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Behavioral Science, Complementary Medicine, Mental Health, Parenting, Pediatrics, Research

Mindfulness and the fourth- and fifth-grade brain

Mindfulness and the fourth- and fifth-grade brain

Maths Homework

As a parent, this Time headline immediately grabbed my attention: “Mindfulness Exercises Improve Kids Math Scores.” But as I read the article, I learned that math scores were just one facet examined by the researchers and that mindfulness training was also shown to help children be less stressed and more caring.

The study, which was published in this month’s issue of Developmental Psychology, looked at a group of 99 fourth and fifth graders in British Columbia. For four months, half of the students were taught a pre-existing “personal responsibility” curriculum, while the rest learned about mindfulness through a program called MindUP that focuses on breathing exercises, mindful smelling and eating, and gratitude. The researchers then looked at cortisol levels, behavioral assessments, self-reports, along with those math scores. The article describes the results in more detail:

The results were dramatic. “I really did not anticipate that we would have so many positive findings across all the multiple levels we looked at,” says study co-author Kimberly A. Schonert-Reichl, a developmental psychologist at the University of British Columbia. “I was very surprised,” she says—especially considering that the intervention took place at the end of the year, notoriously the worst time for students’ self-control.

Compared to the kids in the social responsibility program, children with the mindful intervention had 15% better math scores, showed 24% more social behaviors, were 24% less aggressive and perceived themselves as 20% more prosocial. They outperformed their peers in cognitive control, stress levels, emotional control, optimism, empathy, mindfulness and aggression.

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Behavioral Science, Health and Fitness, Medical Apps, Public Health, Technology

What needs to happen for wearable devices to improve people’s health?

What needs to happen for wearable devices to improve people's health?

15353072639_f3a79557df_z“Wearable devices” are pieces of technology that are worn in clothes or accessories, and they often have biometric functionality – they can measure and record heart rates, steps taken, temperature, or sleep habits. Numerous tech companies have begun manufacturing and marketing such devices, which are part of a larger movement often referred to as the “quantified self” – where data about one’s life is meticulously gathered and recorded. Only 1% to 2% of Americans have used a wearable device, but annual sales are projected to increase to more than $50 billion by 2018.

Health and fitness apps are also proliferating, from software that maps where you run or provides a digital workout community, to programs that count calories or suggest how to improve your sleep. But what’s the real impact for people’s health?

Earlier this month, a report from the Journal of the American Medical Association called into question the idea that wearable devices will effect population-scale changes in health. There is a big gap, the authors claim, between recording health information and changing health behavior, and little evidence suggests that this gap is being bridged. Wearable devices might be seen as facilitating change, but not driving it. Mitesh Patel, MD, MBA, from University of Pennsylvania, and colleagues wrote:

Ultimately, it is the engagement strategies—the combinations of individual encouragement, social competition and collaboration, and effective feedback loops—that connect with human behavior.

The difficulty of population health is that changes have to be sustained to have meaningful effects, and that is quite difficult. The authors identify four steps that must be taken to bridge this gap towards sustained change.

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Behavioral Science, Research, Science

Hormone similarity helps bird couples stay together

Hormone similarity helps bird couples stay together

GreatTit002My husband and I — total opposites. He’s neat, I’m messy. He’s early, I’m late. He dislikes socializing, I love to go out with friends. He digs meat and potatoes, I’m a veggie. And I could go on.

So if we were a type of European songbird called the great tit, I’m afraid we wouldn’t be together. Great tits choose mates quite similar to each other, with a recent study from the Netherlands Institute of Ecology showing they even have similar hormone levels. And those levels converge the longer the birds are together.

Researchers, who presented at the 2015 annual meeting of the Society for Integrative and Comparitive Biology, measured the levels of corticosterone, a stress hormone, in breeding pairs of great tits. Pairs with similar levels of hormones were also more likely to have more healthy babies. “For at least three years, the pairs that stay together increase their similarities year after year after year,” ecologist Jenny Ouyang, PhD, said in a release.

Pairs with dissimilar levels were more likely to “divorce” or break-up, a costly move in the avian world when being without a mate reduces your chances to reproduce. Some researchers have speculated that coordinating the feeding of the babies might lead the partners to have more similar hormone levels. But the exact mechanism remains unknown.

Thankfully, my husband and I can talk, hopefully avoiding the need to compare our hormone levels, which I’d bet are quite different, and growing more so every day.

Previously: “Love hormone” may mediate wider range of relationships than previously thought, Stress hormones moonlight as immune-system traffic cops and My couple’s match: Applying for medical residency as a duo
Photo by Shirley Clarke

Behavioral Science, Mental Health, Stanford News

Resolution check-in with a Stanford psychologist, one week into the new year

Resolution check-in with a Stanford psychologist, one week into the new year

2015 image

Ever make a New Year’s resolution and, one week later, find that you’ve thrown it out the window? The experience is not uncommon. In a recent Stanford News interview, Stanford psychologist and “science-help” expert Kelly McGonigal, PhD, explains the psychology of resolution-making. Here’s a chance to take a look back over the past week, reevaluate your resolution style, and start afresh.

To work, a resolution has to be both meaningful and achievable. The trick to McGonigal’s approach is, essentially, to separate these goals. Think of a resolution that is significant, sweeping, and deeply connected with who you would like to be or how you see your ideal self; then, think of a tiny daily step that relates to that goal. McGonigal explains:

The best kind of resolution is one that has a “big why” – to create health, to reconnect with a personal passion, to strengthen an important relationship, to change your financial situation, to develop yourself in some way, or to contribute to others in some way. And then you pick a small action or change that reflects this big goal, to remind yourself of it and to help you take steps toward it.

If your “big why” is to become more healthy, for example, don’t try to quit smoking or wake up an hour earlier every day to exercise. Try to wait an extra ten minutes before smoking your first cigarette, or dance to two songs in the kitchen after finishing the dishes. Such small, doable steps have been shown to have a big impact when connected with purposeful intention.

Thinking of resolutions as existing on different scales like this can help sustain the huge psychological boost that comes from resolving to change. This boost can easily be lost when people are confronted by how difficult change actually is, after which they give up – what psychologists call “false hope syndrome.” To avoid this, it’s useful to distinguish between resolutions that are expressions of a hopeful mindset, and resolutions that are plans for action. More from McGonigal:

Research shows that when people resolve to change, they immediately feel more confident, in control and hopeful. They even feel stronger and taller, which is kind of ridiculous, but this just shows how uplifting resolving to change can be. If people want to make resolutions as a way to connect to a growth mindset – the belief that through effort and support, you can change and grow in meaningful ways – that’s fine. It’s not necessarily a tragedy if you fall short…

The worst thing to do is make a promise to yourself that you don’t really care about and don’t really plan to see through.

Whether you think of your resolution to change as more of a mindset or more as something for which you want to be accountable, both the abstract and the concrete levels are essential.

McGonigal suggests a few tools for resolution success: recruiting a buddy to you can text when you’ve done your small daily goal, taking time for pre-resolution reflection through a gratitude list, or tricking your brain into thinking you’ve already succeeded by “encoding prospective memories.” Best of luck in 2015!

Previously: How to keep New Year’s resolutions to eat healthy, Ask Stanford Med: Stanford health psychologist Kelly McGonigal taking questions on willpower, Stanford health psychologist Kelly McGonigal discusses how stress shapes us, and How to keep New Year’s resolutions to eat healthy
Photo by Sondem/Shutterstock

Behavioral Science, Public Health, Sleep

Six simple ways to improve your sleep for the holidays

Six simple ways to improve your sleep for the holidays

IMG_5595The holiday season is usually one of the busiest – and often most stressful – times of the year. It’s also a season that often brings poor sleep. To improve your health and your mood, consider six simple ways that you can maintain healthy sleep during the hustle and bustle of the holidays and even discover the resolve to improve your sleep in 2015.

1. Go to bed when you’re sleepy.

It seems obvious, but it isn’t always easy to do: Sleep most easily comes when we are feeling sleepy. Insomnia, characterized by difficulty falling or staying asleep, can plague us throughout the year. With the added stress of the holidays, it can be even harder to fall asleep.

Many insomniacs will start to go to bed earlier, or stay in bed long after waking, to make up for lost sleep. This desperation often thins out sleep and makes it less refreshing. Imagine showing up for a holiday feast after having snacked all day. You wouldn’t have much of an appetite. If you spend too much time in bed, or take naps, you similarly will show up for the eight-hour feast of sleep without much interest.

Prolonged wakefulness helps to build our drive for sleep and staying up a little later until you feel sleepy can ease insomnia.Preserving 30 to 60 minutes to relax before bed can also aid this transition.

2. Ease yourself into a new time zone to prevent jet lag.

If you’re flying across the world, or even across the country, you may find that your sleep suffers. This is due to our body’s natural circadian rhythm, which regulates the timing or our desire for sleep. This rhythm is based in genetics, but it is strongly influenced by environmental cues, especially morning sunlight exposure.

If you suddenly change your experience of the timing of light and darkness by hopping on a jet plane, your body will have to play catch up. As a general rule: “West is best and east is a beast.” This points out that westward travel is more tolerated because it’s nearly always easier to stay up later than it is to wake up earlier.

Another rule of thumb is that it takes one day to adjust for each time zone changed. If you travel across three time zones, from San Francisco to New York City, it will take about three days to adjust to the new time zone. This adaptation can be expedited by adopting the new time zone’s bedtime and wake time before you depart. If you’re like most people, your best intentions might not lead to pre-trip changes.

Never fear: To catch up once you arrive, delay your bedtime until you are sleepy, fix your wake time with an alarm, and get 15 minutes of morning sunlight upon awakening.

3. Put an end to the snoring.

Whether you’re staying in grandma’s spare room or sharing a hotel suite, close quarters during the holidays may call attention to previously unnoted snoring and other sleep-disordered breathing like sleep apnea.

Remember that children should never chronically snore; if they do, they should be seen by a sleep specialist. Adults don’t have to snore either. Snoring is commonly caused by the vibration of the soft tissues of the throat. If the airway completely collapses in sleep, this is called sleep apnea. This may lead to fragmented sleep with nocturnal awakenings and daytime sleepiness. It is also commonly associated with teeth grinding and getting up to urinate at night.

When sleep apnea is moderate to severe, it may increase the risk of other health problems including hypertension, diabetes, heart attack, stroke, and dementia. It’s more than a nuisance, and if you or a loved one experience it, further evaluation and treatment is warranted.

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Behavioral Science, Health and Fitness, Nutrition, Obesity, Public Health, Research

Perceptions about progress and setbacks may compromise success of New Year’s resolutions

3336185391_60148a87fa_zMy physical therapist is constantly telling me to pause during the workday and take stretch breaks to counter act the damage of being hunched over a computer for hours on end. After every visit to his office, I vow to follow his advice, but then life gets busy and before I know it I’ve forgotten to keep my promise.

So I decided that one of my New Year’s resolutions will be to set an alarm on my phone to serve as a reminder to perform simple stretches throughout the day. Keeping in mind that a mere eight percent of people who make resolutions are successful, I began looking for strategies help me accomplish my goal. My search turned up new research about how the perception of setbacks and progress influence achievement of behavior change. According to a University of Colorado, Boulder release:

New Year’s resolution-makers should beware of skewed perceptions. People tend to believe good behaviors are more beneficial in reaching goals than bad behaviors are in obstructing goals, according to a University of Colorado Boulder-led study.

A dieter, for instance, might think refraining from eating ice cream helps his weight-management goal more than eating ice cream hurts it, overestimating movement toward versus away from his target.

“Basically what our research shows is that people tend to accentuate the positive and downplay the negative when considering how they’re doing in terms of goal pursuit,” said Margaret C. Campbell, lead author of the paper — published online in the Journal of Consumer Research — and professor of marketing at CU-Boulder’s Leeds School of Business.

Given these findings, researchers suggest you develop an objective method for measuring your progress and monitor it regularly.

Previously: Resolutions for the New Year and beyond, How learning weight-maintenance skills first can help you achieve New Year’s weight-loss goals, To be healthier in the new year, resolve to be more social and Helping make New Year’s resolutions stick
Photo by Laura Taylor

Behavioral Science, Global Health, Neuroscience, Stanford News

Stanford Rhodes Scholar heading to Oxford to study ways "the brain can go awry"

Stanford Rhodes Scholar heading to Oxford to study ways "the brain can go awry"

10515175_10152524157302002_5878205180193467577_o-001Undergraduate Emily Witt is one of two Stanford students selected to receive the prestigious Rhodes Scholarship to study abroad at Oxford next year; an announcement was made late last month.

Witt is a human biology major with a concentration in neuropathology, and she’s minoring in psychology. Her research experience thus far spans neuroscience, psychology, autoimmune pathology, and health in the developing world; and she says she’s interested in studying “any way that the brain or the nervous system can go awry.”

Witt, who plans to attend medical school after her scholarship tenure, works in the lab of  neurologist Lawrence Steinman, MD, PhD, which seeks to understand the pathogenesis of autoimmune diseases, particularly multiple sclerosis. She’s using the lab to conduct research for her honors thesis, which focuses on the mechanisms of vitamin D in multiple sclerosis. She’s also involved with the Center for Interdisciplinary Brain Sciences Research and has participated in various studies related to autism and social cognition.

After hearing about this honor, I reached out to Witt with some questions about her work and her future plans:

How did you become interested in this field?

I’m interested in MS for two reasons. On a personal level, I have seen the devastating impact of the disease first-hand as my uncle has the progressive form of MS. Watching his condition worsen, and seeing the impact it has had on his life and the life of my aunt and cousins, inspired me to research this horrible disorder.

On an intellectual level, I’m fascinated by the interaction between the immune system and the brain. I believe it’s an incredibly important area of research as the immune system is a contributing factor to numerous neurological diseases, from multiple sclerosis and autism to depression.

What makes Oxford a particularly appealing place for you to study? Who or what do you hope to work with there?

I’m interested in working with two neuroscientists who are experimental psychologists; they’re actually bridging the gap between experimental psychology and neuroscience, which are the two degrees I’m hoping to pursue while at Oxford. One is Elaine Fox, who researches cognitive biases, and the other is Catherine Harmer, [who studies the] pharmacological aspects of depression and how they affect cognitive biases, particularly with respect to depression and anxiety.

Are you interested in contextual understandings of disease or degeneration – its social roots? How does interdisciplinary work fit into your imagining of what you’re doing and would like to do?

That’s what my primary motivation going forward is: kind of connecting what I see in everyday life and how neurological [diseases] manifest and what I understand about them biologically. So what I’m really interested in is combining a fundamental understanding of psychology with clinical applications of neuroscience… Because I do think that… there’s still a wide gap between studying the brain on a molecular and cellular level, and studying it on a behavioral level.

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Behavioral Science, Health and Fitness, Nutrition, Parenting

"Less is more”: Eating wisely, with delight, during the holidays

"Less is more": Eating wisely, with delight, during the holidays

309295507_10531bb128_zSome multi-culture families celebrate their heritage by adding more holidays, writes Maya Adam, MD, a Stanford lecturer who operates the nonprofit Just Cook for Kids. “For our family, with its unusual set of Indian, German and Jewish South African roots, this season seems particularly out of control because we celebrate all of these holidays, one after another. And if we’re not careful, we can easily end up suffering from a severe case of sugar shock.”

Sugar shock, or rather, avoiding sugar shock is the topic of Adam’s blog post on the Healthier, Happy Lives Blog, published by Stanford Children’s Health.

For me, the whole moderation thing is a particularly daunting challenge. Either yes or no seems much simpler. Eat lots or say “no thanks” — none of this healthy balance baloney for me.

But with three simple guidelines, Adam makes moderation seem possible, even doable. Numero uno: Offer healthy alternatives. If potato chips are accompanied by fresh veggies and hummus, it’s much easier to go for the veggies. Dos: Model good behavior for your kiddos. As Adam writes: “When kids see that their parents are able to enjoy a small treat on occasion — and then stop — they learn a great lesson: Less is more.”

And for the third tasty pointer, I’ll let you check that out for yourself. Mmmm, mmmm, it’s a good one.

As Adam writes: “Holidays should be happy times — and sharing food with the people we love is a big part of that happiness.” Bon appetit!

Previously: A physician realizes that she had “officially joined our nation of fellow sugar addicts”, Eat well, be well and enjoy (a little) candy and Pediatrics group issues new recommendations for building strong bones in kids
Photo by Laura

Autism, Behavioral Science, Events, Stanford News

Thinking in pictures: Stanford hosts Temple Grandin

Thinking in pictures: Stanford hosts Temple Grandin

Grandin Temple - smallEarlier this week, I got to hear a presentation by Colorado State University animal behavior expert Temple Grandin, PhD, who is widely known not just for her extensive work to enhance animal welfare, but also because she is one of the world’s most prominent individuals with autism. Like many others, I first became familiar with Grandin’s work through Oliver Sacks’ 1995 book, An Anthropologist on Mars. (The title came from Grandin’s description of how she feels when trying to decode the subtleties of social interactions.) Since I first read Sacks’ book, I’ve written frequently about autism research and treatment, and I’ve gotten some sense of how phenomenally important Grandin is to the autism community. So it was quite a thrill to be sitting just a few feet from her as she spoke to an overflow crowd at the School of Medicine.

Grandin’s talk focused on understanding animal behavior and reducing animals’ stress, but she interwove descriptions of her research with comments on how living with autism has influenced her work – and, indeed, how it influences the world around us. “A little bit of autism gives you Silicon Valley,” she quipped in the introduction to her talk. Although her subject was animals’ stress, at the heart, she was explaining different ways of thinking: in words or in pictures.

Animals think in pictures, especially when it comes to determining which elements of their environment are stressful or frightening, Grandin said: “Animals are all about sensory detail, little bits of detail we tend not to notice.” At one point in the talk, she showed a photo of a cow bending forward to investigate a spot of sunlight on the floor of the room where it was about to have a veterinary exam. To a human, this spot would likely seem insignificant, but to the cow, it is a foreign object that needs to be approached with caution.

“Novelty is a strong stressor for animals,” Grandin said, adding that if something visually new is forced in an animal’s face, it’s scary. The cow in the photo needs a few minutes to sniff the sun spot and figure out that it’s harmless; a human trying to force the situation will soon have a frightened, resistant animal to handle. Humans also have to keep in mind that our word-oriented brains may not categorize “novelty” in the same way that an animal does. For instance, an animal that has become accustomed to the sight of a blue-and-white umbrella may still be frightened by an orange tarp, Grandin said. To people, they’re both rain protection, but to a horse or cow, “It’s a different picture!”

Like many children with autism, Grandin began speaking later than most kids, and she still thinks in images more intuitively than words. “I see movies in my imagination, and this helped me understand animals,” she said. She likened her memory to Google Images, explaining that for her, a particular word will pull up many associated images, categorized by type. Her designs for meat-processing plants, now in use in half of the meat-processing facilities in North America, rely on her ability to mentally take a “cattle’s-eye view” of each step in the animal’s journey before slaughter, playing out a movie in her head that shows her where animals could be forced to encounter new things that might frighten them.

As well as describing her own work, Grandin advocated for broader acceptance of different kinds of thinkers, both with and without autism. People may think predominantly in pictures, or in patterns (that’s the math whizzes among us), or in words, she said, and we need educational and employment systems that can nurture and benefit from each of these ways of thinking. “There is too much emphasis on deficits [of children with autism], and not enough on building their strengths,” she said.

Grandin’s complete talk, which was hosted by the Department of Comparative Medicine, will soon be available on the department’s news website.

Previously: A conversation with autism activist and animal behavior expert Temple Grandin, Growing up with an autistic sibling: “My sister has a little cup” and Finding of reduced brain flexibility adds to Stanford research on how the autistic brain is organized
Photo by Rosalie Winard

Addiction, Behavioral Science, In the News, Mental Health, Research, Stanford News

Veterans helping veterans: The buddy system

Veterans helping veterans: The buddy system

image.img.320.highI interviewed Army specialist Jayson Early by phone over the summer, shortly after he completed an in-patient program for PTSD at the Veterans Affairs hospital in Menlo Park. This was for a Stanford Medicine magazine story I was researching about a pilot project to help get much needed mental-health services to the recently returned waves of Afghanistan and Iraqi vets. What struck me most after talking with Early was just how clueless he had been, first as a teenaged-recruit, then as a young veteran, about the fact that going to war could cause mental wounds.

As the mother of a 17-year-old boy, though, I completely understood: Early just wanted to serve his country. He requested to be sent to war. In 2008, he got his wish and was deployed to Iraq just a year after exchanging his high-school baseball uniform for military fatigues. His first field assignment, an innocuous-sounding public affairs errand to photograph a burned out truck at an Iraqi police station, would be the first of many that left him with permanent scars:

“There were body parts, coagulated blood, hair all over,” [Early] says, pausing. “I just wasn’t expecting it.” An Iraqi family had been executed in the vehicle, presumably by insurgents. Early had gone through intense military training to prepare for moments like these. He blocked any emotions. He followed orders, clicked the camera and moved on. It wasn’t until years later that he realized just how permanently those images, and many more like them, had burned into his brain.

Stanford psychiatrist Shaili Jain, MD, interviewed in a podcast about her work with PTSD and veterans, had told me about a new pilot project that connects veterans with other veterans as a unique way to bridge what she called a “treatment gap” – the difficulty of getting mental-health services to the veterans that need them. My article – which is a timely read, given that today is Veterans Day – tells the story of Early’s connection with one of the veteran’s hired through this project, Erik Ontiveros, who went through treatment for addictions and PTSD himself, and just why it’s so hard to get treatment to veterans. As one well-known expert on PTSD explains in the story:

“It’s wicked difficult to treat anyone with moral injuries from combat in the traditional medical model,” says psychiatrist Jonathan Shay, MD, an expert on PTSD known for his books on the difficulties soldiers face returning home from war. “It destroys the capacity for trust. What it leaves is despair, an expectation of harm, humiliation or exploitation, and that is a horrible state of being. The traditional medical model – in an office with the door closed – is the last thing they want. I’m convinced that’s where peers come in. Peers are indispensable.”

Early told me many of his horror stories from war – stories that he rarely talks about. The time he was called to another execution area where there were enough body parts for 12 people who had all been gagged, bound, shot and burned. But, he said, they could only put together eight people. “We were trying to find a way to identify them,” he said. “Whenever I grabbed a hand, it would just crumble to dust.”

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