For the study, researchers at Yale University used functional magnetic resonance imaging (fMRI), to display the activity of the orbitofrontal cortex, a brain region just above the eyes, to people while they lay in a brain scanner.

Through a process of trial and error, these people were able to learn to control their brain activity, the researchers report.

This neurofeedback led to changes in brain connectivity and to increased control over anxiety.

What’s more, these changes were still present several days after the training, the researchers said.

“Poorly controlled anxiety reduces the quality of life of many healthy individuals and is a key symptom of numerous neuropsychiatric conditions,” the researchers said in the study, which was published in the journal Translational Psychiatry.

“Pharmacological and behavioral interventions are widely used in the treatment of anxiety, but for many individuals these are of little efficacy or are associated with troublesome side effects.”

Hyperactivity in the orbitofrontal cortex is common for people with poorly controlled anxiety or other conditions, such as obsessive-compulsive disorder (OCD), according to the researchers.

fMRI-driven neurofeedback has been used before for other conditions, but it has never been applied to the treatment of anxiety, the researchers add.

The findings raise the possibility that real-time fMRI feedback may provide an effective form of treatment for anxiety and OCD.

The study was conducted by Michelle Hampson, Ph.D., assistant professor of diagnostic radiology, and Dustin Scheinost, a graduate student.

Source: Yale University

On the other hand, adding cognitive behavioral therapy (CBT) — particularly one with exposure and ritual prevention — was significantly more effective than either placebo or risperidone.

“The big message is not that antipsychotic augmentation of SRIs never works, but that it only works in a small subset.

“So if you as a clinician try it and you don’t see effects in four to six weeks, you should take your patient off of it so they don’t wind up on an antipsychotic for no reason while having all the bad side effects,” said lead author H. Blair Simpson, M.D., Ph.D., professor of clinical psychiatry at Columbia University and director of the Anxiety Disorders Clinic at the New York State Psychiatric Institute.

“It’s important for clinicians to know that not only should they go to CBT therapy before antipsychotic use, they should go to exposure and ritual prevention therapy and not something like stress management, which is very different and would not be as effective,” she added.

According to the researchers, few patients with OCD achieve remission with an SRI alone, and doctors are often faced with the challenge of what to do next. Since CBT requires time, access, and a commitment from patients, many clinicians find it easier to simply add another drug – usually an antipsychotic.

For the study, researchers randomly assigned 100 patients who had received 12 weeks of SRIs but who were still at least moderately ill to receive either eight weeks of risperidone, exposure and ritual prevention, or pill placebo, while still taking the SRI.

Exposure and ritual prevention involves confronting thoughts or situations that trigger anxiety (exposure) and then choosing not to respond compulsively after coming in contact with the fearful situation.

At week eight, the patients receiving the exposure and ritual prevention CBT had a significantly greater reduction of symptoms, compared with patients receiving risperidone and those receiving placebo.

As many as 80 percent of patients receiving CBT had a symptom decrease of 25 percent or more, compared with 23 percent of patients receiving risperidone and 15 percent receiving placebo.

Furthermore, 43 percent in the CBT group achieved remission, compared with only 13 percent in the risperidone group and 5 percent in the placebo group.

Interestingly, patients receiving risperidone showed no greater improvement than those receiving placebo.

“Based on previous smaller studies, we expected risperidone to be effective in about a third of patients, but this was a surprise — our sample showed it didn’t differ from pill placebo.”

Although this study involves the largest sample of patients receiving risperidone in comparison with CBT, Simpson cautioned that previous research should also be considered in drawing the correct conclusions.

“I think the careful message is that in our sample, it [risperidone] didn’t work, but in prior, smaller studies, it worked for some,” she said.

In one of Simpson’s prior studies, OCD patients on SRIs who also received CBT and improved after eight weeks were likely to maintain those gains at six months. With that in mind, the team is working on a six-month followup of the current study.

“My prediction is patients who continue to be their own therapists during the follow-up period and follow the instruction that their therapist taught them will be the ones to maintain their gains, but we don’t know that yet. It’s still a hypothesis,” she said.

The findings were presented at the Anxiety and Depression Association of America (ADAA) 33rd Annual Conference.

Source: Columbia University

Image by Shutterstock

A team of researchers from Krembil Neuroscience Centre at Toronto Western Hospital and the University Health Network in Toronto investigated the use of DBS in six patients afflicted with the chronic illness.

The patients, who had an average age of 38, had dealt with the illness for years. In addition to anorexia, all of the patients, except one, also suffered from psychiatric conditions such as depression and obsessive-compulsive disorder.

All of the patients also had suffered various medical complications related to their anorexia. The researchers report that, between them, the six patients had about 50 hospitalizations during their illnesses.

During the phase one safety trial, the patients were treated with DBS, a neurosurgical procedure that moderates the activity of dysfunctional brain circuits. Neuroimaging has shown that there are structural and functional differences in brain circuits that regulate mood, anxiety, and body perception in anorexia patients compared to healthy subjects, according to the researchers.

Patients were awake when they underwent the procedure, which implanted electrodes into a specific part of the brain involved with emotion. During the procedure, each electrode was stimulated to look for changes in mood, anxiety or adverse effects, the researchers noted.

Once implanted, the electrodes were connected to a pulse generator implanted below the right clavicle, much like a heart pacemaker.

Testing was repeated at one, three, and six-month intervals after activation of the pulse generator device. After nine months, three of the six patients had gained weight, with a body-mass index (BMI) significantly greater than they had ever experienced. For these patients, this was the longest period of sustained weight gain since the onset of their illness, the researchers reported.

Four of the six patients also experienced changes in mood, anxiety, urges to binge and purge, and other symptoms related to anorexia, such as obsessions and compulsions. As a result of these changes, two of the patients completed an inpatient eating disorders program for the first time in the course of their illness, according to the researchers.

“We are truly ushering in a new of era of understanding of the brain and the role it can play in certain neurological disorders,” said Dr. Andres Lozano, a neurosurgeon at the Krembil Neuroscience Centre and chairman of neurosurgery at the University of Toronto. “By pinpointing and correcting the precise circuits in the brain associated with the symptoms of some of these conditions, we are finding additional options to treat these illnesses.”

The treatment, still considered experimental, is believed to work by stimulating a specific area of the brain to reverse abnormalities linked to mood, anxiety, emotional control, obsessions and compulsions, the researchers explained.

The research may provide an additional therapy option in the future, as well as further the understanding of anorexia and the factors that cause it to be persistent, the scientists claim.

“There is an urgent need for additional therapies to help those suffering from severe anorexia,” said Dr. Blake Woodside, medical director of Canada’s largest eating disorders program at Toronto General Hospital and a professor of psychiatry at the University of Toronto. “Eating disorders have the highest death rate of any mental illness and more and more women are dying from anorexia. Any treatment that could potentially change the natural course of this illness is not just offering hope, but saving the lives of those that suffer from the extreme form of this condition.”

The study was published in the medical journal The Lancet.

Source: University Health Network

Abstract of brain photo by shutterstock.

The study from researchers at Northwestern Medicine found that 11 percent of postpartum women experience significant obsessive-compulsive symptoms compared to just 2 to 3 percent in the general population.

The symptoms, which include fear of hurting the baby and worrying about germs, are usually temporary, according to the researchers.

Researchers speculate the obsessiveness could result from hormonal changes or manifest as an adaptive response to caring for a new baby.

But if the obsessive compulsions interfere with a new mother’s functioning, they may indicate a psychological disorder, the researchers warn.

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” said study senior author Dana Gossett, M.D., chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”

The researchers noted that their own obsessive and upsetting thoughts after giving birth led them to investigate if the experience was universal.

For postpartum women with obsessive-compulsive symptoms who otherwise are functioning normally, “it would be reassuring to hear that their thoughts and behaviors are very common and should pass,” Gossett said.

Obsessions are unwanted and repeated thoughts or images that create anxiety, the researchers explain. A compulsion is a response to those obsessive thoughts, described as “a ritualistic behavior that temporary allays the anxiety but can’t rationally prevent the obsession from occurring,” said Emily Miller, M.D., lead study author and a clinical fellow in maternal fetal medicine at Feinberg.

The women in the study reported that their most prevalent thoughts were about dirt or germs, followed by compulsions to check that they did not “make a mistake,” Miller said.

For example, new mothers may check and recheck baby monitors are working, the baby’s crib side is properly latched or bottles are properly sterilized.

Some women reported intrusive thoughts that they would harm the baby, according to the researchers.

“That can be emotionally painful,” Miller said. “You don’t intend to harm the baby, but you’re fearful that you will.”

Gossett recalled that after she gave birth to her first child, she routinely worried about falling down the stairs with her baby or that the baby would fall out of bed.

“It comes into your mind unbidden and it’s frightening,” she said.

The women in the study were recruited while hospitalized after delivering their babies at Northwestern Memorial Hospital. They completed screening tests for anxiety, depression and OCD two weeks and six months after going home. According to the researchers, 461 women completed the surveys at two weeks and 329 completed them at six months. Symptoms were self-reported and the women did not receive a clinical diagnosis by a psychologist, the researchers note.

About 50 percent of the women reported an improvement in their symptoms by six months, according to the researchers. However, some women who had not experienced symptoms at two weeks developed symptoms at the six-month mark, the researchers reported.

“If those symptoms are developing much later after delivery, they are less likely to be hormonal or adaptive,” Gossett said. The risk for psychological disorders persists for up to a year after delivery, she added.

About 70 percent of the women who screened positive for obsessive-compulsive symptoms also screened positive for depression. That overlap and the subset of obsessions and compulsions could indicate postpartum OCD represents a distinct postpartum mental illness that is not well classified, according to Miller.

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” she said.

“Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

The study will be published The Journal of Reproductive Medicine.

Source: Northwestern University

Research suggests that anxiety and stress drive the majority of compulsions in OCD, and individuals with the disorder participate in ritualistic behaviors in an effort to alleviate the angst of obsessive thoughts, visions, or emotions.

Anger, shame, and magical thinking can also trigger stressful emotions that drive compulsive behaviors.

Researchers at Hong Kong Shue Yan University recently conducted a study that explored how dream experiences affected waking behaviors and symptoms in a sample of 594 individuals with OCD.

“The overall findings substantiate the notion that individuals with high obsessive-compulsive distress tend to dream certain themes more frequently,” said Calvin Kai-Ching Yu, Ph.D., of the Department of Counseling and Psychology.

In fact, the researchers found that individuals who experienced dreams with strong emotional messages — those that were charged with feelings of guilt, shame, and anger — had increased waking compulsive behavior.

Furthermore, magical thinking — thinking that one had super powers or could control other people or things — also elevated OCD symptoms.

Yu believes that dreams filled with malevolent content can prompt individuals to try to purify themselves during waking hours. Those who feel especially guilty, angry, or shameful may become obsessed with finding ways to remove their negative feelings while they are awake.

The conscious level of anxiety experienced during the day, caused by obsessive magical thoughts and negative dreams, can lead to more compulsions.

Yu theorizes that most of these obsessions are first developed in childhood, when imagination is strongest. As people with OCD get older, they are unable to distinguish between magical thinking and reality.

Feelings of paranoia and other heightened states of anxiety resulting from magical thoughts and intense dreams consume these individuals during their waking hours, making the sole mission of their lives to achieve a state of harmony, absent of anxiety, guilt, anger, or fear.

Yu would like these findings to draw more attention to the way that dreams — especially those of anger — affect anxiety in individuals with OCD.

Source:  Hong Kong Shue Yan University

While previous research into the link between domestic violence and mental health problems focused on depression, this new study from UK researchers at King’s College London’s Institute of Psychiatry and the University of Bristol looked at a wide range of mental health problems in both men and women.

The researchers reviewed data from 41 studies around the world. Compared to women without mental health problems, women with depression were around 2.5 times more likely to have experienced domestic violence over their adult lifetime (prevalence estimate 45.8 percent).

Women with anxiety disorders were over 3.5 times more likely to have experienced domestic violence (prevalence estimate 27.6 percent), and women with post-traumatic stress disorder (PTSD) were around 7 times more likely (prevalence estimate 61 percent).

Women with other disorders, including obsessive compulsive disorder (OCD), eating disorders, schizophrenia and bipolar disorder, were also at an increased risk of domestic violence compared to women without mental health problems, according to the researchers.

Men with all types of mental disorders were also at an increased risk of domestic violence. However, prevalence estimates for men were lower than those for women, indicating that it is less common for men to be victims of repeated severe domestic violence, the researchers noted.

“In this study, we found that both men and women with mental health problems are at an increased risk of domestic violence,” said King’s Institute of Psychiatry Professor Louise Howard, Ph.D., senior author of the study.

“The evidence suggests that there are two things happening: Domestic violence can often lead to victims developing mental health problems, and people with mental health problems are more likely to experience domestic violence.”

“We hope this review will draw attention to the mental health needs of survivors of domestic violence and remind general practitioners and mental health teams that experience of domestic violence may lie behind the presentation of mental health problems,” added University of Bristol Professor Gene Feder, M.D., who is also the chief investigator of PROVIDE, a five-year research program on domestic violence.

Internationally, the lifetime prevalence of physical and/or sexual partner violence among women ranges from 15-71 percent.

In the UK, the 2010/11 British Crime Survey reported that 27 percent of women and 17 percent of men had experienced partner abuse during their lifetime, with women experiencing more repeated and severe violence than men.

“Mental health professionals need to be aware of the link between domestic violence and mental health problems, and ensure that their patients are safe from domestic violence and are treated for the mental health impact of such abuse,” Howard concluded.

Funded by the National Institute for Health Research, the study was published in PLoS ONE.

Source: King’s College London

Using brain scans of human volunteers, researchers at the Princeton Neuroscience Institute (PNI) found that updating goals takes place in the prefrontal cortex, and appears to involve signals associated with the brain chemical dopamine. When the researchers used a magnetic pulse to interrupt activity in that region of the brain, the volunteers were unable to switch to a new task when playing a game requiring them to push a button after seeing letters pop up on a screen.

“We have found a fundamental mechanism that contributes to the brain’s ability to concentrate on one task and then flexibly switch to another task,” said Jonathan Cohen, Ph.D., co-director of PNI. “Impairments in this system are central to many critical disorders of cognitive function, such as those observed in schizophrenia and obsessive-compulsive disorder.”

Cohen explained that existing research has shown that when new information is used to update a task, behavior or goal, this information is held in a type of short-term memory storage known as working memory. Researchers, however, did not know what mechanisms were involved in updating this information.

To find out, Cohen’s research team used functional magnetic resonance imaging (fMRI) to scan the brains of volunteers playing a game in which they pressed a specific button depending on a particular visual cue.

If the volunteer saw the letter A prior to seeing the letter X, he or she had to press button 1. But if the volunteer saw the letter B prior to seeing the X, the participant had to press button 2. The A and B served as the new information that the person used to update their goal of deciding which button to press. Another version of the task required the same participants to press button 1 upon seeing an X regardless of whether an A or B was shown.

With the fMRI, the researchers detected activity in the right prefrontal cortex during tasks that required the participants to remember whether they saw an A or a B before pressing the correct button, but not during tasks where the participant only had to press the button when prompted by an X.

These results confirmed findings from a previous study led by Cohen that used another scanning method to gauge the timing of brain activity. Using electroencephalography (EEG), the researchers found that the prefrontal cortex showed a spike in brain electrical activity 150 milliseconds after the participant viewed the letter A or B.

For the new study, the researchers demonstrated that the prefrontal cortex is indeed the area of the brain involved with updating working memory by sending a short magnetic pulse to the region. This pulse disrupted cortex activity at the precise time — as revealed by the EEG — the researchers suspected that the prefrontal cortex was updating working memory.

When the researchers introduced the pulse to the right side of prefrontal cortex about 150 milliseconds after the volunteers saw the A or B, the participants were unable to press the correct buttons, Cohen said.

“We predicted that if the pulse was delivered to the part of the right prefrontal cortex observed using fMRI, and at the time when the brain is updating its information as revealed by EEG, then the subject would not retain the information about A and B, interfering with his or her performance on the button-pushing task,” Cohen said.

Finally, the researchers explored their theory that dopamine — a naturally occurring chemical involved in motivation and reward — tags new information entering the prefrontal cortex as important for updating working memory and goals.

Cohen and his team imaged a brain region called the midbrain, which contains clusters of nerve cells called dopaminergic nuclei that are the source of most of the dopamine signals in the brain.

Using high-resolution fMRI, the researchers probed the activity of these dopamine-releasing cells in the brains of volunteers engaged in the game. The researchers found that the activity in these areas correlated with the activity in the right prefrontal cortex and with the ability of the volunteers to press the correct buttons.

“The remarkable part was that the dopamine signals correlated both with the behavior of our volunteers and their brain activity in the prefrontal cortex,” Cohen said. “This constellation of findings provides strong evidence that the dopaminergic nuclei are enabling the prefrontal cortex to hold on to information that is relevant for updating behavior, but not information that isn’t.”

The study was published by the Proceedings of the National Academy of Sciences.

Source: Princeton University

Improper treatment can exacerbate symptoms and can lead to harmful and dangerous outcomes.

Two relatively common disorders, obsessive compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD), fit this pattern as they often include symptoms of impaired attention, memory, or behavioral control.

In a new study, clinical psychologist Dr. Reuven Dar of Tel Aviv University’s School of Psychological Sciences argues that these two neuropsychological disorders have very different roots — and there are enormous consequences if they are mistaken for each other.

Dar and fellow researcher Amitai Abramovitch, Ph.D., have determined that despite appearances, OCD and ACHD are far more different than alike.

While groups of both OCD and ADHD patients were found to have difficulty controlling their abnormal impulses in a laboratory setting, only the ADHD group had significant problems with these impulses in the real world. Dar believes this proves that while OCD and ADHD may appear similar on a behavioral level, the mechanism behind the two disorders differs greatly.

That is, people with ADHD are impulsive risk-takers, rarely reflecting on the consequences of their actions. In contrast, people with OCD are all too concerned with consequences, causing hesitancy, difficulty in decision-making, and the tendency to over-control and over-plan.

Researchers believe their findings, published in the Journal of Neuropsychology, draw a clear distinction between OCD and ADHD and provide more accurate guidelines for correct diagnosis.

Ritalin, a psychostimulant commonly prescribed to ADHD patients, can actually exacerbate OCD behaviors, for example. Prescribed to an OCD patient, it will only worsen symptoms.

Researchers were able to determine the relationship between OCD and ADHD by studying three groups of subjects: 30 diagnosed with OCD, 30 diagnosed with ADHD, and 30 with no psychiatric diagnosis.

All subjects were male with a mean age of 30. Comprehensive neuropsychological tests and questionnaires were used to study cognitive functions that control memory, attention, and problem-solving, as well as those that inhibit the arbitrary impulses that OCD and ADHD patients seem to have difficulty controlling.

As predicted, both the OCD and ADHD groups performed less well than a comparison group in terms of memory, reaction time, attention and other cognitive tests.

Both groups were also found to have abnormalities in their ability to inhibit or control impulses, but in very different ways. In real-world situations, the ADHD group had far more difficulty controlling their impulses, while the OCD group was better able to control these impulses than even the control group.

When people with OCD describe themselves as being impulsive, this is a subjective description and can mean that they haven’t planned to the usual high degree, said Dar.

It is understandable why OCD symptoms can be mistaken for ADHD, Dar said. For example, a student in a classroom could be inattentive and restless, and assumed to have ADHD.

In reality, the student could be distracted by obsessive thoughts or acting out compulsive behaviors that look like fidgeting.

“It’s more likely that a young student will be diagnosed with ADHD instead of OCD because teachers see so many people with attention problems and not many with OCD. If you don’t look carefully enough, you could make a mistake,” said Dar.

Currently, 5.2 million children in the U.S. between the ages of 3 and 17 are diagnosed with ADHD, according to the Centers for Disease Control and Prevention, making it one of the most commonly diagnosed neuro-developmental disorders in children. By comparison, less than 10,000 children and adolescents are diagnosed with OCD.

Experts believe the correct diagnosis is crucial for successful outcomes as the diagnosis affects the choice of medication and psychological and behavioral treatment. Moreover, an accurate diagnosis significantly influences the manner in which families and teachers interact with the child and young adult.

Source: American Friends of Tel Aviv University

A new German study discusses diagnostic and treatment challenges of OCD, in the journal Deutsches Ärzteblatt International. In the article, Susanne Walitza, M.D., and colleagues point out that appropriate early recognition and treatment can positively affect the course of the disease.

Walitza discovered that compulsive washing, the most common obsessive-compulsive manifestation among children and adolescents, is present in up to 87 percent of all patients.

Children may also demonstrate compulsive repetitive behavior and checking, and obsessive thoughts of an aggressive type.

Attention deficit hyperactivity disorder is present in more than 70 percent of patients. Obsessive-compulsive disorder presenting in childhood or adolescence often becomes chronic and impairs mental health onward into adulthood.

Researchers believe the specific manifestations of obsessive-compulsive disorder can be diagnosed early with psychodiagnostic testing.

Behavioral therapy, although time-consuming, has been found effective and is considered a first-line treatment. In behavioral therapy, the patient is confronted with the situation that precipitates the obsessive-compulsive manifestations, while suppressing the manifestations.

Second-line treatment consists of behavioral therapeutic intervention combined with drug therapy.

Despite intensive treatment, the pervasive nature of the disorder often means that patients will need ongoing psychotherapy or combination therapy to prevent a later recurrence.

Experts believe much is still to be learned about the disorder. Currently, researchers believe the disorder stems from a complex, multifactorial combination of psychological, neurobiological, and genetic factors.

Source: Deutsches Aerzteblatt International

“Faced with a problem of this type, people suffering from this type of anxiety disorder show that they worry considerably more,” said Carles Soriano, Ph.D., researcher at Hospital de Bellvitge in Barcelona.

For the new study, scientists looked at the neurofunctional basis of this increased moral sensitivity. Using functional magnetic resonance imaging, they measured the brain activity of a group of 73 patients with OCD and 73 healthy patients.

All participants had to face a variety of moral problems in which they had to choose between two alternatives both leading to very negative consequences.

For example, they were asked to imagine themselves in a hypothetical war. Enemy soldiers lie in wait to attack and the entire village is hiding in a cellar. A baby starts to cry. If nobody makes the baby stop, the enemy soldiers will find them. Would it be justifiable to smother the baby’s cry, possibly suffocating it to save the others?

The results demonstrated that during situations of moral dilemma, the brains of those with OCD showed a higher degree of activation in the orbitofrontal cortex, especially in the medial part, which is associated with decision making and the development of moral sentiment.

“The majority [of people with OCD] are characterized by being obsessed with dirt and compulsive cleaning or by doubting that they have carried out important actions properly, like turning off the gas. Such behavior makes then repeatedly check whether they have performed such actions,” said Soriano.

There are other types of obsessions and compulsions as well, such as needing objects in the environment to be perfectly symmetrical and in order.   

There are also those that suffer from involuntary and unwanted thoughts of a sexual or religious kind.  They may feel unsure whether they have committed a sexual act that is unacceptable in their opinion or they worry that they have blasphemed God.

“The last group of patients is identified for precisely having a higher level of moral hypersensitivity,” said Soriano.

The research included help from experts at Barcelona’s Hospital del Mar and the University of Melbourne in Australia.

Source:  Archives of General Psychiatry
 

 
Very anxious woman photo by shutterstock.

Researchers from Johns Hopkins Children’s Center studied a number of parent-child pairs to ascertain whether people with certain anxiety disorders engaged more often in anxiety-provoking behaviors.

Based on the new study findings, they do. A report on the team’s findings appears online ahead of print in the journal Child Psychiatry and Human Development.

Researchers have found as many as one in five kids will suffer from an anxiety disorder, and the condition often goes unrecognized. Social anxiety disorder is the most prevalent type of anxety and is the third most prevalent psychiatric disorder after depression and alcohol dependence.

Researchers identified a subset of behaviors in parents with social anxiety disorder and in doing so, clarified some of the confusion that has shrouded the trickle-down anxiety often seen in parent-child pairs.

These behaviors included a lack of or insufficient warmth and affection and high levels of criticism and doubt leveled at the child. Such behaviors, the researchers say, are well known to increase anxiety in children and — if engaged in chronically — can make it more likely for children to develop a full-blown anxiety disorder of their own, the investigators say.

“There is a broad range of anxiety disorders so what we did was home in on social anxiety, and we found that anxiety-promoting parental behaviors may be unique to the parent’s diagnosis and not necessarily common to all those with anxiety,” said study senior investigator, Golda Ginsburg, Ph.D.

The Hopkins team emphasizes that the study did not directly examine whether the parents’ behaviors led to anxiety in the children, but because there is plenty of evidence they do, the researchers say physicians who treat parents with social anxiety should be on alert about the potential impact on offspring.

“Parental social anxiety should be considered a risk factor for childhood anxiety, and physicians who care for parents with this disorder would be wise to discuss that risk with their patients,” said Ginsburg.

Anxiety is the result of a complex interplay between genes and environment, the researchers say, and while there’s not much to be done about one’s genetic makeup, controlling external factors can go a long way toward mitigating or preventing anxiety in the offspring of anxious parents.

“Children with an inherited propensity to anxiety do not just become anxious because of their genes, so what we need are ways to prevent the environmental catalysts — in this case, parental behaviors — from unlocking the underlying genetic mechanisms responsible for the disease,” Ginsburg said.

During the research, investigators analyzed interactions between 66 anxious parents and their 66 children, ages 7 to 12. Among the parents, 21 had been previously diagnosed with social anxiety, and 45 had been diagnosed with another anxiety disorder, including generalized anxiety disorder, panic disorder and obsessive-compulsive disorder.

The parent-child pairs were asked to work together on two tasks: prepare speeches about themselves and to replicate increasingly complex designs using an Etch-a-Sketch device. The participants were given five minutes for each task and worked in rooms under video surveillance.

Using a scale of 1 to 5, the researchers rated parental warmth and affection toward the child, criticism of the child, expression of doubts about a child’s performance and ability to complete the task, granting of autonomy, and parental over-control.

Parents diagnosed with social anxiety showed less warmth and affection toward their children, criticized them more and more often expressed doubts about a child’s ability to perform the task. There were no significant differences between parents on controlling and autonomy-granting behavior.

Researchers say that early diagnosis of social anxiety disorders among children is critical as delays in diagnosis and treatment can lead to depression, substance abuse and poor academic performance. These conditions can extend throughout childhood and well into adulthood.

Source: Johns Hopkins Medicine

Anxious mother and daughter photo by shutterstock.

Experts say their findings could lead to a better understanding of many brain disorders, from drug addiction to depression.

Investigators used mouse models to study dopamine neurons in the striatum, a region of the brain involved in both movement and learning.

In people, these neurons release dopamine, a neurotransmitter that allows us to perform tasks such as walking, speaking and even typing on a keyboard.

When a person has Parkinson’s the dopamine cells die and the ability to easily initiate movement is lost. Current Parkinson’s drugs are precursors of dopamine that are then converted into dopamine by cells in the brain.

On the other hand, dopamine hyperactivity is associated with drug-seeking behaviors as heroin, cocaine and amphetamines rev up or mimic dopamine neurons, ultimately reinforcing the learned reward of drug-taking. Conditions such as obsessive-compulsive disorder, Tourette syndrome and even schizophrenia may also be related to the misregulation of dopamine.

In a current issue of Nature, Bernardo Sabatini and co-authors Nicolas Tritsch and Jun Ding report that midbrain dopamine neurons release not only dopamine but also another neurotransmitter called GABA, which lowers neuronal activity.

This unsuspected presence of GABA could explain why restoring only dopamine could cause initial improvements in Parkinson’s patients to eventually wane, say the researchers. And if GABA is made by the same cells that produce other neurotransmitters, such as depression-linked serotonin, similar single-focus treatments could be less successful for the same reason.

“If what we found in the mouse applies to the human, then dopamine’s only half the story,” said Sabatini.

The surprising GABA story began in the Sabatini lab with a series of experiments designed to see what happens when cells release dopamine.

The scientists used optogenetics, a powerful technique that relies on genetic manipulation to selectively sensitize cells to light. In laboratory dishes, researchers tested brain tissue from mice engineered to show activity in dopamine neurons.

Typically in such experiments, other neurotransmitters would be blocked in order to highlight dopamine, but Tritsch, a postdoctoral fellow in the Sabatini lab, decided instead to keep the cell in as natural a state as possible.

When Tritsch activated the dopamine neurons and examined their effects on striatal neurons, he naturally expected to observe the effects of dopamine release.

Instead, he saw rapid inhibition of the striatal neurons, making it clear that another neurotransmitter — which turned out to be the quick-acting GABA — was at work.

This was so unusual that the team launched a series of experiments that confirmed GABA was being released directly by these dopamine neurons.

The researchers then tested other transporters, zeroing in on one protein that ferries dopamine and a variety of other neurotransmitters. For reasons they don’t yet understand, this protein — the vesicular monoamine transporter — also shuttles GABA.

“What makes this important now is that every manipulation that has targeted dopamine by targeting the vesicular monoamine transporter has altered GABA as well. And nobody’s paid any attention to it,” said Sabatini.

“Every Parkinsonian model that we have in which we’ve lost dopamine has actually lost GABA, too. So we really have to go back now and think: Which of these effects are due to loss of GABA and which are due to loss of dopamine?”

Anatol Kreitzer, an assistant investigator at the Gladstone Institute of Neurological Disease in San Francisco, who was not involved in the research, called the findings remarkable.

“It was totally unexpected,” said Kreitzer, who is also an assistant professor of physiology and neurology at the University of California, San Francisco.

“At the molecular level, nobody really expected dopamine neurons to be releasing significant amounts of GABA. At the functional level, it’s surprising that this major modulator of plasticity in the brain, which is so critical for Parkinson’s, for learning and rewards, and for other psychiatric illnesses, can also release GABA. That raises a question as to what role GABA has.”

GABA can very quickly change the electrical state of cells, inhibiting their activity by making them less excitable. Sabatini wonders if the loss of GABA in dopamine neurons could explain why hyperactivity is sometimes seen after chronic loss of these neurons.

The next challenge will be to explore whether other neurons that express the vesicular monoamine transporter also release GABA in addition to neurotransmitters such as serotonin and noradrenaline.

Researchers say the finding demonstrates our still infantile knowledge of brain physiology.

“These findings highlight how little we actually know about the most basic features of cell identity in the brain,” said Sabatini.

Tritsch said what started out as a straightforward project to understand dopamine quickly changed direction, with lots of starts and stops on the way to some exciting new findings.

“It can be nice to come up with a hypothesis, test it, verify it, and have everything fall into place,” he said. “But biology rarely works that way.”

Source: Harvard University

Much research of late has explored whether Internet use leads to undesirable psychosocial outcomes such as depression and loneliness. Experts say that certain motivations to communicate online can have negative consequences, as the Internet itself can, for some, serve as an object of compulsive use.

CIU refers to the inability to control, reduce, or stop their online behavior, while EIU is the degree to which an individual feels that he or she spends an excessive amount of time online or even loses track of time when using the Internet.

The inability to self-control online use may lead some to develop depression, loneliness, and avoid face-to-face contacts.

In the new study, Joseph Mazer, Ph.D., of Clemson University and Andrew M. Ledbetter, Ph.D., of Texas Christian University explored how specific online communication attitudes—such as individuals’ tendency for online self-disclosure, online social connection, and online anxiety—predicted their compulsive and excessive Internet use and, in turn, poor well-being.

The study may be found in the Southern Communication Journal.

Mazer and Ledbetter found that an individual’s tendency for online self-disclosure and online social connection led them to use the Internet in more compulsive ways. Moreover, if a person has poor face-to-face communication skills that individual will likely be more attracted to the social features of online communication, which can foster CIU.

Research suggests that socially anxious individuals turn to online communication as they perceive the environment as less threatening.

However, the findings from Mazer and Ledbetter’s study are not entirely consistent with this claim as they discovered compulsive users also experience anxiety when communicating online.

The finding conflicts with traditional theory that frames online communication as a safe activity for the socially anxious to escape their communication anxiety.

Nevertheless, to the extent that socially anxious individuals are drawn to the Internet, suggest anxiety seems to stimulate compulsive, but not necessarily excessive, use.

On the other hand, excessive users seem to have a more realistic perception of online communication as convenient but sometimes limited in communicative effectiveness by a lack of social cues often available in face-to-face interactions.

Researchers summarize the findings by stating that anxiety motivates compulsive use of the Internet, while efficiency drives excessive use of the Internet.

Mazer and Ledbetter found that CIU, not EIU, led individuals’ to experience poor well-being outcomes.

Researchers do not know if the use of social networking sites to maintain social connections will influence online communication frequency, or how excessive participation in these sites might foster compulsive and excessive Internet use.

Source: Clemson University

Upset woman using the computer photo by shutterstock.

University of Helsinki researchers, in collaboration with an international group of researchers, are using an animal model to study the genetic background and environmental factors associated with human obsessive compulsive disorders (OCD).

Researchers reviewed a questionnaire study completed by nearly 400 dog owners and discovered several similarities between compulsive behavior in dogs and humans.

Investigators report the following commonalities: early onset, recurrent compulsive behaviors, increased risk for developing different types of compulsions, compulsive freezing, the beneficial effect of nutritional supplements, the effects of early life experiences and sex hormones and genetic risk.

The study has been published in the journal PLoS ONE.

Experts say that stereotypical behavior in pets has not been studied extensively, even though several different types of compulsive behavior occur in different species including dogs. For example, a dog may recurrently chase lights or shadows, bite or lick its own flank, pace compulsively or chase its own tail.

Researchers believe different environmental and genetic factors can predispose to compulsive behavior. Many stereotypes are breed-specific, which emphasizes the role of genes.

Compulsive tail chasing occurs in several dog breeds, but worldwide it is most common in breeds such as bull terriers and German shepherds.

The aim of this study was to describe the characteristics of tail chasing in dogs, to identify possible environmental risk factors, and to find out whether a previously discovered gene region associated with compulsive behavior is also linked to tail chasing.

Nearly 400 Finnish dogs were included in this study, including bull terriers, miniature bull terriers, German shepherds and Staffordshire bull terriers.

Researchers discovered a connection with stereotypic OCD behavior and vitamins and minerals. Dogs that received nutritional supplements, especially vitamins and minerals, with their food, chased their tails less.

“Our study does not prove an actual causal relationship between vitamins and lessened tail chasing, but interestingly similar preliminary results have been observed in human OCD,” said researcher Katriina Tiira, Ph.D.

Follow-up studies will aim to determine whether vitamins could be beneficial in the treatment of tail chasing.

Researchers also found that in comparison to control dogs, tail chasers suffered more from also other stereotypic behaviors. In addition, tail chasers were more timid and afraid of loud noises.

This finding also correlates to human behavior.

“Different types of compulsive behavior occur simultaneously in humans suffering from obsessive compulsive disorder or other diseases such as autism” said the head of the study, Dr. Hannes Lohi.

Dogs may turn out to be of significant use in investigating the causes of human psychiatric diseases, he said.

“Stereotypic behavior occurs in dogs spontaneously; they share the same environment with humans, and as large animals are physiologically close to humans. Furthermore, their strict breed structure aids the identification of genes.”

The gene region previously associated with compulsive flank licking and biting in Dobermans was not found to be associated with tail chasing in any of the breeds in this study. The next aim of this research project is thus to discover new gene regions connected to tail chasing.

The study is part of a larger DOGPSYCH project, funded by the European Research Council, in which the genetic background of different anxiety disorders, such as timidity, compulsive behavior and sound sensitivity are investigated, as well as their similarities with corresponding human diseases.

Source: University of Helsinki

“Both disorders clearly have a complex underlying genetic architecture, and these two studies lay the foundation for understanding the underlying genetic etiology of Tourette syndrome and OCD,” said Dr. Jeremiah Scharf, a neurologist at Massachusetts General Hospital in Boston, who worked on both projects.

In the Tourette syndrome study, researchers compared the genomes of more than 1,200 people with the disorder to the genomes of nearly 5,000 healthy individuals.

They carried out a “genome-wide association study,” which includes scanning hundreds of thousands of genetic variants across the genomes to see whether any were more common in people with the disorder.

No single genetic signal was found to be significantly different between the two genomes, meaning that the researchers could not rule out random chance as the reason for any given difference.

However,  among the top genetic variations, there was an unusually high number of variations in the frontal lobe of the brain— a region implicated in both Tourette syndrome and OCD, said Scharf.

One gene in particular that had a strong variation between Tourette- and non-Tourette genomes was called COL27A1, which encodes a collagen protein found in cartilage. The same gene is also active in the cerebellum, a brain region important for motor control during development. More research is needed to find what link, if any, this gene has to Tourette syndrome, Scharf said.

In the OCD study, researchers conducted the same analysis on healthy genomes as well as about 1,500 people with OCD. Again, no one gene stood out as a definitive OCD gene, but the findings show a good candidate near a gene called BTBD3, which is involved in multiple cellular functions.

This first genome-wide results are bound to turn up some false positives, noted Scharf, so researchers will now need to study these intriguing genes in larger samples of people.

Scientists are also comparing the two studies to identify any genetic linkages that might explain why Tourette syndrome and OCD so frequently appear together.

“The important thing this study does is that it really brings Tourette syndrome and OCD into the company of a number of other psychiatric diseases, which people have studied using genome-wide association,” Scharf said, citing autism, schizophrenia and bipolar disorder as examples.

“Now that we have these data for Tourette syndrome and OCD, we can work with investigators who are studying those other diseases to try to see what we can learn about what variants are shared between different neurodevelopment disorders.”

Source: Molecular Psychiatry