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Is Bipolar Disorder Chronic?

Bipolar spectrum disorders have traditionally been thought to be chronic in course. However, recent epidemiological research suggests that there may be developmentally limited forms of bipolar disorder. An article published in the August 2009 issue of Journal of Abnormal Psychology presents the results of two large, nationally representative studies that challenge existing perceptions about the prevalence of bipolar disorder over time.   The results reveal a strikingly high prevalence of bipolar disorders in emerging adulthood (5.5%–6.2% among 18–24-year-olds) that appear to resolve substantially during the latter half of the 3rd decade of life (3.1%–3.4% among 25–29-year-olds). There is potential bias due to early mortality, institutionalization, incarceration, and homelessness that may account for some of this reduction, the prevalence distribution suggests a high incidence in late adolescence and emerging adulthood that appears to resolve spontaneously in most cases. There were very few differences across age groups in symptom endorsement and comorbid diagnoses, suggesting that 18–24-year-olds that meet criteria for bipolar diagnoses experience clinically significant impairment and associated consequences of the disorder. Better longitudinal research is needed to determine whether developmentally limited forms of bipolar disorder exist and, if so, what markers might distinguish these forms of the disorder from more chronic courses.

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Searching versus Surfing: Is there a difference?

People have different ways of finding information online. Whether searching for specific information or simply coming across new facts while surfing at leisure, the end result should be the same in terms of how that new information is perceived. Or is it? A recent study published in a 2009 issue of Journal of Media Psychology describes a mixed-design experiment exploring differences between searching and surfing on cognitive and emotional responses to online news. In a sample ofninety-two participants recruited from an undergraduate marketing class, the participants were asked to read three unpleasant news stories from a website. Half of the participants acquired their stories by searching, meaning they had a previous information need in mind. The other half of the participants acquired their stories by surfing, with no previous information need in mind. Heart rate, skin conductance, and EMG measures were while participants read each story. Self-report measures of article relevance and accuracy in a later recognition trial were also measured. Stories acquired by searching elicited greater heart rate acceleration, skin conductance level, and EMG activity during reading. These stories were rated as more unpleasant, and their details were recognized more accurately than similar stories that were acquired by surfing. The authors conclude the paper by discussing the implications of these results for understanding how people process new information online.

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Sexual Harassment Among Male and Female Police Officers

An article published in the October 2009 issue of the Journal of Occupational Health Psychology examines the impact of sexual harassment on mental and physical health of both men and women, and to explore the possible moderating effects of gender on the relation between sexual harassment and health. Often defined as "“unwanted sex-related behavior at work that is appraised by the recipient as offensive, exceeding her resources or threatening well-being”, sexual harassment occurs frequently in many organizations. This is especially true in police forces where research has shown that 77% of policewomen from 35 countries have reported harassment from colleagues. Not only does sexual harassment impact psychological well-being, but it has been linked to health problems relating to emotional distress. The present study used a representative sample of 3,001 policemen and 1,295 policewomen in the Dutch police force who were asked to fill out an Internet questionnaire. Based on research results, it appeared that women were more often bothered by sexual harassment than men, but gender did not moderate the relation between sexual harassment and mental and physical health. In addition, victims who felt bothered by the harassing behaviors reported more mental and physical health problems than victims who did not feel bothered. The distinction between bothered and nonbothered victims is important because appraisal is an essential aspect in evaluating the impact of sexual harassment on victims.  The authors conclude that sexual harassment policies need to address male and female victims and also addresses the need to take sexual harassment seriously, even when the victims don't seem bothered by it.

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When Families Are Homeless

The July 2009 issue of American Journal of Orthopsychiatry presents a special issue on the complex issue of parenting and homelessness.  Families are the fastest-growing segment of the homeless population and now make up more than one-third of the overall number of homeless people.  The epidemic of family homelessness has been linked to the current economic crisis, skyrocketing foreclosure rates, and failure of social service agencies to accommodate family needs.  There is a tendency to define homeless families only in terms of family members who present at shelters and other service programs with their children,  often only a single parent—most often a mother—with one or more children, 42% of whom are less than six years old.   Many of the homeless men and women who enter shelters as individuals are also parents who, for various reasons, are not currently in possession of their children.  Family composition may also change over time, as the structures of homeless family units are fluid due to the high rates of separations of family members who are homeless.   Social agencies dealing with the homeless often ignore the broader context of the nontraditional family system and support networks that homeless people need (including providing basic necessities for their children).  Homeless parents frequently face stigma and discrimination because of their homelessness status. Mothers who are homeless describe feeling that their parenting practices are being monitored closely; if not viewed as adequate, they risk losing their children to foster care.  The authors recommend continuing research into homeless families including: identifying the range of interrelationships of family and social support networks among individuals and families who are homeless,  identifying young women who are at risk for homelessness and pregnancy, and Identifying which families will succeed in independent living and which families require long-term supportive housing interventions.

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Learning to be a Parent

An article published in a recent issue of Developmental Psychology presents the results of a longitudinal study of cross-generational parenting quality.  The researchers examined parenting skills in a sample of 61 participants (26 boys and 35 girls) in a lower socioeconomic status sample of moderate ethnic diversity. All subjects were part of a long-term study involving mothers recruited from Minneapolis public health clinics between 1976 and 1977.  The current study participants are second-generation subjects permitting assessment  of parenting skills across generations. Data was collected based on direct observation assessments for both generations in the study with controls being made for critical background factors such as stress, socioeconomic status, child and parent IQ.  For both parenting samples, parenting skills were assessed over a 24-month period.   Statistical analysis showed moderate stability (r = .43) in parenting quality across generations, and findings held after controlling for all other factors. The authors suggest that early parenting experience may play a significant role in passing on parenting skills to the next generation although extensive research is needed to demonstrate it further

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Encephalon 78

A hearty welcome to the 78th edition of Encephalon, the bi-monthly showcase for the best in brain and mind blogging.  I have been a long-time fan of this carnival and it's a pleasure for me to host it this time around.  There is a full roster of fascinating posts to cover so let's get started...

First up is Ionian Enchantment with a two-part entry on the visual assessment of formidability that can be found here and here.  We learn that being able to size up an opponent quickly is a survival trait (I learned that in grade school).

Next we have Brain Blogger giving us two separate posts.  The first post is on the cognitive impairments that are often seen in patients who have undergone major surgery, especially older patients.  The second post focuses on the evolutionary history of depression.  Is it always a disease or can it have adaptive value?

Does meditation affect brain performance?  Generally Thinking reviews neuroscience research examining Buddhist meditation practices.

Brain Stimulant tells us about a radical new research program using robots to model specialized neurological processes.

Then we come to Neurocritic with two posts.  The first post is on the newest fad of genomarketing, i.e., do our genes shape our buying choices?    The post  weighs in on the pros and con.   The second post deals with some very unusual case studies in sexology and the brain. 

I weigh in with a modest contribution about a tragic case of dementia pugilistica in a professional boxer who couldn't bring himself to quit.

Then we have the intrepid Mo from Neurophilosophy who gives us two posts.  The first post recaps some fascinating research into the Cocktail Party effect and the problems dyslexic children face in making sense from noise.  The second post deals with the Phantom Limb syndrome and the bizarre form it can take in some patients.

Our final contributor is Sandeep from The Mouse Trap who gives us three posts.  His first post is an addendum to his recent series on IQ, SES and heritability. While "know thyself" is an ancient bit of advice that never goes out of date, how many different ways are there to do it?  According to this post about Ulric Neisser, at least five.  Then we come to the third post that deals with the epigenetics of autism and how it may relate to schizophrenia.

That's it for this time. We're still looking for a host for the next edition, so if you're a neuro/psychology blogger and you'd like to be the next Encephalon editor, please email encephalon dot  host at gmail dot com.

Encephalon #78 - Call for submissions

Providentia will be hosting the 78th installment of ENCEPHALON, the regular neuroscience and psychology carnival on November 16th. A tradition since February 2008, ENCEPHALON provides a selection of the best neuroscience and psychology posts of the previous two weeks.  We're looking for the best mind and brain writing from around the net.  So, fire up those neurons and see what you can share with the rest of us.

As ever, please e-mail submissions (up to 3 posts) to encephalon dot host at gmail dot com, by the end of this Sunday 15th November!

Postconcussive Symptoms and PTSD in Veterans

Veterans with a history of mild traumatic brain injury (mTBI) are reporting postconcussive symptoms in addition to experiencing postdeployment physical and emotional comorbidities. The Veterans Health Administration has mandated specialized evaluation and treatment for veterans with a history of mTBI and has suggested widespread use of the Neurobehavioral Symptom Inventory (NSI) as a measure of postconcussive symptoms. A study published in a recent issue of Rehabilitation Psychology evaluated the NSI’s factor structure and assessed the impact of posttraumatic stress (PTS) on the scale at the item and factor levels. Five hundred twenty-nine charts of returning veterans who screened positive for traumatic brain injury were reviewed, and 345 who met criteria for mTBI were included in the study. The study results were examined and the resulting factor analysis on the NSI revealed a difficult-to-interpret factor structure that was inconsistent with the results of civilian studies. PTS explained 5%–38% of the variance in individual postconcussive symptoms, and after controlling for this variance, the factor structure more closely paralleled findings from the civilian literature. The authors conclude that posttraumatic stress is an important variable to account for when evaluating PCSx in veterans. The authors also discuss research and clinical implications for the measurement and interpretation of self-reported postconcussive symptoms.

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Chronic Pain and Traumatic Brain Injury

Chronic pain conditions are common sequelae of traumatic brain injury (TBI). Unfortunately, the incidence of TBI among personnel deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) is significant, and there is growing evidence that ongoing pain, particularly headaches, will be a primary concern for these individuals. In a recent paper published in Rehabilitation Psychology, the authors examined empirical data from civilian and veteran populations and clinical experience with OEF/OIF personnel with multiple traumas to provide recommendations for the assessment and treatment of chronic pain among those with TBI. The available data signal the need for the incorporation of early and aggressive pain management strategies into existing treatment models. Challenges to providing effective pain management for OEF/OIF veterans are numerous and include comorbid cognitive, medical, and emotional impairments that complicate readjustment to civilian life. It is likely that the problem of polytrauma pain and associated comorbid conditions such as posttraumatic stress disorder and postconcussive syndrome will require the development of integrated approaches to clinical care which bridge traditional subspecialty divisions.

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Responding to Medication and Therapy in Depression

A study reported in the August 2009 issue of Journal of Consulting and Clinical Psychology examined the relative success rates for medication and cognitive therapy in depression. Previous research has shown the two treatments to be roughly equivalent in alleviating chronic depression although evidence suggests that patient factors may affect relative treatment success. A randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In the study, the authors attempted to identify the variables that were associated with response across both treatments as well as variables that predicted superior response in one treatment over the other. The sample consisted of 180 depressed outpatients: 60 of whom were randomly assigned to cognitive therapy; 120 were assigned to antidepressant medications. Treatment was provided for 16 weeks in both groups. Factors such as chronic depression, older age, and lower intelligence each predicted relatively poor response across both treatments. Three patient variables—being married, unemployment, and having experienced a greater number of recent life events—were identified, and each predicted superior response to cognitive therapy relative to antidepressant medications. Overall, six 6 markers of treatment outcome were identified, each of which might be expected to carry considerable clinical utility. The 3 prognostic variables identify subgroups that might benefit from alternative treatment strategies; the 3 client variables identify groups who appear to respond particularly well to cognitive therapy. The authors suggest that there are different mechanisms at work in both treatment modalities which can interact with client factors to affect outcome.

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