Psychology & Psychiatry – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Mon, 09 Apr 2018 12:00:43 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.4 Finding the Right Way to Use Ketamine for Depression http://brainblogger.com/2018/04/06/finding-the-right-way-to-use-ketamine-for-depression/ http://brainblogger.com/2018/04/06/finding-the-right-way-to-use-ketamine-for-depression/#respond Fri, 06 Apr 2018 12:00:32 +0000 http://brainblogger.com/?p=23637 Many studies have shown ketamine to be a promising treatment for those suffering from severe depression, but figuring out how to safely administer the drug has been a challenge for researchers. One hopeful delivery method was a nasal spray device because of its ease-of-use and the fact that it is less invasive than other methods such as injection.

But a new Australian study published in the Journal of Psychopharmacology reveals some unexpected problems with the nasal spray method. In particular, the study shows the unpredictable nature of intranasal ketamine tolerance from one person to the next.

Lead author Professor Colleen Loo at the University of New South Wales (UNSW), who is based at Black Dog Institute, states:

It’s clear that the intranasal method of ketamine delivery is not as simple as it first seemed. Many factors are at play when it comes to nasal spray ketamine treatments. Absorption will vary between people and can fluctuate on any given day within an individual based on such things as mucous levels in the nose and the specific application technique used.

The pilot trial aimed to analyze the effectiveness of repeated doses of ketamine through an intranasal device amongst 10 volunteers with severe depression, ahead of a larger randomized controlled trial.

First, the participants were given extensive training in proper self-administration techniques before receiving either a course of eight ketamine treatments or an active control over a period of four weeks, under supervision at the study center.

Following the observation of each patients’ initial reaction to the nasal spray, the dosages were adjusted to include longer time intervals between sprays.

However, the trial had to be put on hold after testing with five participants resulted in unexpected problems with tolerability. Side effects included high blood pressure, psychotic-like effects, and motor incoordination which left some participants unable to continue to self-administer the spray.

Professor Colleen Loo commented:

Intranasal ketamine delivery is very potent as it bypasses metabolic pathways, and ketamine is rapidly absorbed into the bloodstream. But as our findings show, this can lead to problems with high peak levels of ketamine in some people causing problematic side effects. Other recent studies have questioned whether changes to ketamine’s composition after being metabolised into derivative compounds may actually deliver useful therapeutic effects. It remains unclear whether ketamine nasal sprays can be safely relied upon as a treatment for patients with severe depression.

Previous research led by Loo last year revealed the success of ketamine’s antidepressant effects in elderly patients when delivered in repeated doses, which were adjusted on an individual basis and given by the subcutaneous method (injections under the skin):

Our prior research has shown that altering the dose on an individual patient basis was important. However, we wanted to see if a simpler approach using a set dose of ketamine for all people and administered by nasal spray could work just as well in this latest pilot. More research is needed to identify the optimal level of ketamine dosage for each specific application method before nasal sprays can be considered a feasible treatment option.

The researchers are now recruiting participants for the world’s largest independent trial of ketamine to treat depression, to determine the safety and effects of repeated dosing using subcutaneous injections.

This guest article appeared on PsychCentral.com: Ketamine Nasal Spray for Depression Runs Into Problems and was originally posted on Psych Central by Traci Pedersen.

References

Gálvez V, Li A, Huggins C et al. Repeated intranasal ketamine for treatment-resistant depression – the way to go? Results from a pilot randomised controlled trial. Journal of Psychopharmacology. 2018;32(4):397-407. doi:10.1177/0269881118760660.

Image via ThorstenF/Pixabay.

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Different Coping Styles May Cause, Prevent, or Treat OCD http://brainblogger.com/2018/03/26/different-coping-styles-may-cause-prevent-or-treat-ocd/ http://brainblogger.com/2018/03/26/different-coping-styles-may-cause-prevent-or-treat-ocd/#respond Mon, 26 Mar 2018 12:00:20 +0000 http://brainblogger.com/?p=23634 People with obsessive-compulsive disorder (OCD) tend to fall back on maladaptive coping strategies such as rumination and thought suppression, according to new research; even though adaptive coping skills such as acceptance and problem-solving could improve their quality of life.

Unfortunately, many OCD patients tend to lack those adaptive coping skills while in the throes of the disorder, according to a new German study published in the journal Cognitive Therapy and Research.

OCD is a complex psychological condition in which the patient suffers from persistent unwanted thoughts and high levels of anxiety. The disorder can lead to a severe reduction in one’s quality of life.

For the study, the researchers compared the behavior of 60 patients with OCD to a group of 110 people with depression as well as a control group of 1,050 adults. All participants completed anonymous online surveys in which they reported their medical and psychological histories, along with their levels of compulsivity and abilities to cope in specific situations.

Participants also answered a questionnaire that covered different adaptive and maladaptive coping styles that one might use to deal with difficult situations.

The participants also completed the Maladaptive and Adaptive Coping Styles Questionnaire (MAX) that had been recently developed by the researchers. This questionnaire measures coping styles using three dimensions: maladaptive coping (thought suppression, rumination), adaptive coping (problem-solving, acceptance), and avoidance.

Participants gave information about the coping strategies they use against their OCD symptoms such as problem-solving and rumination, as well as other coping styles that have recently been adopted in therapy, such as acceptance and suppression.

People with OCD were found to possess more maladaptive coping skills than all of the other participants, including those suffering from depression. They also possessed fewer functional skills to help them cope and adapt. Those who lacked adaptive coping skills were more likely to have poor insight into their condition and a resistance to symptoms.

As put by the study leader, Dr. Steffen Moritz from the University Hospital Hamburg in Germany:

Patients with OCD are characterized by both more maladaptive coping and less adaptive coping relative to controls. Coping skills are important for many aspects of daily life beyond mental health.

Teaching children skills such as how to cope with bullying at school, poor performance or problems with their parents, for example, in the framework of general cognitive preventative treatment and resilience training in school, may help children to better deal with emotional turmoil and challenging situations during adolescence.

It may also prevent the progression of a vulnerability to later obsessive-compulsive disorder or depression as well as other disorders.

Although the findings highlight some of the skills that patients with OCD lack, Moritz says further research is needed to find out to what extent improving such coping skills during childhood and adolescence through cognitive behavioral therapy (CBT) or similar interventions may indeed improve an OCD patient’s quality of life.

This guest article appeared on PsychCentral.com: Many OCD Patients Tend to Use Poor Coping Strategies and was originally posted on Psych Central by Traci Pedersen.

Reference

Moritz, S., Fink, J., Miegel, F., Nitsche, K., Kraft, V., Tonn, P., & Jelinek, L. (2018). Obsessive–Compulsive Disorder is Characterized by a Lack of Adaptive Coping Rather than an Excess of Maladaptive Coping. Cognitive Therapy And Research, 1–11. doi:10.1007/s10608-018-9902-0

Image via aleksandra85foto/Pixabay.

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Dying Young and the Psychology of Leaving a Legacy http://brainblogger.com/2018/03/19/dying-young-and-the-psychology-of-leaving-a-legacy/ http://brainblogger.com/2018/03/19/dying-young-and-the-psychology-of-leaving-a-legacy/#respond Mon, 19 Mar 2018 12:00:12 +0000 http://brainblogger.com/?p=23470 Often the biggest existential distress that we carry is the idea that no-one will remember us when we are gone—initially we know that our friends and family will hold who we are, but after a generation, these people are likely gone too. At the end of life, the pressure to leave an unquestionably relevant legacy can be crippling for people, particularly for young people. When coupled with the limited energy that people have when they are unwell, the very nature of what people expect to achieve in the world shrinks, and the really important pieces come into focus.

When time is seen to be limited, every moment can take on a weight that has never before been experienced. Some of these expectations come from within and some externally, but regardless of their origin they can be paralyzing for the young person facing their mortality, particularly when unwell. Culturally, there are multiple references as to what ‘dying young’ is meant to mean and most refer to extraordinary and often unobtainable expectations. For instance, members of the ‘27 club’ (celebrities who die on or before their 27th birthday) and notable cancer-related concepts around ‘bucket lists’ and works of fiction (e.g., The Fault in Our Stars). Most young people, particularly those who are dying, do not have the capacity or the options to engage in an extraordinary feat, they can become overwhelmed and paralyzed by what they are ‘meant to be doing’.

I think I have well and truly missed my opportunity for greatness, I now just want enough energy to spend time with my friends. Maybe even go to the pub.

~18-year-old male

Often, as is the case with many things in life, simple and small are the gestures and moments which are the most meaningful, with huge projects and adventures feeling too overwhelming and out of the grasp of someone with limited energy and resources. As such, the fantasy of what something may have looked and felt like, had they have been well, is a much more satisfying space for them to sit with. Similarly, relationships become much more meaningful, as do the simple things that are taken away through the treatment process, like being able to sit in the sun or go to the pub with a friend.

‘I had been playing online games with him for years, and I thought that I would never meet him now. He made it happen though.’

~19-year-old male

Young patients can be bombarded with well-intentioned suggestions about what they ‘need’ to do, including making future legacy-based activities, such as leaving cards for each of their younger sibling’s birthdays, video journals of their death, or chronicling how they feel about all the people in their world. Although these are good ideas, they are emotionally and physically difficult to manage with limited resources. Patients need to be feeling very resilient and well before attempting any of these things with most being abandoned due to the confronting nature of conceptualizing the world without them present in it. It is a difficult ask for anyone to be able to take the relatively abstract idea of the world continuing following your own death; this does not change for young people and, in some ways, it is even more challenging due to their pervasive sense of self, even in the face of very real threats to their mortality.

‘I could clean out my room, and all of my stuff. But then I think, well I don’t want to do it really, and it’s not like it’s going to be my problem.’

~23-year-old male

The way that young people respond to being presented with a very limited life expectancy can vary tremendously. Some may stick their head firmly in the sand and refuse to discuss or conceptualize anything about what may happen in the lead-up to their death, or following. Others will organize everything about the end of their lives, including where they want to die, how alert they want to be, as well as what will happen following their death—such as where their belongings go and how they want to be remembered. For most people in this situation, in an existential sense, almost everything is out of control, the disease will do what it does, the pain is what it is, and they are an observer to the things happening in their bodies. The things that people can control is what they talk about, how much they talk about it, and who they talk about it too.

Just because death, dying, and legacy are not being talked about, does not mean that it is not in the consciousness and thoughts of the person pondering their own end. Instead, it may be that they have done as much thinking and talking about it as they need to do; it is often these patients that have very well-considered plans about what they want to happen as they deteriorate and the decisions that must be made about their care.

References

Chochinov, H., Kristjanson, L., Breitbart. W., et al. (2011). Effect of Dignity Therapy on Distress and End-of-Life Experience in Terminally Ill Patients: A Randomised Controlled Trial. The lancet oncology. 12. 753-62. DOI:10.1016/S1470-2045(11)70153-X

Hack, T., Mcclement, S., & Chochinov, H., et al. (2010). Learning from dying patients during their final days: Life reflections gleaned from dignity therapy. Palliative medicine. 24. 715-23. DOI:10.1177/0269216310373164

Hedkte, L., (2014). Creating stories of hope: A narrative approach to illness, death and grief. Australian New Zealand Journal of Family Therapy. 35. 4-19. DOI:10.1002/anzf.1040

Kehl, K., (2006). Moving Toward Peace: An Analysis of the Concept of a Good Death.. American Journal of Hospice and Palliative Medicine. 23. 277-286. DOI:10.1177/1049909106290380

Smith, R. (2000). A good death: an important aim for health services and for us all. BMJ. 2000;320:129-130.

Steinhauser, K. E., Clipp, E. C., McNeilly, M., et al. (2000). In search of a good death: observations of patients, families, and providers. Ann Intern Med. 2000;132:825-832

Steinhauser, K. E., Alexander, S. C., Bycock, I., et al. (2008). Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial. Journal of Palliative Medicine. 11. 1234 – 1240. DOI:10.1089/jpm.2008.0078

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Your Behavior—How to Understand and Change It! http://brainblogger.com/2018/02/07/your-behavior-how-to-understand-and-change-it/ http://brainblogger.com/2018/02/07/your-behavior-how-to-understand-and-change-it/#respond Wed, 07 Feb 2018 16:30:04 +0000 http://brainblogger.com/?p=23435 Richard Pfau, who holds a doctorate in science education and an undergraduate degree in psychology, wrote Your Behavior: Understanding and Changing the Things You Do as a reaction to what he sees as the current state of psychology. In his own words, the psychology field today is “scattered and speculative”.

Pfau’s goal with Your Behavior is to synthesize work from various fields including psychology, sociology, anthropology, and biology into a coherent explanation of why we do the things we do, and to do so in a way that is accessible to both laypeople and professionals. Throughout the book, he draws from perceptual control theory (PCT) to help readers understand their own behavior and how to change it.

Pfau does an excellent job of ordering and organizing his work. He begins with establishing the reader as an “autopoietic being,” which includes the assertion that we are wired to survive. As such, he asserts that most of our behaviors are done to ensure survival and often occur without conscious thought.

Pfau examines the origins of behavior from the cellular level up to all possible environmental levels and discusses how the different levels interact with each other in a system that is not strictly linear.

In life, most of us have “references,” or things like goals, plans, or how we think things ought to be. We change our behaviors based on our perceptions of how congruent they are with our references. A basic example could be something as simple as putting on a jacket when it is cold. Our body’s reference is to maintain its optimum temperature and homeostasis. But it can also be much more complicated. For instance, the references a person may have in his or her political or religious beliefs may lead to behaviors to bring the references for those beliefs into being.

We behave in such a way that our perceptions give us feedback to ensure we are in congruence with our references, whether our behavior is or is not a conscious thing. At times, we may mistakenly attribute a behavior to one level when it is a result of a different level. We are in constant interaction with our environment in terms of our perceptions of our references. Pfau offers a truly intriguing look at human behavior.

The first ten chapters offer a comprehensive overview of perceptual control theory (PCT) and why people behave the way they do, which includes a look at both ourselves and others. Pfau has organized the book in a way so that the reader can delve as deeply as they want.

Each chapter begins with a brief overview and contains multiple boxed highlights that give examples of topics in the chapter, or more in-depth information about concepts. These were very helpful as refreshers of what concepts mean throughout the book. I do not recall ever coming across PCT or autopoiesis before reading Your Behavior.

Each chapter ends with a preview of the following chapter, which gives a sense of the intentional continuity of the educational process of this book. There is an extensive list of references for further reading at the end of each chapter, as well as endnotes that give further information on the covered material. The organization and presentation are very straightforward, well thought out, and excellently presented.

I am still debating Pfau’s critique of current behavioral theory. He says that the term “culture” is abstract, and therefore a statement such as “culture causes behavior” is meaningless or misleading, and cannot be verified. But just as humans evolve in the interplay with their environment to survive, cultures also evolve, and generally due to the shortness of our lives, cultures (our interplay with our environment in a systems way) evolve outside of our awareness.

I think it may come down to “abstract” versus “construct.” There are arguments that the self is a construct, which I don’t think is addressed in this work. While reading this, I became curious as to how PCT would address the self, and perhaps culture, as a construct.

After providing a very thorough understanding of PCT and why we and others behave the way we do, the final two chapters guide us through analyzing our own behaviors, and how to systematically change them.

Pfau calls upon the works of several individuals for this, but one that stood out to me was John Norcross, who has been involved in the transtheoretical model of change over the years. (Curiously, I didn’t find any reference to the model here.)

There are very useful appendices including checklists and forms with cues to help readers analyze and develop a way to change their own behavior. Pfau even discusses his own change process with weight and smoking.

This is a very comprehensive work that is clearly presented. Your Behavior is a good book for anyone interested in behavioral change with a theory backing it that encompasses a comprehensive system from the cellular level up.

This guest article appeared on PsychCentral.com: Your Behavior: Understanding & Changing the Things You Do and was originally posted on Psych Central by Richard H. Pfau and reviewed by Stan Rockwell, PsyD.

References

Richard H. Pfau (2017) Your Behavior: Understanding and Changing the Things You Do. Paragon House.

Image via aleksandra85foto/Pixabay.

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How Mindfulness Can Kill Your Cravings http://brainblogger.com/2018/02/05/using-mindfulness-strategies-to-curb-cravings/ http://brainblogger.com/2018/02/05/using-mindfulness-strategies-to-curb-cravings/#respond Mon, 05 Feb 2018 16:30:01 +0000 http://brainblogger.com/?p=23433 A new study from the U.K. suggests mindfulness strategies may help prevent or interrupt cravings for food, cigarettes, and alcohol.

Craving can be defined as an intense, conscious desire, usually to consume a specific drug or food. There is also a significant body of research that suggests it is causally linked to behavior.

Investigators reviewed experimental studies that addressed the effects of different types of mindfulness strategies on cravings. They discovered that in many instances these strategies brought about an immediate reduction in craving.

For example, craving predicts relapse episodes in substance use, and food cravings predict both eating and weight gain. As such, cravings are often considered an appropriate target for intervention.

Researchers from City, University of London believe the mindfulness techniques work by occupying short-term memory which in turn lead to clinically relevant changes in behavior. Their findings appear in the journal Clinical Psychology Review.

Mindfulness meditation has a long tradition of being used to address cravings. According to ancient Buddhist texts, craving leads to suffering but can be avoided through meditation practice.

Mindfulness interventions typically employ a range of strategies. Some techniques include exercises designed to promote greater awareness of bodily sensations, while others help to develop an attitude of acceptance toward uncomfortable feelings.

Additionally, a mindfulness objective may be to help individuals see themselves as separate from their thoughts and emotions.

However, there is currently a limited understanding of the ways in which these different types of strategy may influence craving-related outcomes, either independently, or in combination.

As a result, the review aimed to address these limitations by reviewing studies that have examined the independent effects of mindfulness on craving.

Looking at 30 studies which met the criteria, it was found that some of the beneficial effects seen for mindfulness strategies in relation to craving are likely to stem from interrupting cravings by loading working memory. Working memory is a part of short-term memory concerned with immediate conscious perceptual and linguistic processing.

In addition, it was also seen that mindfulness reduced craving over the medium term, most likely due to “extinction processes,” essentially strategies that result in the individual inhibiting craving-related responses and behaviors which eventually lead to reduced cravings.

Dr. Katy Tapper, author of the review and a Senior Lecturer in the Department of Psychology at City, University of London, said:

The research suggests that certain mindfulness-based strategies may help prevent or interrupt cravings by occupying a part of our mind that contributes to the development of cravings. Whether mindfulness strategies are more effective than alternative strategies, such as engaging in visual imagery, has yet to be established.

However, there is also some evidence to suggest that engaging in regular mindfulness practice may reduce the extent to which people feel the need to react to their cravings, though further research is needed to confirm such an effect.

This guest article appeared on PsychCentral.com: Using Mindfulness Strategies to Curb Cravings and was originally posted on Psych Central by Rick Nauert PhD.

References

Tapper, K. (2017). Mindfulness and craving: effects and mechanisms. Clinical Psychology Review, 59, pp. 101-117. doi: 10.1016/j.cpr.2017.11.003

Image via aleksandra85foto/Pixabay.

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How Does Starting School Early Impact Educational Attainment? http://brainblogger.com/2017/12/13/how-does-starting-school-early-impact-educational-attainment/ http://brainblogger.com/2017/12/13/how-does-starting-school-early-impact-educational-attainment/#respond Wed, 13 Dec 2017 16:30:56 +0000 http://brainblogger.com/?p=23211 A singular cutoff point for school entry results in age differences between children of the same grade. In many school systems, September-born children, begin compulsory education in September of the year in which they turn five, making them relatively older than summer born children who begin school aged four.

Research on these annually age-grouped cohorts reveal relative age effects (RAEs) that convey the greater achievements accrued by the relatively old (RO) students compared to the relatively young (RY) students. RAEs are pervasive. Across OECD countries, in fourth grade, RY students scored 4–12% lower than RO students, while in eight grade the difference was 2–9% lower. RAEs are most evident in early formal education and can diminish as children mature. In 2016 for instance, Thoren, Heinig, and Brunner published a study on three grades attending public school in Berlin, Germany, and showed that the RAE in disappeared for reading by grade 8 and was reversed for math in favor of RY students.

Investigating the mechanisms involved is important because RAEs can remain evident in high-stakes exams taken at the end of compulsory education. RAEs may impact educational attainment, which is defined as an individual’s highest educational qualification (i.e., compulsory schooling, apprenticeship, or university education). For example, research by Sykes, Bell, and Rodeiro found that 5% less August-born GCSE students than September-born GCSE students chose at least one A level. Likewise, August-born students were 20% less likely to progress to university than September-born students. RO students also outperformed RY students on college admission tests to a university in Brazil, which significantly impacted the probability of being accepted to that university. Moreover, in Japan the percentage of graduates (aged 19–22 and 23–25) was two points greater for those born in April than those born in March. Collectively, these findings indicate that RAEs impact educational attainment because of their direct link to students’ acceptance to higher education. Since much of children’s development occurs within compulsory education, a natural question is whether educators act to alleviate or exacerbate RAE.

RAEs emerge primarily because of within-group maturity differences among RO and RY children (age-at-school-entry effect). RO children, have a one-year developmental advantage over RY children when they sit exams (age-at-test effect). Based on these advantaged test scores and maturation, RO children receive special opportunities from educators to excel in school. Using attainment, program participation, and attendance data from 657 students aged 11–14 from a secondary school in North England, a study by Cobley, McKenna, Baker and Wattie found that RO students were more likely than RY students achieve high scores across various subjects and be admitted to gifted programs. Even if RO students accepted to gifted programs are not actually gifted, the prestige of attending such programs would help them to foster strong positive self-esteem, which can persist over time. In turn, RO students may experience enhanced learning and praise long after small age differences are important in and of themselves.

Conversely, teachers lower their expectations of RY students because RY students appear less developed and intelligent than RO students. Interestingly, having RO classmates can prompt a spillover effect that boosts RY students’ grades, but also increases the probability that RY students will to be pathologized. This research suggests that RAEs emerge as a consequence of maturity differences but are maintained by the magnitude and persistence of social factors, such as educator-student interaction. Another study also reported RAEs in the diagnosis and treatment of ADHD in children aged 6–12 in British Columbia. Incorrect diagnosis can unnecessarily limit RY students’ academic performance by diminishing their self-esteem and task involvement, which are school achievement predictors.

If these inequalities decline over time, the influence of RAE on educational attainment is arguably minimal. However, if relative advantages such as skill accumulation persist in favor of RO students throughout formal education, RAEs translate into academic disadvantages for RY students. For instance, RY students’ negative self-perceptions of academic competence and learning disability can mediate the relationship between depressive symptoms and school dropout in adolescence. In turn, lack of formal education or poor academic performance makes entry to higher education arduous. Research illustrates with 16-year-old RY students scoring 0.13 standard deviations lower than RO students. This test score predicted that RY students would have a 5.8% higher potential dropout rate from high school and a consequently 1.5% lower college admission rate than RO students. Initial gains for RO students partly explain why they have a 10% greater probability of attending top-ranking universities and why they are more likely to graduate from university than RY students.

Research on the impact of RAE on educational attainment is not as straightforward as discussed thus far. Cascio and Schanzenbach used experimental variation by randomly assigning students to classrooms. Results showed improved test scores for RY students up to eight years after kindergarten and an increased probability of taking a college-entry exam. These positive spillover effects are evident when RY students, in a relatively mature peer environment, strive to catch up with higher-achieving RO students and end up surpassing them. Since RO students may strain under the expectations placed on them to be top of the class, RY students have an opportunity to catch up. Alternatively, RO students may not have the same incentive as RY students to work hard for academic success because RAEs already work in their favor. To overcome RAEs and succeed academically, RY students need greater persistence and attention than RO students in their schoolwork, which helps them gain a motivated mindset that benefits lifelong learning. For example, RY students in high school are more likely than RO students to study and compensate for poor academic achievement in middle school.

At a university in Italy, RY students obtained better grades than RO students. This reversal effect was also reported at university in the UK. The researchers postulated that due to RAEs, the RY students developed social skills more slowly. Therefore, RY students had less active social lives and more time to concentrate on educational attainment. The impact of RAEs on educational attainment is, subsequently, probabilistic not deterministic. Although research by Abel, Sokol, Kruger, and Yargeau indicated that RAEs do not affect the success of either RO or RY students’ university applications, they reported that more RO than RY students applied to medical school. In addition, Kniffin and Hank’s study did not find RAEs that influence whether a university student obtains a PhD. These two studies suggest that RAEs do not have such an important influence on college acceptance or educational attainment once in college. Instead, RAEs are a salient influence in so far as students in compulsory education obtain the necessary grades to apply to university in the first place.

The acquisition of higher mental functions and schooling over time helps normalize the student population by minimizing the attainment gap between RO and RY students, which helps explain why RAEs lessen in university. In addition, universities are often learning environments with great diversity in age (i.e., mature and repeat students), culture (i.e., international students), and academic achievement (i.e., doctorate/master’s students). Perceived developmental parities are inherently less important in university because classroom composition becomes heterogeneous, mitigating and masking the remaining relative age differences. Given this knowledge, greater classroom heterogeneity could be applied to compulsory education to minimize RAEs. Students in mixed-grade classrooms in Norwegian junior high schools, for example, outperformed students in single-grade classrooms on high-stakes school finishing exams. With this classroom composition, it is not disproportionately skewed in favor of younger/older students, the losses for RO students following class mixing would not outweigh the gains of the RO students. With more heterogenous classes, educational attainment could subsequently become less influenced by RAEs and a more equalized pursuit.

Since mitigating the impact of RAE on educational attainment depends partly on the strength of compensating investments such as classroom environments, streaming remains controversial. Academic streaming involves separating students according to innate ability. In reality, streaming is based on students’ prior academic performance, which is an imperfect measure of ability that can lead to misallocations. Streaming in early education can be particularly unfair because RY students do not get the opportunity to more closely approximate older classmates’ mental and physical development when sitting exams. In Germany for instance, being relatively old increased test scores by 0.40 standard deviations, increasing the probability of attending the highest secondary school track (gymnasium) by 12%. RY students are also at risk of being unfairly streamed into lower-ability classes because they are more likely than RO students to be diagnosed with behavioral problems and learning disabilities. Streaming thereby provides students with unequally differentiated educational experiences of teaching, competition, and opportunity that limit their academic exposure. Therefore, postponing streaming can reduce the impact of RAEs on educational attainment by ensuring that any developmental gaps have time to narrow.

Unequal educational experiences can limit RY students’ educational attainment. In 2015, the average number of 25–64-year-olds with tertiary education was greater for countries who exhibit almost no streaming, such as Ireland (42.8%), compared to the OECD average (35%). Is it the case that streaming at multiple stages can rectify initial misallocations while still enhancing academic achievement? In Austria, children are streamed in grade five (aged ten) and in grade nine (aged fourteen). In one study, RY students in grade five were 40% less likely to be streamed into higher classes, but the second streaming, in grade nine, helped mitigate RAEs by giving students the opportunity to upgrade to a higher stream. In a complex interplay, streaming and RAEs can reinforce and be reinforced by existing socioeconomic inequalities. In this vein, the researchers concluded that RAEs only disappeared for students with favorable parental backgrounds in the second streaming. In contrast, RY students with unfavorable parental backgrounds were 21% less likely than RO students to move to a high-ranking school. As previously mentioned, learning at the wrong academic level can strain academic achievement and reduce the chances of continuing to higher education.

Socioeconomic status is the extent to which learning opportunities are disadvantaged as a result of low-income. Socioeconomic status can exacerbate the impact of RAEs on educational attainment. Huang and Invernizzi’s research examined a cohort of 405 students in a high poverty, low performing school from the beginning of kindergarten until the end of grade two. Results concluded that early-age literacy achievement gaps between RO and RY students narrowed over time but did not fully close by the end of grade two. Similarly, a Madagascar-based study by Galasso, Weber, and Fernald indicated that differences in home stimulation are dependent on the wealth gradient and accounted for 12–18% of the predicted gap in early outcomes between advantaged and disadvantaged children. At least in early education, these findings suggest that diminished academic performance and exacerbated RAEs are in direct proportion to socioeconomic status. Thus, greater flexibility regarding age at entry in compulsory schooling could help lessen the impact of RAE on academic performance.

Suziedelyte and Zhu published a “Longitudinal Study of Australian Children” and reported that starting school early benefits children from low-income families who, compared to children from high-income families, have limited access to learning resources at home and formal pre-school services. However, a three-month postponement of the cutoff enrollment date (increasing grade age) can increase both academic success and the likelihood of repeating a grade. Similarly, a one year delay in school enrollment (redshirting) can produce a 0.303 standard deviation decrease in test scores and lead to significantly lower math scores for students identified with a disability when compared to nonredshirted students with disability. These mixed findings suggest that equalizing educational attainment opportunities among RO and RY students, by implementing a flexible entry cutoff point, varies as a function of individual difference. Therefore, managing and mitigating RAEs requires greater sensitivity to confounds such as socioeconomic status.

The impact of starting school early on educational attainment is mediated by social factors, school policy, and socioeconomic factors, resulting in individual differences in learning outcomes. RAEs fade throughout formal schooling and can even reverse in higher education. The relative age phenomenon, nevertheless, caveats that ascribing merit to students based on relative age can lead to the provision of unequal learning opportunities and harmful pathologies. Unfortunately, the mechanisms that underpin the impact of RAEs on educational attainment are currently quite speculative and inconclusive. In this sense, existing findings warrant further empirical research and reveal the need for more comprehensive methods for determining an appropriate school entry cutoff point.

References

Abel, E., Sokol, R., Kruger, M., & Yargeau, D. (2008). Birthdates of Medical School Applicants. Educational Studies, 34(4), 271-275. http://dx.doi.org/10.1080/03055690802034302

Barrett, P., Davies, F., Zhang, Y., & Barrett, L. (2015). The Impact of Classroom Design on Pupils’ Learning: Final Results of a Holistic, Multi-Level Analysis. Building And Environment, 89, 118-133. http://dx.doi.org/10.1016/j.buildenv.2015.02.013

Bedard, K., & Dhuey, E. (2006). The Persistence of Early Childhood Maturity: International Evidence of Long-Run Age Effects. Quarterly Journal Of Economics, 121(4), 1437-1472. doi:10.1162/qjec.121.4.1437

Billari F., & Pellizzari, M. (2011). The Younger, the Better? Age-Related Differences in Academic Performance at University. Journal Of Population Economics, 25(2), 697-739. doi:10.1007/s00148-011-0379-3

Cascio, E., & Schanzenbach, D. (2016). First in the Class? Age and the Education Production Function. Education Finance And Policy, 11(3), 225-250. doi:10.1162/edfp_a_00191

Cobley, S., McKenna, J., Baker, J., & Wattie, N. (2009). How Pervasive are Relative Age Effects in Secondary School Education?. Journal Of Educational Psychology, 101(2), 520-528. doi:10.1037/a0013845

Crawford, C., Dearden, L., & Greaves, E. (2011). “Does When You are Born Matter? The Impact of Month of Birth on Children’s Cognitive and Non-Cognitive Skills in England.” IFS Briefing Note: BN 122, Institute of Fiscal Studies.

Crawford, C., Dearden, L., & Meghir, C. (2010). When You Are Born Matters: The Impact of Date of Birth on Educational Outcomes in England. Institute for Fiscal Studies, 2-4, 21-22. doi:10.1920/wp.ifs.2010.1006

Elder, T., & Lubotsky, D. (2009). Kindergarten Entrance Age and Children’s Achievement: Impacts of State Policies, Family Background, and Peers. Journal Of Human Resources, 44(3), 641-683. doi:10.1353/jhr.2009.0015

Fortner, C., & Jenkins, J. (2017). Kindergarten Redshirting: Motivations and Spillovers Using Census-Level Data. Early Childhood Research Quarterly, 38, 44-56. doi:10.1016/j.ecresq.2016.09.002

Galasso, E., Weber, A., & Fernald L. C. H., (2017). Dynamics of Child Development: Analysis of a Longitudinal Cohort in a Very Low Income Country. The World Bank Economic Review, lhw065.

Huang, F., & Invernizzi, M. (2012). The Association of Kindergarten Entry Age with Early Literacy Outcomes. The Journal Of Educational Research, 105(6), 431-441. doi:10.1080/00220671.2012.658456

Kniffin, K., & Hanks, A. (2015). Revisiting Gladwell’s Hockey Players: Influence of Age Effects upon Earning the PhD. Contemporary Economic Policy, 34(1), 21-36. doi:10.1111/coep.12114

Leuven, E., & Rønning, M. (2014). Classroom Grade Composition and Pupil Achievement. The Economic Journal, 126(593), 1164-1192. doi:10.1111/ecoj.12177

Matta, R., Ribas, R., Sampaio, B., & Sampaio, G. (2016). The Effect of Age at School Entry on College Admission and Earnings: A Regression-Discontinuity Approach. IZA Journal Of Labor Economics, 5(1). doi:10.1186/s40172-016-0049-5

Matsubayashi, T., & Ueda, M. (2015). Relative Age in School and Suicide among Young Individuals in Japan: A Regression Discontinuity Approach. PLOS ONE, 10(8), e0135349. doi:10.1371/journal.pone.0135349

Morrow, R., Garland, E., Wright, J., Maclure, M., Taylor, S., & Dormuth, C. (2012). Influence of Relative Age on Diagnosis and Treatment of Attention-deficit/hyperactivity Disorder in Children. Canadian Medical Association Journal, 184(7), 755-762. doi:10.1503/cmaj.111619

N.A. (2015) Education attainment – Adult education level – OECD Data. Retrieved 10 April 2017, from https://data.oecd.org/eduatt/adult-education-level.htm

Nam, K. (2014). Until When Does the Effect of Age on Academic Achievement Persist? Evidence from Korean Data. Economics Of Education Review, 40, 106-122. doi:10.1016/j.econedurev.2014.02.002

Pehkonen, J., Viinikainen, J., Böckerman, P., Pulkki-Råback, L., Keltikangas-Järvinen, L., & Raitakari, O. (2015). Relative Age at School Entry, School Performance and Long-term Labour Market Outcomes. Applied Economics Letters, 22(16), 1345-1348. doi:10.1080/13504851.2015.1031864

Pekrun, R., Lichtenfeld, S., Marsh, H., Murayama, K., & Goetz, T. (2017). Achievement Emotions and Academic Performance: Longitudinal Models of Reciprocal Effects. Child Development. doi:10.1111/cdev.12704

Peña, P. A. (2015). Creating Winners and Losers: Date of Birth, Relative Age in School, and Outcomes in Childhood and Adulthood”, unpublished manuscript.

Puhani, P., & Weber, A. (2006). Does the Early Bird Catch the Worm? Instrumental Variable Estimates of Early Educational Effects of Age of School Entry in Germany. Empirical Economics, 32(2-3), 359-386. doi:10.1007/s00181-006-0089-y

Quiroga, C., Janosz, M., Bisset, S., & Morin, A. (2013). Early Adolescent Depression Symptoms and School Dropout: Mediating Processes Involving Self-Reported Academic Competence and Achievement. Journal Of Educational Psychology, 105(2), 552-560. doi:10.1037/a0031524

Roberts, S., & Stott, T. (2015). A New Factor in UK Students’ University Attainment: The Relative Age Effect Reversal?. Quality Assurance In Education, 23(3), 295-305. doi:10.1108/qae-01-2013-0008.

Robertson, E. (2011). The Effects of Quarter of Birth on Academic Outcomes at the Elementary School Level. Economics Of Education Review, 30(2), 300-311. doi:10.1016/j.econedurev.2010.10.005

Schneeweis, N., & Zweimüller, M. (2014). Early Tracking and the Misfortune of Being Young. The Scandinavian Journal Of Economics, 116(2), 394-428. doi:10.1111/sjoe.12046

Suziedelyte, A., & Zhu, A. (2015). Does Early Schooling Narrow Outcome Gaps for Advantaged and Disadvantaged Children?. Economics Of Education Review, 45, 76-88. doi:10.1016/j.econedurev.2015.02.001

Sykes, E., Bell, J., & Rodeiro, C. (2009). Birthdate Effects: A Review of the Literature from 1990-on (pp. 3-4). Cambridge, England: University of Cambridge.

Thomas, J. (2012). Combination Classes and Educational Achievement. Economics Of Education Review, 31(6), 1058-1066. doi:10.1016/j.econedurev.2012.07.013

Thoren, K., Heinig, E., & Brunner, M. (2016). Relative Age Effects in Mathematics and Reading: Investigating the Generalizability across Students, Time and Classes. Frontiers In Psychology, 7 (n/a). http://dx.doi.org/10.3389/fpsyg.2016.00679

Zhang, S., Zhong, R., & Zhang, J. (2017). School Starting Age and Academic Achievement: Evidence from China’s Junior High Schools. China Economic Review. doi:10.1016/j.chieco.2017.03.004

Image via frolicsomepl/Pixabay.

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Ketamine for Rapid Treatment of Depression http://brainblogger.com/2017/09/27/ketamine-for-rapid-treatment-of-depression/ http://brainblogger.com/2017/09/27/ketamine-for-rapid-treatment-of-depression/#respond Wed, 27 Sep 2017 15:30:01 +0000 http://brainblogger.com/?p=22955 A team of researchers funded by the National Institutes of Health (NIH) recently discovered why the drug ketamine may act as a rapid antidepressant.

Ketamine is best known as an illicit, psychedelic club drug. Often referred to as “Special K” or a “horse tranquilizer” by the media, it has been around since the 1960s and is a staple anesthetic in emergency rooms and burn centers. In the last 10 years, studies have shown that it can reverse — sometimes within hours or even minutes — the kind of severe, suicidal depression that traditional antidepressants can’t treat.

Researchers writing in the August 2010 issue of Archives of General Psychiatry reported that people in a small study who had treatment-resistant bipolar disorder experienced relief from depression symptoms in as little as 40 minutes after getting an intravenous dose of ketamine. Eighteen of these people had previously been unsuccessfully treated with at least one antidepressant medication and a mood stabilizer; the average number of medications they had tried unsuccessfully was seven. Within 40 minutes, 9 of 16 (56 percent) of the participants receiving ketamine had at least a 50 percent reduction in symptoms, and 2 of 16 (13 percent) had full remission and became symptom-free. The response lasted an average of about a week.

In a small 2006 NIMH study, one of the first to look at ketamine for depression, 18 treatment-resistant, depressed (unipolar) patients were randomly selected to receive either a single intravenous dose of ketamine or a placebo. Depression symptoms improved within one day in 71 percent of those who were given ketamine, and 29 percent of the patients became nearly symptom-free in a day. Thirty-five percent of patients who received ketamine still showed benefits seven days later.

In the most recent study published online in the journal Nature in May 2016, researchers discovered that a chemical byproduct, or metabolite, is created as the body breaks down ketamine. The metabolite reversed depression-like behaviors in mice without triggering any of the anesthetic, dissociative, or addictive side effects associated with ketamine.

As put by Carlos Zarate, MD, of the National Institute of Mental Health (NIMH), and a study coauthor and pioneer of research using ketamine to treat depression:

This discovery fundamentally changes our understanding of how this rapid antidepressant mechanism works, and holds promise for development of more robust and safer treatments. By using a team approach, researchers were able to reverse-engineer ketamine’s workings from the clinic to the lab to pinpoint what makes it so unique.”

In response to the Nature report, Sara Solovitch of The Washington Post wrote that:

experts are calling [ketamine] the most significant advance in mental health in more than half a century.

She reported that many academic medical centers, including Yale University, the University of California in San Diego, the Mayo Clinic, and the Cleveland Clinic, have all begun offering ketamine treatments off-label for severe depression.

It all sounds too good to be true, right?

The Drawbacks of Ketamine

The predominant drawback of ketamine is the lack of data.

There haven’t been enough clinical trials on the drug to assure its safety, and there’s a lack of information on the long-term effects of its use.

Ketamine’s effects are also short-lived. To be used as an effective antidepressant, it would need to be administered regularly, which leads to concerns about addiction, tolerance, and, again, long-term effects. The data that we do have on long-term use comes from people who have taken ketamine recreationally, as well as those who have used it to treat chronic pain.

One 2014 study published in the British Journal of Clinical Pharmacology included among possible side effects, psychedelic symptoms (hallucinations and panic attacks), nausea, cardiovascular stimulation, memory defects, and bladder and renal complications.

Still, the drug holds promise for uncovering new ways of treating depression and offers hope for the most severe and complicated mood disorders that baffle psychiatrists today.

Richard J. Hodes, MD, director of the National Institute on Aging, commented on the most recent NIH study and the importance of furthering the research:

Unraveling the mechanism mediating ketamine’s antidepressant activity is an important step in the process of drug development. New approaches are critical for the treatment of depression, especially for older adults and for patients who do not respond to current medications.

Join Project Hope & Beyond, the new depression community.

This guest article appeared on PsychCentral.com: Ketamine: A Miracle Drug for Depression? and was originally posted on Sanity Break at Everyday Health by Therese J. Borchard.

References

Diazgranados, N., Ibrahim, L., Brutsche, N., Newberg, A., Kronstein, P., & Khalife, S. et al. (2010). A Randomized Add-on Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Bipolar Depression. Archives Of General Psychiatry, 67(8), 793. DOI: archgenpsychiatry.2010.90.

Zanos, P., Moaddel, R., Morris, P., Georgiou, P., Fischell, J., & Elmer, G. et al. (2016). NMDAR inhibition-independent antidepressant actions of ketamine metabolites. Nature, 533(7604), 481-486. DOI: 10.1038/nature17998.

Zarate, C., Singh, J., Carlson, P., Brutsche, N., Ameli, R., & Luckenbaugh, D. et al. (2006). A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression. Archives Of General Psychiatry, 63(8), 856. DOI: 10.1001/archpsyc.63.8.856.

Image via stevepb/Pixabay.

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The Science of Raising a Friendly Psychopath http://brainblogger.com/2016/12/06/the-science-of-raising-a-friendly-psychopath/ http://brainblogger.com/2016/12/06/the-science-of-raising-a-friendly-psychopath/#respond Tue, 06 Dec 2016 16:00:24 +0000 http://brainblogger.com/?p=22194 What makes someone a psycopath? Nature or nurture? And can we stop at risk children from growing up into dangerous adult psycopaths? One of the oldest queries in psychology — Nature Vs Nurture — asks if what makes us who we are is predisposed by our DNA, or by life experiences. It is a pretty poignant question when it comes to psychopaths, who are estimated to account for up to 50% of all serious crimes in the US.

Clinically known as anti-social personality disorder in the DMS-V, some troublesome psychopathic traits include:

• an egocentric identity
• an absence of pro-social standards in goal-setting
• a lack of empathy
• an incapacity for mutually intimate relationships
• manipulativeness
• deceitfulness
• callousness
• irresponsibility, impulsivity and risk taking
• hostility

Although these characteristics may be unpleasant, not all psychopaths are dangerous or criminals, and not all dangerous criminals are psychopaths. Counter-intuitively there are pro-social psycopaths too. Nonetheless, some psychopaths do pose a genuine threat for the safety of others.

The real unsolved problem when it comes to psychopathy is how to treat the personality disorder. Although certainly not to be considered impossible with the malleable brains we have even as adults, Dr. Nigel Blackwood, a leading Forensic Psychiatrist at King’s College London, has stated that adult psychopaths can be treated or managed, but not cured. Curing adult psycopathy is considered a near-impossible challenge.

Therefore, understanding when and how psychopathy develops from child to adult is an important part of the research engine that will hopefully identify what parents, caregivers and governments can do to prevent an at risk child from growing up to be a dangerous psycopath.

Development of psycopathic personalities is mainly due to genes

Enter new psychopathy research published in Development and Psychopathology by lead author Dr. Catherine Tuvblad from the University of Southern California. Her research was a twin-based study designed to overcome many previous drawbacks and limitations. Ultimately, the study was designed to provide a more reliable indication of the extent to which genes or the environment, that is nature or nurture, is responsible for the development of psychopathic personality features as a child grows into a young adult.

In the study, 780 pairs of twins and their caregivers filled out a questionnaire that allowed for measuring features of child psychopathy at ages 9–10, 11–13, 14–15, and 16–18. This included measuring psychopathic personality features indicative of future psychopathy, such as high levels of callous behavior towards peers and problems adhering to social norms.

The changes in the childrens’ psychopathic personality features between age groups was considered to be:

• 94% due to genetics between the ages of 9-10 and 11-13, and 6% environmental
• 71% due to genetics between the ages of 11–13 and 14–15, and 29% environemental
• 66% due to genetics between 14-15 and 16-18<, and 44% environmental This suggests that environmental factors may gradually play a greater part in changing the levels of psychopathic features a child develops in later teenage years, which is very promising for the development of future interventions for the prevention of psychopathy. It should be noted that while the childrens' test results pointed to the environment around them becoming increasingly important to their psycopathic behavior, their parents almost exclusively thought that the psycopathy they observed in their children was purely genetic. Considering parents are largely responsible for their child's environment, its not that surprising. Nurture is important at key developmental stages in psychopathy development

The analysis also revealed that there may be a key turning point in the development of psychopathy during the age range studied. The authors considered this turning point to be caused by the onset of puberty, when gene-environment interactions that are highly significant in inhibiting or promoting the development of psychopathy are at play.

Interestingly, the data also indicates that if these rapid gene-environment based changes in psychopathic traits occur early on (e.g. 11-13), any later additional environmental changes to psychopathic traits would be minimal. In other words, once the psychopathic personality traits are set during puberty, they tend to last into later years.

Other research has found that there may be other key turning points on route to becoming a psychopath much earlier in life. One study found that the total number of early negative life events between the ages of 0-4 were positively correlated with the emotion-based aspects of psychopathy. The findings suggest that early environmental factors could have important implications for the development of psychopathic traits and may also impact attachment to parents for children with genetic potential for psychopathy.

So although psychopathy is largely genetic, where it’s mostly down to if you have the right combination of genes needed to become a psychopath or not, life experiences during puberty and early infant years could make or break a potential psychopath.

The cure for psychopathy is love?

So what does science suggest as a successful environmental antidote to developing psychopathy? Believe it or not, love!

One neuroscientist, Dr. James Fallon, made a shocking discovery that on paper he is a psychopath. For example, he had a version of the monoamine oxidase A (MAOA) gene that is linked with violent crime and psychopathy. Also known as the warrior gene, MAOA encodes an enzyme that affects the neurotransmitters dopamine, norepinephrine, and serotonin.

His brain scans also resembled those of a psychopath. He had low activity in certain areas of the frontal and temporal lobes linked challenges with empathy, morality and self-control. In his family tree, there were also seven alleged murderers.

Although Dr. Fallon, in his own words, is obnoxiously competitive, kind of an asshole and won’t even let his grandchildren win games, he was certainly not a dangerous psychopath. So why not? His genes and even his brain screamed potential for antisocial psychopathy.

His answer was that the love he received from his mother led to him becoming a pro-social psycopath. And a newly published study tends to agree with him. OK love in itself is not enough. But, how a mother expresses that love in guiding the child’s pro-social behavior and in setting good examples of pro-social behavior might be the real key.

A new discovery coming from research on adopted infants suggests this is the case. Researchers found that the development of one of the largest child risk factors for psychopathy, that is highly heritable from biological mothers with severe antisocial behaviors — callous-unemotional behavior — was inhibited by high levels of positive reinforcement at 18 months by the adopted mother.

Further research will hopefully identify a whole repertoire of ways parents, schools and governments alike can lovingly nurture the development of at risk children through these key developmental stages. Ultimately, this could stop a large amount of future violent criminals literally in their diapers, before they even start.

References

Bartels, M., Hudziak, J. J., van den Oord, E. J. C. G., van Beijsterveldt, C. E. M., Rietveld, M. J. H., & Boomsma, D. I. (2003). Co-occurrence of Aggressive Behavior and Rule-Breaking Behavior at Age 12: Multi-Rater Analyses. Behavior Genetics, 33(5), 607–621. doi:10.1023/a:1025787019702

Hawes, S. W., Byrd, A. L., Waller, R., Lynam, D. R., & Pardini, D. A. (2016). Late childhood interpersonal callousness and conduct problem trajectories interact to predict adult psychopathy. Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.12598

Hyde, L. W., Waller, R., Trentacosta, C. J., Shaw, D. S., Neiderhiser, J. M., Ganiban, J. M., … Leve, L. D. (2016). Heritable and Nonheritable pathways to early callous-unemotional behaviors. American Journal of Psychiatry, 173(9), 903–910. doi:10.1176/appi.ajp.2016.15111381

Miller, J. D., Jones, S. E., & Lynam, D. R. (2011). Psychopathic traits from the perspective of self and informant reports: Is there evidence for a lack of insight? Journal of Abnormal Psychology, 120(3), 758–764. doi:10.1037/a0022477

Neumann, C. S., & Hare, R. D. (2008). Psychopathic traits in a large community sample: Links to violence, alcohol use, and intelligence. Journal of Consulting and Clinical Psychology, 76(5), 893–899. doi:10.1037/0022-006x.76.5.893

Rogers, T. P., Blackwood, N. J., Farnham, F., Pickup, G. J., & Watts, M. J. (2008). Fitness to plead and competence to stand trial: A systematic review of the constructs and their application. Journal of Forensic Psychiatry & Psychology, 19(4), 576–596. doi:10.1080/14789940801947909

Tuvblad, C., Wang, P., Bezdjian, S., Raine, A., & Baker, L. A. (2015). Psychopathic personality development from ages 9 to 18: Genes and environment. Development and Psychopathology, 28(01), 27–44. doi:10.1017/s0954579415000267

Image via jarmoluk / Pixabay.

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How to Secure Therapy Completion with Meta-Intervention http://brainblogger.com/2016/12/05/how-to-secure-therapy-completion-with-meta-intervention/ http://brainblogger.com/2016/12/05/how-to-secure-therapy-completion-with-meta-intervention/#respond Mon, 05 Dec 2016 16:00:53 +0000 http://brainblogger.com/?p=22477 Keeping messages brief and simple is more effective when trying to encourage patients to complete a health care program, according to new research.

In a study that analyzes six years of data, a team of researchers found small “nudges” in the right direction were a simple, inexpensive, and effective way to increase completion of health care programs, leading to a 16 percent jump in the completion rate for an already fastidious audience.

Dr. Dolores Albarracin, a professor of psychology and business administration at the University of Illinois and one of the co-authors of the study said that:

“Retention and completion are critical components of the effectiveness of health care interventions in real-world conditions, so a 16 percent increase in completion is significant.”

She noted that most health care intervention programs — for example, 10 sessions with a counselor — are expensive to implement and deliver:

“Patients start but they often drop out, which is not beneficial and is a huge deadweight loss of resources for everyone. That’s why increasing retention rates is vital for public health, because multi-session behavioral interventions or a series of appointments with a health care provider are more efficacious when completed.”

For the study, a randomized control trial with more than 700 eligible patients in Florida was conducted to identify a simple, effective intervention to increase the completion of an HIV-prevention counseling program delivered at the Duval County Department of Health.

The study involved two factors: One representing an instrumental message and the other an empowering message. The messages were brief videos played immediately after the counseling program.

The instrumental message reminded participants that they could discuss issues other than HIV with their counselor. The empowering message was designed to make them feel free, independent and in charge of their decision to return — a strategy that doubled enrollment in programs in other work by the same team, according to the study.

The idea was to use brief, simple marketing messages not for a commercial product. As Albarracin explains:

“health programs to get people to complete interventions that change detrimental behavior. These messages were designed to either empower clients as agents responsible for their own change or to highlight the instrumental outcomes of the intervention in terms of participants’ lives by addressing health concerns other than HIV, such as employment or education.”

Results indicated that the instrumental message alone produced more completion than either the empowering message alone or combined with the instrumental message.

The success of the simple, post-session message, which the researchers termed “meta-intervention,” comes down to the power of the nudge as a “gentle reminder to do something,” Albarracin said:

“The word ‘nudge’ has such a nice connotation to it because it reminds us that we need to find strategies that are simple and cost-effective. In a health care setting, you need something that’s practical, implementable and inexpensive. This is that kind of approach.”

For people who are vulnerable or disadvantaged, repeated contact with the health care system is important, according to Albarracin.

“Contact with the public health system is often the front door to accessing a lot of other public services — mental health services, career and employment services, and other forms of social assistance,” she said. “So the public health system might design a program with health in mind, but the audience who is buying into the program has multiple goals in mind, not just health.”

Having a good job or access to other services is just as important, which is why you have to sell the benefits of the program from the perspective of the audience, not of the provider, according to Albarracin:

“Social marketing is a marriage between psychological approaches and an approach that has the consumer in mind. Make it recipient- and patient-centered, not provider-centered. The instrumental message capitalizes on that.”

This guest article originally appeared on PsychCentral.com: Brief ‘Nudge’ Can Help Patients Finish Health Program by Rick Nauert PhD.

REFERENCE
Albarracín, D., Wilson, K., Durantini, M. R., Sunderrajan, A., & Livingood, W. (2016). A meta-intervention to increase completion of an HIV-prevention intervention: Results from a randomized controlled trial in the state of Florida. Journal of Consulting and Clinical Psychology, 84(12), 1052–1065. doi:10.1037/ccp0000139

Image via Picudio / Pixabay.

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Homosexuality Link to Child Sex Abuse Confirmed — Gender Nonconformity http://brainblogger.com/2016/11/21/homosexuality-link-to-child-sex-abuse-confirmed-gender-nonconformity/ http://brainblogger.com/2016/11/21/homosexuality-link-to-child-sex-abuse-confirmed-gender-nonconformity/#respond Mon, 21 Nov 2016 16:00:01 +0000 http://brainblogger.com/?p=22189 Can sexual abuse make you gay? The short answer according to new research is, no. Child sexual abuse is not a common cause of being gay. But, new research says that the opposite is true. There is something common in the childhood of homosexual men that makes them a target for pedophilia and sexual abuse — gender non-conformity.

Many homophobic religious institutions make unfounded claims about same-sex sexual child abuse causing homosexuality, like those coming from the pro-heterosexual, anti-gay activist group, Heterosexuals Organized for a Moral Environment (HOME):

We can see that sexual abuse can theoretically account for every case of homosexuality…

Under the lens of science these claims are considered ridiculous and laughable at best, often followed by outrageous and scientifically unfounded claims that being gay is the cause of pedophilia.

Nonetheless, non-heterosexuals with a history of same-sex sexual abuse as a child often ask if this made them desire the same-sex as an adult. Similarly, gay men and women who were sexually abused by the opposite sex as a child, ask if this caused a sexual fear and revulsion towards the opposite sex that ‘made’ them gay.

Whether the pedophile or child molester was gay or straight, gay victims tend to ask the same question at some point, “Did sexual abuse make me gay?”

Research indicates that this isn’t true of straight people abused as children, they are less likely to question if being abused made them straight. Thus it is often argued that it is the culturally ingrained negative views of gay people, particularly of gay men, or simply belonging to a minority group, that the question is even asked in the first place.

Even so, it is still a common view that sexual abuse can ‘turn’ a child gay despite no convincing or reliable evidence that premature sexual activity or child sexual abuse grossly changes sexual orientation.

The main withstanding argument in support of this view is that child sexual abuse is more common in the gay community than the straight community. In fact, meta-analysis indicates that sexual minority school children were on average almost 4 times more likely to experience sexual abuse than heterosexual children.

The latest research stands against this argument, providing the most convincing causal evidence yet that it is a common aspect of many gay men’s childhoods that is linked with higher rates of sexual abuse in boys who later identify as gay in adulthood — not sexual abuse ‘making’ a child gay.

Published in Sexual Abuse: A Journal of Research and Treatment the new research suggests that a child’s gender nonconformity, which is more common for non-heterosexuals, that may make them more desirable targets for pedophiles and child abusers.

To clarify, gender nonconformity you may also know as gender bending. Gender nonconformity is when people identify with or behave like what is culturally considered typical for the opposite sex, going against the gender grain if you will. For example, boys that like to play dress-up, or girls that prefer rough play.

In the study, 1753 participants filled out an online survey that regarding their sexual orientation, history of child abuse, and the degree of gender nonconformity they recall from childhood, including the activities and kinds of play and types of clothes they liked.

Although other research has suggested a link between gender nonconforming and sexual abuse in children, whether nonconforming caused abuse, or abuse caused nonconforming had not previously been assessed this directly. By using a special type of analysis called instrumental variable analysis, the new study was able to estimate causal relationships. It is therefore study able to more confidently address the complex question “Can sexual abuse make you gay?”

In line with other research, gay participants (being male or female homo and bisexuals) in the new study had greater odds (~45% greater) of being sexually abused in childhood than heterosexual participants.

They also found that heterosexual and non-heterosexual men who are more gender nonconforming (i.e. ‘feminine’) in childhood had higher chances of abuse than sexual orientation matched boys who are more gender conforming (i.e. ‘masculine’). In other words being gay or not had nothing to do with it. It was whether boys behaved like stereotypical boys or not that was key.

However, gender non-conforming girls were not at higher risk of sexual abuse than conforming girls in the present study. It is research supported factoid that gender nonconformity in girls, like being a ‘tomboy’, is generally more socially accepted, approved of and tolerated in Western cultures than gender nonconforming in boys, who are often considered as mama’s boys, sissies or brats.

The authors suggest that gender nonconforming boys are less generally approved of partly due to cultural femi-negativity. Cultural femi-negativity being where femininity is particularly devalued when it does not adhere to gender norms. The idea that abusers target children with feminine qualities as to make for more compliant and less socially valued abuse targets fits well with the study and the body of research as a whole considering more girls are targets of pedophilia and child molestation than boys, and that more gender non-conforming feminine boys are targeted more than masculine conforming ones, whether they are gay or not.

This also makes sense when considering research suggesting that most abusive pedophiles are generally aroused by youth, and that the child’s sex, at the core of their desires, is pretty immaterial. Whether they abuse mainly boys or girls, it’s about a child being a child, ease of access to that child and avoiding getting caught through ease of controlling the child.

Whereas adult child molesters, who can be a pedophiles (i.e. someone specifically attracted to children) but are not necessarily pedophiles, get a sexual kick out of domination, power and control, marking those with more feminine qualities as being easier and less risky targets.

Importantly, the research suggests that it is having feminine personality traits and behaviors more common to gay boys, i.e. gender nonconforming, that leads to such high rates of child abuse cases in gay men. There is no credible research as of yet that indicates that it is common that child sexual abuse is a cause of being gay.

It seems that there is something, or somethings, about gender-non-conforming in boys that puts them at an increased risk of sexual abuse. If research now focuses on exploring further what those somethings are we can better protect children from the traumas of sexual abuse.

References

Bailey, M. J., Vasey, P. L., Diamond, L. M., Breedlove, M. S., Vilain, E., & Epprecht, M. (2016). Sexual orientation, controversy, and science. Psychological Science in the Public Interest, 17(2), 45–101. doi:10.1177/1529100616637616

Coyle, E. F., Fulcher, M., & Trübutschek, D. (2016). Sissies, mama’s boys, and Tomboys: Is children’s gender Nonconformity more acceptable when Nonconforming traits are positive? Archives of Sexual Behavior, 45(7), 1827–1838. doi:10.1007/s10508-016-0695-5

Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E. M., & Stall, R. (2011). A Meta-Analysis of disparities in childhood sexual abuse, parental physical abuse, and peer Victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101(8), 1481–1494. doi:10.2105/ajph.2009.190009

Xu, Y., & Zheng, Y. (2015). Does sexual orientation precede childhood sexual abuse? Childhood gender Nonconformity as a risk factor and instrumental variable analysis. Sex Abuse. doi:10.1177/1079063215618378

Image via Unsplash / Pixabay.

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Affection, Not Money, Key to Child Health http://brainblogger.com/2016/10/18/money-cant-buy-kids-health-without-affection/ http://brainblogger.com/2016/10/18/money-cant-buy-kids-health-without-affection/#respond Tue, 18 Oct 2016 11:34:04 +0000 http://brainblogger.com/?p=22365 Growing up in a well-off home can benefit a child’s physical health even decades later, but a lack of parent-child warmth, or the presence of abuse, may eliminate the health advantage of a privileged background, according to a Baylor University study.

Assistant professor of sociology at Baylor University, Matthew A. Andersson, Ph.D., explains:

Previous research has associated high socioeconomic status with better childhood nutrition, sleep, neighborhood quality, and opportunities for exercise and development of social skills. But good parent-child bonds may be necessary to enforce eating, sleep, and activity routines.

For example, if parent-child relationships are strained or abusive, meals may be less coordinated among the family, and children may be more likely to eat sugary or high-fat foods as snacks or even in place of meals.

Sleep and activity routines also may become irregular, keeping children from developing healthy lifestyles and social and emotional skills useful for successful aging, Andersson said.

Unfortunately, although good parent-child bonds in economically disadvantaged homes, promote health, they do not seem to lessen the negative impact of low socioeconomic status as the children age, Andersson said.

Previous research has shown parents with less education and fewer financial advantages are more apt to threaten or force obedience rather than have constructive dialogue, and that may lessen warm relationships.

In addition, disease rates or inflammation among those children when they become adults have been linked strongly to abuse, mistreatment, or lower levels of parental warmth.

The study on Midlife Health and Parent-Child Relationships appears in the Journal of Health and Social Behavior.

For the study, health at midlife was defined as being free from 28 possible conditions, among them cancer, circulatory or respiratory disease, endocrine diseases, nervous system diseases, infectious and parasitic diseases, skin or digestive disease, and musculoskeletal conditions. Andersson explains the take-home message:

Much research continues to view socioeconomic status and parent-child bonds as highly related or even interchangeable. But in fact they may quite independently influence a child’s well-being. The key takeaway is that without adequate parent-child relationship quality to match, socioeconomic advantage during childhood may not offer much protection at all against major chronic disease as children become adults and reach middle age.

For the study, Andersson analyzed data on disease or poor health of middle-aged adults drawn from the National Survey of Midlife Development in the United States (MIDUS).

He surveyed 2,746 respondents ages 25 to 75 in 1995 about their childhood treatment by parents. He conducted surveys again about 10 years later, with 1,692 of the individuals taking part.

The follow-up analysis, adjusted for personal background in 1995 and for probability of dropping out of the MIDUS study, revealed that childhood abuse continued to undermine any protection from disease linked to childhood socioeconomic advantage.

This guest article originally appeared on PsychCentral.com: Lack of Affection May Cancel Health Benefits of Well-Off Family

References

Andersson, M. A. (2016). Chronic disease at Midlife: Do parent-child bonds modify the effect of childhood SES? Journal of Health and Social Behavior, 57(3), 373–389. doi:10.1177/0022146516661596

Image via Pezibear / Pixabay.

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Best Strategy to Manage Stress Depends on the Person http://brainblogger.com/2016/10/14/best-strategy-to-manage-stress-depends-on-the-person/ http://brainblogger.com/2016/10/14/best-strategy-to-manage-stress-depends-on-the-person/#respond Fri, 14 Oct 2016 11:22:46 +0000 http://brainblogger.com/?p=22354 People use different coping strategies to deal with stressful events, and some people use coping strategies more than others. Three techniques for keeping perspective through the ups and downs of life that have been studied are:

Mindfulness: Staying aware in the present moment
Reappraisal: Finding ways of reinterpreting negative events to give them more positive meaning
Emotion Suppression: Putting negative emotions out of side and out of mind

To learn more about how these strategies work on a day-to-day basis, a team of researchers recently performed a study of 187 participants looking at how use of these strategies affected people’s moods.

Overall, different strategies had different benefits for different people.

Mindfulness helped people keep their emotions balanced in two ways. It both increased people’s levels of positive emotions and decreased their levels of negative emotions.

Emotion suppression turned out to have the exact opposite effect. When people used more emotion suppression, they reported higher levels of negative emotions and lower levels of positive emotions.

For reappraisal, the picture was a little more nuanced. For about half the people in the study, reappraisal seemed to be of no use in regulating their negative emotions. Overall, appraisal tended to be more helpful for people who were older: for older participants, using appraisal was associated with lower levels of negative emotions while for adolescents, it was linked to higher levels of negative emotions!

These results indicate that there’s no one-size-fits-all coping strategy that works for everyone. Finding whatever way of dealing with stressful situations works best for you is the way to go.

That said, some strategies seem like promising places to look. Mindfulness is an especially promising candidate while for many emotion suppression will do more harm than good. And reappraisal? You’ve probably got about a fifty-fifty chance on that one.

This guest article originally appeared on PsychCentral.com: Mindfulness, Reappraisal, Emotion Suppression: Which Coping Strategies Work?

Reference

Brockman, R., Ciarrochi, J., Parker, P., & Kashdan, T. (2016). Emotion regulation strategies in daily life: Mindfulness, cognitive reappraisal and emotion suppression. Cognitive Behaviour Therapy. doi:10.1080/16506073.2016.1218926

Image via lecreusois / Pixabay.

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The Science of a Happy Family – Leisure Time http://brainblogger.com/2016/10/12/happy-family-linked-with-time-spent-together-at-home/ http://brainblogger.com/2016/10/12/happy-family-linked-with-time-spent-together-at-home/#respond Wed, 12 Oct 2016 11:22:43 +0000 http://brainblogger.com/?p=22358 Family fun often means new activities and destinations but a new study suggests leisure time spent at home in familiar pastimes may be a better route to happiness.

The lead author of a newly published study in the World Leisure Journal, Dr. Karen K. Melton, assistant professor of child and family studies at Baylor University talks causality:

That may be because when the brain is focused on processing new information, such as taking part in an unfamiliar activity with unfamiliar people in a new location, less ‘brain power’ is available to focus on the family relationships,

While research results suggest that all quality time together contributes to satisfaction with family life, “all family leisure is not equal,” she said.

The best predictor of happiness for families may be spending quality time together in familiar activities inside the home. And that’s great news for families who have little time or few resources.

Researchers performed the online research beginning with a sample of 1,502 individuals in 884 families in the United Kingdom. Each family unit taking part in the online research had at least one child between the ages of 11 and 15.

Participants answered questions about whether they took part in family leisure in the past year, and if so, what activities (from 16 categories) they did, how much time they spent doing them and how frequently they did so.

Melton said that the catchy expression “The family that plays together, stays together!” carries two misconceptions: that all family leisure brings positive results and that all family activities are equal.

Family members also can express stress and conflict as well as pleasure during leisure time. The activities alone will not heal the scars of hurting families.

Melton noted that some studies support the idea that eating together is one of the best predictors of functioning families, while watching TV is seen as ineffective for individual happiness or family function. Melton warns, however, that each family is different and that a one-size-fits-all notion is often incorrect.

For some families, quality togetherness is having dinner together or playing games; for others, it may be hobbies, videos, TV or music… At the end of the day, what matters is that we are social beings who crave a sense of belonging and connectivity.

This guest article originally appeared on PsychCentral.com: Leisure Time At Home May Be Best Path to Happy Family

References
Melton, K. K., & Zabriskie, R. B. (2016). In the pursuit of happiness all family leisure is not equal. World Leisure Journal, 58(4), 311–326. doi:10.1080/16078055.2016.1228154

Image via ArtsyBee / Pixabay.

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Challenging Goal? Improve Focus by Engaging Your Brain http://brainblogger.com/2016/10/10/challenging-goal-improve-focus-by-engaging-your-brain/ http://brainblogger.com/2016/10/10/challenging-goal-improve-focus-by-engaging-your-brain/#respond Mon, 10 Oct 2016 11:22:42 +0000 http://brainblogger.com/?p=22363 New research confirms anecdotal observations that people can easily be distracted if they want to be, and that the ability to concentrate on a task and stay disciplined is best accomplished when an individual is interested.

Investigators say their findings provide evidence that one’s motivation is just as important for sustained attention to a task as is the ease with which the task is done.

The research also challenges the hypothesis, proposed by some cognitive neuroscientists, that people become more distractible as they tackle increasingly difficult tasks.

A report of the new study appears in the Journal of Experimental Psychology: General. The authors of the study, University of Illinois psychology professors Drs. Simona Buetti and Alejandro Lleras write:

People must almost continuously balance their need for inner focus (reflection, mental effort) with their need for attending to the world. But, when the need for inner focus is high, we may have the impression that we momentarily disengage from the world entirely in order to achieve a heightened degree of mental focus.

Buetti and Lleras designed several experiments to test whether people are more easily distracted when the mental effort required to complete a task goes up, as is generally assumed in their field.

The researchers first asked participants to solve math problems of varying difficulty while photographs of neutral scenes — for example, cows in a pasture, a portrait of a man, a cup on a table — flashed on a computer display for three seconds, enticing the subjects to look at them.

An eye-tracking device measured the frequency, speed, and focus of participants’ eyes as they completed the math problems.

The results showed that participants who were engaged in an easy version of the task were more likely to look at the distractors than those engaged in an extremely challenging version. These results run counter to current theories, the researchers said. As put by Buetti:

This suggests that focus on complex mental tasks reduces a person’s sensitivity to events in the world that are not related to those tasks

This finding corresponds to research on a phenomenon called “inattentional blindness,” in which people involved in an engaging task often fail to notice strange and unexpected events. As put by the authors:

Between the inner world of solving a problem and the outer world — what’s going on around you — there seems to be a need to disengage from one when heightened attention to the other is required…Interestingly, when participants completed a mix of easy and hard tasks, the difficulty of the task did not seem to affect their distractibility.

This finding led the researchers to hypothesize that the ability to avoid being distracted is not driven primarily by the difficulty of the task, but is likely the result of an individual’s level of engagement with the endeavor. They call this concept the “engagement theory of distractibility.”

The team did further studies to test this idea, manipulating subjects’ enthusiasm for the task with financial incentives. To the researchers’ surprise, this manipulation had little effect on participants’ distractibility. However, as explained by Buetti there were large differences between people in terms of their distractibility:

The more participants struggled with a task, the more they reflexively avoided distraction, irrespective of financial incentive. So, the take-home message is: Characteristics of the task itself, like its difficulty, do not alone predict distractibility. Other factors also play a role, like the ease with which we can perform a task, as well as a decision that is internal to each of us: how much we decide to cognitively engage in a task.

This guest article originally appeared on PsychCentral.com: Motivation Linked to Ability to Stay on Task

References

Buetti, S., & Lleras, A. Distractibility is a function of engagement, not task difficulty: Evidence from a new oculomotor capture paradigm. (2016). Journal of Experimental Psychology: General, 145(10), 1382–1405. doi:10.1037/xge0000213

Image via keijj44 / Pixabay.

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How to Deal with Destination Memory Issues – Did I Already Tell You? http://brainblogger.com/2016/09/16/how-to-deal-with-destination-memory-issues-did-i-already-tell-you/ http://brainblogger.com/2016/09/16/how-to-deal-with-destination-memory-issues-did-i-already-tell-you/#respond Fri, 16 Sep 2016 08:50:30 +0000 http://brainblogger.com/?p=22220 Have you ever realized or been informed that the person you are talking to has already heard the joke or story you are telling?

I already told your this?

If you have been in this situation, you are not alone. You are dealing with what experts call, destination memory.

Destination memory is the ability to remember to whom you told what. The reason that so many of us have problems with it, is that it has been found to be weaker than other forms of memory regardless of age.

Why is Destination Memory Weaker?

• According to Nigel Gopie and Colin MacLeod, the researchers who coined the term destination memory, we may have more practice and feedback developing other forms of memory like explicit memory, our memory for facts, dates, vocabulary etc. or implicit memory, our memory for riding a bike, driving a car etc. You’ve heard the expression, “ It’s like riding a bike, you never forget it.” The destination of what we say may be weaker because we have more need to remember the fact than the person with whom we share it.

• Gopie and Mackleod’s research findings reported in 2009 in Psychological Science reveal that when students are asked to speak a fact they are trying to memorize out loud to someone’s picture, their later performance on remembering the facts and faces declines compared to students who asked to simply memorize facts matched with faces.

• One hypothesis is that the telling of the fact to another person is actually a competing task that interferes with memory. Perhaps we suppress the memory of our audience to reduce the interference.

• Certainly more research is needed, but for now…

How Do You Improve Destination Memory?

These researchers suggest that saying the recipient’s name before you share your information increases the likelihood of remembering to whom you told what. “Joe, I have to tell you what happened at the office last week.”

How Do You Actually Avoid The Embarrassment Of Re-telling A Story?

It is suggested that if uncertain, you might preface the story with a caveat like “Stop me if I told you this – it’s just so interesting to me…. Or “I might have told your this, if so…. etc.”

Should We Correct Our Partner’s Destination Memory?

Think twice. If it is a choice between “Honey, you already told them about our nightmare cruise,” or relying on the patience of your listening friends – go with the friends.

Destination Memory Doesn’t Have to Count Between Partners

The telling and re-telling of stories old and new – particularly of shared experiences is not only inevitable between partners – it is desirable. It is a little bit like the “ mutual stuff” both partners accept as their shared clutter in the place they call home. Such stories are welcomed and appreciated as the favorite legends of their relationship.

Whereas the kids no longer want to hear about the “nightmare cruise” and the friends no longer care, the couple can take them off the shelf over and over and enjoy the re-telling. It is part of their fabric, their shared oral history, and the destination that they share.

This guest article originally appeared on PsychCentral.com: Do you have a problem with destination memory?

Reference

Gopie, N. and MacLeod, C.M. (2009) ‘Destination memory: Stop me if I’ve told you this before’, Psychological Science, 20(12), pp. 1492–1499. doi: 10.1111/j.1467-9280.2009.02472.x.

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