Booster Shots

Oddities, musings and news from the health world

Category: PTSD

Black and Latino males twice as likely to have poor health

June 30, 2010 |  8:17 am

Black Latino Men health Given the inequality in healthcare in the United States, it's no surprise that some groups of people suffer far worse health outcomes than people with better resources. But if there is one group that has been especially overlooked in this equation, it's black and Latino boys. The major factor in their poor health, according to a new report by the California Endowment, is where they live. Growing up in poor and stressful neighborhoods with limited healthcare resources leads to poor health.

According to the findings in the report:

  • The odds of poor health outcomes for boys and men of color are more than two times higher than for white boys and men in California.
  • Latino boys are 4.1 times more likely than white boys to suffer from post-traumatic stress disorder.
  • African-American boys are 2.5 times more likely.
  • Latinos are 3.1 times more likely to have limited access to health care and 4.8 times more likely to lack health insurance.
  • Asthma disproportionately affects children who live in poorer neighborhoods.
    Black young men have a homicide rate 16 times greater than that of young white men.
  • African-American and Latino children are 3.5 times more likely to grow up in poverty compared to whites.

Poorer neighborhoods mean less access to stores selling health foods, fewer parks and safe places to run and play in and fewer social networks to promote health and safety.

The California Endowment has launched a 10-year initiative, called Building Healthy Communities, to improve the health of men and boys of color by making strategic improvements in the communities and neighborhoods in which they live. In the report, the group identifies a handful of successful programs to improve the lives of men of color already in place in the state that could be applied on a larger scale -- and why implementing these programs statewide cannot wait.
-- Shari Roan

Photo credit: Carlos Chavez  /  Los Angeles Times

Killings in the neighborhood take toll on young minds

June 18, 2010 |  8:08 pm

In the week that a homicide has occurred on their block, school-aged African American kids in predominately low-income neighborhoods suffer a steep slide in verbal and language skills that are key to reading, learning and thriving, a new study has found.

The study found that faced with similar levels of mayhem in their neighborhoods, Latino children did not appear to experience significant declines in academic performance. And slayings in study neighborhoods populated by white children were so rare the study could not discern an effect.

The effect was seen among African American children even when they were not directly exposed to the violence, suggesting that the fear and anxiety caused by proximity to an act of violence can, in some communities, ripple outward across social networks and disrupt the intellectual circuitry of entire neighborhoods. In neighborhoods where violence is endemic, the study suggests that children's academic progress can be severely stunted.

"The pattern of findings is consistent with the literature on acute stress disorder, which is defined as a response to a threatening event that induces fear, helplessness or horror," writes Patrick Sharkey, a New York University sociologist and author of the study, published this week in the Proceedings of the National Academy of Sciences. "Among other symptoms are reduced awareness and difficulties in concentration for a period last at least two days and as long as one month after the stressor."

The study combined several databases to arrive at its striking findings. It cross-checked data on all reported homicides between 1984 and 2002 in Chicago neighborhoods with children's performance on cognitive tests administered in the course of two University of Michigan studies: the Project on Human Development in Chicago Neighborhoods, and a three-city study of welfare, children and families (of which only Chicago-based children were scrutinized). 

Chicago's 6,041 homicides recorded during that period afforded lots of opportunities to discern the effects of such violence on children who lived on the block where it took place and within the census tract of the crime. Some of those assessments of language and verbal skills took place within days of the violence. Others happened to have been administered a week or later after the event.

The result allowed Sharkey to discern not only a proximity effect of neighborhood violence -- that the cognitive function of black children closer to a killing was more significantly affected than that of children farther away. The results also showed a temporal effect -- that in the days after a homicide, the effect of the violence on cognitive performance was dramatic. But a week after a slaying, African American schoolchildren began to regain their cognitive composure.

In the days after a slaying, however, the effects on children who lived nearby was profound and far-reaching. The performance of these African American children slid dramatically on several tests that are reliable predictors of a child's academic performance in the long term. In total, data from some 1,100 African American children 5 to 17 were used in the study.

For a helpful guide to the lasting effects that witnessing a horrific event can have, check out this well-written article. If a child you know has witnessed violence, check out this site, and this helpful guide to choosing a mental health professional who can help. 

--Melissa Healy

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Rodent of the Week: Why women are more vulnerable to psychiatric stress

June 18, 2010 |  5:13 pm

It’s well known that women are more susceptible to some kinds of psychiatric disorders than men. For instance, studies have found that depression and post-traumatic stress disorder are twice as common among women as among men. But why?

Rodent One theory involves a brain hormone called corticotropin-releasing factor, or CRF. It is responsible for kicking off the stress response, and it is regulated by the female sex hormone estrogen. So perhaps estrogen causes female and male brains to respond differently to CRF.

To test this, scientists at Children’s Hospital of Philadelphia and the nearby Thomas Jefferson University subjected male and female rats to a swim stress test. Then they studied their brains in minute detail.

It turned out that the female rats were more responsive to CRF – it registered more strongly in their brains than it did in the male rats. What’s more, the female rats weren’t able to tone down the hormone after their stressful swims. But the male rats were – their brain cells changed in a way that prevented some of the CRF from doing its usual job.

“The findings identify molecular and cellular mechanisms that could result in enhanced sensitivity of female rats to CRF and a decreased ability to adapt to excessive CRF,” the researchers wrote. But they cautioned that further research is needed to see if the same gender differences are at play in human brains.

The study was published this week in the June issue of Molecular Psychiatry.

-- Karen Kaplan

Photo: Advanced Cell Technology Inc.

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About 1 in 10 Iraq veterans develops a serious case of PTSD, researchers say

June 7, 2010 |  1:19 pm

It’s well known that combat takes a toll on the mental health of soldiers -- for instance, studies of people who served in the ongoing conflicts in Iraq and Afghanistan have found that those who experienced combat were two to three times more likely to develop post-traumatic stress disorder than their counterparts who remained out of harm’s way. But studies have been less consistent in determining how many soldiers develop PTSD and other mental health disorders after deployment.

PTSD So a group of experts from the U.S. Army Medical Research and Materiel Command examined 13,226 anonymous surveys completed by veterans of Operation Iraqi Freedom. Some of those veterans were part of active duty Army divisions, and others served in National Guard infantry brigades.

Using a strict definition of PTSD, the researchers found that roughly 1 in 10 survey-takers had PTSD that was severe enough to cause “serious functional impairment.” The prevalence ranged from 7.7% to 8.9% for active duty Army personnel and from 6.7% to 12.4% for members of the National Guard. In both cases, the numbers went up over the first 12 months of their deployments.

When adding serious depression to the mix, the researchers found that 8.5% to14% of the veterans had a mental health problem that made it “very difficult” or “extremely difficult” to function properly. The findings are published in Tuesday’s edition of Archives of General Psychiatry.

The problems of PTSD can last long after soldiers retire from combat duties, according to a second study from the same journal.

Researchers from UC San Francisco and the San Francisco Veterans Affairs Medical Center examined the health records of 181,093 vets who were at least 55 years old. They found that the vets who had been diagnosed with PTSD were almost twice as likely to have dementia compared with the vets who did not have PTSD.

It’s not known how PTSD would increase the risk of dementia, but the researchers offer several theories. Perhaps PTSD robs veterans of some of their cognitive reserve, leaving them more vulnerable to dementia. The chronic stress associated with PTSD may also damage the hippocampus, the part of the brain that plays a key role in learning and memory.

Scientists are researching ways of preventing cases of PTSD. A study released this year found that soldiers who received morphine within the first few hours of a painful combat injury were 50% less likely to develop PTSD than those who didn’t get the powerful analgesic. A hypertension drug called prazosin has also been shown to reduce nightmares in vets with PTSD.

-- Karen Kaplan

Photo: PTSD -- and its ill effects -- can linger long after combat ends. Credit: Rick Loomis/Los Angeles Times

Web-based counseling service Vets Prevail offered to veterans

November 11, 2009 | 12:35 pm

Veterans in need of counseling, support or information to deal with mental and emotional issues can now turn to an online, interactive program called Vets Prevail. The services are provided confidentially and free of charge.

The website allows veterans to connect with other vets through forums, blogs and multimedia content. Vets can also sign up for a six-week online mental health program tool designed to help them build resilience and readjust to life after deployment. The aim of the training is to help vets tackle negative emotions and keep the trauma of the battlefield from affecting daily life and relationships.

About 500 veterans will be able to access the training program based on funds provided by Major League Baseball and the McCormick Foundation. However, organizers aim to continue the service with additional funding.

"The current mental health care crisis facing our service members is a very real problem with very real consequences," Richard Gengler, chief executive of Prevail Health Solutions, the parent company of Vets Prevail, said in a news release. "As a veteran-owned company, we have a personal stake in the matter and intend to help all veterans that are in need without ever charging a veteran or military family member."

The acute need for mental health services in the military was highlighted by last week's Ft. Hood shootings and was detailed in the L.A. Times today in a story, column and editorial. Research shows that less than one-quarter of veterans in need of mental health services actually seek it, often due to stigma and confidentiality issues.

— Shari Roan

Photo: Families wait at Ft. Hood on Tuesday for their loved ones with the U.S. Army 1st Cavalry Division to arrive home after a year of deployment in Iraq. The unit was the first to return home since U.S. Army Maj. Nidal Malik Hasan killed 13 people and wounded 30 at the base. Credit: Joe Raedle / Getty Images.

Combat stress can cause persistent attention problems

September 7, 2009 |  1:00 pm

Iraq Soldiers who spend months in combat situations are known to have cognitive changes when they return home. They tend to respond to dangers quicker and have some trouble with skills related to attention, learning and memory. A study published today shows those deficits can still be measured one year after returning from Iraq.

Researchers studied 268 men and women who served in Iraq between 2003 and 2006. They were given neuropsychological tests before and after deployment. One group was assessed immediately after their return and again in one year. Another group was assessed before deployment and then 122 days after returning. The study found that soldiers with post-traumatic stress disorder had poorer attention at the one-year mark, but this link was not found in soldiers who recently returned from deployment.

The study provides more evidence that the psychological wounds of war may persist and appear in various manifestations over time.

 "Our finding indicating that the relationship between PTSD and attentional impairment is minimal early on but strengthens over time is consistent with previous research," the authors wrote. The study also demonstrates "that psychiatric symptoms often reflect more extensive biological changes, including those affecting brain function."

The study was performed by researchers at Veterans Affairs Boston Healthcare System and Boston University. It is published in the Archives of General Psychiatry.

-- Shari Roan

Photo credit: Petr David Josek  /  AP

Today at noon: Live chat on PTSD and sleep disorders

August 5, 2008 | 10:39 am

Dr. Thomas C. Neylan, director of the Posttraumatic Stress Disorders (PTSD) Program at the San Francisco Veterans Affairs Medical Center, and Steve Woodward, director of the Sleep Research Laboratory at the VA's National Center for Posttraumatic Stress Disorder in Palo Alto, will be here at noon Pacific time to discuss the influence of war on sleep and how physicians try to treat the resulting problems.

If you or a loved one are losing sleep (literally) as a result of PTSD, read Jia-Rui Chong's story and join us in the chat room below (it'll open shortly before noon and no sign-up is required; just enter a guest name and come on in).  Welcome!


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