“Most teenagers have their first alcoholic drink during puberty. However, most research on the risks of early-onset alcohol use up to now has not focused on the pubertal stage during which the first alcoholic drink is consumed,” said Miriam Schneider, Ph.D., a researcher at the Central Institute of Mental Health, University of Heidelberg, and one of the authors of the new study.

She noted that a common notion in alcohol research is that the earlier adolescents began to drink, the bigger problems they faced later in life.

“However, a closer look at the statistics revealed a peak risk of alcohol use disorders for those beginning at 12 to 14 years of age, while even earlier beginners seemed to have a slightly lower risk,” she said.

On average, girls begin puberty between the ages of 10 and 11, while boys typically start between the ages 11 of 12. Puberty lasts approximately 5 to 6 years for most teens.

For the study, Schneider and her colleagues determined the age at first drink in 283 young adults — 152 females, 131 males — who were part of a larger epidemiological study.

In addition, the participants’ drinking behavior — such as number of drinking days, amount of alcohol consumed, and hazardous drinking — was assessed at ages 19, 22, and 23 years via interviews and questionnaires.

The researchers also concurrently conducted a rodent study to examine the effects of mid-puberty or adult alcohol exposure on voluntary alcohol consumption in later life by 20 male Wistar rats.

“Both studies revealed that those individuals that initiated alcohol consumption during puberty tended to drink more and also more frequently than those starting after puberty,” said Schneider.

That means that puberty is a “risk window” for having that first drink, said Rainer Spanagel, Ph.D., head of the Institute of Psychopharmacology at the University of Heidelberg.

The study’s results also show a higher Alcohol Use Disorders Identification Test (AUDIT) score later in life in those individuals who had their first drink in puberty, he said.

“A higher AUDIT score is indicative of a high likelihood of hazardous or harmful alcohol consumption,” he explained. “This information is of great relevance for intervention programs. Even more interesting, neither pre-pubertal nor post-pubertal periods seem to serve as risk-time windows. Therefore, intervention programs should be directed selectively towards young people in puberty.”

Both Schneider and Spanagel noted the influence of a high degree of brain development that occurs during puberty.

“Numerous neurodevelopmental alterations are taking place during puberty, such as maturational processes in cortical and limbic regions, which are characterized by both progressive and regressive changes, such as myelination and synaptic pruning,” said Schneider.

“Typically, an overproduction of axons and synapses can be found during early puberty, followed by rapid pruning during later puberty, indicating that connections and communication between subcortical and cortical regions are in a highly transitional state during this period.”

“Puberty is a phase in which the brain reward system undergoes major functional changes,” added Spanagel. “For example, the endocannabinoid and dopamine systems are at their peak and these major neurobiological changes are reflected on the behavioral level; reward sensitivity is highest during puberty.

“Therefore, during puberty the brain is in a highly vulnerable state for any kind of reward, and drug rewards in particular. This high vulnerability might also affect reward seeking, or in this particular case, alcohol seeking and drinking behavior later in life.”

Said Schneider, “It is exactly during puberty that substances like drugs of abuse — alcohol, cannabis, etc. — may induce the most destructive and also persistent effects on the still developing brain, which may in some cases even result in neuropsychiatric disorders, such as schizophrenia or addictive disorders.

“Prevention work therefore needs to increase awareness of specific risks and vulnerability related to puberty.”

Source: Alcoholism: Clinical & Experimental Research

Adolescent drinking alcohol photo by shutterstock.

Still, a new study suggests college kids eat healthier and exercise more on the days when they talk with a parent.

“Only a third of college students consumes a diet that is consistent with national recommendations,” said Penn State’s Meg Small, Ph.D., a research associate in the Prevention Research Center for the Promotion of Human Development.

“In addition, college students’ physical activity levels decline from the first semester to their seventh semester. Our research suggests that parents may play an important role in influencing their adolescents to establish behavioral patterns that improve their long-term health and chronic-disease risk.”

For the study, researchers recruited 746 first-year students at a large university in the U. S. to complete a baseline survey plus 14 daily surveys.

The surveys included questions about how much time students spent talking to, e-mailing or text messaging their parents. In addition, the surveys included questions about how often and for how long students worked out or played sports and how many times they ate fruits or vegetables.

Investigators found that on days when students communicated with their parents for 30 minutes or more, they were 14 percent more likely to consume fruits and vegetables and 50 percent more likely to engage in 30 minutes or more of physical activity.

The results appear in the Journal of Adolescent Health.

According to Small, the researchers did not document the content of the conversations between students and their parents; therefore, they do not know why the conversations had such positive effects on students’ behaviors.

“It is likely that communication with parents has both direct and indirect effects on college students’ eating and physical activity behaviors,” said Small.

“Parents may directly remind students to eat a variety of healthy foods and engage in physical activity. Indirectly, communication with parents may remind students someone cares about their health and well-being, and that may motivate them to take better care of themselves.”

Source: Penn State

College student with her mother photo by shutterstock.

If the mother contracts the flu, the child has a nearly four-fold increased chance of developing bipolar disorder in adulthood, say researchers.

The findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza.

“Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic,” said Alan Brown, M.D., M.P.H, of Columbia University.

“In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.”

Brown and colleagues reported their findings online in the journal JAMA Psychiatry.

Although researchers have suspected a linkage between maternal influenza and bipolar disorder, the new study is the first to prospectively follow families using physician-based diagnoses and structured standardized psychiatric measures.

The research was made possible by use of comprehensive electronic medical records by Kaiser-Permanente, in association with county and Child Health and Development Study databases.

This shared health care data repository allowed the evaluation of more cases with detailed maternal flu exposure information than in previous studies.

Among nearly a third of all children born in a northern California county during 1959-1966, researchers followed, 92 who developed bipolar disorder, comparing rates of maternal flu diagnoses during pregnancy with 722 matched controls.

The nearly fourfold increased risk implicated influenza infection at any time during pregnancy, but there was evidence suggesting slightly higher risk if the flu occurred during the second or third trimesters.

Moreover, the researchers linked flu exposure to a nearly six-fold increase in a subtype of bipolar disorder with psychotic features.

Prior research suggested a threefold increased risk for schizophrenia associated with maternal influenza during the first half of pregnancy.

Autism has similarly been linked to first trimester maternal viral infections and to possibly related increases in inflammatory molecules.

“Future research might investigate whether this same environmental risk factor might give rise to different disorders, depending on how the timing of the prenatal insult affects the developing fetal brain,” suggested Brown.

Bipolar disorder shares with schizophrenia a number of other suspected causes and illness features, the researchers note.

For example, both share onset of symptoms in early adulthood, susceptibility genes, run in the same families, affect nearly one percent of the population, show psychotic behaviors and respond to antipsychotic medications.

Source: NIH/National Institute of Mental Health

Specifically, breastfeeding may protect against the development of attention-deficit/hyperactivity disorder (ADHD) later in childhood.

ADHD is a common neurobehavioral disorders usually first diagnosed in childhood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

Although the origins of ADHD are not yet known, experts believe genetics and perinatal factors are major factors toward development of the condition.

In the research, a team of Israeli researchers compared breastfeeding history and other factors in a group of children 6-12 year of age diagnosed with ADHD to control groups of children who did not have ADHD.

The results demonstrated that overall, the children with ADHD were less likely to have been breastfed at 3 and 6 months of age than the children without ADHD.

This association between ADHD and lack of breastfeeding was statistically significant.

The study, led by Aviva Mimouni-Bloch, M.D., is reported in Breastfeeding Medicine, the Official Journal of the Academy of Breastfeeding Medicine.

“Breastfeeding has been shown to have a positive impact on child development, good health, and protection against illness. Now, another possible benefit of breastfeeding for three months and especially six months or longer has been identified,” said Ruth Lawrence, M.D., editor-in-chief of Breastfeeding Medicine and professor of pediatrics, University of Rochester School of Medicine.

“This study opens another avenue of investigation in the prevention of ADHD.”

Source: Mary Ann Liebert

“This suggests there are a lot of opportunities for prevention,” said Anne Rhodes, Ph.D., a research scientist at St. Michael’s Hospital Suicide Studies Research Unit.

“Most of these youth were seen by an outpatient physician or went to an emergency department where they could have potentially benefited from an intervention.”

Her research found that among those seen by an outpatient physician, half of young men and over 67 percent of young women were there for mental health-related reasons.

“Since not all were seen for mental health reasons, the potential benefits of screening and preventative interventions in these settings are underrated,” the researchers wrote in the study.

Rhodes and her colleagues looked at 724 young adults and teens between the ages of 10 and 25 years who had an outpatient physician visit, emergency department visit or inpatient stay in the year prior to their death. Subjects lived in Ontario, Canada.

The researchers found that young women had more outpatient physician and emergency department contact than young men, and the young women’s visits were closer to their time of death.

“We suspect that, in general, female youth are more likely than male youth to have their mental health problems detected and acted on when they present to the emergency department,” Rhodes said.

She added the emergency department may be an underused site for suicide prevention, given that high-risk groups may be more prevalent and can be more efficiently detected than in other settings.

“The role of the health care system in caring for these vulnerable youth is especially important because, given their age, many may no longer be in school and therefore, would not benefit from school-led interventions,” she noted.

The study was published in the Canadian Journal of Psychiatry.

Source: St. Michael’s Hospital

Unhappy teenager being seen by a doctor photo by shutterstock.

In the University of Notre Dame study, college-age women were presented with a series of photos of either noticeably thin or noticeably overweight women engaging in “fat talk” or positive body talk. They were then asked to rate the women on various dimensions, including how likable they were.

The women in the photos were rated significantly less likable when they made “fat talk” statements about their bodies, whether or not they were overweight, the researchers found.

The women rated most likable were the overweight women who made positive statements about their bodies.

“Though it has become a regular part of everyday conversation, ‘fat talk’ is far from innocuous,” said Dr. Alexandra Corning, research associate professor of psychology and director of Notre Dame’s Body Image and Eating Disorder Lab.

“It is strongly associated with, and can even cause, body dissatisfaction, which is a known risk factor for the development of eating disorders.”

While some psychologists believe fat talk is one way women attempt to initiate or strengthen social bonds, the new research finds that fat-talkers are liked less than women who make positive statements about their bodies.

“These findings are important because they raise awareness about how women actually are being perceived when they engage in this self-abasing kind of talk,” she said.

“This knowledge can be used to help national efforts to reduce ‘fat talking’ on college campuses.”

Source: University of Notre Dame 

Two women having a conversation photo by shutterstock.

For the study, researchers at the University of Toronto examined the association between parental addictions and adult depression in a sample of 6,268 adults, taken from the 2005 Canadian Community Health Survey.

Among the subjects, 312 had a major depressive episode within the year preceding the survey and 877 reported that while they were under the age of 18 and still living at home that at least one parent drank or used drugs “so often that it caused problems for the family.”

Parental addictions were associated with more than twice the odds of adult depression, said lead author Esme Fuller-Thomson, Ph.D., of the University of Toronto.

“Even after adjusting for factors ranging from childhood maltreatment and parental unemployment to adult health behaviors including smoking and alcohol consumption, we found that parental addictions were associated with 69 per cent higher odds of depression in adulthood,” she said.

“These findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development,” said Fuller-Thomson.

“As an important first step, children who experience toxic stress at home can be greatly helped by the stable involvement of caring adults, including grandparents, teachers, coaches, neighbors and social workers.

“Although more research is needed to determine if access to a responsive and loving adult decreases the likelihood of adult depression among children exposed to parental addictions, we do know that these caring relationships promote healthy development and buffer stress.”

The study was unable to determine the exact cause of the relationship between parental addictions and adult depression.

According to co-author and graduate student Robyn Katz, ”It is possible that the prolonged and inescapable strain of parental addictions may permanently alter the way these children’s bodies reacts to stress throughout their life.

“One important avenue for future research is to investigate potential dysfunctions in cortisol production – the hormone that prepares us for ‘fight or flight’ –which may influence the later development of depression.”

Source:  University of Toronto

This heightened sensory perception may help explain why some people with autism are painfully sensitive to noise and bright lights.

It also may be connected to some of the complex social and behavioral deficits found in the disorder, said Duje Tadin, Ph.D., one of the lead authors on the study and an assistant professor of brain and cognitive sciences at the University of Rochester.

“We think of autism as a social disorder because children with this condition often struggle with social interactions, but what we sometimes neglect is that almost everything we know about the world comes from our senses. Abnormalities in how a person sees or hears can have a profound effect on social communication,” said Tadin.

Prior research has shown that people with autism have enhanced visual abilities with static images, but this is the first study to uncover a sharper awareness of motion, said the authors.

The study involved 20 children with autism and 26 typically developing children, ages 8 to 17.  They were asked to look at brief video clips of moving black and white bars and to indicate which direction the bars were heading, right or left.

Each time a participant made a correct guess, the next video clip became slightly shorter and a little more difficult. If the subjects made a mistake, the next video became slightly longer and therefore easier to see. In this way, the researchers were able to determine how quickly children with autism can perceive motion.

The findings showed that when the bars in the image were just barely visible, both groups of children performed identically.

Similarly, when the contrast or darkness of the bars was increased, all participants in the study got better at perceiving the direction of movement.

“But kids with autism, got much, much better — performing twice as well as their peers,” said Jennifer Foss-Feig, Ph.D., a postdoctoral fellow at the Child Study Center at Yale University, and colleagues at Vanderbilt University.

In fact, the worst performing participant with autism was about equal to the average of the participants without autism.

“This dramatically enhanced ability to perceive motion is a hint that the brains of individuals with autism keep responding more and more as intensity increases. Although this could be considered advantageous, in most circumstances if the neural response doesn’t stop at the right level it could lead to sensory overload,” said Foss-Feig.

The authors noted that such hypersensitive perception is the neural signature for a brain that is unable to dampen its response to sensory information. This same increase in neural “excitability” is also found in epilepsy, which is strongly linked to autism.

In fact, up to one-third of individuals with autism also have epilepsy. Normally, the brain has the ability to slow down its responses to sound, taste, touch, and other stimuli when they become too intense.

“If the processing of our vision, hearing, and other sensory systems is abnormal in some way, it will have a cascading effect on other brain functions,” said Carissa Cascio, Ph.D., assistant professor of psychiatry at Vanderbilt University, in whose lab the study was conducted.

“You may be able to see better, but at some point the brain really is over-responding. A strong response to high intensity stimuli in autism could be one reason for withdrawal.”

Source: University of Rochester

Young autistic boy photo by shutterstock.

“This finding surprised us,” said principal investigator Alexandra Wang, a third-year medical student at the university. “It shows we need to start earlier with prevention of drug and alcohol use and treatment of social phobia [in children].”

The study involved 195 teens (102 girls, 52 percent), aged 14 to 18 years, who met the current diagnosis of substance use disorder and had received medical detoxification if needed.

Researchers assessed the teens’ history of drug and alcohol use and looked into whether they’d had any of three anxiety disorders: social anxiety disorder, panic disorder, and agoraphobia.

Marijuana was the most popular drug of choice.  Of the 195 participants, 92 percent had marijuana dependence, starting at a mean age of 13 years; 61 percent were alcohol-dependent, having started drinking at 13.5 years on average.

Teens with either social anxiety disorder or panic disorder were far more likely to have marijuana dependence, Wang said. Both of these disorders were more likely to occur before marijuana dependence.

Approximately 80 percent of teens with social anxiety disorder and 85 percent with panic disorder had symptoms of that disorder before the onset of their substance abuse.  Furthermore, panic disorder tended to start before alcohol dependence and occurred in 75 percent of alcohol-dependent adolescents.

There was no clear evidence showing whether agoraphobia came before or after either marijuana use or the first drink, according to the authors.

A limitation of the study, according to the research team, was that 128 (66 percent) of the teens were juvenile offenders who had received court-referred treatment for their substance abuse. These findings might not generalize to a less severely addicted population.

Still, interventions to reduce social anxiety might help prevent substance abuse in teens.

“We need to treat these young patients initially with nonpharmacologic means, such as cognitive behavioral therapy or mindfulness meditation,” said Christina Delos Reyes, M.D., a psychiatrist specializing in addictions at University Hospitals Case Medical Center.

Patrick Bordeaux, M.D., a child and adolescent psychiatrist in Quebec, Canada, said that “comorbidities tend to be the rule in adolescents, not the exception.”

“Adolescents are more likely to have social and mental disorders that make them more likely to use drugs,” said Bordeaux, who was not involved with the study.

Source:  Case Western Reserve University School of Medicine

Teenager smoking marijuana photo by shutterstock.

“This higher risk held if they were hospitalized for an infection at any given age before the onset of schizophrenia,” said lead investigator Philip R. Nielsen, a Ph.D. candidate at the National Centre for Register-based Research, Aarhus University, Denmark.

The findings also showed an increased risk for schizophrenia if the child’s father had been hospitalized for infection.

“These are serious infections requiring hospitalization, so it is only the more severe cases of infections that are implicated here, and the fact that we found raised risk if the father had a history of being hospitalized for infection indicates that there may be some familial susceptibility to infection and subsequent schizophrenia risk,” Nielsen said.

“We know that we are dealing with a multifactorial etiology in the case of schizophrenia, so infection is probably not a single causal factor. The association between childhood infection and schizophrenia may be due to inflammatory responses affecting the brain, or genetic and environmental risk factors in certain families,” Nielsen said.

The research was presented at the 14th International Congress on Schizophrenia Research (ICOSR).

Although several studies have reported links between maternal infections during pregnancy and schizophrenia, few studies have investigated infections in children, and their results have been inconclusive, Nielsen said.

In the new study, researchers pulled data from two population-based registers — the Danish Psychiatric Central Register and the Danish National Hospital Register — and selected all individuals born in Denmark between 1981 and 2000, which totaled 843,390 individuals.

They then identified 3,409 individuals who had entered a hospital for the first time with schizophrenia between the years 1991 and 2010. Of these, 1549 were exposed to an infection during their childhood that required hospitalization.

Those who were hospitalized for infection during childhood were almost 50 percent more likely to develop schizophrenia than individuals who were not.  Bacterial infection was associated with the highest risk. Viral infections increased the risk by 40 percent.

“There are several schools of thought in terms of the infection-based hypothesis of the link between infection and schizophrenia,” said Emily G. Severance, Ph.D., a schizophrenia expert at Johns Hopkins University School of Medicine in Baltimore, Md., who was not involved in the study.

“Perhaps it is something that occurs prenatally that affects the development of the neurons in the developing brain, or perhaps it happens postnatally, as in this study, when the brain is still developing. Infection could also disrupt synaptic connections,” Severance said. “There are a number of different risk factors associated with the immune system and schizophrenia.”

Source:  International Congress on Schizophrenia Research

Young boy in the hospital photo by shutterstock.

“High versus low experience of violent gaming seems to be related to different physiological, emotional and sleep related processes [after] exposure to violent video games,” according to a new study by Malena Ivarsson, Ph.D., and her colleagues at the Stress Research Institute at Stockholm University.

The study included two groups of boys, between the ages of 13 and 15. Fifteen boys played violent video games at least three hours a day. The other 15 played no more than an hour a day.

The researchers monitored the boys’ reactions to playing two different video games: a violent game (“Manhunt”) and a nonviolent cartoon game (“Animaniacs”). The boys played the games at home, on two different evenings, for two hours each.

The researchers then monitored the boys’ physiological, emotional, and sleep reactions.

Although there were few differences in reactions while playing the games, some significant differences appeared later, the researchers report.

For instance, while sleeping later that night, boys in the low-exposure group had faster heart rates after playing the violent game, compared to the night after playing the nonviolent game.

In contrast, for boys in the high-exposure group, heart rate was lower on the night after playing the violent game.

There were also some differences in heart rate variability (HRV), which measures beat-to-beat variations in heart rate. The patterns of HRV differences suggested blunting of sympathetic nervous system reactions among boys in the high-exposure group, the researchers report.

On sleep questionnaires, boys who played less reported lower sleep quality on the night after playing the violent game, compared to the nonviolent game. They also reported increased feelings of sadness.

For high-exposed boys, there was no difference in sleep quality after playing the two games, according to the researchers.

However, both groups had higher anxiety and stress levels after playing the violent game.

“The violent game seems to have elicited more stress at bedtime in both groups and it also seems as if the violent game in general caused some kind of exhaustion,” the researchers write in the study.

“However, the exhaustion didn’t seem to be of the kind that normally promotes good sleep, but rather as a stressful factor that can impair sleep quality, especially for low exposed gamers.”

The differences between the boys may represent a desensitizing effect of frequent exposure to violent video games, the researchers speculate. They add it’s also possible that boys with certain traits may be attracted to violent games. The researchers noted they had difficulty recruiting boys with high exposure to violent gaming to participate in the study.

The study was published in Psychosomatic Medicine: Journal of Biobehavioral Medicine.

Source: Wolters Kluwer Health

For example, some doctors started preschoolers on medication too soon before trying any non-drug treatment, such as counseling parents on how to deal with their child’s behavior.

The results are concerning because doctors should recommend behavioral treatments first, the researchers said.

“At a time when there are public and professional concerns about overmedication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children,” said study researcher Dr. Jaeah Chung, of Cohen Children’s Medical Center in New York.

For the study, researchers surveyed 560 doctors who specialize in diagnosing and managing children ages 4 to 6 with ADHD.

The findings revealed that only 8 percent of doctors followed all guidelines from the American Academy of Pediatrics.

The rest prescribed medications too soon, prescribed medications without first checking to see if behaviora; therapy was working, or did not use the drug methylphenidate as the first drug treatment.

One in five doctors said they often prescribe medications to preschoolers with ADHD as their first line of treatment. The AAP said in 2011 that doctors should attempt to treat ADHD in preschoolers with behavioral therapies before prescribing medications.

Furthermore, about 40 percent of doctors said that when they did prescribe drugs, they initially used a medication other than the ADHD drug methylphenidate (Ritalin).

According to the AAP, methylphenidate should be used first in preschoolers because it has been more rigorously studied in young children than other medications such as amphetamines.

Approximately 20 percent of doctors said they expected the number of children they treated with medications would increase in the future.

Study researcher Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s, noted that the AAP guidelines are written for general pediatricians, and it’s possible that specialists see children with more severe ADHD (who are more likely to need medications).

However, “Doctors collectively should recommend their patients pursue behavior therapies first,” Adesman said.

Adesman noted that there may be obstacles to behavioral therapy: The treatment is not always covered by insurance, and families may live in an area without a behavior therapy specialist.  In this case, the AAP recommends that doctors weigh the risks of starting drugs at an early age against the risks of delaying treatment.

Source: North Shore-Long Island Jewish (LIJ) Health System

Doctor holding out pills in his hand photo by shutterstock.

What’s more, 15 percent of those kids can access both guns and bullets.

Suicide is the second leading cause of death among young people between the ages of 10 to 24 years in the United States, according to data from the Centers for Disease Control and Prevention. Nearly half who die by suicide use a firearm, according to researchers.

As part of a study to create a suicide risk screening tool that can be used in the emergency departments of hospitals, researchers asked kids about access to guns in or around their home and about gun and bullet storage.

“For more than 1.5 million adolescents, the emergency department is their primary point of contact with the health care system, which makes the ED an important place for identifying youth at risk for suicide,” said Stephen J. Teach, M.D., M.P.H., F.A.A.P., associate chief in the Division of Emergency Medicine at Children’s National Medical Center in Washington, D.C., and co-author of the study.

Because many health professionals and parents don’t know how to ask kids about suicide, they need screening tools to assist in detection, added study senior author Lisa M. Horowitz, Ph.D., M.P.H., staff scientist and a pediatric psychologist at the National Institute of Mental Health.

“According to our data, when asked their opinion, nearly all of the kids in our study were in favor of suicide screening in the emergency department,” she said.

“Our study shows that if you ask kids directly about suicide, they will tell you what they are thinking.”

Study participants included 524 patients between the ages of 10 and 21 who were seen for medical, surgical or psychiatric complaints at one of three pediatric emergency departments. They were asked to fill out a 17-item questionnaire that the researchers used to develop the Ask Suicide-Screening Questions (ASQ), a four-question screening tool that can be used for all pediatric patients visiting the ED. The ASQ has been validated against a longer more in-depth suicide assessment tool, researchers noted.

Of the patients who completed the screening tools, 151 — 29 percent — were found to be at risk for suicide, according to the researchers. The study also found that 17 percent of them reported guns in or around the home.

Of those at risk for suicide and reporting guns in the home, 31 percent knew how to access the guns, 31 percent knew how to access the bullets, and 15 percent knew how to access both the guns and the bullets, according to the study’s findings.

“This study highlights the importance of parents understanding the risks of having guns in their homes,” said co-author and youth suicide expert Jeffrey A. Bridge, Ph.D., principal investigator at The Research Institute at Nationwide Children’s Hospital.

“Being at risk for suicide and having access to firearms is a volatile mix. These conversations need to take place in the ED with families of children at risk for suicide.”

Bridge also noted that up to 40 percent of kids who kill themselves have no known mental illness. “Therefore, it is important to screen all children and adolescents for suicide, regardless of the reason they are visiting the ED,” he added.

The study was presented at the annual meeting of the Pediatric Academic Societies.

Source: American Academy of Pediatrics

For the new study, researchers at Columbia University analyzed results of a 2008 survey completed by 1,312 students at four inner-city high schools in New York to determine if there was an association between regular exercise and violence-related behaviors.

“Violence in neighborhoods spans the entire length of this country and disproportionately affects the poor and racial and ethnic minorities. It results in significant losses to victims, perpetrators, families and communities and costs our country billions of dollars,” said lead author Noe D. Romo, M.D., primary care research fellow in community health in the Department of Child and Adolescent Health at Columbia University.

“There is a need for innovative methods to identify potential interventions to address this issue and lessen the burden it is having on our society.”

The survey included questions on how often students exercised, how many sit-ups they did and the time of their longest run in the past four weeks, as well as whether they played on an organized sports team in the past year.

Students also were asked if they had carried a weapon in the past 30 days or if they were in a fight or in a gang in the past year.

Nearly three-quarters of the respondents were Latino, and 19 percent were black, the researchers report. Fifty-six percent were female.

The study showed that females who reported exercising regularly had decreased odds of being involved in violence-related behaviors. For example, girls who exercised more than 10 days in the last month had decreased odds of being in a gang.

Those who did more than 20 sit-ups in the past four weeks had decreased odds of carrying a weapon or being in a gang.

The girls who reported running more than 20 minutes the last time they ran had decreased odds of carrying a weapon.

Those who participated in team sports in the past year had decreased odds of carrying a weapon, being in a fight or being in a gang.

For the boys, none of the measures of exercise was associated with a decrease in violence-related behaviors, according to Romo, who postulates that could be because a larger proportion of males than females did not answer all of the survey questions.

“This study is only a start,” concluded Romo. “It suggests a potential relationship between regular exercise and decreased involvement in violent behavior.

“Further studies are needed to confirm this association and to evaluate whether exercise interventions in inner-city neighborhoods can decrease youths’ involvement in violence-related behavior.”

The study was presented at the Pediatric Academic Societies annual meeting in Washington, D.C.

Source: American Academy of Pediatrics

A dysfunctional childhood is linked to several conditions associated with premature death, including smoking, substance abuse, obesity, cardiovascular disease, depression, and attempted suicide.

According to the researchers, early childhood adversity changes stress responsivity, potentially leading to these negative outcomes.

“The good news is that, if detected early enough, the impact of family adversity on child health outcomes can be reversed, or at least attenuated. For example, if maternal depression is treated to remission, the patients’ children show symptomatic and functional gains,” said David A. Brent, M.D., of the University of Pittsburgh School of Medicine and co-author Michael Silverstein, M.D., M.P.H., of the Boston University School of Medicine..

“Economic interventions that provide local employment and move parents out of poverty have been shown to be temporally related to a decreased risk for behavioral disorders in the children of the assisted families.

Earlier foster placement can, to some extent, reverse the deleterious neurobiological and cognitive effects of extreme deprivation in infancy,” they said.

The authors add that physicians should be taught about the effects of adversity, how to detect it, and what steps to take once identified.

Screening, referral, and monitoring may prevent or ease the destructive multigenerational effects of dysfunctional parenting that occur as a consequence of an untreated psychiatric disorder.

Physicians must be advocates for social policies that can help families achieve what all parents want — a secure environment for their children to develop into competent adults, said the authors.

“Home visitation programs for at-risk families of infants have been shown to have long-term positive effects on physical and mental health, education, employment, and family stability. Access to quality preschool education can help to buffer the deleterious effects of poverty,” they said.

“The economic cost — in excess health care utilization, nonresponse to treatment, incarceration, loss of employment, decrease in productivity, and disability — weighs heavily on families burdened with adversity but ultimately is borne by society as a whole.

“In the drive to improve quality of health care and contain costs, the huge price tag to society of early adversity cannot be neglected,” said the authors.

Source:  JAMA