Providentia

New Report Highlights Substance Abuse Dangers for Pregnant Teens

According to a new report released by the Substance Abuse and Mental Health Services Administration (SAMSHA), of the 57,000 teenage females in substance abuse treatment programs each year, as much as 2000 (4  percent) are pregnant.    The report, titled "Characteristics of Pregnant Teen Substance Abuse Treatment Admissions" is based on on SAMHSA statistics from 2007 to 2010 and focuses on females aged 12 to 19.   In exploring the problems faced by pregnant teens in substance abuse programs, the report indicates that pregnant teens are three times more likely than non-pregnant teens to require public assistance, and also less likely to be enrolled as students when not in the workforce.    Despite the risk to their unborn children, about half (51 percent) reported some use of drugs or alcohol in the month prior to their entering treatment with nearly a fifth (19.1%) reporting daily drug or alcohol use. For both pregnant and non-pregnant teens, marijuana was the most commonly used drug though pregnant teens were also more likely to abuse methamphetames.

In discussing the report findings, SAMHSA Administrator Pamela S. Hyde stressed the  treatment needs faced by pregnant teens.  “These specialized needs are even more acute for our pregnant teens. Community programs that can address the needs of pregnant teens by providing them both access to substance abuse support services and specialized pregnant and post partum services can help ensure that these future mothers and their children live healthier, happier and more productive lives." she stated.

SAMHSA has a Service Grant Program for Residential Treatment for Pregnant and Postpartum Women providing family-centred treatment in residential programs to help low-income pregnant women with substance abuse problems with all their treatment needs as helping non-residential family meembers.  They may also need referral for medical services including pre- and post-natal care and parenting courses, as well as information to correct misconceptions about birth control, substance abuse risks, and venereal disease.  Referrals also receive psychological assessment and counseling to address mental health care needs in addition to substance abuse treatment.  

The criminal justice system remains the most common source of referral for pregnant teens (41.4%) with community agencies and self-referral being the next most common.     Most pregnant teens are living in poverty with a high percentage living on Medicaid or no income at all.  Lacking access to affordable medical care represents one of the most critical barriers to safe delivery of their children and successful transition to adult life.  For pregnant teens lacking proper care, the long-term consequences for them and their children remains bleak.

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Genetics and the Aging Brain

 

We all hope to stay physically and mentally active as we grow older but the reality is often very different.  Research has demonstrated that certain cognitive abilities tend to decease as we grow older, including perceptual speed and episodic memory, but this decline is hardly consistent.   While some older adults develop severe memory problems at a relatively young age, even to the point of being diagnosed with dementia, others remain mentally active even into extreme old age.   Though lifestyle factors including nutrition, physical exercise, and mental stimulation can help people grow older successfully,  new research has also focused on the role that genetic differences can play.

Twin studies looking at genetic variability in cognitive abilities has shown that genetics plays a stronger role as we grow older, ranging from about 30% in children to well over 50% in adults.    A Swedish study looking at older twins  suggests that genetics can account for as much as 62% of individual differences in general cognitive ability in  older adults.   In recent years, researchers have identified several key genetic markers that have been linked to cognitive functioning in older adults and which can also be linked to many of the dementias that have been seen in older populations.    

To read more, check out my new Psychology Today blog post.

The Immortality Experiments (Part 2)

Continued from Part 1

In March 1926, the Soviet government granted Alexander Bogdanov a large building in downtown Moscow, not far from the Kremlin itself.  It was an impressive looking structure; a former mansion built by a prosperous merchant in the 1890s.  Despite assorted delays, Bogdanov used his generous budget to renovate the building and hire new staff.   Much as his appointment had been controversial, so was his choice of staff members since they were mostly his fellow blood-transfusion enthusiasts instead of any of the prominent members of the Moscow medical community already experienced  in blood transfusions.  The institute's special status meant that the health ministry could not oversee its operations.  Instead, Bogdanov and his institute only answered to the commissar directly.

While the institute's reports were kept confidential, Bogdanov  published glowing reports on his progress in Isvestiia including ambitious plans for using blood transfusions to treat a range of diseases such as trauma, anemia, and  blood poisoning. He also stressed that the Soviet Union lagged far behind other countries in availability of blood transfusions (which was true enough) and that the new procedure would help combat the "Soviet exhaustion"  killing older Soviet workers.   By the time renovations were finished, Bogdanov's institute was expanded to a ten-bed clinic though many of his promises had yet to materialize.  His 1927 treatise, Struggle for Viability, was hardly the comprehensive manual for blood transfusion  medical doctors had been promised.  According to medical historian Douglas Huestis,  who provides one of the first English translations for Bogdanov's monograph,  The Struggle for Viability proposed a "physiological collectivism" with blood transfusions  not only extending life but effectively rejuvenating older people as well. A rehashed version of Bogdanov's earlier work on tectology , it did little to help the Soviet Union catch up to the West in blood medicine. 

Alexander Bogdanov was hardly the only Russian doctor making bold claims about solving the problem of aging, though.   Elie Metchnikoff had done the same years before.   Though Metchnikoff's claims had been just as grandiose in linking aging to "toxicity" of intestinal bacteria, his scientific credentials were far greater than Bogdanov's (Metchnikoff won the 1908 Nobel prize in Medicine).    Many other researchers around the world were also pursuing the dream of rejuvenation, whether through gland injections or actual organ transplants.    Serge Voronoff's research into transplanting monkey testicles into elderly humans during the 1920s and 1930s appeared to be succeeding, at least according to the enthusiastic newspaper coverage he was receiving at the time.    Along with funding Bogdanov's clinic, the Soviet Health Ministry established a primate breeding station to supply monkey glands for transplants.

For his part, Bogdanov argued that monkey gland transplants, Metchnikoff's yogurt remedies, and all the other rejuvenation treatments being offered could be replaced by regular blood transfusions which would be safer and more effective.  Blood was a "universal tissue" that could be "purified" through transfusions and he specifically viewed aging as being due to a "weakening" of the sex glands.   Since young people had "too much" sex hormone and older people "too little",  blood transfusions could be beneficial to both.   Bogdanov also maintained that blood transfusions could be used to "transfer" immunity with diseases such as cancer and tuberculosis being treated by blood exchanges between healthy and non-healthy subjects.  Along with his own radical notions about collectivism, Bogdanov promoted basic misconceptions regarding safe blood transfusion.  He argued against transfusions between men and women due to the incompatible hormones involved, for example.

The reaction to Bogdanov's flamboyant claims were less than positive.  Legitimate medical researchers with greater experience with blood transfusion pointed out that Bogdanov's ideas were based on a small number of clinical trials and lack of any real method of measuring the benefits he claimed to have produced through transfusions.   In his laboratory, Bogdanov simply asked subjects how they felt after the transfusion without bothering to do any actual medical tests to measure improvement. 

As for Alexander Bogdanov and his Politburo backers, they ignored the criticism and the institute soon began publishing progress reports which proudly described carrying out over a hundred transfusions.  Again, these reports were extremely light when it came to actual statistics although they contained case histories describing (mostly anecdotal) recovery from conditions including burns, anemia, and infectious diseases such as tuberculosis.   Bogdanov's reports were aimed directly at the Politburo members funding his research and the general public.   He made no attempt to win over his actual medical colleagues and none of the Institute staff bothered attending medical meetings.  Even the long-promised training courses for physicians never materialized.  

Despite the controversy, the Institute grew and expanded to include laboratories for animal experiments and biochemistry.   He also hired eminent pathophysiologist Oleksandr Bogomoletz, a respected authority on aging and endocrinology, to oversee operations.   Along with being a noted medical researcher, Bogomoletz was also a longtime Bolshevik sympathizer (which likely secured the position for him).    Bogdanov also hired more clinical experts to provide medical services to patients at the Institute's clinic.  After a mishap in which two patients were accidentally infected with syphilis, Bogdanov hired a specialist in venereal diseases as well.

Unfortunately, Bogdanov often clashed with the Politburo over many of the hiring decisions.   Politburo members often insisted on hiring their own political appointees and Bogdanov threatened to resign in 1928.   Though he won that battle,  the Institute was still under pressure to provide more concrete results to justify the money being spent.  

All of which led up to the fateful transfusion of March 24, 1928 when Bogdanov selected a twenty-one year old male student at Moscow University for his twelfth mutual blood transfusion.   Although this student had an inactive form of tuberculosis, Bogdanov  considered himself immune to tuberculosis.   Within hours, both the student and Bogdanov developed an adverse reaction despite having the same blood type (possibly due to an incompatible Rh factor).   While the student recovered, Alexander Bogdanov died two weeks later of what his doctors described as acute "hemolysis" resulting in liver and kidney failure.

While Bogdanov was honoured as a medical hero, his ambitious plans ended with his  death.   The Institute (which was renamed the Bogdanov State Scientific Institute of Blood Transfusion) abandoned the notion of "physiological collectivism" under the leadership of  Bogdanov's replacement,  Oleksandr Bogomoletz.   Mutual blood exchanges were stopped and blood transfusion began following the accepted standard common in most Western countries by that time.    When the Bogdanov Institute finally published a manual of blood transfusion for doctors in 1930, none of Bogdanov's ideas were mentioned.   The name attached to the Institute was his only legacy.

While the Institute went on to revolutionize blood transfusion across the Soviet Union making it a standard medical procedure by the mid 1930s, Alexander Bogdanov is still better remembered as a science fiction writer and political theorist than he was a scientist.   Ultimately, he was extremely lucky to have died when he did since Stalin's purges were only just beginning and he likely would not have survived considering his radical politics and his previous arrest by the Bolsheviks.   Given the convenient timing, some biographers even suggested that his final transfusion may have been a deliberate suicide but no real evidence of that has ever surfaced. 

Still, Alexander Bogdanov's political ideals managed to shape Soviet science for years to come.   His views on proletarian science would definitely have an impact on how science would be practiced during the Stalinist era with ideology trumping actual science.    That it would help set the stage for demagogues such as Trofim Lysenko, whose rejection of Mendelian genetics would devastate Soviet biology and cost countless lives, was likely an outcome that the idealistic Bogdanov could never have foreseen.

 

 

 

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Procrastination: When Good Things Don’t Come to Those Who Wait.

Procrastination is a well-known phenomenon that often entails negative outcomes with regard to performance and subjective well-being. In an attempt to understand the (alarming) character of procrastination, a large body of research on the causes, correlates, and consequences of procrastination has been accumulating over the last 40 years. A paper recently publised in European Psychologist provides a systematic characterization of the trends in procrastination research and to suggest future directions for research and practice. The systematic characterization comprises a comparison of procrastination to functional forms of delay (referred to as strategic delay) and a presentation of the theoretical approaches to explaining procrastination. The future directions suggested pertain to the development of a differentiated understanding of procrastination and of integral interventions.

For the abstract

Learning to be Scientists

Why do people believe the things that they do? While only science can generate testable hypotheses, advocates of various paranormal claims tend to rely more on anecdotes, appeals to authority and “intuition” and the general public tends to be ambivalent about the distinction between science and the supernatural. Ongoing controversies over intelligent design in schools, climate change and vaccination have demonstrated that the public perception about science is often shallow due to misunderstandings about how science works.

A recent article published in the Journal of Educational Psychology presents the results of a research study directly comparing the processes that influence how people form opinions on scientific and paranormal concepts. Written by Andrew Shtulman of Occidental College in Los Angeles, the article is part of his research program studying conceptual development relating to science education and how people weigh the actual evidence involved before forming opinions on complex subjects.

To read more, check out my new post on the James Randi Education Foundation blog.

Are Antipsychotic Medications being Overused in Veterans with PTSD?

When the Australian special forces soldier identified as only "Trooper M" returned from a tour of duty in Afghanistan, his frequent nightmares and anxiety led him to seek professional help.  In an interview with Lateline,  the 23-year old veteran reported that he was prescribed Seroquel, (quetiapine) for his symptoms.   An atypical antipsychotic used for treating schizophrenia, bipolar disorder and major depression,  it has also being used off-label for treating posttraumatic stress disorder.  

In Trooper M's case, he was prescribed Seroquel for his nightmares without ever seeing a psychiatrist.  "So the mental health nurse liaised with one of the medical officers and from that... before I saw a psychiatrist or anything like that, they decided that Seroquel would be the choice of medication", he said.    He took the medication as prescribed despite adverse symptoms such as extreme sleepiness.  One time after accidentally taking 400 mg, he slept longer than 24 hours which he described as a "wake-up call."

Based on complaints from soldiers such as Trooper M, psychiatrists in Australia and the United States are calling for a formal review of the off-label use of quetiapine for treatment veterans with posttraumatic symptoms.    Australia's Department of Defense has confirmed that prescribing Seroquel alone has increased 600 per cent over the past five years.   Though prescribing anti-psychotics for PTSD is still controversial, many soldiers report that they are often placed on the medication just to help them sleep. 

According to the Lateline news story looking at Seroquel use in treating traumatized veterans, military doctors or family doctors sanctioned by Australia's Defense Department often prescribe Seroquel as a sedative despite lack of actual research relating to off-label use.  Along with hypersomnia, other adverse effects include fatigue, hypotension, blurred vision, and stomach problems.  In more extreme cases, Seroquel can also cause slurred speech, hypothyroidism,  language problems and hallucinations.     In the United States, the deaths of six U.S. soldiers have been linked to "drug cocktails" that include Seroquel  and AstraZeneca is facing over 10,000 lawsuits relating to adverse effects of Seroquel ranging from slurred speech to death.

News stories about antidepressant overuse in soldiers deployed in combat situations have attempted to call attention to the potential dangers involved.  A 2008 expose by the Denver Post, "The Battle Within" showed the "pharmaco-battlefield" in Iraq and other high-risk settings.  Seroquel has been specifically implicated in suicides by soldiers on actual deployment and in veterans following their return to civilian life.     More psychiatrists are speaking out against its use for off-label treatment without proper clinical trials.  According to one critic, Professor Stan Catts of the University of Queensland in Australia,  using Seroquel as a sedative is counterproductive since the underlying issues such as PTSD are largely ignored.

"I think the Seroquel issue is worrying because it is an indicator, probably, (of) poor quality treatment." he said.  "It is an indicator that treatment that can be administered through a minute of a prescription is replacing intensive psychological treatments that require highly trained staff and require a lot more time to administer."   While implementing trauma and stress counseling

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Learning to be Resilient

Does surviving traumatic situations make people stronger?  A recent research study investigating suicide rates following the L’Aquila earthquake that struck central Italy in 2009 actually showed a lower number of suicides in the years that followed.   Though most people are going to encounter a major traumatic experience at least once in their lives and we are all bombarded by daily “hassles” on a regular basis, how we respond to stress can vary widely.   Even in extremely negative situations involving poverty, physical and verbal abuse, and parental mental illness, there are still going to be children who somehow manage to cope and even thrive successfully.   Early research looking at protective factors that allow some people to cope better than others have identified a key quality in these cases that has been labeled psychological resilience.

While researchers have agreed on a common label, the various definitions of resilience have been very different.  A review of resilience research published recently in European Psychologist lists as many as nine different definitions given by researchers looking at resilience including:  “The process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances’’, “The personal qualities that enables one to thrive in the face of adversity’’, and “The capacity of individuals to cope successfully with significant change, adversity or risk’’.

To read more, check out my new Psychology Today blog post. 

Conspiracy Theories over Boston Marathon Bombing Popular in Chechnya

Following the two explosions on April 15, 2013, the intense manhunt for the ones believed responsible led to the arrest of 19-year old Dzhokhar Tsarnaev and the death of his older brother, Tamerlan.   As events continue to unfold and more information becomes available, conflicting news stories have generated a sense of cynicism among many observers.   While conspiracy theories continue to flourish over the Boston Marathon bombings being a "false-flag operation"  orchestrated by the Federal government,   particularly among conservative groups,  the bombings received little notice in the former Soviet Union.   That is, until the discovered that the main suspects were Chechens. 

Since the involvement of the Tsarnaev brothers became public,  their role in the Boston bombings have dominated the Russian language Internet (known as RuNet for short).   Due to the popularity of conspiracy theories among RuNet users, accusations that Dzhokhar and Tamerlan Tsarnaev were framed by the U.S. intelligence community have become especially well-received in their native Chechnya.   With members of the Tsarnaev family being particularly outspoken in demanding Dzhokhar Tsarnaev's release and calling for an investigation into his brother's death.  

Many of the most extreme conspiracy theories, including accusations that the widely-seen pictures of victims who had lost limbs following the explosion were all faked using actors.  Using pictures and materials taken directly from American conspiracy sites,  RuNet bloggers including fralik are largely repeating claims that have since been debunked in the Western media.    These include claims that one victim, Jeff Bauman Jr., who lost both his legs in the bombing was actually a previous amputee named Nick Vogt.    While other bloggers have tried to rebut these claims,  the idea that the FBI and the CIA was actually behind the bombings is definitely appealing.

Chechen bloggers are extremely outspoken in rejecting evidence that the Tsarnaev brothers are responsible for the bombings.   Along with members of the Tsarnaev family,  Chechen defenders include the Chechen President, Ramzan Kadyrov, and even his political opponents.   Even in a country as divided as Chechnya, the innocence of the Tsarnaevs seems to be one topic on which everyone agrees.    In commenting on the Boston bombings, President Kadyrov has stated that "what happened in Boston is the fault of the American security services"  while his political opponents are blaming American and Russian security agencies alike. 

Along with endless speculation about who was actually responsible for the bombings,  there is also an active defense of Dzhokhar Tsarnaev underway.    An April 21 petition on Avaaz.org titled "Dzhokhar Tsarnaev is innocent” has already gathered thousands of signatures by Russians and Chechens alike.    The petition has since been closed with no word about what the petition's author plans to do with the names received to date.  As events unfold and Dzhokhar Tsarnaev goes on trial,  the political storm will likely become even more intense.

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Race and Gender Discrimination in the Marines.

Although women of color have been hypothesized to experience double jeopardy in the form of chronic exposure to both race-based (RBD) and gender-based discrimination (GBD; Beal, 1970), few empirical investigations that examine both RBD and GBD in multiple comparison groups have been conducted. In addition to being one of the only simultaneous examinations of RBD and GBD in multiple comparison groups, the current study includes both self-report and objective behavioral data to examine the independent and interactive effects of both forms of discrimination. A study published recently in Cultural Diversity and Ethnic Minority Psychology is the first of its kind to examine these constructs in these ways and to explore their impact in a unique sample of ethnically diverse male and female Marine recruits (N = 1,516). As anticipated, both RBD and GBD had a strong and consistent negative impact on mental health symptoms (e.g., depression, anxiety), independent of the contributions of gender and race. Partial support was found for the hypothesis that people of color are able to maintain resiliency (as measured by physical fitness testing) in the face of low levels of RBD, but are less able to overcome the negative effects of discrimination at high levels. It is interesting to note that the interaction between race, gender, and levels of discrimination was only found with objective physical fitness test scores but not with self-report measures. These findings underscore the importance of including objective measures when assessing the impact of discrimination in order to understand these complex interrelationships.

For the abstract

May is Mental Health Awareness Month

While attitudes towards mental illness are slowly changing,  people experiencing mental health problems still face enormous stigma that can delay their recovery and prevent them from becoming reintegrated into their community.    To help improve the quality of life for the estimated one in four people living with mental illness, the month of May has been designated Mental Health Awareness Month in the United States.    First launched as Mental Health Awareness Week during the 1940s, it was later expanded to a full month during the 1960s.

The 2013 theme for Mental Health Month is Pathways to Wellness.  Among the key messages by Mental Health America as part of this broader theme are:

• Wellness is essential to living a full and productive life.  It's about keeping healthy as well as getting healthy.
• Wellness involves a set of skills and strategies that prevent the onset or shorten the duration of illness and promote recovery and well-being. Wellness is more than just the absence of disease.
• Wellness is more than an absence of disease. It involves complete general, mental and social well-being. And mental health is an essential component of overall health and well-being. The fact is our overall well-being is tied to the balance that exists between our emotional, physical, spiritual and mental health.
• Whatever our situation, we are all at risk of stress given the demands of daily life and the challenges it brings-at home, at work and in life. Steps that build and maintain well-being and help us all achieve wellness involve a balanced diet, regular exercise, enough sleep, a sense of self-worth, development of coping skills that promote resiliency, emotional awareness, and connections to family, friends and community.
• These steps should be complemented by taking stock of one's well-being through regular mental health checkups and screenings. Just as we check our blood pressure and get cancer screenings, it's a good idea to take periodic reading of our emotional well-being.
• Fully embracing the concept of wellness not only improves health in the mind, body and spirit, but also maximizes one's potential to lead a full and productive life. Using strategies that promote resiliency and strengthen mental health and prevent mental health and substance use conditions lead to improved general health and a healthier society: greater academic achievement by our children, a more productive economy, and families that stay together.

During the month of May, other mental health campaigns will be run across the United States with similar campaigns being run in Canada.    To participate in National Mental Health Month or to get further information,  check out the various resources available on the Mental Health America site including factsheets and the 2013 Media Toolkit.