Mental Health

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The number of male eating disorder cases is on the rise. This NBC Nightly News segment takes a closer look at increasing prevalence of anorexia among boys and how the disorder differs between genders. In the video, James Lock, MD, PhD, a psychiatrist at Lucile Packard Children’s Hospital, explains why anorexia is generally more advanced among boys by the time they seek treatment.

Previously: Shedding light on how binge eating affects men, What a teenager wishers her parents knew about eating disorders, Stanford’s eating disorder program owes its success to holistic treatment and KQED health program examines causes and effects of disordered eating

Previous studies have shown that stress can contribute to a range of health conditions, from the common cold to heart disease. Now new research from UC San Francisco suggests that the mere anticipation of a stressful situation may increase a person’s risk for age-related diseases.

In the study, researchers examined how major forms of stress in individuals’ lives can influence how they respond to more minor forms of stress and how this psychological response impacts neurobiology and cellular health. To do so, they informed 50 women, about half of which were caregivers for a relative with dementia (and who, presumably, deal with daily stress), that they would be asked to perform public speaking or math tasks. The researchers then assessed participants’ cellular age by measuring the women’s telomeres, the protective caps on the ends of chromosomes. Short telomeres index older cellular age and are associated with increased risk for a various chronic diseases of aging such as cancer, heart disease and stroke.

According to a university release:

…The psychologists found that those most threatened by the anticipation of stressful tasks in the laboratory and through public speaking and solving math problems, looked older at the cellular level.

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The researchers also found evidence that caregivers anticipated more threat than non-caregivers when told that they would be asked to perform the same public speaking and math tasks. This tendency to anticipate more threat put them at increased risk for short telomeres. Based on that, the researchers propose that higher levels of anticipated threat in daily life may promote cellular aging in chronically stressed individuals.

Although the findings are preliminary, researchers say the study results are a significant step forward in their goal of understanding how psychological stress promotes biological aging and developing interventions to reduce the risk for disease in chronically stressed individuals.

The research is slated to appear in the May issue of Brain, Behavior and Immunity.

Previously: Workplace stress and how it influences health, How work stress affects wellness, health-care costs, Robert Sapolsky discusses stress physiology, Can stress increase risk of neurodegenerative diseases?, No surprise here: Anger and stress are bad for your health, Robert Sapolsky on stress and your health and New year, new (less stressed) you
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Here’s something to reflect on this Valentine’s Day. A recent study shows that Americans’ deep-seated regrets most often involve personal relationship mishaps, not missed career opportunities.

In the study (subscription required), researchers surveyed 500 U.S. adults about their biggest disappointments in life and then analyzed their remorse to identify what parts of their lives were most directly impacted. Healthland reports:

Study participants were asked to describe regrets that they considered both strong and weak, along with the situation that surrounded the regret. Analysis revealed that regrets involving love — think ending a relationship or cheating — rankle more than those related to less intimate choices such as dropping out of college or quitting a job. The study, published online last week in the journal Social Psychological and Personality Science, reported that love regrets outnumbered work regrets by more than 2 to 1 — 56% to 20% — in some of the comparisons. The more intense a regret, the more likely it was to be connected to personal relationships.

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What that means in general is that being bad at keeping in touch with old friends or forgetting to buy Valentine’s chocolates for your sweetie has the potential to make you feel worse — much worse — than making a mistake at work. “As you are thinking about how to feel good about your life, the thing you will feel most strongly about is protecting and strengthening your personal relationships,” says [Neal Roese, PhD, a marketing professor at the Kellogg School of Management at Northwestern University].

Previously: How social ties can influence our health, happiness
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Stanford psychology researchers are using imaging techniques to learn more about what happens in the brains of young girls at risk of depression and, as recently described here, they’re exploring a novel way to train brains away from negative situations. Ian Gotlib, PhD, discusses the work, which represents a “critical step in learning how to prevent the onset of a depressive episode,” in a Stanford Report article and the video above.

And for more on the topic, my colleague recently reported on adolescent depression and efforts to prevent it in Stanford Medicine.

Previously: Using brain-training games to stave off depression in adolescents

A new social network called AnxietySocialNet aims to help people suffering from anxiety disorders address their symptoms, find information and network with others.

Founded by Salomon Ptasevich, a former anxiety sufferer, the site also hopes to attract friends and family members who may be watching a loved one struggle with anxiety who feel helpless or confused about how to help. In a WebWire news release, Ptasevich explains:

The whole idea behind ASN is to allow people to share their emotions in a safe place and learn from each other’s experiences. We try to encourage users to get themselves out there and conquer their anxiety.

AnxietySocialNet hopes to help sufferers of agoraphobia, social anxiety disorders, obsessive compulsive disorder or any of the other forms of anxiety affecting many. The National Institute of Mental Health estimates that anxiety disorders affect as many as 40 million Americans age 18 or older.

Photo courtesy of Thinkstock Photos

Since she was a toddler, my five-year-old has been utterly devoted to a mint-green stuffed hippo named, appropriately, Hippo. He/she (the toy’s gender remains undecided) has been a faithful companion to my daughter, accompanying her on vacations, snuggling up with her at naps and bedtime, and serving as a playmate when my other daughter is otherwise engaged. Hippo even benefits me by offering traffic advice in the car: “Mommy, Hippo says we should go the other way because there’s an accident straight ahead,” my daughter will say.

I’ve always assumed that having an imaginary friend – in stuffed or human form - is normal and healthy for children, but I was still heartened to read today that this is, indeed, the case. In summarizing some of the research on the benefits of imaginary companions, Huffington Post’s Lisa Belkin writes:

They serve a variety of roles in a child’s development. The NYU Child Study Center describes the creation of these companions as “the product of a creative and curious mind figuring out how to make sense of the widening world.” Marjorie Taylor, the University of Oregon professor who is one of the leading voices in the field, and who runs a website that is all about imaginary friends, says one of the many reasons for their existence is as a shield against fear. “Children can walk confidently past a scary dog when there is an invisible tiger at their side,” she writes. Others researchers have looked at how these pals help children to “try out different relationships at a critical point in their social development,” or “allow children to explore issues of control, discipline and power with the anxiety attached to interactions with real authority figures,” or just have have “fun.”

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Children are better off because of them. Among the conclusions of research into children with imaginary companions are: “those who have them more able to see things from someone else’s perspective;” “children who pretend and imagine usually are healthier emotionally as adults”; “these children are likely to be less shy and have more real life friends.”

Last month, we introduced a Scope feature that gives readers the opportunity to ask questions of our medical school faculty and researchers. Fred Luskin, PhD, a research associate at the Stanford Prevention Research Center and co-founder of the Stanford Forgiveness Project, served as our first guest and took questions about why forgiveness is important for health.

Below Luskin responds to a selection of questions submitted via the @SUMedicine Twitter feed using the hashtag #AskSUMed and the comments section on Scope.

Preethi Reddy Chintha asks: What is forgiveness? What does it mean to be able to forgive?

Forgiveness is making peace with not getting what you wanted. It is an open-hearted way of being in your life even though a piece of it turned out differently than you hoped. It is to say something was painful and unwanted but I am not stuck in such remembrance.

@lap201156 asks: What does one need to do to get through the layers of hurt, anger, etc. to get to forgiveness?

First, feel the pain in it’s changing experience. Second, be clear about what happened to you including the harm done. Third, tell a couple of trusted people about your experience. Fourth, make the decision to forgive. Fifth, practice being at peace for moments at a time and do so regularly. Sixth, understand the choice to forgive continues with daily practice.

Kritika asks: How can the failure to forgive increase a person’s risk of heart disease and mental illness?

If a person doesn’t learn to forgive, he or she will lose a sense of efficacy at dealing with life’s hurts. The individual may also tend to become less trusting because they have not found a source of peace within themselves. If there is a physical stress part of the upset, the person may also suffer from stress-related illnesses.

The effects of unregulated stress arising from ongoing negative affect and cognitions, which impacts the nervous, endocrine and cardiovascular systems, can increase a person’s risk of heart disease and mental illness. In addition, the inability to manage one’s emotions leads to helplessness and despair. The mind-body effect can be cumulative and impact, weaken or damage parts of the body. Our work has demonstrated that.

Continue Reading »

The more ongoing stress children are exposed to the greater the odds they will struggle with their weight as adolescents, according to a study recently published in Pediatrics.
The findings (subscription required) support past research showing molecules released when a person is stressed may unlock the body’s fat cells, and additional studies suggesting that stress contributes to childhood obesity.

Futurity reports that in the latest study:

The researchers measured the height and weight of 244 9-year-olds in rural New York state and calculated their various physical and psycho-social stressors–for example, exposure to violence, living in a substandard house, or having no access to such resources as books.

They also measured the children’s ability to delay gratification by offering them a choice between waiting for a large plate of candy versus having a medium plate immediately. The researchers measured the children’s height and weight again four years later.

The study showed children who were chronically exposed to stressors such as poverty, crowded housing and family turmoil gained more weight and were significantly heavier by age 13 than they would have been otherwise. Researchers say the findings could have implications for weight management interventions and policies aimed at reducing individual stressors.

Previously: How should parents talk to their kids about weight control?, How should pediatricians talk about obesity?, Scientists take a divide-and-conquer approach to combating childhood obesity and How to combat childhood obesity? Try everything
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Raise your hand if you’re having trouble keeping your New Year’s resolution. Not to worry; you’re in good company. Recent data shows that four out of five people who vowed to reform bad habits will eventually break those promises. A third of this group will give up on their resolutions by Feb. 1, which is Wednesday.

So now is a good time to reflect on your 2012 goals and re-commit to your efforts. A Q&A posted with Florida State University social psychologist Roy Baumeister, PhD, offers insights and tips to help boost your willpower, which research suggests is limited, and break bad habits.

On the topic of things you can do to maximize your chance of successfully keeping a resolution, Baumeister suggests sharing your goals with others, tracking progress and findings ways to minimize decision-making. He says:

Social support and interpersonal pressure can help quite a bit. The most important thing is to keep track, day by day, of what you are trying to control. Keep an explicit, written record of how much you eat or spend or exercise. Sharing this record with others is also helpful.

Pre-commitment is another class of helpful strategies. When people choose what they are going to eat well in advance, they eat better than when they decide, impulsively, what and how much to eat on each occasion. Pre-commitment includes things like automatic savings plans that transfer some of your paycheck into a savings account, without you having to make a decision each time.

In the article, Baumeister echoes several key points discussed by Stanford health psychologist Kelly McGonigal, PhD, in this earlier Scope Q&A.

Previously: Stanford health psychologist offers tips for increasing your willpower and The science of willpower
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Past studies have shown that exercising can reduce anxiety, help in treating depression and boost your mental health in other ways. Now a study (subscription required) recently published in Journal of Business and Psychology shows it could also make the workplace more enjoyable — that is if it’s your boss who’s hitting the gym.

Scientific American reports:

Researchers asked 98 MBA students who were also employed full-time to rate how their supervisors treated them, by responding to statements like “[my boss] puts me down in front of others.” The researchers also had supervisors fill out a different survey, about their stress levels and weekly exercise. And, as the authors expected, the more stressed-out supervisors were, the more their employees felt belittled by them. But the employees felt better about bosses who exercised, whether it was yoga, cardio or weight lifting. And just one or two days a week did the trick.

Exercise didn’t simply melt away the stress—bosses who worked out reported feeling just as much pressure as their sedentary counterparts. Active bosses just spared subordinates the verbal attacks.

Previously: Taking time out to exercise during the workday may boost productivity, Do exercise breaks improve mental and physical fitness? and Exercise may be effective in treating depression
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Hitting the gym or going for a jog could alleviate fatigue, depressive symptoms and other mental health issues among chronically ill patients, according to new findings (subscription required) published in Archives of Internal Medicine.

Reuters reports:

[Researchers] combed through 90 previous studies including more than 10,000 people with health problems like cancer, heart disease, chronic obstructive pulmonary disorder (COPD), fibromyalgia, chronic pain or obesity.

In each study, people had been randomly chosen to do exercises — on average, three times a week over 17 weeks — or not.

According to [study author Matthew Herring, PhD], people’s depressive symptoms, as rated on a variety of psychological scales, dropped about 22 percent with exercise overall. That’s similar to the effects on fatigue, anxiety, pain and other mental health outcomes.

More study is needed – the researchers say they haven’t determined what types of exercise are most beneficial and how long the effects last – but the findings add to the evidence on the health benefits of exercise. As one of our surgeons opined in a recent Stanford Medicine article on the topic, “There’s practically nothing that exercise isn’t good for.”

Previously: How light exercise can help prevent arthritis from getting worse,Exercise may alleviate symptoms of arthritis regardless of weight loss and Treating joint pain with physical activity, self-management programs
Photo by Sasha Wolff

A growing body of research suggests that children’s friends can provide a strong calming influence on them and that these relationships have a measurable effect on stress hormones during tense times. Echoing these findings is research published in Developmental Psychology showing the presence of friends mitigates the effects of negative experiences on children.

In the small study (subscription required), researchers assigned 5th and 6th graders enrolled in Montreal schools to keep journals on their feelings and experiences over the course of four days and submit to regular saliva tests that monitored cortisol levels. Study results showed children’s feelings of self-worth and levels of cortisol, a hormone produced naturally by the adrenal gland in direct response to stress, are largely dependent on the social context of a negative experience.

Study co-author William M. Bukowski, PhD, director of the Concordia Centre for Research in Human Development, discussed the significance of the findings in a release:

Having a best friend present during an unpleasant event has an immediate impact on a child’s body and mind. If a child is alone when he or she gets in trouble with a teacher or has an argument with a classmate, we see a measurable increase in cortisol levels and decrease in feelings of self-worth.
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Our physiological and psychological reactions to negative experiences as children impacts us later in life. Excessive secretion of cortisol can lead to significant physiological changes, including immune suppression and decreased bone formation. Increased stress can really slow down a child’s development. What we learn about ourselves as children is how we form our adult identities. If we build up feelings of low self-worth during childhood, this will translate directly into how we see ourselves as adults.

Previously: Study offers insights into how friendships help children manage stress
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Speaking of tweens, there’s an interesting (and sobering) article in The Atlantic today on how parents’ money-related depression may affect their middle-school-aged children. It highlights a 2011 study that found:

The more stressed the parents were about money, the more likely they (the parents) were to be depressed. Not a surprising finding. But parental depression also affected the strength of the relationships between the parents and their kids: Parents who experienced more depressive symptoms were less connected to their children — and this was true based on reports from both the parents and the kids.

But the most revealing connection was one between the intimacy of the parent-child relationships and the “pro-social behavior” of the kids. The children, between the ages of 10 and 14 when the study began, were polled on how they felt about reaching out to friends, family, and strangers. They ranked themselves on statements like “I help others even if it’s not easy for me,” “I volunteer in programs to help others in need,” and “I really enjoy doing small favors for my family.” Kids who had less-connected relationships with their parents were less likely to exhibit these pro-social behaviors than kids who enjoyed stronger relationships with their parents.

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While earlier studies have looked at the effects of the economy on kids’ psyches, they have typically considered only the development of negative behaviors, like substance abuse, mental illness, aggression, and other “problem behaviors.” The idea that the economy could, through indirect means, cause a shift or decline in kids’ positive social behaviors has not been illustrated until now.

Today’s San Jose Mercury News included an interesting Q&A with Mark Cullen, MD, professor of medicine at Stanford, about how job stress can affect your health. In the interview, Cullen discussed the contributing factors to occupational stress, how it can impact a person physically and how stress in the workplace has changed over the past few decades.

On the topic of reducing job-related stress, he said:

There are two totally different components – individual and societal. I think the unrest in our society is not just due to unemployment, but also to the vast insecurity about work and its future. As terrible as the Great Recession was, in which 8 to 10 million people lost their jobs, 200,000 million people got nervous, real nervous. So the biggest question is, how do we return to some civil society in which people have security that there will be work, and they can be productive?

But, individually, the biggest step most people can take is to become their own advocates. To do their own job analysis and to think about what parts of their job — the demands, the control over their job and the rewards — are amenable to change. For example, people who have trouble sleeping should give some thought to ways in which they can protect their sleep, even if they can’t change some aspects of their work. Or you can decide that after 8 p.m. at night, your computer is staying off and people in your environment will learn that if they need you in an emergency, there’s always the telephone. Many of us can exercise more control and leverage over our work than we realize. If people dissect these components of their job, many people can actually make the current situation much more compatible with day-to-day good health.

The full Q&A is worth a read.

Previously: The health benefits of compassion and tips for dealing with unpleasant people, interactions, How work stress affects wellness, health-care costs, Robert Sapolsky discusses stress physiology, Can stress increase risk of neurodegenerative diseases?, No surprise here: Anger and stress are bad for your health, Robert Sapolsky on stress and your health and New year, new (less stressed) you
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In a perspective today on parenting blog Strollerderby, Katherine Stone discusses what she wants to teach her children about love this Valentine’s Day. For Stone, the most important lesson for her children to learn about love is forgiveness. She writes:

… I want them to know that you can’t experience and maintain love for another without forgiveness. Sometimes people hurt you because you are caught up in their whirlpool of self-destruction. It’s not because they woke up that day and decided their goal was to ruin your life. I know this. I’ve been through the most devastating of hurts, and I’ve learned that most of the time I was hurt because I was the nearest person to someone who was suffering and unable to cope. I’ve watched those people learn to forgive themselves, learn from their mistakes and become healthy human beings. I’ve forgiven them, just as they’ve forgiven me when my own maelstrom sucked them in. We have rich and rewarding relationships now. Make forgiveness a part of your life. You will learn that there are a lot more things you can let go of than you think.

A growing body of research over the past decade has shown that the act forgiveness is not only beneficial to our emotional health but for our physical health as well. This week, Stanford psychologist Fred Luskin, PhD, a research associate at the Stanford Prevention Research Center and co-founder of the Stanford Forgiveness Project, is taking questions about why forgiveness is important for health via our @SUMedicine Twitter feed.

Previously: Stanford psychologist Fred Luskin taking questions on the health benefits of forgiving
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