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  • Early childhood appetite traits linked to adolescent eating disorders, study finds

    Early childhood appetite traits linked to adolescent eating disorders, study finds

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    In a recent study published in The Lancet Child & Adolescent Health, researchers investigated the longitudinal relationships between appetitive qualities in early childhood and eating problem symptoms in adolescence.

    Study: Early childhood appetitive traits and eating disorder symptoms in adolescence: a 10-year longitudinal follow-up study in the Netherlands and the UK. Image Credit: Oksana Kuzmina/Shutterstock.comStudy: Early childhood appetitive traits and eating disorder symptoms in adolescence: a 10-year longitudinal follow-up study in the Netherlands and the UK. Image Credit: Oksana Kuzmina/Shutterstock.com

    Background

    Eating disorders and obesity are common mental health diseases across the world, and hunger is a neurobehavioral risk factor. Eating disorders are frequently associated with other mental problems and have a high death rate.

    The lack of efficient preventative strategies warrants epidemiological research to uncover innovative risk factors and treatment options.

    Eating disorders and BMI have similarities, such as food intake control and genetic overlap. The behavioral susceptibility theory may apply to eating disorders.

    About the study

    The present study investigated the association between childhood appetitive qualities and adolescent eating disorders.

    The team analyzed the Gemini (Wales and England) and Generation R (Rotterdam) cohort data to measure appetitive traits using the Child Eating Behaviour Questionnaire (CEBQ) based on parent-reported data for four-to-five-year-olds and self-reported data for 12–14-year-olds.

    They documented symptoms of overeating eating disorders (binge eating, uncontrolled eating, and emotional eating) and restrained eating disorders (compensatory behaviors and restrained eating).

    The Generation R study included pregnant women with an expected delivery date between April 2002 and January 2006, resulting in 9,745 live-born children. The Gemini study cohort comprised 4,804 children (2,402 twin pairs).

    The self-reported outcome measures included behavioral eating disorders (compensatory behaviors and binge eating symptoms) and disordered eating behaviors (restrained eating, uncontrolled eating, and emotional eating).

    The team assessed compensatory behaviors in the past three months using the Developmental and Well-Being Assessment (DAWBA) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

    They assessed restricted eating using the Dutch Eating Behavior Questionnaire (DEBQ) and emotional and uncontrolled eating using the Three Factor Eating Questionnaire (TFEQ).

    The researchers used logistic regressions to determine odds ratios (OR), adjusting for sociodemographic covariates (age at outcome assessment, biological sex, gestational age, ethnicity, household income, maternal education, and maternal BMI) and the child’s age- and sex-adjusted body mass index (BMI) scores at ages four to five years.

    They examined interaction effects for appetite by biological sex and obtained pooled ORs by meta-analysis, with sensitivity analyses performed using the inverse probability-type weighting method.

    Results

    The study included 2,801 Generation R participants and 869 Gemini study participants. Emotional overeating during early childhood elevated adolescent compensatory behavior odds (OR, 1.2).

    Contrastingly, higher satiety responsiveness decreased adolescent uncontrolled eating odds (OR, 0.9) and compensatory behavior (OR, 0.9) odds.

    Slow eating during early childhood reduced the likelihood of restrained eating and compensatory behavior (OR, 0.9 for both) in adolescence.

    The study hypothesis was that higher responsiveness to food during early childhood enhanced overeating disorder risk in adolescence, with the highest risk being binge eating (ORpooled, 1.5 for every unit enhancement in response to food).

    Contrary to the hypothesis, higher food responsiveness increased restrictive eating risk; in particular, food responsiveness increased moderate to high restricted eating risk (OR 1.2 for every unit increase).

    Response to food and emotion-related overeating among young children increased adolescent comprehensive behavior risk (ORpooled, 1.2 for every unit increase). The cohort-specific analysis indicated that higher food enjoyment increased binge eating odds among Gemini (OR Gemini 1.6) but not among Generation R participants.

    Emotional overeating during childhood elevated uncontrolled eating odds in adolescents among Gemini participants (ORGemini 1.5).

    Contrary to the hypothesis, childhood food aversion traits did not elevate adolescent-restricted eating odds. Instead, slow eating reduced the chances of moderate to highly restrained eating symptoms (ORpooled, 0.9 for every unit increase).

    Slow eating and high satiety responsiveness significantly lowered adolescent compensatory behavior odds (ORpooled of 0.9 and 0.9, respectively).

    Among Generation R participants, the relationship between slow eating during early childhood and adolescent restrained eating showed lower odds among females.

    Only male Gemini participants showed positive associations between emotional overeating during early childhood and emotional and binge eating in adolescence.

    Conclusion

    The study findings showed that early childhood food responsiveness increases adolescent eating disorder risk.

    In contrast, slow eating and high satiety decrease the probability of eating disorders. Appetitive characteristics in children may be early neurobehavioral factors increasing eating disorder risk.

    Parental feeding practices that help children establish proper eating habits include educating them to identify internal hunger and fullness, promoting slower eating, and avoiding food for reasons other than homoeostatic hunger.

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  • Neighborhood violence impacts children’s brain development

    Neighborhood violence impacts children’s brain development

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    Living in neighborhoods with high levels of violence can affect children’s development by changing the way that a part of the brain detects and responds to potential threats, potentially leading to poorer mental health and other negative outcomes, according to research published by the American Psychological Association.

    However, nurturing parents can help protect kids against these detrimental effects, according to the study, published in the journal Developmental Psychology.

    Decades of research has shown that growing up in neighborhoods with concentrated disadvantage can predict negative academic, behavioral and mental health outcomes in children and teens. And recent research is beginning to show that one way it does that is by impacting the developing brain. However, less is known about how neighborhood disadvantage ‘gets under the skin’ to impact brain development.”


    Luke W. Hyde, PhD, study co-author of the University of Michigan

    Hyde and his colleagues hypothesized that one way might be through the amygdala, the hub of the brain’s stress response system that’s involved in socioemotional functioning, threat processing and fear learning. The amygdala is sensitive to facial expressions, and previous research has found that children who have been abused or neglected by family members, for example, show increased reactivity in the amygdala when looking at faces with negative, fearful or neutral expressions.

    To study whether exposure to neighborhood violence might also affect children’s amygdala reactivity, the researchers analyzed data from 708 children and teens ages 7 to 19, recruited from 354 families enrolled in the Michigan Twins Neurogenetic Study. Most were from neighborhoods with above-average levels of poverty and disadvantage, as measured by the U.S. Census Bureau. Fifty-four percent of the participants were boys, 78.5% were white, 13% were Black and 8% were other races and ethnicities. The participants lived in a mix of rural, suburban and urban areas in and around Lansing, Michigan.

    Teens completed a set of surveys that asked about their exposure to community violence, their relationship with their parents and their parents’ parenting style. Participants also had their brains scanned by functional MRI while they looked at faces that were angry, fearful, happy or neutral.

    Overall, the researchers found that participants who lived in more disadvantaged neighborhoods reported more exposure to community violence. And participants who reported more exposure to community violence showed higher levels of amygdala reactivity to fearful and angry faces. The results held true even when controlling for an individual family’s income, parental education and other forms of violence exposure in the home, such as harsh parenting and intimate partner violence.

    “This makes sense as it’s adaptive for adolescents to be more in tune to threats when living in a more dangerous neighborhood,” said Hyde.

    However, he and his colleagues also found that nurturing parents seemed to be able to break the link between community violence and amygdala reactivity in two ways.

    “Despite living in a disadvantaged neighborhood, children with more nurturing and involved parents were not as likely to be exposed to community violence, and for those who were exposed, having a more nurturing parent diminished the impact of violence exposure on the brain,” said Gabriela L. Suarez, a graduate student in developmental psychology at the University of Michigan and co-author of the study. “These findings really highlight how nurturing and involved parents are helping to support their children’s success, even in potentially harsh environments, and offer clues as to why some youth are resilient even when facing adversity.”

    Overall, the researchers said, the study highlights the need for structural solutions to protect children from the negative impact of exposure to community violence. It also points to the ways in which strong, positive parents can promote resilience among children and teens exposed to adversity.

    “Parents may be an important buffer against these broader structural inequalities, and thus working with parents may be one way to help protect children — while we also work on policies to reduce the concentration of disadvantage in neighborhoods and the risk for exposure to violence in the community,” said co-author Alex Burt, PhD, of Michigan State University.

    Source:

    American Psychological Association

    Journal reference:

    Suarez, G. L., et al. (2024) Exposure to community violence as a mechanism linking neighborhood disadvantage to amygdala reactivity and the protective role of parental nurturance. ​​Developmental Psychology. doi.org/10.1037/dev0001712.

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  • Delta opioid receptor agonist reduces anxiety-like behavior in mice

    Delta opioid receptor agonist reduces anxiety-like behavior in mice

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    Anxiety-related disorders can have a profound impact on the mental health and quality of life of affected individuals. Understanding the neural circuits and molecular mechanisms that trigger anxiety can aid in the development of effective targeted pharmacological treatments. Delta opioid receptors (DOP), which localize in the regions of the brain associated with emotional regulation, play a key role in the development of anxiety. Several studies have demonstrated the therapeutic effects of DOP agonists (synthetic compounds which selectively bind to DOPs and mimic the effect of the natural binding compound) in a wide range of behavioral disorders. One such selective DOP agonist-;KNT-127-;has been shown to exert ‘anxiolytic’ or anxiety-reducing effects in animal models, with minimal side effects. However, its mechanism of action is not clearly understood, thereby limiting its widespread clinical application.

    To bridge this gap, Professor Akiyoshi Saitoh, along with Ms. Ayako Kawaminami and team from the Tokyo University of Science, Japan, conducted a series of experiments and behavioral studies in mice. Explaining the rationale behind their work, Prof. Saitoh says, “There are currently no therapeutic drugs mediated by delta opioid receptors (DOPs). DOPs likely exert anti-depressant and anti-anxiety effects through a mechanism of action different from that of existing psychotropic drugs. DOP agonists may, therefore, be useful for treatment-resistant and intractable mental illnesses which do not respond to existing treatments.”  Their study was published on 29 December 2024, in Neuropsychopharmacology Reports,

    The neuronal network projecting from the ‘prelimbic cortex’ (PL) of the brain to the ‘basolateral nucleus of the amygdala’ (BLA) region, has been implicated in the development of depression and anxiety-like symptoms. The research team has previously shown that KNT-127 inhibits the release of glutamate (a key neurotransmitter) in the PL region. Based on this, they hypothesized that DOP activation by KNT-127 suppresses glutamatergic transmission and attenuates PL-BLA-mediated anxiety-like behavior. To test this hypothesis, they developed an ‘optogenetic’ mouse model wherein they implanted a light-responsive chip in the PL-BLA region of mice and activated the neural circuit using light stimulation. Further, they went on to assess the role of PL-BLA activation on innate and conditioned anxiety-like behavior.

    They used the elevated-plus maze (EPM) test, which consists of two open arms and two closed arms on opposite sides of a central open field, to assess behavioral anxiety in the mice. Notably, mice with PL-BLA activation spent lesser time in the central region and open arms of the maze, compared to controls, which was consistent with innate anxiety-like behavior. Next, the researchers assessed conditioned fear response of the animals by exposing them to foot shocks and placing them in the same shock chamber the following day without re-exposing them to current. They recorded the freezing response of the animals which reflects fear. Notably, animals with PL-BLA activation and controls exhibited similar behavior, suggesting that distinct neural pathways control innate anxiety-like behavior and conditioned fear response.

    Finally, they examined the effects or KNT-127 treatment on anxiety-like behavior of mice using the EPM test. Remarkably, animals treated with KNT-127 exhibited an increase in the percentage time spent in the open arms and central field of the maze, compared to controls. These findings suggest that KNT-27 reduces anxiety-like behavior induced by the specific activation of the PL-BLA pathway.

    Overall, the study reveals the role of the PL-BLA neuronal axis in the regulation of innate anxiety, and its potential function in DOP-mediated anxiolytic effects. Further studies are needed to understand the precise underlying molecular and neuronal mechanisms, for the development of novel therapies targeting DOP in the PL-BLA pathway.

    Highlighting the long-term clinical applications of their work, Prof. Saitoh remarks, “The brain neural circuits focused on in this study are conserved in humans, and research on human brain imaging has revealed that the PL-BLA region is overactive in patients with depression and anxiety disorders. We are optimistic that suppressing overactivity in this brain region using DOP-targeted therapies can exert significant anxiolytic effects in humans.”

    Source:

    Tokyo University of Science

    Journal reference:

    Saitoh, A., et al. (2018). The delta opioid receptor agonist KNT-127 in the prelimbic medial prefrontal cortex attenuates veratrine-induced anxiety-like behaviors in mice. Behavioural Brain Research. doi.org/10.1016/j.bbr.2017.08.041.

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  • Health care workers push for their own confidential mental health treatment

    Health care workers push for their own confidential mental health treatment

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    States are redefining when medical professionals can get mental health treatment without risking notifying the boards that regulate their licenses.

    Too often, health care workers wait to seek counseling or addiction treatment, causing their work and patient care to suffer, said Jean Branscum, CEO of the Montana Medical Association, an industry group representing doctors.

    “They’ve invested so much time in their career,” Branscum said. “To have anything jeopardize that is a big worry on their mind.”

    Montana, like other states, has a recovery program for health professionals who have a substance use disorder or mental illness. However, medical associations say such programs often come with invasive monitoring, even for voluntary care. And gray areas about when a mental illness should become public breeds fear that seeking care jeopardizes a medical career.

    Montana is among the states looking to boost confidential care for health professionals as long as they’re not deemed a danger to themselves or patients. In recent years, at least a dozen states have considered or created confidential wellness programs to offer clinicians help early on for career burnout or mental health issues. States have also reworked medical licensing questions to avoid scrutiny for providers who need mental health treatment. The changes are modeled after Virginia legislation from 2020.

    During a legislative committee meeting last month, advocates for Montana medical professionals asked state lawmakers to follow Virginia’s lead. They say the goal is twofold: to get clinicians treatment before patients are at risk and to curtail the workforce burnout that’s partly fueled by untreated stress.

    Montana’s existing medical monitoring program, the Montana Recovery Program, is run by the global company Maximus. Montana’s professional advocates had backed another nonprofit to run Montana’s program, which didn’t win the state contract.

    The Montana Recovery Program declined a request for an interview, instead referring KFF Health News to the Montana Department of Labor & Industry, which oversees the state’s medical licensing boards. Department staffers didn’t comment by deadline.

    In a Medscape survey released this year, 20% of physicians said they felt depressed, with job burnout as a leading factor. The majority said confiding in other doctors wasn’t practical. Some said they might not tell anyone about their depression out of fear people would doubt their abilities, or that their employer or medical board could find out.

    Health professionals are leaving their jobs. They’re retiring early, reducing work hours, or switching careers. That further dwindles patients’ care options when there already aren’t enough providers to go around. The federal government estimates 74 million people live in an area without enough primary care services due to a workforce shortage.

    Aiming to ensure patient safety, state medical boards can suspend or revoke clinicians’ rights to practice medicine if substance use or psychological disorders impair their work. Those cases are rare. One study found roughly 4,400 actions against the licenses of U.S. physicians for either substance use or psychological impairment from 2004 to 2020.

    Nonetheless, workforce advocates say disclosure requirements cause some health professionals to dodge questions about mental health histories on licensing and insurance forms or forgo care altogether. They’re worried divulging any weakness will signal they shouldn’t practice medicine.

    The mental health questions health workers are asked vary by state and profession. For example, nurses in Montana renewing their license are asked if they have any psychological condition or substance use that limited their ability to practice “with reasonable skill and safety” in the previous six months. Along with being asked about substance use on the job, doctors are required to say whether they’ve experienced a mental condition that “might adversely affect any aspect of your ability to perform.”

    “When I see that question on my renewal, do I have to report that I was depressed because I was going through a really tough divorce?” Branscum cited as an example of workers’ uncertainty. “You know, my life is turned upside down now. Am I obligated to report that?”

    A “yes” wouldn’t immediately result in licensing problems. Those who do report mental health troubles would be flagged by state workers as a potential concern. They could end up before the board’s same screening panel that recommends whether to revoke a license, or be referred to long-term monitoring with regular screening.

    Additionally, health professionals are required to report when other clinicians show unprofessionalism or have potential issues that affect performance. Branscum said medical professionals worry that what they say in a counseling session could be flagged for licensing boards, or that a co-worker may make a report if they seem depressed at work.

    Bob Sise, a Montana addiction psychiatrist and co-founder of the nonprofit 406 Recovery, told state lawmakers that job stressors are playing into workers’ mental health challenges, such as long shifts and heavy patient loads. And with the rising cost of health care, physicians feel they’re sacrificing their commitment to healing as they routinely substitute optimal treatment for lesser care that patients can afford.

    Sise said his practice now has roughly 20 health professionals as patients.

    “They were able to access care before it was too late,” Sise said. “But they’re the exception.”

    In Virginia, doctors, nurses, physician assistants, pharmacists, and students can join the state’s SafeHaven program. Melina Davis, CEO of the Medical Society of Virginia, said the service offers counseling and peer coaching with staffers available to answer a call 24/7.

    “If you only have a moment at 2 a.m., or that’s when you had the chance to first process the death of a patient, then you can talk to somebody,” Davis said.

    Those in the program are assured that those conversations are privileged and can’t be used in lawsuits. This year, the state is considering adding medical diagnoses under the program’s confidential protections.

    States that have followed suit have slight variations, but most create a “safe haven” with two types of wellness and reporting systems. Those who seek out care before they’re impaired at work have broad privacy protections. The other defines a disciplinary track and monitoring system for those who pose a risk to themselves or others. Indiana and South Dakota followed Virginia’s lead in 2021.

    States are also narrowing the time frame that licensing boards can ask about mental illness history. The American Medical Association has encouraged states to require health care workers to disclose current physical or mental health conditions, not past diagnoses.

    Last year, Georgia updated its license renewal form to ask doctors if any current condition “for which you are not being appropriately treated” affects their ability to practice medicine. That update replaces a request for seven years of mental health history.

    Even outside the “safe haven” framework, some states are grappling with how to grant doctors privacy while guaranteeing patient safety.

    The Medical Board of California is creating a program to treat and monitor doctors with alcohol and drug illnesses. But patients’ advocates have argued too much privacy, even for voluntary treatment, could risk consumers’ well-being. They told the state medical board that patients have a right to know if their doctor has an addiction.

    Davis said states should debate how to balance physicians’ privacy and patients’ safety.

    “We in medical professions are supposed to be saving lives,” she said. “Where’s the line where that starts to fall off, where their personal situation could affect that? And how does the system know?”

    According to the Montana Recovery Program website, it’s not a program of discipline but instead one “of support, monitoring, and accountability.” Participants may self-refer to the program or be referred by their licensing board.

    Branscum, with the Montana Medical Association, said the state’s monitoring program is needed for cases in which an illness impairs a clinician’s work. But she wants that form of treatment to become the exception.

    Vicky Byrd, CEO of the Montana Nurses Association, said nurses don’t tend to join the program until they’re forced to in order to keep their license. That leaves many nurses struggling in silence until untreated illness shows up in their work, she said.

    “Let’s get them taken care of before it has to go on their license,” Byrd said.

    Because after that point, she said, it’s hard to recover.




    Kaiser Health NewsThis article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

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  • An under-recognized contributor to the mortality of new mothers

    An under-recognized contributor to the mortality of new mothers

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    Painting a sobering picture, a research team led by Children’s National Hospital culled years of data demonstrating that maternal mental illness is an under-recognized contributor to the death of new mothers. They are calling for urgent action to address this public health crisis in the latest edition of JAMA Psychiatry. 

    Backed by dozens of peer-reviewed studies and health policy sources, the journal’s special communication comes as maternal mortality soars in the United States to as much as three times the rate of other high-income countries. 

    The contribution of mental health conditions to the maternal morbidity and mortality crisis that we have in America is not widely recognized. We need to bring this to the attention of the public and policymakers to demand action to address the mental health crisis that is contributing to the demise of mothers in America.”


    Katherine L. Wisner, M.D., associate chief of Perinatal Mental Health and member of the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National 

    The evidence review laid out the risks facing new mothers: More than 80% of maternal deaths in the United States are preventable, particularly the nearly 1 in 4 maternal fatalities that are attributable to mental health disorders. Overdose and other maternal mental health conditions are taking the lives of more than twice as many women as postpartum hemorrhage, the second leading cause of maternal death. For non-Hispanic Black mothers, the mortality rate is a striking 2.6 times higher than non-Hispanic White mothers. 

    Yet the research team found that recent national efforts to combat maternal mortality have failed to address maternal mental health as “the public health crisis that it represents.” Even methodologies to measure maternal health statistics are inconsistent, which challenges efforts to shape health policy. 

    In examining 30 recent studies and another 15 historical references, the team – which included Caitlin Murphy, MPA, PNP, research scientist at the Milken School of Public Health at George Washington University, and Megan Thomas, M.D., FACOG, obstetrician at the University of Kansas School of Medicine – found ample data to support the need to elevate maternal mental health as a priority. Some examples: 

    • Multiple studies show that the perinatal period puts women at higher risk for new and recurrent psychiatric disorders, with 14.5% of pregnant mothers having a new episode of depression and another 14.5% developing an episode three months after birth. 

    • Nationwide, more than 400 maternity healthcare centers closed between 2006 and 2020, creating “maternity care deserts” that left nearly 6 million women with limited or no access to maternity care. 

    • Mental health conditions such as suicide or opioid overdose are to blame for nearly 23% of maternal deaths in America, according to reports from three dozen Maternal Morbidity and Mortality Review Committees, which are state-based organizations that review each maternal death within a year of pregnancy. That’s followed by hemorrhage (13.7%), cardiac conditions (12.8%) and infection (9.2%). 

    Even with these sobering statistics, Dr. Wisner says that only 20 percent of women are screened for depression postpartum. “Given that this is a time that many mothers have contact with healthcare professionals, it’s critically important that all mothers are screened and offered treatment,” she said. “Mental health is fundamental to health – of the mother, the child and the entire family.” 

    Source:

    Children’s National Hospital

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  • The rising distress among Latinos in the U.S. amidst deportation fears

    The rising distress among Latinos in the U.S. amidst deportation fears

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    Changes to the social and political landscape between 2011-2018, with dramatic events such as DACA rule changes, new presidential leadership, immigration bills and more, have left one major threat looming-; deportation. 

    How this threat has impacted the mental health of some undocumented Latino immigrants in the United States has been previously studied, but new research has found it’s not just undocumented immigrants who feel at risk. 

    Analyzing data from 2011-2018, Amy Johnson, assistant professor of sociology at Lehigh University, and a team of research collaborators have found an increase over time in psychological distress among Latinos, both citizens and noncitizens, in the U.S. 

    The study, “Deportation Threat Predicts Latino U.S. Citizens and Noncitizens’ Psychological Distress, 2011-2018,” co-authored by Johnson, Christopher Levesque, assistant professor of law and society and sociology at Kenyon College, Neil A. Lewis, Jr., associate professor of communication and social behavior at Cornell University, and Asad L. Asad, assistant professor of sociology at Stanford University, is forthcoming in the Proceedings of the National Academy of Sciences (PNAS). 

    Looking at Deferred Action for Childhood Arrivals (DACA), for example, the researchers found when President Obama announced temporary reprieve from deportation for some undocumented immigrants, it relieved distress for naturalized citizens. 

    This same pattern occurred following the announcement of Deferred Action for Parents of Americans (DAPA). Oppositely, the dramatic societal event of the Trump presidency triggered anxiety and depressive symptoms among Latino noncitizens, worsening well-being. 

    While there are direct impacts of changes to the federal administration and its policies, it’s not just presidential elections that matter, the research determines.

    Beyond the federal level, the researchers find that day-to-day environments about immigration and immigration enforcement also impact psychological distress. For example, ICE’s detainer requests to local police, or even conversations online. 

    “How people are talking about immigration and how salient immigration and deportation are to day-to-day life is potentially equally as important to distress as these more dramatic changes and events, like the Trump election or DACA,” Johnson explains.

    It’s important to note that U.S.-born Latinos are not susceptible to deportation, but these events still impact their psychological health as well. Using Google Trends, the researchers show that U.S.-born Latinos experienced higher distress in periods where there are spikes in Google searches to topics related to deportation and immigration. 

    Latinos across all citizenship statuses are responding to this feeling of deportation threat in a negative way, the researchers find. But the exact pathway through which that happens depends on citizenship status.

    “The fact that racial and ethnic divisions are so prominent that even citizens feel the threat of deportation, and distress related to deportation threat, is really striking,” says Johnson. 

    Although the impact of deportation threat could increase during the highly polarizing 2024 election year, it’s not just federal policy to consider as a solution, the researchers emphasize. Creating a sense of cultural belonging is essential as well. 

    “We concretely show that the deportation-focused approach to immigration that the U.S. has been taking is psychologically damaging even to U.S. citizens,” says Johnson. “Moving forward, we can make the argument for policy change around deportation, but equally so, we can advocate for cultural practices of inclusion and belonging.”

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  • Sleep-circadian disturbances can trigger or worsen a range of psychiatric disorders

    Sleep-circadian disturbances can trigger or worsen a range of psychiatric disorders

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    Problems with our sleep and internal body clock can trigger or worsen a range of psychiatric disorders, according to a new review of recent research evidence.

    The review, published today [19 February] in Proceedings of the National Academy of Sciences (PNAS), suggests gaining a better understanding of the relationship between sleep, circadian rhythms and mental health could unlock new holistic treatments to alleviate mental health problems.

    Sleep-circadian disturbances are the rule, rather than the exception, across every category of psychiatric disorders. Sleep disturbances, such as insomnia, are well understood in the development and maintenance of psychiatric disorders, but our understanding of circadian disturbances lags behind.


    It is important to understand how these factors interact so we can develop and apply sleep-circadian interventions that benefit the sleep and mental health symptoms of patients.”


    Dr Sarah L. Chellappa from the University of Southampton, senior author of the review

    An international team of researchers from the University of Southampton, Kings College London, Stanford University and other institutions explored recent evidence on sleep and circadian factors, focusing on adolescents and young adults with psychiatric disorders. This is a time when people are most at risk of developing mental health disorders and when disruption to sleep and circadian rhythms are likely to occur.

    Insomnia is more common in people with mental health disorders than in the general population – during remission, acute episodes and especially in early psychosis, where difficulty falling and staying asleep affects over half of individuals. Around a quarter to a third of people with mood disorders have both insomnia and hypersomnia, where patients find it hard to sleep at night, but are sleepier in the daytime. Similar proportions of people with psychosis experience this combination of sleep disorders.

    Meanwhile, the few studies looking at circadian rhythm sleep-wake disorders (CRSWD) suggest that 32 per cent of patients with bipolar disorder go to sleep and wake later than usual (a condition called Delayed Sleep-Wake Phase Disorder). Body clock processes (such as endogenous cortisol rhythms) have been reported to run seven hours ahead during manic episodes and four to five hours behind during the depressive phase. Timing is normalized upon successful treatment.

    What are the mechanisms?

    The researchers examined the possible mechanisms behind sleep-circadian disturbances in psychiatric disorders. During adolescence, physiological changes in how we sleep combine with behavioural changes, such as staying up later, getting less sleep on school nights and sleeping in on weekends.

    Dr Nicholas Meyer, from King’s College London, who co-led the review said: “This variability in the duration and timing of sleep can lead to a misalignment between our body clock and our sleep-wake rhythms can increase the risk of sleep disturbances and adverse mental health outcomes.”

    Researchers also looked at the role of genes, exposure to light, neuroplasticity and other possible factors. Those with a genetic predisposition towards a reduced change in activity levels between rest and wake phases are more likely to experience depression, mood instability, and neuroticism. Population-level surveys show self-reported time outdoors was associated with a lower probability of mood disorder. Sleep is thought to play a key role in how the brain forms new neural connections and processes emotional memories.

    New treatments

    Dr Renske Lok, from Stanford University, who co-led the review said: “Targeting sleep and circadian risk factors presents the opportunity to develop new preventative measures and therapies. Some of these are population-level considerations, such as the timing of school and work days, or changes in the built environment to optimize light exposure. Others are personalized interventions tailored to individual circadian parameters.”

    Cognitive Behavioural Therapy for Insomnia (CBT-I) has been shown to reduce anxiety and depressive symptoms, as well as trauma symptoms in people experiencing PTSD.

    In unipolar and bipolar depression, light therapy (delivered on rising in the morning) was effective compared with a placebo. Using it in combination with medication was also more effective than using medication alone. Other findings suggest light is effective in treating perinatal depression.

    The timing of medication, meals and exercise could also impact circadian phases. Taking melatonin in the evening can help people with Delayed Sleep-Wake Phase Disorder to shift their body clock forward towards a more conventional sleep pattern and may have beneficial effects in comorbid psychiatric disorders. Nightshift work can adversely affect mental health but eating in the daytime rather than during the night could help, with research showing daytime eating prevents mood impairment.

    The review also points to innovative multicomponent interventions, such as Transdiagnostic Intervention for Sleep and Circadian dysfunction (Trans-C). This combines modules that address different aspects of sleep and circadian rhythms into a sleep health framework that applies to a range of mental health disorders.

    Dr Chellappa said: “Collectively, research into mental health is poised to take advantage of extraordinary advances in sleep and circadian science and translate these into improved understanding and treatment of psychiatric disorders.”

    The research was funded by the Alexander Von Humboldt Foundation.

    Source:

    University of Southampton

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  • Can grandparental support improve the mental health of single mothers?

    Can grandparental support improve the mental health of single mothers?

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    In a recent study in Population Studies, researchers explored the role of grandparental support in protecting mothers from depression.

    Their results indicate that grandparental support may matter more for single mothers, while the role of grandmothers is more significant than that of grandfathers.

    Study: Grandparental support and maternal depression: Do grandparents’ characteristics matter more for separating mothers? Image Credit: Monkey Business Images/Shutterstock.comStudy: Grandparental support and maternal depression: Do grandparents’ characteristics matter more for separating mothers? Image Credit: Monkey Business Images/Shutterstock.com

    Background

    Mothers often bear a larger share of childcare responsibilities compared to fathers, especially among single parents due to various circumstances such as widowhood or separation. In many cases of parental separation, children tend to primarily reside with their mothers, even when custody is shared.

    Separated mothers may need the support of family members as they navigate the challenges associated with single parenthood.

    Grandparents can be a significant source of support for families with young children, particularly if they are younger, retired, healthy, and live close to their children and grandchildren.

    Having a strong support system is known to be protective against depression, but few studies have explored the association between grandparental support and maternal depression.

    Single mothers may be more likely to develop symptoms of depression and emotional stress than those who are partnered. Therefore, such investigations affect parental well-being, childcare, and related social policies.

    About the study

    In this study, researchers explored whether maternal depression differed based on the characteristics of grandparents, if these differences were greater for separating mothers compared to partnered ones, and whether grandparent characteristics lead to different trajectories in maternal depression when they are separating.

    Focusing on mothers of children aged less than 12 years, the authors measured depression by using antidepressant purchases as a proxy, though this could underestimate mild depressive symptom prevalence.

    The mothers were all born in Finland from 1945 to 1995. Mothers who were followed for at least three hours between 2000 and 2014 and whose children could be linked to at least one grandparent were included in the study.

    The dataset included information on three generations – children, biological parents, and maternal and paternal grandparents.

    Mothers were classified as non-separating if their union had not been dissolved during the child’s 13th birthday. In contrast, separated mothers lived with their children for a year after a parental separation. Maternal age, income, education, employment status, and area of residence were included as controls.

    The grandparents’ characteristics were age, union stability, geographical proximity, and health. Lower age, stable unions, greater geographical proximity, and good health were beneficial and hypothesized to be associated with lower maternal depression.

    These effects were also predicted to be greater for separating mothers compared to non-separating ones and grandmothers compared to grandfathers.

    Findings

    Grandparents were less than 70 years old on average, and separating mothers were more likely than non-separating ones to have parents who were still working.

    Non-separating mothers were less likely to live close to their parents but more likely to live close to their parents-in-law. Separating mothers were likelier to have parents or in-laws who did not live together.

    Mothers were more likely to use antidepressants if their children’s grandparents were older, in poor health, or were not employed.

    They were also more likely to have bought the medication if they did not live close to their children’s grandparents or if their parents did not live together. All mothers were significantly more likely to use antidepressants if their parents were in poor health.

    As predicted, these differences were more pronounced for mothers who were separating from their partners, who were also significantly more likely to use antidepressants.

    Maternal grandparents, particularly the grandmother, had a particularly important role to play in reducing maternal depression.

    The use of psychotropic medications by mothers showed similar trends to antidepressant use, suggesting that the results were robust to multiple mental health treatments.

    Conclusions

    The findings demonstrate how multigenerational support exchanges can have important implications for mental health.

    Grandparents provide support and resources for their daughters as they bring up their children, reducing mental stress and depression during this critical time.

    These contributions are even more significant during periods of upheaval, such as maternal separation from their partner.

    A limitation of the study is that it uses antidepressant and psychotropic medication use as a proxy for depression; however, this may underestimate actual depression prevalence since it may not capture less severe symptoms.

    For children whose parents were separated, the dataset did not include information on the father’s involvement after separation. Exchanges of support between generations were also not directly measured.

    Focusing only on Finland, the results of this study cannot be easily generalized to other populations. Future research can shed further light on these gaps.

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  • Study provides evidence that antidepressant use in pregnancy affects child’s brain development

    Study provides evidence that antidepressant use in pregnancy affects child’s brain development

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    The prefrontal cortex (PFC) is an important brain region with respect to behavioral regulation. Aberrations in serotonin (5-HT) during early development have been reported to be associated with behavioral dysregulations over the long term, but how this works is still unclear.

    Study: Serotonin modulates excitatory synapse maturation in the developing prefrontal cortex. Image Credit: fizkes/Shutterstock.com
    Study: Serotonin modulates excitatory synapse maturation in the developing prefrontal cortex. Image Credit: fizkes/Shutterstock.com

    A new study published in Nature Communications explored synapse maturation in the PFC of mice when exposed to 5-HT, shedding light on the link between the chemical and future behavioral changes.

    Researchers from the University of Colorado Anschutz Medical Campus demonstrated a direct link between antidepressant use during pregnancy, particularly fluoxetine found in medications like Prozac and Sarafem, and altered development of the prefrontal cortex in children, as well as subsequent mental health risks.

    Background

    The brain has over a billion neurons, with equal numbers of other cells linked in intricate and interwoven networks. These require exquisitely precise chemical regulation to develop correctly so as to provide the substrate for communication between themselves and the formation of neuronal pathways.

    5-HT is among the first neurochemicals to be detected, being found at peak levels two years after birth in humans. In mice, it peaks during the first week after birth. This period coincides with the time when excitatory synapses mature following experience-driven activity.

    Various causes of alteration in 5-HT are known, including maternal malnutrition, maternal abuse, varying levels of dietary tryptophan (the substrate for 5-HT formation), and the presence of chemicals that regulate the uptake or degradation of 5-HT.

    An example of the latter is the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). These can readily cross the placenta or enter breast milk, becoming available to the offspring during a critical period of brain development.

    Such imbalances in 5-HT levels at this period have been linked to a higher chance of neurodevelopmental disorders, including autism spectrum disorder (ASD), as well as permanent behavioral changes. The PFC is involved in cognitive processes that facilitate social interaction and is lavishly supplied with neurons that release 5-HT.

    Excitatory synapses are fundamental to the formation of neural circuits. They need to mature and stabilize for this to happen, with the primary sites of action of the neurotransmitter released at the synapse being the dendritic spines of the post-synaptic neuron. These bear multiple receptor types for 5-HT, with 5-HT2A and 5-HT7 being especially abundant in early infancy.

    When these are activated, excitatory cascades are activated via the coupled Gαq proteins. Higher levels of 5-HT signaling increase the dendritic spine plasticity. The current study looked at targeted 5-HT signaling at the level of neural circuits and individual excitatory synapses, seeking to identify the mode of regulation. 

    What did the study show?

    The scientists found that 5-HT is crucial for the normal development of excitatory synapses on the pyramidal neurons within layer 2/3 of the PFC during early development. With 5-HT inhibition, both spine density and maturation were reduced significantly within the PFC, though spine size remained intact. The converse was also true, with increased density, especially of large spines, but with normal size and morphology.

    Apart from these anatomical changes, 5-HT signaling causes structural long-term potentiation of dendritic spines on these neurons during this developmental window independent of excitatory stimulation. This effect, namely, the enlargement of small and medium spines, did not appear to depend on the activity of glutamate.

    Not only was it specific for the pattern of 5-HT stimulation, but also it was not observed at later stages or in pyramidal neurons. In addition, it occurred only in the presence of post-synaptic 5-HT2A and 5-HT7 signaling. This suggests that the underlying mechanism is 5-HT7 receptor-mediated influx of extracellular calcium ions, leading to 5-HT2A receptor-induced activation of PKC.

    Functional long-term potentiation of these receptors was also observed in response to 5-HT release, again via 5-HT2A and 5-HT7 receptor signaling. That is, stronger post-synaptic excitatory currents were measured following 5-HTergic stimulation.

    Individual dendritic spines newly formed on these neurons in the PFC were more likely to survive, indicating greater long-term stabilization following Gαs coupled 5-HT7 receptor signaling. This is important as it leads to increased spine density. Again, this effect, linked to long-term potentiation, is independent of glutamate release or structural potentiation and does not appear to occur with 5-HT2A receptor stimulation.

    Significantly, early research shows a risk of behavioral deficits and neurodevelopmental disorders with early fluoxetine exposure. In the present study, the use of fluoxetine, an SSRI that increases 5-HT levels in the synaptic cleft in younger but not older pups, led to increased spine density but not spine size. This was mediated by 5-HT2AR and 5-HT7R signaling in the PFC.

    What are the implications?

    The findings of this study indicate that 5-HT signaling plays a key role in excitatory synapse maturation during early development of the PFC circuits, regulating spine maturation and function. The effect is structural and functional potentiation of excitatory synapses of layer 2/3 pyramidal neurons in the PFC at a specific age and with a specific pattern of stimulation.

    The results also suggest a direct effect of 5-HT on maturation rather than via changes in excitability, but further work is required to rule out glutamatergic involvement in synaptic plasticity secondary to 5-HT signaling completely.

    The researchers propose that nascent spines are stabilized by 5-HT7 receptor activation via voltage-gated calcium channel opening, leading to the entry of calcium into the neuron. However, as they mature, both 5-HT7 and 5-HT2A receptors lead to synapse maturation via PKC activation, which further enhances extracellular calcium ion influx.

    Moreover, 5-HT receptor-mediated synaptic plasticity occurs in the first two weeks in mice. Further research will be required to demonstrate what receptor classes are involved at later stages. Again, increased excitatory post-synaptic current strength without spine size alterations needs to be explained.

    These findings may help treat patients who have been exposed to drugs like fluoxetine during early development, as this is a commonly prescribed drug during pregnancy. Moreover, it may be possible to treat individuals with aberrations in 5-HT receptor-mediated plasticity during this key period by selective inhibition of 5-HT receptors in certain brain regions or certain types of neurons.

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  • What is the association between relationship factors, financial difficulties, and socio-demographic factors with mental health?

    What is the association between relationship factors, financial difficulties, and socio-demographic factors with mental health?

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    In a recent study published in PLoS ONE, a group of researchers investigated the impact of marital/relationship perceptions, financial difficulties, and socio-demographic factors on the mental health of Australian adults, using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey.

    Study: Associations of nuptiality perceptions, financial difficulties, and socio-demographic factors with mental health status in Australian adults: Analysis of the Household, Income and Labour Dynamics in Australia (HILDA) survey. Image Credit: SewCreamStudio/Shutterstock.comStudy: Associations of nuptiality perceptions, financial difficulties, and socio-demographic factors with mental health status in Australian adults: Analysis of the Household, Income and Labour Dynamics in Australia (HILDA) survey. Image Credit: SewCreamStudio/Shutterstock.com

    Background 

    Mental health is crucial for individual well-being, defined as managing life’s stresses, realizing one’s potential, working productively, and contributing to the community.

    It is influenced by various life challenges, including financial hardship, employment struggles, and domestic violence, which can significantly increase mortality risk during hospital admissions.

    Recent research highlights the impact of social determinants on mental health, revealing differences across gender, age, and socioeconomic factors. In Australia, mental health issues affect one in five people.

    Further research is needed to unravel the complex interactions between socio-demographic factors, nuptiality, financial stress, and mental health, informing targeted interventions and policies.

    About the study 

    The present study utilized data from the HILDA survey, a comprehensive source that began in 2001 and includes information on wealth, labor market outcomes, household and family dynamics, health, and education.

    Employing a multistage sampling strategy, it started with selecting Census Collection Districts, followed by households within these districts, ensuring a broad representation of the Australian population.

    Over the years, the survey has adapted to include new household members and children of respondents, maintaining a dynamic and growing dataset. For this analysis, the latest available wave (wave 19) was used, focusing specifically on mental health variables and excluding incomplete records, leading to a final sample of 6,846 participants.

    Mental health status was gauged using the mental component summary (MCS) subscale of the Short-Form (SF)-36 health survey, a widely recognized tool for measuring the quality of life-related to mental health, with a scoring system that converts responses into a composite score indicative of mental health status.

    Financial difficulties were assessed through direct questions about participants’ ability to meet essential payments and needs. At the same time, nuptiality and relationship perceptions were measured through questions about marital status, relationship quality, and satisfaction.

    The analysis employed hierarchical multiple linear regression to explore the impact of socio-demographic factors, financial difficulties, and nuptiality/relationship perceptions on mental health, with a systematic approach that first considered the influence of socio-demographic characteristics before introducing financial and nuptiality variables.

    This methodological framework allowed for a better understanding of the relative contributions of these factors to mental health outcomes.

    Ethical considerations were thoroughly addressed, with data access granted to authorized researchers under strict guidelines to ensure confidentiality and consent. 

    Study results 

    In the study, 6,846 individuals were analyzed to understand the relationship between socio-demographic factors, nuptiality/relationship perceptions, financial difficulties, and mental health status among Australian adults.

    The demographic profile of participants indicated a predominance of individuals over 42 years (60.9%), with females making up 51.4% of the sample.

    The majority were born in Australia (77.5%) and were married (78.2%). Educationally, 27.7% had a year 11 certificate or lower, and about 70% were employed.

    The average MCS score, which measures mental health status, was 76.4, with a standard deviation 15.8, indicating generally good mental health among participants. However, 7.1% of participants were identified with poor mental health (MCS score less than 50).

    The analysis revealed that demographic characteristics explained a small portion (2.1%) of the variance in mental health scores. Older participants (aged 60 and above) demonstrated higher mental health scores compared to the youngest cohort (less than 25 years), suggesting better mental health with age.

    Conversely, being female, born outside of Australia, retired, or a student were factors associated with lower mental health scores. Financial difficulties significantly impacted mental health, accounting for an additional 3.2% of the variance in MCS scores.

    Challenges such as difficulty paying bills, needing to pawn or sell belongings, and seeking financial assistance from friends, family, or welfare/community organizations were linked to lower mental health scores.

    Nuptial and relationship factors were notably influential, explaining 9.8% of the variance in mental health scores. Positive perceptions of one’s relationship quality and the extent to which it met original expectations were associated with better mental health.

    On the contrary, negative aspects such as frequently wishing not to have been married or in a relationship, problems within the relationship, and the intensity of love for a spouse or partner correlated with lower mental health scores. 

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