Best and Worst in Psychology and Psychiatry – March 2015




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March served us a whole host of significant research developments, highlighting the effectiveness and ineffectiveness of various medications, therapies, drugs and techniques for the treatment of disorders of the mind. Harder to swallow although equally important are reports identifying and exploring how causal and contributing factors influence and exasperate these conditions.

But before we dish out this month’s Best and Worst Psychology and Psychiatry research news, we have some very special birthdays to honor. Among some of THE most distinguished and well-known psychologists in the world, are the thought leaders and publishing power houses, Prof. Philip George Zimbardo and Dr. Daniel Goleman.

Born New Yorker turned Californian Professor Emeritus at Stanford University, Philip George Zimbardo is best-known for his controversial Stanford Prison Experiment that highlighted how people can adapt to roles and hurt others because of the role and inspired a deeper investigation of psychology research ethics. He now focuses research on the psychology of heroism and has published more than 50 books and 400 professional and popular articles and chapters, among them, Shyness, The Lucifer Effect, The Time Cure and The Time Paradox. Prof. Zimbardo is currently promoting his non-profit organization, The Heroic Imagination Project, that teaches people how to take effective action in challenging situations.

Born Californian turned New York Times journalist, psychologist and writer, Dr. Daniel Goleman is best-known for his internationally best-selling books Emotional Intelligence and Social Intelligence, and development of the experimentally validated emotional intelligence (EQ) appraisal test, shown to accurately predict leadership performance. Goleman has also written books on topics including self-deception, creativity, transparency, meditation, social and emotional learning, ecoliteracy and the ecological crisis and has rightfully been honored as one of the most influential business thinkers of our time.

Prof. Zimbardo and Dr. Goleman, we salute you!

THE BEST

Brain Activity Test in Infants Predicts Language Outcomes in Autism Spectrum Disorder

A large-scale fMRI study on ASD children with poor language outcomes revealed that when these children were toddlers or infants, they had very little activity in the language-sensitive brain region, the superior temporal cortex,  when compared with ASD children with strong conversation abilities.

By combining fMRI scans detecting superior temporal cortex activity with behavioral questionnaires, the prognostic accuracy for non-verbal ASD reached a sizable 80%. This is one of the first large-scale studies to identify very early neural precursors that help to predict which children may develop non-verbal ASD, and benefit from early language intervention.

Could A Dose of Nature Be Just What The Doctor Ordered?

Researchers are trying to establish a basis for effectively measuring and comparing the therapeutic effects of exposure to nature as one would for a medical drug, using dose-response curves. In this sense, the greater the nature exposure is, the greater the “dose” is. Ultimately, this could help us understand how best to manipulate urban nature to enhance human health in a world were more and more people are living in cities.

Light Therapy Promising for Gulf War Illness and PTSD

Light emitting diode (LED) therapy known best for wound healing and treating joint problems, as well as muscle aches and pains, is now proving promising in treating the mind as well as the body. Following up on encouraging results from pilot work, researchers at the VA Boston Healthcare System are testing the effects of light therapy on brain function in veterans with Gulf War Illness.

The researchers hypothesize that light therapy can be a valuable adjunct to standard cognitive rehabilitation, in order to exercise the brain in various ways in order to take advantage of brain plasticity and forge new neural networks. While LED therapy use targeting the brain has its skeptics, the US department of veteran affairs has funded multiple studies to test its efficacy in treating veterans with PTSD and chronic traumatic brain injury.

Promising Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa

A systematic review of 45 publications that includes 3,646 anorexia and bulimia nervosa patients, evaluated the efficacy of using technology-based interventions (including computer-, mobile- and Internet-based interventions) for both prevention and treatment of eating disorder patients, as well as for their carers.

Computer and Internet based interventions (CBIs) were particularly effective for improving symptoms of bulimia nervosa, with videoconferencing also showing promise as a therapeutic tool. For anorexia patients, CBIs may be better suited for relapse prevention. Furthermore, CBIs may also be considered in the prevention and early intervention of eating disorders as well as for supporting carers of eating disorder patients. Mobile interventions on the other hand may be more useful for relapse prevention.

The analysis emphasized that human contact in the form of guidance may augment technology-based interventions. A clearer picture as to how much and what kind of contact is required will be essential in devising the most effective treatment programs.

New Parents Should Aim to Enhance Relationship Satisfaction, Communication and Closeness to Prevent Perinatal Depression and Anxiety

A meta-analysis of data from 120 studies identified risk and protective factors for perinatal depression and anxiety, which effects more than 13% of parents, that are feasibly modifiable by relationship partners in the absence of professional intervention or assistance. The findings suggest that future prevention programs should aim to enhance relationship satisfaction, communication and emotional closeness, as well as to facilitate instrumental and emotional support and minimize conflict between partners.

THE WORST

Prenatal Exposure to Maternal Anxiety is Related to More Extensive Processing of Fear-Related Stimuli

The study involved 9-month-old infants and their mothers, investigating how infants process fearful versus happy faces and voices in the context of prenatal exposure to maternal anxiety. The main finding from the research reveals that the higher the level of maternal anxiety during pregnancy the child was exposed to in the womb, the greater the child’s response to fearful sounds.

The researchers discuss how maternal anxiety during pregnancy influences the development of the child’s brain in the womb, where the child pays more attention to and is more heavily influenced by fearful stimuli, potentially through changes in cortisol and placental enzyme levels induced by the mother’s anxious mental states.

Heroes’ Extent of World Trade Center Exposure May Compound Post-Disaster Life Stress

The research found that the greater a World Trade Center responder’s disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one), the greater post-disaster life stress was, negatively influencing posttraumatic stress disorder (PTSD) symptoms and overall functioning. Results indicate that the more extreme exposure experienced by police responders led to more severe WTC-related PTSD symptoms and decreased overall functioning over time.

Adolescent Drinking Affects Adult Behavior Through Long-Lasting Changes In Genes

Researchers may have identified the mechanisms through which youth binge drinking increases risk for psychiatric problems and addictions, including alcoholism and anxiety. The researchers gave 28-day-old rats alcohol for two days in a row, followed by two days off, and repeated this pattern for 13 days, reminiscent of binge-drinking weekends in teens. This resulted in epigenetic changes observed in the amygdala, including lowered expression of genes coding for brain-derived neurotrophic factor (BDNF) and activity-regulated cytoskeleton-associated (Arc) protein, that nerve cells need in order to form new synaptic connections.

When the binge-drinking teen rats reached adulthood, nerve connectivity in the amygdala was diminished, their anxiety-like behaviors increased and they preferentially drank more alcohol over water than non-binge drinking rats. Researchers surmised that teen binge-drinking in humans may similarly degrade the ability of the brain to form the connections it needs to during adolescence, through epigenetic alteration in gene activity.

Publication Bias and ‘Spin’ Raise Questions about Drugs For Anxiety Disorders

Gross overestimates of the effectiveness of the increasingly common use of antidepressent drugs to treat anxiety disorders, and underestimates the drugs’ harmful effects, are all too common in the scientific literature. In some cases these medications, which are some of the most commonly prescribed in the world, are not significantly more useful than a placebo, although some antidepressants can have value in treating anxiety disorders.

This mirrors what was found previously for both antidepressents and antipsychotics in the treatment of depression. The researchers remind us that this level of bias is extremely worrying, indicating that conclusions are being manipulated and over-exaggerated, perhaps to receive greater scientific attention, faster and more impactful publication and ultimately, higher drug sales and profits.

Higher Antipsychotic Drug Doses Lead To Greater Death Risk for Dementia Patients

Yet another article providing evidence against the use of behavior-calming antipsychotic drugs as a treatment for the delusions, hallucinations, agitation and aggression that many people with Alzheimer’s disease and other dementias experience. The retrospective case-control study involved a colossal 90,786 dementia patients reveals that the absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose.

For example, mortality risk is increased by 12.3% for patients taking the antipsychotic haloperidol when compared to patients taking antidepressants, with only 8 patients needing to take the drug, for one individual’s treatment to be associated with death. Conversely, the study puts emphasis on the use of non-pharmacological strategies first and foremost.

The researchers provide a framework that doctors and caregivers can use to make the most of what’s already known, called Describe, Investigate, Evaluate and Create (DICE) that individually tailors approaches to each person with dementia, and as symptoms change.

References

Lombardo et al. Neuron. “Different functional neural substrates for good and poor language outcome in autism” http://dx.doi.org/10.1016/j.neuron.2015.03.023

Maust DT, Kim HM, Seyfried LS, Chiang C, Kavanagh J, Schneider LS, & Kales HC (2015). Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia: Number Needed to Harm. JAMA psychiatry PMID: 25786075

Naeser MA, Zafonte R, Krengel MH, Martin PI, Frazier J, Hamblin MR, Knight JA, Meehan WP 3rd, & Baker EH (2014). Significant improvements in cognitive performance post-transcranial, red/near-infrared light-emitting diode treatments in chronic, mild traumatic brain injury: open-protocol study. Journal of neurotrauma, 31 (11), 1008-17 PMID: 24568233

Otte RA, Donkers FC, Braeken MA, & Van den Bergh BR (2015). Multimodal processing of emotional information in 9-month-old infants I: Emotional faces and voices. Brain and cognition, 95, 99-106 PMID: 25839109

Pandey SC, Sakharkar AJ, Tang L, & Zhang H (2015). Potential role of adolescent alcohol exposure-induced amygdaloid histone modifications in anxiety and alcohol intake during adulthood. Neurobiology of disease PMID: 25814047

Pilkington PD, Milne LC, Cairns KE, Lewis J, & Whelan TA (2015). Modifiable partner factors associated with perinatal depression and anxiety: A systematic review and meta-analysis. Journal of affective disorders, 178, 165-180 PMID: 25837550

Roest AM, de Jonge P, Williams CD, de Vries YA, Schoevers RA, & Turner EH (2015). Reporting Bias in Clinical Trials Investigating the Efficacy of Second-Generation Antidepressants in the Treatment of Anxiety Disorders: A Report of 2 Meta-analyses. JAMA psychiatry PMID: 25806940

Schlegl S, Bürger C, Schmidt L, Herbst N, & Voderholzer U (2015). The Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa: A Systematic Review and Recommendations for Future Research. Journal of medical Internet research, 17 (3) PMID: 25840591

Zvolensky MJ, Farris SG, Kotov R, Schechter CB, Bromet E, Gonzalez A, Vujanovic A, Pietrzak RH, Crane M, Kaplan J, Moline J, Southwick SM, Feder A, Udasin I, Reissman DB, & Luft BJ (2015). World Trade Center Disaster and Sensitization to Subsequent Life Stress: A Longitudinal Study of Disaster Responders. Preventive medicine PMID: 25840022

Image via wavebreakmedia / Shutterstock.

Carla Clark, PhD

Carla Clark, PhD, is BrainBlogger's Psychology and Psychiatry Section Editor and a scientific consultant, writer and researcher in fields including psychology and neuropsychology, as well as biotechnology, molecular biology and biophysical chemistry. She is also our newly appointed Digital and Social Media Manager. Follow her on Facebook or Twitter @GeekReports
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