Best and Worst in Psychology and Psychiatry – April 2015by Carla Clark, PhD | May 8, 2015
So far in our monthly “Best and Worst” roundups, there have been some pretty clear themes linking together interesting and impactful findings in psychology and psychiatry research. This month however, I couldn’t gleam any clear-cut themes. Instead it seemed that for every significant “Worst” finding, there was a related “Best” finding to match. As science research tells us that we typically like to have news delivered to us in improving sequences (as the last thing you hear affects you mood), the bad news comes first!
WORST: Most Psychotropic Drugs are Carcinogenic in Animal Models
Drugs used to treat psychiatric conditions require safety studies of carcinogenicity in animals that provide a database for assessment of the potential biological risk of the drug causing cancer in humans. A systematic review of this database revealed that a shocking 71.4% (30 of 42) of all drugs examined showed evidence of carcinogenicity in 43.2% (38 of 88) of the experimental studies. New generation antipsychotics (9 of 10 tested) and anticonvulsants (6 of 7) showed the highest evidence of carcinogenicity among those drugs assessed. While animal studies do not allow us to draw definitive conclusions, it’s a serious warning requiring immediate investigation.
BEST: Drug Reduces OCD Symptoms with Limited Side Effects
Obsessive compulsive disorder (OCD) is far from a walk in the park, it can be chronically debilitating and there is a lack of reliable and safe pharmacotherapies available. N-acetyl cysteine (NAC) has been showing potential for treating OCD. It is a precursor to the amino acid cysteine, which ultimately has two key metabolic roles, it has antioxidant activities and influences the reward-reinforcement pathway. The review paper published this month indicates that NAC appears to be extremely well tolerated, with minimal adverse effects reported and is actually considered to be protective against cancer, with the main reported side-effect being bad wind (which ceases within one week of administration).
Most importantly, the review revealed that from the four clinical trials and five case reports/series identified, within 8-12-weeks of 2,400-3,000 mg/day of NAC the severity of OCD symptoms was reduced. However, there were notable inconsistencies in treatment efficacy that require larger cohorts, higher doses and longer treatment to help provide more definitive answers regarding the benefits of NAC, and its potential for future OCD suffers to have a speedier, side-effect free and over the counter route to getting rid of OCD.
WORST: Pathological Gamblers More Willing to Bet on Make-Believe Money-Making Illusions
If you have ever played roulette, you may have fallen for seeing illusory patterns, i.e. it was black six times in a row, the chances are 50:50 so I need to start betting on the red! In reality, we know that for every spin the odds are ALWAYS 50:50, the previous history is irrelevant. The study compared habitual gamblers and regular community members on which of two slot machines they put their money into: The better slot machine that has a 67% chance of winning each turn and the worse slot machine has 33% chance of winning each turn.
The gamblers had a false impression of intuitively knowing which of the two machines to play and rather than sticking to the better slot machine like the non-gamblers. Instead the gamblers matched their choices to the probabilities and chose the better one 67% of the time and the worse one 33% of the time. This adds to the body of evidence that habitual gamblers in a sense, are more gullible to illusions that are part in the parcel of gambling games, as they perceive and believe in, as well as more impulsively bet on, illusory patterns more readily. They are ready and willing to literally waste their money on an illusion.
BEST: Love Inspires Being Charitable and Giving More To Distant Strangers
The study involved participant engaging in self-reflective writing when viewing emotion-laden charitable advertisements for some causes that they felt connected to such as a food drive for local families, and others that felt more distant to, such as rainforest conservation in a faraway country. The findings revealed that while positive emotions, like compassion and hope, in general encouraged people to give to those they felt connected to, love was the only emotion that enhanced giving to distant people and charities – love transcended geographical location.
WORST: Short-Term Debt and Depression Symptoms
Many of us have near enough monthly short-term household debt i.e. credit card payments and overdue bills to pay. The new study on 8,500 working adults indicates that this short-term debt, as opposed to mid- or long-term debt, increases depressive symptoms, with a particularly strong effect among unmarried people, people reaching retirement age and those who are less well educated. Future research will likely focus on if the effects can be reversed and if reducing short-term debt can help alleviate symptoms of depression.
BEST: Identifying Ways to Improve E-Mental Health Treatment for Depression
E-Mental health services accessed online have been shown to be effective and cost-effective for the treatment of depression. A new study outlined promising strategies, including endorsement of e-mental health services by government entities, education for clinicians and consumers, adequate funding of e-mental health services, development of an accreditation system, development of translation-focused activities and support for further translational research to optimize their impact. While the study had a specific focus on the Australian health care system these strategies and their associated economic, treatment efficacy and accessibility benefits are likely transferable to other healthcare systems.
WORST: Stronger Case for Childhood Adversity Translating Into Adult Mental Health Problems
A systematic review of the association between childhood adversity and the course and development of psychotic experiences, disorders and symptoms over time was conducted. Childhood diversity includes maltreatment, exposure to domestic violence or living with another person with serious mental illness. 17 out of 20 studies that met inclusion criteria reported positive associations between exposure to adversity and experiencing psychotic experiences and symptoms later in life.
A meta-analysis of the studies pooled together the odds of psychotic symptoms occurring, revealing that children experiencing adversity had almost double (1.5-1.8 times) the chance of psychotic experiences compared to the children not experiencing diversity. Bear in mind that the authors found high heterogeneity in the results, and encourage caution in interpreting the results. Nonetheless, the as of yet limited evidence suggests that exposure to adverse events in childhood is associated with persistence of psychotic experiences and clinically relevant psychotic symptoms.
BEST: Parent-Child Warmth May Play a Key Role in Long-Term Positive Functioning for Children Exposed to Intimate Partner Violence
This study gives us more hope for children experiencing childhood adversity. Models of the relationships between intimate partner violence (IPV) exposure, parent-child warmth, symptoms of psychopathology during adulthood and life satisfaction were made from self-report surveys completed by 703 Swedish 20-24 year olds. IPV exposure was related to lower levels of parent-child warmth, higher levels of psychopathology symptoms and lower life satisfaction. Conversely, for those exposed to IPV, positive outcomes in adulthood were mediated by parent-child warmth.
WORST: Worriers may more readily detect errors at the cost of cognitive control
We have action-monitoring systems functioning in our brains so that we can optimize our behavior by detecting conflicts, responding to errors, and preventing future errors by signalling the need for greater cognitive control. Worrying is well-established to alter how the action-monitoring works, and is similarly dysfunctional in depression and obsessive compulsive disorder.
The study in the spotlight suggests that while worrying may heighten your chances of correctly predicting when something is amiss, there are negative consequences. Worriers upon detecting an error are less likely to improve their cognitive control to prevent the error from occurring again (such as appropriate stimulation of reasoning and action, and flexibly changing goals to suit the context). So in simple terms, overt worrying might make problems stand out more, but doesn’t typically give your brain the boost it needs to effectively overcome the problem. The take home message, worry less, think more.
BEST: Belief in the Afterlife Raises Hope When Thinking about Death for People with Low-Self Esteem
Some might argue that the opposite of worrying is hope. A new study reports that people with low self-esteem lose hope when thinking about death, but not for those with high self-esteem, in alignment with Terror Management Theory. While thoughts of death caused individuals with low self-esteem to lose hope when reading an argument that there is no afterlife, when they read “evidence” supporting life after death, or an essay affirming scientific medical advances that promise immortality, their hope remained strong – literal immortality beliefs can aid psychological adjustment when thinking about death.
Amerio A, Gálvez JF, Odone A, Dalley SA, & Ghaemi SN (2015). Carcinogenicity of psychotropic drugs: A systematic review of US Food and Drug Administration-required preclinical in vivo studies. The Australian and New Zealand journal of psychiatry PMID: 25916799
Batterham PJ, Sunderland M, Calear AL, Davey CG, Christensen H, Teesson M, Kay-Lambkin F, Andrews G, Mitchell PB, Herrman H, Butow PN, & Krouskos D (2015). Developing a roadmap for the translation of e-mental health services for depression. The Australian and New Zealand journal of psychiatry PMID: 25907269
Berger, L., Collins, J., & Cuesta, L. (2015). Household Debt and Adult Depressive Symptoms in the United States Journal of Family and Economic Issues DOI: 10.1007/s10834-015-9443-6
Gaissmaier W, Wilke A, Scheibehenne B, McCanney P, & Barrett HC (2015). Betting on Illusory Patterns: Probability Matching in Habitual Gamblers. Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming PMID: 25921650
Miller-Graff LE, Cater ÅK, Howell KH, & Graham-Bermann SA (2015). Parent-child warmth as a potential mediator of childhood exposure to intimate partner violence and positive adulthood functioning. Anxiety, stress, and coping, 1-15 PMID: 25800826
Moran TP, Bernat EM, Aviyente S, Schroder HS, & Moser JS (2015). Sending mixed signals: Worry is associated with enhanced initial error processing but reduced call for subsequent cognitive control. Social cognitive and affective neuroscience PMID: 25925270
Oliver G, Dean O, Camfield D, Blair-West S, Ng C, Berk M, & Sarris J (2015). N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 13 (1), 12-24 PMID: 25912534
Trotta A, Murray RM, & Fisher HL (2015). The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis. Psychological medicine, 1-18 PMID: 25903153
Wisman A, & Heflick NA (2015). Hopelessly mortal: The role of mortality salience, immortality and trait self-esteem in personal hope. Cognition & emotion, 1-22 PMID: 25920481
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