounding or killing the enemy.

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Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A)

Kathleen Ries Merikangas et al.
Journal of the American Academy of Child & Adolescent Psychiatry, October 2010, Pages 980-989

Objective: To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates.

Method: The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.

Results: Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2% (11.2% with mood disorders, 8.3% with anxiety disorders, and 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for substance use disorders.

Conclusions: These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every four to five youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention.

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Cytokine levels in the blood may distinguish suicide attempters from depressed patients

Shorena Janelidze et al.
Brain, Behavior, and Immunity, February 2011, Pages 335-339

Abstract:
Elevated plasma cytokines is a common finding in Major Depressive Disorder (MDD), although not consistent. It is currently not known whether the inflammatory changes are confined to any specific subgroup of depressive patients. We here analyzed three inflammatory markers in suicidal and non-suicidal depressed patients, as well as healthy controls. Plasma interleukin (IL)-2, IL-6 and tumor necrosis factor (TNF)-α were measured in 47 suicide attempters, 17 non-suicidal depressed patients and 16 healthy controls. Study participants were evaluated using the Comprehensive Psychopathological Rating Scale (CPRS) with subscales for anxiety and degree of depression, as well as the Suicide Assessment Scale (SUAS). We found increased levels of IL-6 and TNF-α as well as decreased IL-2 concentrations in suicide attempters compared to non-suicidal depressed patients and healthy controls. The results were adjusted for potential confounders of cytokine expression, such as age, sex, body mass index (BMI), degree of depression, anxiety, personality disturbance, abuse and type of medication. These results demonstrate for the first time that suicidal patients display a distinct peripheral blood cytokine profile compared to non-suicidal depressed patients. Thus, our study provides further support for a role of inflammation in the pathophysiology of suicidality.

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Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic

Greg Reger et al.
Journal of Traumatic Stress, February 2011, Pages 93-96

Abstract:
Exposure therapy is an evidence-based treatment for posttraumatic stress disorder (PTSD), but research evaluating its effectiveness with active duty service members is limited. This report examines the effectiveness of virtual reality exposure therapy (VRE) for active duty soldiers (N = 24) seeking treatment following a deployment to Iraq or Afghanistan. Relative to their pretreatment self-reported symptoms on the PTSD Checklist, Military Version (M = 60.92; SD = 11.03), patients reported a significant reduction at posttreatment (M = 47.08; SD = 12.70; p < .001). Sixty-two percent of patients (n = 15) reported a reliable change of 11 points or more. This study supports the effectiveness of exposure therapy for active duty soldiers and extends previous research on VRE to this population.

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Young adult narcissism: A 20 year longitudinal study of the contribution of parenting styles, preschool precursors of narcissism, and denial

Phebe Cramer
Journal of Research in Personality, February 2011, Pages 19-28

Abstract:
The role of parenting styles in the development of young adult narcissism is investigated with individuals from the Block and Block (1980) longitudinal study. At age 3, participants were assessed for the presence of narcissism precursors, and mothers and fathers provided information about their parenting styles. At age 23, the presence of both healthy and maladaptive narcissism was assessed, along with the use of denial. The results showed that parenting styles had a direct effect on the development of healthy narcissism, but the effect on the development of maladaptive narcissism depended on the child's initial proclivity towards narcissism. Also, the use of denial was positively associated with the presence of maladaptive narcissism, but not with healthy narcissism.

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Observant, nonaggressive temperament predicts theory-of-mind development

Henry Wellman et al.
Developmental Science, March 2011, Pages 319-326

Abstract:
Temperament dimensions influence children's approach to and participation in social interactive experiences which reflect and impact children's social understandings. Therefore, temperament differences might substantially impact theory-of-mind development in early childhood. Using longitudinal data, we report that certain early temperament characteristics (at age 3) - lack of aggressiveness, a shy-withdrawn stance to social interaction, and social-perceptual sensitivity - predict children's more advanced theory-of-mind understanding 2 years later. The findings contribute to our understanding of how theory of mind develops in the formative preschool period; they may also inform debates as to the evolutionary origins of theory of mind.

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Association between Tryptophan Hydroxylase 2 Gene Polymorphism and Completed Suicide

Sylwia Fudalej et al.
Suicide and Life-Threatening Behavior, December 2010, Pages 553-560

Abstract:
The association between suicide and a single nucleotide polymorphism (rs1386483) was examined in the recently identified tryptophan hydroxylase 2 (TPH2) gene. Blood samples of 143 suicide victims and 162 age- and sex-matched controls were examined. The frequency of the TT genotype in the TPH2 polymorphism was higher in suicide victims than in controls (17.5% vs. 8.6%; p = 0.02), particularly in those with a history of repeated suicide attempts (53.3% vs. 8.6%; p < 0.0001). The examined TPH2 polymorphism was found to be associated with suicide. This genetic marker may be particularly important in understanding risk of multiple suicide attempts. Further analyses are needed to confirm these results.

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Prevalence of exposure to potentially traumatic events in a healthy birth cohort of very young children in the northeastern United States

Margaret Briggs-Gowan et al.
Journal of Traumatic Stress, December 2010, Pages 725-733

Abstract:
Prevalence estimates of very young children's exposure to potentially traumatic events (PTEs) are limited. The study objective was to estimate the lifetime prevalence and correlates of noninterpersonal PTEs and violence exposure in a representative healthy birth cohort (ages 1-3 years) from an urban-suburban region of the United States (37.8% minority, 20.2% poverty). Parents completed 2 surveys approximately 1-year apart. By 24-48 months of age, the prevalence of exposure was 26.3% (14.5% noninterpersonal, 13.8% violence). Exposure was common among children living in poverty (49.0% overall, 19.7% noninterpersonal, 33.7% violence). The most consistent factors associated with exposure were poverty, parental depressive symptoms, and single parenting. Findings underscore the potential for prevention and intervention in early childhood to advance public health and reduce morbidity.

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Mental- and Physical-Health Indicators and Sexually Explicit Media Use Behavior by Adults

James Weaver et al.
Journal of Sexual Medicine, March 2011, Pages 764-772

Introduction: Converging evidence from culturally diverse contexts indicates that sexually explicit media use behavior (SEMB; i.e., pornography consumption) is associated with risky sexual health perceptions and behaviors, many that involve high risks of HIV/STD transmission.

Aim: Essentially unexplored, and the focus here, are potential relationships between SEMB and nonsexual mental- and physical-health indicators.

Main Outcome Measures: Variability in six continuously measured health indicators (depressive symptoms, mental- and physical-health diminished days, health status, quality of life, and body mass index) was examined across two levels (users, nonusers) of SEMB.

Methods: A sample of 559 Seattle-Tacoma Internet-using adults was surveyed in 2006. Multivariate general linear models parameterized in a SEMB by respondent gender (2 × 2) factorial design were computed incorporating adjustments for several demographics.

Results: SEMB was reported by 36.7% (n = 205) of the sample. Most SEMB users (78%) were men. After adjusting for demographics, SEMB users, compared to nonusers, reported greater depressive symptoms, poorer quality of life, more mental- and physical-health diminished days, and lower health status.

Conclusions: The findings show that mental- and physical-health indicators vary significantly across SEMB, suggesting the value of incorporating these factors in future research and programmatic endeavors. In particular, the findings suggest that evidence-based sexual health promotion strategies simultaneously addressing individuals' SEMB and their mental health needs might be a useful approach to improve mental health and address preventable sexual health outcomes associated with SEMB.

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Effect of Copayments on Use of Outpatient Mental Health Services Among Elderly Managed Care Enrollees

C.D. Ndumele & A.N. Trivedi
Medical Care, March 2011, Pages 281-286

Background: Recent parity legislation will require many insurers and the federal Medicare program to reduce mental health copayments, so that they are equivalent to copayments for other covered services. The effect of changes in mental health cost sharing has not been well studied, particularly among elderly populations.

Objective: To examine the consequences of increasing and decreasing copayments on the use of outpatient mental health services among the elderly.

Research Design: Difference-in-differences (DID) design comparing the use of outpatient mental health care in Medicare plans that changed mental health copayments compared with concurrent trends in matched control plans with unchanged copayments.

Study Population: A total of 1,147,916 enrollees aged 65 years and older in 14 Medicare plans that increased copayments by >=25%, 3 plans that decreased copayments by >=25%, and 17 matched control plans with unchanged copayments.

Results: In 14 plans that increased mental health copayments from a mean of $14.43 to $21.07, the proportion of enrollees who used mental health services remained at 2.2% in the year before and year after the increase (adjusted DID, 0.1 percentage points; 95% confidence interval, 0.0-0.1). Among 3 plans that decreased copayments from a mean of $25.00 to $8.33, utilization rates were 1.2% before and after the decrease (adjusted DID, 0.1 percentage points; 95% confidence interval, -0.2 to 0.3). Stratified analyses by age, gender, race, and presence of a disability yielded similar results.

Conclusions: Few older adults in managed care plans used outpatient mental health services. Among this population, increasing or decreasing mental health copayments had negligible effects on the likelihood of using outpatient mental health care.

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John Nash, Game Theory, and the Schizophrenic Brain

Donald Capps
Journal of Religion and Health, March 2011, Pages 145-162

Abstract:
This article focuses on John Nash, recipient of the Nobel Prize in Economics in 1994, and subject of the Award winning 2001 film A Beautiful Mind, who was diagnosed with paranoid schizophrenia in 1958 at the age of 29. After presenting an account of the emergence, course, and eventual remission of his illness, the article argues for the relevance of his contribution to game theory, known as the Nash equilibrium, for which he received the Nobel Prize, to research studies of the schizophrenic brain and how it deviates from the normal brain. The case is made that the Nash equilibrium is descriptive of the normal brain, whereas the game theory formulated by John van Neumann, which Nash's theory challenges, is descriptive of the schizophrenic brain. The fact that Nash and his colleagues in mathematics did not make the association between his contributions to mathematics and his mental breakdown and that his later recovery exemplified the validity of this contribution are noted and discussed. Religious themes in his delusional system, including his view of himself as a secret messianic figure and the biblical Esau, are interpreted in light of these competing game theories and the dysfunctions of the schizophrenic brain. His recognition that his return to normalcy came at the price of his sense of being in relation to the cosmos is also noted.

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Buffering Effects of Benefit Finding in a War Environment

Michael Wood et al.
Military Psychology, March 2011, Pages 202-219

Abstract:
Benefit finding (BF) has been extensively examined after exposure to traumatic events. However, less research has examined BF as a buffer against the negative effects of an ongoing stressful event. Data from 1,925 U.S. Army soldiers deployed in support of Operation Iraqi Freedom (OIF) was used to examine whether BF would moderate the relationship between combat exposure and posttraumatic stress disorder (PTSD) and depression. Regression analyses revealed that BF was associated with lower levels of PTSD and depression. However, we found that BF during the combat deployment was found to moderate the combat exposure-PTSD relationship, such that the relationship was stronger when BF was low. Results are discussed in terms of BF being a form of meaning-based coping that may help soldiers adjust to the challenges of war.


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