Booster Shots

Oddities, musings and news from the health world

Category: psychology

For depression, therapy should focus on thoughts rather than behavior

May 13, 2010 | 10:24 am

Cognitive behavioral therapy can be effective for even severely depressed people, but the therapy should focus on changing how people think instead of focusing on how they behave, according to a new study.

Encouraging behavior changes to improve mood appears to make a lot of sense. Depressed people are often advised to go for a walk, visit friends and schedule activities. But it may be more helpful for therapists to work with patients on their thought processes, such as challenging negative thoughts and replacing those thoughts with more positive and realistic ideas. Researchers at Ohio State University studied 60 patients with severe depression. Various therapists treated the patients and the sessions were analyzed to rate how much the therapists relied on cognitive and behavioral methods of therapy. The patients completed questionnaires to track their depression.

The study found that patients improved when therapists focused on cognitive techniques but didn't improve when therapists focused on behavioral techniques. The effects of cognitive techniques were strongest in the first few weeks of therapy. The patients who improved the most also were the ones who collaborated with the therapist on a treatment plan and who followed the plan.

"If you're a patient and willing to fully commit to the therapy process, our data suggest you will see more benefit," the lead author of the study, Daniel Strunk, said in a news release. The study is published online in the journal Behaviour Research and Therapy.

-- Shari Roan


At a woman's touch, financial empires are wagered

May 12, 2010 |  6:56 pm

In the art of the deal, a woman's touch possesses special magic, some new research suggests.

For men and women alike who are engaged in financial gamesmanship, a woman's gentle touch inspired reassurance, self-confidence and a heightened willingness to take risks, a series of experiments described in the journal Psychological Science found. A light, reassuring pat on the shoulder, when performed by a woman, was a more powerful prod to financial risk-taking than a woman's handshake. And the female touch outperformed a man's handshake, as well as his version of the reassuring pat on the shoulder, in inspiring financial risk-taking.

The study, by Jonathan Lavav of Columbia University Business School and Jennifer J. Argo of University of Alberta, was released Wednesday. Their experiments put just over 250 undergraduates -- men and women -- into a variety of investment schemes in which they were instructed by male and female study confederates who shook hands, performed the light-touch gesture and in some cases, had no physical contact with subjects.

"We suggest that a simple pat on the back of the shoulder -- by a female -- in a way that connotes support may evoke feelings that are similar to the sense of security afforded by a mother's comforting touch in infancy," wrote Lavav and Argo in the article. "Despite the subtlety of the manipulation: a momentary touch on the shoulder," the data gathered over three experiments "indicate that our participants perceived a real sense of security and that it led them to take greater financial risk than untouched participants did."

This finding comes on the heels of research finding that women's sense of touch -- in their fingertips -- is actually finer and more acute than that of men. And just last week, the Journal of Neuroscience published a study by University of California Irvine child neurologist Dr. Tallie Z. Baram finding that a mother's touch triggers activity in a baby's brain that improves cognitive function and builds resilience to stress.

The hand that rocks the cradle does rule the world. It can also, apparently, rock the market.

--Melissa Healy


Book Review: 'For Better' by Tara Parker-Pope

May 8, 2010 |  2:18 pm

For better One of the perks of being a journalist is that it can give professional license to explore subjects of personal interest and to knock on doors closed to most people -- all in the course of doing your job.

Author Tara Parker-Pope has made the most of that opportunity with her excellent new book, "For Better: The Science of a Good Marriage."

Parker-Pope, who writes about health in her Well blog for the New York Times, said she became interested in the science of marriage when her own 17-year union began to founder.

She sought help in making sense of the situation but was put off by the platitudes she found in self-help books. "I knew where to look for answers about heart disease, diabetes, allergies, and numerous other health issues, and I wanted the same objective, evidence-based advice about my marriage," she writes.

As she ventured into scientific databases, she was surprised  to discover a large body of research on marriage and relationships that offered practical advice about marital health. She said she realized that basic scientific truths she uncovered could have helped her see the signs of trouble earlier in her marriage.

In "For Better," Parker-Pope seeks to help other people make better choices and save or strengthen their own relationships. Her passion for the subject creates a driving momentum that propels the reader through the book as she attempts to answer the question, "What makes a good marriage?"  

Continue reading »

Book Review: 'Difficult Personalities' by Helen McGrath and Hazel Edwards

April 17, 2010 |  1:26 pm

Difficult PersonalitiescoverMost people have at least one person in their lives they consider "difficult." This is the co-worker, in-law, neighbor or friend who's bullying, controlling, hypercritical or so anxious they can't make a decision.

Interactions with them can be challenging, frustrating, even perilous, depending on the role they play in your life. A new book, "Difficult Personalities," by Helen McGrath, a clinical psychologist and adjunct university professor in Melbourne, Australia, and writer Hazel Edwards, offers advice on managing this kind of behavior in other people -- and in yourself.

The authors share insights into what's behind various personality traits, typical behavior, positive aspects of the types and practical strategies you can use to deal with them or cope with your own tendencies.

Their approach changes depending on the behavior. With worriers and perfectionists, they suggest offering understanding, empathy and a reality check. With inflexible and over-controlling people they suggest an assertive, rational and sometimes reassuring manner. They describe pragmatic ways to confront and defuse (or avoid) negative, bossy or "superior" people. And for dealing with bullies, con artists and sociopaths, they focus on concrete steps to identify the behaviors and protect yourself.

But for the most part, McGrath and Edwards advise an approach toward other people -- and ourselves -- that is respectful and compassionate, recognizing that we all have flaws and annoying traits. To that end, they include chapters on getting on top of anxiety, practicing rational thinking, managing anger, negotiating conflict and maintaining strong romantic partnerships.

They base much of their material, they say, on the "Diagnostic and Statistical Manual of Mental Disorders," the widely used American Psychiatric Assn. reference book. They also draw on the Myers-Briggs Type Indicator psychological test to discuss ways to manage differences between introverts and extroverts, thinkers and feelers, and planners and "optionizers." 

-- Anne Colby

Photo: "Difficult Personalities," Helen McGrath and Hazel Edwards, the Experiment, $14.95

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Racial and gender stereotyping may spring from different roots

April 12, 2010 |  7:45 pm

People with Williams syndrome have a genetic deletion that has a wide range of effects, including narrowed blood vessels, developmental delays and -- oddly -- love of music and extreme friendliness.

The extreme friendliness of this small population -- about 1 in 8,000 U.S. babies is thought to have the genetic anomaly -- has always interested personality psychologists and neuroscientists. The remarkable regularity of Williams kids' trusting personalities and social fearlessness has prompted many researchers to wonder how the known deletion of 25 genes in the massively complex human genome could relate to the uniformly predictable appearance of a personality trait -- extraversion -- that helps make us who we are.

In a study reported in the journal Current Biology and published Monday, German and French researchers report on a heretofore undiscovered behavior pattern that also unites people with Williams syndrome: They do not seem inclined to stereotype those of minority ethnic or racial groups in the insidious and generally unacknowledged ways that most of the rest of us do. The researchers took a group of 20 children with Williams syndrome and a matched-group of normal-development children and had the subjects look at a series of people -- some with brown skin, others white -- engaged in a range of daily activities. The kids were asked to describe the pictured person and to characterize that person using one of a range of positive and negative prompts.

While the normal-development kids followed long-established patterns of viewing the pictured person with the skin color different from their own in a less favorable light, children with Williams syndrome were far less likely to make any such distinctions.

The researchers relate the absence of the impulse to racially stereotype to the hallmark personality trait of those with Williams syndrome: the same lack of social fear or wariness that makes individuals belonging to this special population sometimes unnervingly friendly to strangers. And the researchers suggest that this says something interesting about racial stereotyping: that it is based in fear and is a primitive impulse that helps us hold those who are identifiably different from us -- the "outgroup" -- at arm's length.

Interestingly, the Williams syndrome kids -- half male, half female -- did engage in gender stereotyping.

To author Andreas Meyer-Lindenberg of the University of Heidelberg's Central Institute of Mental Health in Germany,  this suggests that gender stereotyping springs from a different source than racial stereotyping. Unlike even the most subtle forms of racism, gender stereotyping serves no deep-seated fear impulse, Meyer-Lindenberg suggests. Rather, the impulse to make assumptions on the basis of sex is learned behavior -- "social imitative learning and over-generalization" -- not fear. (For if it were fear, it too would have been extinguished in Williams syndrome.)

It's at moments like this that neuroscience has the potential to change -- or at least explain -- the things we do. Past studies of kids with Williams syndrome have shown that those who are most socially fearless have an amygdala -- the primitive nugget deep in the brain from which the sensation of fear springs -- that doesn't function properly. For the rest of us, the amygdala does perform normally. And the primitive fear it pumps out at the sight of a member of an "outgroup" representative can be extinguished only if our prefrontal cortex -- the seat of reason -- steps in and overrides it.

It makes you wonder who is the most "evolved" -- someone with normal development or the one with the genetic deletion? 

Learn more about Williams syndrome here

--Melissa Healy


Near-death experiences: Can chemistry explain them?

April 9, 2010 |  3:08 pm

Wonderful-life The phenomenon known as "near-death experience" is the stuff of hospital dramas, a dramatic conceit for movies about do-overs and for a (I guess lucky) few of us, a mysterious peephole to "the other side."

The phenomenon is very real: By various estimates, 11% to 23% of those who had experienced cardiac arrest and lived to tell about it report some unique cognitive experience -- an overwhelming feeling of transcendence, doors opening, beckoning light, a thumbnail life-review -- that broadly fits the description. (The Internet yields a bounty of personal accounts as well, so it must be real!)

But their observations are not very well explained -- not, at least, by standard earthly measures.

A study appearing this week in the open-access British journal Critical Care offers an intriguing blood-chemistry analysis of the phenomenon, which may point to further avenues of research.

Researchers from University of Maribor's School of Medicine in Slovenia followed 52 patients in Slovenia who had suffered out-of-hospital cardiac arrests, were resuscitated after they had ceased breathing and lost a pulse, and survived. Eleven of the 52 patients -- aged on average 53 years and 42 of whom were male -- reported having had a near-death experience. The researchers compared the 11 patients whose recalled experiences measured at least a seven on a possible 33-point scale measuring near-death experience (yes, there is such a thing).

Near-death experiences were significantly more likely to have been recalled by survivors who, within five minutes of their arrival at the hospital, had higher concentrations of carbon dioxide in arterial blood and higher blood-potassium levels, the Slovenian physicians found. At least as important is what factors were not associated with a higher likelihood of a patient having had the near-death experience: Researchers found no link between near-death experience and patients' religious belief, fear of death, education level, age, sex, time elapsed until resuscitation or drugs administered during resuscitation. They also looked for links to patients' sodium levels -- another critical piece of blood chemistry -- and found none.

The mystery of near-death experiences, of course, is very far from answered here. One thing we don't know -- and I'd venture to claim will never be known -- is how many and which of the heart attack victims that failed to survive also had a near-death experience before dying. One 2007 study found that low blood levels of potassium in patients with heart failure, for instance, is associated with a higher risk of death. Possibly, patients with higher carbon dioxide and potassium levels who had had near-death experiences were simply more likely to survive to recount the sensation.

And then there's the simple fact that many people have described cognitive disturbances that could readily be mistaken for near-death experiences when they were not (technically) near death: fighter pilots have described such experiences under the influence of high G-forces; patients anesthetized for surgery have reported similar experiences -- as have, of course, psychotic patients. There's a fine overview of all the vagaries of the near-death experience here.

So, have you had a near-death experience? Please share!

-- Melissa Healy

Photo: In Frank Capra's 1946 film "It's a Wonderful Life," George Bailey gains a greater appreciation for life once he sees what it would have been like if he never existed. Credit: Reuters


Neuroscientists use magnetism to fool our moral compass

March 31, 2010 | 10:51 am

Neuroscientists have marched forward by many means in their understanding of how the brain and its component parts work. They have long studied people with injuries to certain parts of their brains and, by seeing how the behavior of those individuals changes, have inferred the role that the damaged part of the brain plays. In more recent years, functional magnetic resonance imaging and electro-encephalograms (those electrical wires you see attached to babies' bald pates in pictures) have helped researchers divine the roles of certain brain regions by "seeing" blood flow or metabolic activity in those regions during certain tasks.

But there's also a little known and somewhat low-tech gadget that can have surprising powers of revelation. It's called transcranial magnetic stimulation, in which a small device that emits a powerful but narrow-spectrum magnetic charge is passed over a region of the brain. It won't penetrate very far, but the result is that the cells in that region of the brain are briefly scrambled: For a few minutes, they go silent or misfire. (Neuroscientists have been known to have a bit of fun with this gadget.)

In the neuroscience lab of MIT researcher Rebecca Saxe, the role of the right temporoparietal junction -- an area toward the back of your head, a couple of inches above your right ear -- is an area of particular interest. This area has long been thought to play a role in how we interpret the actions and motives of the people around us -- a largely-human talent called "theory of mind."

In a recent study using transcranial magnetic stimulation, researchers in Saxe's lab have found that the right temporoparietal junction -- and our ability to infer other people's thoughts and motives -- may be important in how we make and act on moral and ethical judgments.

In a pair of experiments published in this week's issue of the Proceedings of the National Academy of Sciences, MIT researchers passed a transcranial magnetic stimulator over the right temporoparietal junction, in one case for 25 minutes while the study participants read a series of scenarios and decided how they should behave, and in the second experiment, briefly, while participants were asked to make a complex moral judgment. In both experiments, researchers set up the moral conundrums so that the participants could make a dangerous or immoral decision (such as driving drunk) but not have any moral consequences (such as an accident ensuing).

With their right temporoparietal junctions scrambled, participants seemed unable to recognize an action as wrong unless it led to harm -- a moral judgment that virtually all could make easily when their brains were not being magnetically scrambled. It seems that when unable to infer the motives and actions of another, they had to rely only on outcomes to tell them if their own actions were ethical.

The implications for human behavior are potentially far-reaching: Unless we can understand what's on other people's minds, we may be hampered in understanding how best to live cooperatively (and ethically) with others. And then there's a take-home message for each of us: If someone you know seems to behave without moral bearings, you might try looking for a transcranial magnetic stimulator hidden with the remote control in the folds of his or her couch. Or you might infer that his or her powers of "theory of mind" need a bit of exercise.

-- Melissa Healy


Smile your way to a long life

March 25, 2010 |  6:00 am

People who smile a lot are usually happier, have more stable personalities, more stable marriages, better cognitive skills and better interpersonal skills, according to research. Science has just uncovered another benefit of a happy face. People who have big smiles live longer.

Vladdy Researchers at Wayne State University used information from the Baseball Register to look a photos of 230 players who debuted in professional baseball before 1950. The players' photos were enlarged and a rating of their smile intensity was made (big smile, no smile, partial smile). The players' smile ratings were compared with data from deaths that occurred 2006 and 2009. The researchers then corrected their analysis to account for other factors associated with longevity, such as body mass index, career length, career precocity and college attendance.

For those players who had died, the researchers found longevity ranged from an average of 72.9 years for players with no smiles (63 players), to 75 years for players with partial smiles (64 players) to 79.9 years for players with big smiles (23 players).

This isn't a bunch of psycho-hooey, the authors said. Smiles reflect positive emotion. Positive emotion has been linked to both physical and mental well-being. They added a caveat to their study, noting: "The data source provided no information as to whether expressions were spontaneous or in response to a photographer's request to smile." Still, big smiles are more likely to reflect true happiness than partial smiles.

What I'm wondering is, did they account for each team's winning records? Maybe the non-smilers were thinking about batting averages.

The study is published in the journal Psychological Science.

-- Shari Roan

Photo: Former Los Angeles Angels' player Vladimir Guerrero is known for his beatific smile. Credit: Alex Gallardo  /  Los Angeles Times


Drop the chitchat and get serious

March 17, 2010 |  6:00 am

Talk Small talk may be common, but it doesn't do much to nourish our sense of well-being. Compared with people who rated themselves as more unhappy, people who were happiest spent 70% more time talking, had one-third as much small talk and twice as many substantive conversations.

Researchers came to their conclusions by having a group of 79 college students wear a tape recorder for four days and eavesdropping on their conversations. The students also were given tests to measure happiness and personality.

The findings "demonstrate that the happy life is social rather than solitary, and conversationally deep rather than superficial," the authors, from the University of Arizona and Washington University in St. Louis, wrote.

It's not clear, however, whether happy people attract others for deep conversation or whether deep conversation makes people happier. Further research should be done, they said, to see if having more substantive conversations helps unhappy people become happier.

The study is published online in the journal Psychological Science.

-- Shari Roan

Photo credit: Wong Maye-e  / Associated Press


What's in your head? Study suggests a psychiatric self-test can tell you

March 8, 2010 |  4:08 pm

Brain Depression, bipolar disorder, anxiety disorder, post-traumatic stress disorder .... Maybe you could, or should, just screen yourself for these conditions.

A study published online Monday in the Annals of Family Medicine found that a simple 27-item questionnaire shows promise in effectively screening potential patients for a variety of psychiatric disorders. That's the conclusion of researchers at the University of North Carolina who asked 647 adults at a family medicine clinic to test themselves while in the waiting room. The whole thing took less than five minutes. 

In fact, write the researchers, the one-stop-shopping diagnostic tool called the M-3 (explained later) was as effective as screening tools for individual disorders. They're optimistic about its potential, especially in the primary-care setting, noting that many folks are inclined to simply consider depression or anxiety, not a profusion of possible diagnoses.

That's not to say a doctor would glance at a checklist and write a prescription based on the answers, but those answers could help shape effective followup inquiry. As the authors write in their conclusion:  

"As with all screening instruments, the M-3 seeks to efficiently identify patients at high risk for one or
more specific psychiatric conditions. However, while the M-3 increases the likelihood of identifying a patient experiencing a psychiatric illness, the M-3 by itself is not a definitive diagnostic instrument. Indeed, as a screening tool, the M-3 screen was more likely to identify a risk of psychiatric illness than was confirmed by diagnostic interview."

Here's the full study. And here's the test, as published in the journal, and as offered by My Mood Monitor (hence the M-3 reference above). M-3 Information paid for the study.

Go ahead. Test yourself. (It's almost as much fun as the Patient Safety IQ Quiz.)

-- Tami Dennis

Photo credit: Custom Medical Stock



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