Monthly Archives: April 2013

Google Searches Reveal Seasonal Trends in Mental Illnesses

Psycological Health

Google Searches Reveal Seasonal Trends in Mental Illnesses

2013-04-12

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It’s easy to appreciate the seasonality of winter blues, but web searches show that other disorders may ebb and flow with the weather as well.

Google searches are becoming an intriguing source of health-related information, exposing everything from the first signs of an infectious disease outbreak to previously undocumented side effects of medications. So researchers led by John Ayers of the University of Southern California decided to comb through queries about mental illnesses to look for potentially helpful patterns related to these conditions. Given well known connections between depression and winter weather, they investigated possible connections between mental illnesses and seasons.

Using all of Google’s search data from 2006 to 2010, they studied searches for terms like “schizophrenia” “attention deficit/hyperactivity disorder (ADHD),” “bulimia” and “bipolar” in both the United States and Australia.  Since winter and summer are reversed in the two countries finding opposing patterns in the two countries’ data would strongly suggest that season, rather than other things that might vary with time of year, was important in some way in the prevalence of the disorders.

“All mental health queries followed seasonal patterns with winter peaks and summer troughs,” the researchers write in their study, published in the American Journal of Preventive Medicine. They found that mental health queries in general were 14% higher in the winter in the U.S. and 11% higher in the Australian winter.

The seasonal timing of queries regarding each disorder was also similar in the two countries. In both countries, for example, searches about eating disorders (including anorexia and bulimia) and schizophrenia surged during winter months; those in the U.S. were 37% more likely and Australians were 42% more likely to seek information about these disorders during colder weather than during the summer. And compared to summer searches, schizophrenia queries were 37% more common in the American winter and 36% more frequent during the Australian winter. ADHD queries were also highly seasonal, with 31% more winter searches in the U.S. and 28% more in Australia compared to summer months.

Searches for depression and bipolar disorder, which might seem to be among the more common mental illnesses to strike during the cold winter months, didn’t solicit as many queries: there were 19% more winter searches for depression in the U.S. and 22% more in Australia for depression. For bipolar, 16% more American searches for the term occurred in the winter than in the summer, and 18% more searches occurred during the Australian winter. The least seasonal disorder was anxiety, which varied by just 7% in the U.S. and 15% in Australia between summer and winter months.

Understanding how the prevalence of mental illnesses change with the seasons could lead to more effective preventive measures that alert people to symptoms and guide them toward treatments that could help, say experts. Previous research suggests that shorter daylight hours and the social isolation that accompanies harsh weather conditions might explain some of these seasonal differences in mental illnesses, for example, so improving social interactions during the winter months might be one way to alleviate some symptoms. Drops in vitamin D levels, which rise with exposure to sunlight, may also play a role, so supplementation for some people affected by mood disorders could also be effective.

The researchers emphasize that searches for disorders are only queries for more information, and don’t necessarily reflect a desire to learn more about a mental illness after a new diagnosis. For example, while the study found that searches for ‘suicide’ were 29% more common in winter in America and 24% more common during the colder season in Australia, other investigations showed that completed suicides tend to peak in spring and early summer. Whether winter queries have any relationship at all to spring or summer suicides isn’t clear yet, but the results suggest a new way of analyzing data that could lead to better understanding of a potential connection.

And that’s the promise of data on web searches, says the scientists. Studies on mental illnesses typically rely on telephone or in-person surveys in which participants are asked about symptoms of mental illness or any history with psychological disorders, and people may not always answer truthfully in these situations. Searches, on the other hand, have the advantage of reflecting people’s desire to learn more about symptoms they may be experiencing or to improve their knowledge about a condition for which they were recently diagnosed. So such queries could become a useful resource for spotting previously undetected patterns in complex psychiatric disorders.  “The current results suggest that monitoring queries can provide insight into national trends on seeking information regarding mental health, such as seasonality…If additional studies can validate the current approach by linking clinical symptoms with patterns of search queries,” the authors conclude, “This method may prove essential in promoting population mental health.”

Size Does Matter: Study Shows Women Judge Male Attractiveness by Penis Size

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Size Does Matter: Study Shows Women Judge Male Attractiveness by Penis Size

2013-04-10

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Call it sexist or sensationalist, but now science suggests it’s so: women find men with bigger penises more attractive.

(UPDATED) Reporting in the journal Proceedings of the National Academy of Science, researchers led by Brian Mautz, now a postdoctoral fellow at the University of Ottawa in Canada, studied how 105 young Australian women rated attractiveness in males.

The researchers, including those from Monash University and Australian National University, asked the women to view life-size video clips of computer-generated images of naked men who varied in height, body shape and flaccid penis size, but not in other qualities like facial attractiveness and hair. The women gave each image a rating from 1 to 7 on total sexual attractiveness, rather than assessing individual characteristics.

“We show that penis size actually is important on some level and, importantly, it interacts with other traits,” says Mautz.

The size of a model’s member, for example, had a greater influence on attractiveness if the model were tall, since proportion may have been an important factor in how appealing the men appeared to the women. “A change in penis size has a larger effect for taller men than it does for other heights,” Mautz says. “This result could be because penis size was smaller when assessed relative to the height of a taller man,” the authors note.

But height was equally important. Shorter men with larger penises were ranked as more attractive than shorter men who were not as well endowed, but they still remained on the low end of the scale for overall appeal, says Mautz. “You’d think that if penis size is super attractive, it might help shorter guys more. It does increase attractiveness for short men, but they still are under average in attractiveness scores.”

It turns out there may also be a threshold for the ideal size, which may also work against the vertically challenged; the study found that above about 3 in., additional enlargement in genitalia doesn’t make that much of a difference in attractiveness, regardless of a man’s height.

That’s not to say that there’s an upper limit on penis size, however; Mautz and his team did not find a maximum on desired size, but noted that “the most attractive penis size” appeared to fall outside the range used in the study, which was designed to capture 95% of the variability women would encounter. So although attractiveness beyond the 3 in. continued to increase in a linear fashion, it did so at a slower rate.

The results may not be as superficial as they seem. Based on evolutionary principles, it could be possible that women look to penis size to judge a man’s appropriateness as a mate; the size of a man’s member may indicate an ability to sire and produce healthy and robust children (something that obviously tended to play a greater role before developed societies began wearing clothes). And that, say the researchers, might help to explain why men have evolved relatively large penises in relation to those of other primates.

While size may matter, the findings don’t suggest that only size matters. In fact, body shape seemed to trump both height and genital endowment in determining attractiveness. Based on the women’s answers, the researcher calculated that height was as important as endowment in a male’s attractiveness, while wider shoulders and narrow hips was more important than both combined.

So if appealing to women is the goal, then it’s the gym membership that may make more sense than investing in genital enhancement devices.

(Note:  A previous version of this story was incorrectly edited and did not accurately reflect the data on the relative importance of the three factors studied in the research.)

Youth: Straight, LBGT or ‘other’?

Sexual Health

Youth: Straight, LBGT or ‘other’?

2013-04-08

By Ian Kerner, Special to CNN

Are younger people more likely to embrace their sexual identity? That’s the implication of findings from a recent large Gallup survey.

The survey, which asked 120,000 American adults whether they identified as lesbian, gay, bisexual or transgender, found that 6.4% of people aged 18 to 29 said they were LGBT: about three times more than people over age 65.

But do results like these indicate that younger adults are more likely to be LGBT, or are they simply more likely to acknowledge it? It’s probably the latter, say my colleagues.

“These numbers might reflect a generational change in social acceptance for LGBT identities,” said psychotherapist Jean Malpas, director of the at the New York-based Ackerman Institute for the Family. “Today’s youth and young adults, at least in some communities, are gradually more comfortable being open about their sexual and gender identities.”

Another potential reason for the increase in self-identified LGBT youth is the influence of a new generation of parents who embody a positive attitude and wouldn’t have it any other way.

“Today’s millennial parents are more than just accepting of their children’s sexual identity. They’re comfortable and embracing of it, too,” said Ron Taffel, psychologist and author of the book “Childhood Unbound.” “They want to actively support and engage their children through communication about all aspects of their lives.”

Research, including this survey, also suggests that young women may be more likely than men to identify as bisexual.

“The pattern across surveys is that men are more likely to identify as gay, whereas women are more likely to identify as bisexual,” explained social psychologist Justin Lehmiller. “We don’t know exactly why this is, but many psychologists believe it results from women’s sexuality being somewhat more ‘flexible’ or ‘fluid’ and men’s sexuality being somewhat more ‘fixed.’ ”

Many other young people are eschewing traditional descriptors for sexuality and gender completely.

“There’s been a lot of work done on how LGBT youth is more and more frequently rejecting labels altogether, blurring the lines between sexual orientation and gender, creating new labels and identifying as gender-queer, gender-fluid or pansexual, to name a few,” said sex therapist Margie Nichols. “The very term ‘LGBT’ is too confining now, which is why I prefer the term Gender and Sexual Diversity, or GSD.”

That term could also include the 1% of people who identify as asexual, which means they aren’t sexually attracted to anyone.

“While we’re creating space for a variety of sexual identities, we also need to create space for non-sexual identities,” said college sex educator Emily Nagoski.

Indeed, many of the experts I spoke to expressed frustration that Gallup and other surveys limit the options from which a respondent can choose.

“The terms lesbian, gay and bisexual just don’t capture all sexual minority identities,” Lehmiller said.

Nichols agrees. “These studies are missing a tremendous opportunity by not including an ‘other’ category. It’s a shame, because the ‘other’ category is the wave of the future.”

Separate from sexual identity is gender identity. While not addressed in the Gallup survey, experts say, this distinction is increasingly important, particularly for today’s youth.

“Gender nonconforming expression and identity are different from sexual orientation,” Malpas explained.

“Sexual orientation is about who you are attracted to and who you fall in love with. Gender expression and identity refer to the gender you feel comfortable expressing and identifying with, which might or might not be aligned with the biological sex you were assigned at birth.”

As transgender and gender-nonconforming children and teens become more visible, both in communities and in the media, parents are less likely to dismiss them.

“Only a decade ago, a parent would have probably answered ‘stop saying silly things’ to a 6-year-old son who insisted on being a girl,” Malpas added. “Today, the same parent will stop and think about the transgender children they’ve seen on TV or in magazines and may more readily inquire with professionals and other parents.”

More than just stop and think, they’ll also hopefully want to talk. Says Taffel, who specializes in breaking through to teens, “Open communication is a primary value for today’s parents, much more so than setting limits and rules, and the spirit of open communication trumps the content of any conversation.”

While it’s important not to confuse gender and sexual identity, parents can take a similar approach in discussing them with their kids.

“Of course, you should reassure the child of your love, but you’ll also want to find ways to expose your child to others like him or her so the child doesn’t feel different or alone,” Nichols suggested. “Allow yourself to experience mixed or negative feelings if you have them, and consider joining a support group. You’ve also got to be prepared to be your child’s advocate with schools, neighbors and community activities.”

I find the survey results very encouraging, as they indicate not just a shift of differences in human sexuality toward the mainstream but also suggest that the future is promising for people who don’t fit into “the norm.”

“We’re evolving, culturally, beyond the need to impose rules on who’s allowed to do what with their genitals and their hearts,” Nagoski said. “This new generation of young people understands that love is love, that people are people and that the freedom to experience joy and mutually consensual pleasure is a birthright.”

This Is Your Body On Stress (INFOGRAPHIC)

Psycological Health

This Is Your Body On Stress (INFOGRAPHIC)

2013-04-04

Your boss reams you out for a bad presentation — you break out into a sweat. Your demanding mother-in-law comes for a visit — your head pounds. Rumors swirl about possible layoffs at work — you can’t sleep. An unexpected expense takes a hit on your bank account — your stomach aches.

Here’s why: Historically, the majority of stressors facing humans were physical (lions and tigers and bears, oh my!), requiring, in turn, a physical response. “We are not particularly splendid physical creatures,” says David Spiegel, M.D., director of the Center on Stress and Health at Stanford School of Medicine, who explains that plenty of other animals can outrun us, overpower us, out-see us, out-smell us. “The only thing that has allowed us to explore the planet is the fact that we can respond effectively to threats.”

Humans are equipped with a sophisticated fight or flight response that allows us to outrun a grizzly bear or fight off an animal far more powerful than we are. When stressed, the sympathetic nervous system takes control of the body, which then triggers fight or flight. (The counterpart of the sympathetic nervous system is the parasympathetic nervous system, also known as the “rest and digest system,” which is in control during more relaxing times. Both are part of the autonomic nervous system, which controls involuntary actions.) Once our bodies identify a threat, we prepare for war (or getting the heck out of there): muscles tense up, the heart starts beating faster and blood flows away from any non-essential body system.

The problem, though, is that while just a few hundred years ago our stressors were primarily physical, today the vast majority of stress is psychological — work, finances, families and the like. But our bodies have yet to catch up. And that means the stress response is still a physical one. Your boss yells, your body thinks “grizzly bear.”

What’s more, the brain isn’t always particularly good at evaluating how serious a particular stressor is. Think of lighting a sparkler (or a candle or a match) inside a house, explains Amit Sood, M.D., associate director of Complementary and Integrative Medicine and chair of Mayo Mind Body Initiative at Mayo Clinic. Now imagine you can’t tell the difference between that sparkler and a multiple-alarm fire — so each time, you send every available firefighter to put it out. “It would probably extinguish the sparkler, but it would waste a lot of resources,” he says. Similarly, when the body is constantly stressed, it’s pouring resources into fighting that stress, which can, over time, take a profound physical toll.

So to help understand what exactly is going on inside your body when you’re stressed out, we asked Sood and Spiegel to break it down. Read through the graphic, then tell us: How do you deal with stress?

The stress response starts with the amygdala, which acts as a sensor at the base of the brain by vetting every input for possible threats. When it senses danger, it shuts down the entire brain operation (now is not the time for, say, creative thinking) and prepares the body to pool all of its resources for survival, allowing you to react before you even have time to think about what is happening. When constantly, severely stressed, the amygdala can become overly sensitive and hyper-vigilant, making even relatively harmless events (such as a whiny child or a snoring spouse) seem like a threat. That explains those instinctively snappy over-reactions we can all have when feeling strung out.

Amygdala

After picking up on a potential threat to safety, the amygdala sends impulses to an area of the brain called the locus coeruleus, which awakens your whole body to prepare for either fight or flight. “It’s like you took four big lattes and just infused those in your brain,” Sood says. The locus coeruleus triggers the release of a chemical called norepinephrine, which mobilizes sugars from around the body to fuel an effective stress response and activates the sympathetic nervous system.

Locus Coeruleus

Once the amygdala communicates with the locus coeruleus to fuel an immediate stress response, it sends signals to the prefrontal cortex, located in the higher cortical brain. The prefrontal cortex is more rational, and can help to evaluate how real a stressor is — it learns from experience and tells the amygdala when a response is unwarranted. “It’s like your elderly grandpa in your brain,” Sood says. Just as the amygdala can condition itself to become over-vigilant, we can strengthen the prefrontal cortex through mindfulness practices — like meditation — to help avoid overreactions.

Prefrontal Cortex

Ever find you get the sustained attention span to finish a project in the final hour before a deadline? Here’s why: During times of stress, a part of the brain called the anterior cingulate cortex acts like a telephoto lens, allowing you to zoom in on a problem and ignore everything else that’s happening. This area of the brain can help you to detach when necessary to take stock of what needs to be done. This also explains why some people are able to stay strategic and calm during a serious crisis, such as being attacked or fighting in war (and why later people sometimes describe feeling as if the events were unreal or dreamlike when they were actually happening).

Anterior Cingulate Cortex

This is a crucial area of the brain that helps with memory — it doesn’t actually store all the memories, but decides where you will store what. “It’s the director of the orchestra,” Sood says. But when excessive cortisol (a stress hormone) is in your system, it can kill the hippocampus nerve cells, causing memory problems (that’s why you can never find your keys when you’re perpetually frazzled). The good news is that you can get those nerve cells back. What works? Meditation, relaxation, a generally healthy lifestyle and cultivation of compassion, gratitude, forgiveness and acceptance.

Hippocampus

Once the amygdala picks up on a threat, it talks to a part of the brain called the hypothalamus, which in turn releases chemicals telling the pituitary gland, a small gland near the brain, to react. The pituitary gland then tells the adrenal glands, located on top of the kidneys, to pour out steroids (including the stress hormone cortisol) and adrenaline to fuel the sympathetic nervous system and mobilize sugars from various parts of the body to give it more energy.

Adrenal Glands

The cortisol released from the adrenal glands functions mainly to raise glucose levels to energize the body. And that glucose is secreted from the liver.

Liver

The flight or fight reaction pushes blood flow to the muscles, and away from the skin, to prepare you for war. This redistribution of blood flow, depending on the person, can either cause you to look paler or to flush (plus the autonomic nervous system can control the size of small arteries in the skin, causing blushing). This response is helpful when you really need it. But when it’s happening at a low grade all the time in response to chronic stress, it can actually cause the skin to age faster. You might also start perspiring, as your body wants to cool off in case you need to start running. What’s more, stress can aggravate certain skin conditions, such as psoriasis or rashes. And cortisol, the stress hormone, increases oil production and can stimulate acne. For some people, stress triggers a release of histamine in the body, which can then cause an inflammatory response that shows up in the form of hives or rashes.

Skin

There’s a reason you get a “gut feeling.” The intestines are like a second brain, Sood says, packed with nerve cells. In moments of acute stress, gastrointestinal functioning decreases so that the body’s energy goes toward fighting or fleeing instead of digesting food. That means the body doesn’t always properly process the food, which can dis-regulate activity in your gut. And when people are chronically stressed, it can affect the motility of the gastrointestinal system, which might lead to constipation, diarrhea, indigestion, reflux or bloating. Extreme acute stress can cause people to lose control of their bowels, which is where the term scared — well, you know — comes from.

Intestines

Craving a big, fat piece of chocolate cake after a tough day of work? There are several complicated factors that can trigger stress eating. Among them, feeling anxious can cause you to crave chocolate or carbohydrates, both of which will trigger a release of serotonin, a feel-good chemical, in the brain. And those calorie- and fat-packed foods make us feel better, even if it’s just temporary. Some research has also indicated that stress might up the hunger hormones in your body. Even worse? Increased levels of the stress hormone cortisol have been linked to the storage of excess abdominal fat.

Weight Gain

With the activation of the sympathetic nervous system, the body is primed to fight — it can’t tell the difference between a grizzly bear or an annoying boss. And that means your muscles will tense up, as your body prepares itself to either fight the attacker or escape it. That constant tension can aggravate existing muscular conditions, or cause pain all its own. “You need that if you’re going to start running very soon,” Spiegel says. “You don’t need it if you have a bad back and your boss is yelling at you.”

Muscles

The fight or flight response causes muscles to tense up, preparing you to either fight or run. But over time, maintaining constant tension in your neck can cause your head to ache.

Head

With the activation of the sympathetic nervous system, the heart starts pumping out blood faster and harder to the rest of the body, fueling it for action. “Initially the changes are functional and reversible,” Sood says. “But eventually, the changes become structural and irreversible.” Your body will start to think you need to constantly maintain a high blood pressure and the heart muscles can become thicker. Unchecked, chronic stress has been linked to increased risk of heart disease, heart attack and stroke.

Heart

During sleep, the relaxed parasympathetic system is in control and the active sympathetic nervous system gets very quiet. But when you’re acutely stressed, the sympathetic nervous system doesn’t want to shut itself down. “You still want to protect yourself from whatever the danger is,” Spiegel says. Plus, when your brain is hyper-aroused from ruminating over all those daytime anxieties, it tends to be more difficult to drift off to sleep.

Sleep

Because the body is diverting resources to the systems required for immediate survival, the immune system can become suppressed. And not only does that make you susceptible to new viruses (one study found that people who recently experienced a major stressful life event were more likely to catch a cold), but it can also activate existing infections and viruses. Stress can affect the regulation of inflammation, and increased inflammation can, in turn, exacerbate conditions such as asthma, inflammatory bowel disease and rheumatoid arthritis. That inflammatory response also means we’re less able to fight off infections, making symptoms worse.

Immunity

It’s a no-brainer that the last thing we feel after a long, stressful day is sexy. The stress response is a physical one, and when we’re feeling threatened, sex is the least important priority. Stress activates the sympathetic nervous system (read: an uptick in heart rate and blood pressure), while the more relaxing parasympathetic nervous system is involved in sexual arousal. And, at the most basic level, people typically need to feel comfortable and relaxed to be in the mood for sex, not strung-out and distracted.

Libido

When you’re under pressure, the body is diverting all of its resources toward immediate survival, not future goals like reproduction. “Fertility is a long-term evolutionary privilege we have to transmit our genes,” Sood says. “We don’t want to have babies if I don’t know if I’m going to live through the next two minutes.” Not to mention: Stress can really zap sex drive.

Fertility

While the long-perpetuated myth that stress can turn your hair gray is yet to be conclusively proven, we do know that too much stress can stimulate hair loss. Hair naturally cycles through growth and rest phases — but when we’re experiencing acute, severe stress, the body might start to divert resources away from the hair, meaning it can spend a longer amount of time in the resting phase, a condition called telogen effluvium. The result is less hair growth and, at the same time, more hair loss. Chronic stress can also trigger a disorder called trichotillomania, where people feel compelled to pull or twist hair — whether it’s from the scalp, eyebrows, eyelashes or other body parts — until it falls out.

Hair

When we’re stressed out, our muscles tense up to prepare for the fight or flight response — and this includes the muscles in the jaw. Why some people are more likely to tense up in the jaw than others “is less clear, but we commonly ‘clench our teeth’ when stressed, fearful or angry,” Spiegel says. Tension can also trigger teeth-grinding.

Jaw

The body needs more oxygen to fuel the fight or flight response, which can cause us to start breathing more rapidly. And in order to breathe quickly, we take shallow, more superficial breaths instead of fewer, deep ones. Before you know it, you’re short of breath and, in severe cases, maybe even hyperventilating. Consciously taking deep breaths can have the opposite effect by activating the calming parasympathetic nervous system. Stress also predisposes us to inflammation, which can make asthma attacks more likely.

Lungs

Sources: Stanford School of Medicine, Mayo Clinic, A.D.A.M. Medical Encyclopedia, Proceedings of the National Academy of Sciences of the United States Of America, American Heart Association

How Junior High Friendships Affect Adult Relationships

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How Junior High Friendships Affect Adult Relationships

Middle school is typically a time of chaotic emotions, confusing relationships and challenging growing pains. But it may also have a surprisingly lasting influence on the future.

In a study published in Child Development, researchers found that adolescents who were best able to negotiate the relationship minefield of finding friends and making sound behavior choices were most likely to be rated by their parents as successful both socially and professionally when they became young adults.

“We tend to think that peer relationships in early adolescence don’t mean that much, but that tends to be dead wrong,” says Joseph Allen, a professor of psychology at the University of Virginia. “How well you do with peers as an early teen tells us a whole lot about how you manage in a lot of different ways as an adult.”

Allen and his colleagues followed 184 youths from a public middle school in the Southeast, which included kids from both urban and suburban neighborhoods. They interviewed the teens’ parents as well as other adolescents that they identified as their closest friends annually for three years, starting when the participants were around 13. The authors followed up again when they were ages 20 to 23.

“What we’re finding is that the path is not straightforward, it’s more like a tightrope walk between trying to connect well with peers on one side and avoiding getting swept up into peer influences toward deviant behavior like delinquency and drug use on the other,” says Allen.

Indeed, the study showed that teens who best resisted peer pressure during junior high were less likely to engage in criminal behavior or to have alcohol or drug problems. Unfortunately, this ability to resist peer pressure can also be isolating; this same group also had fewer and weaker friendships as adults.

Those who had the strongest interactions as adults, not surprisingly, were teens who walked a middle ground, remaining open to peer influence, but not allowing themselves to be overwhelmed by the pressure to conform. “Teens who can manage that well have strong close friendships as adults,” says Allen. “They’re better at negotiating disagreements with romantic partners when we observed them doing that. They are less likely to have problems with alcohol and substance use and less likely to engage in criminal behavior.”

That doesn’t mean, however, that when it came to the most common pressures during adolescence, such as smoking, drinking and trying drugs, these teens were abstinent. “The people who were best at connecting have a lower risk of problems with alcohol and drug abuse, but they actually drink slightly more,” Allen says. This confirms earlier research that suggested teens who were well adjusted didn’t always abstain entirely, but rather were able to avoid excess.

“In terms of alcohol and drug use, the safest path would be to be more resistant of peer influences and slightly less connected, but that would then cost you in terms of your social relationships,” Allen notes. And being socially isolated could have negative health consequences. “The research shows that being socially isolated as an adult is as big a risk factor for dying early as cigarette smoking or obesity,” says Allen. “There’s no free lunch here.”

As with many behaviors and their consequences, there are tradeoffs. Teen drinking is obviously not socially desirable, but it could lead to fewer friendships that translate into isolation later in life. The complexity of these actions and reactions may in part explain why abstinence programs of any kind, whether for sex, alcohol or other drugs, aren’t particularly effective, since they come with a cost in peer connections and acceptance that teens aren’t willing to pay.

The findings also highlight how important being accepted by their peers is to teens, and suggests that adults should take these adolescent priorities more seriously. “Many people think, ‘Why are teens so preoccupied with these relationships? They’re really no big deal.’’’ Allen says. “They’re preoccupied because these [early relationships] are precursors for how they will function in life socially for the rest of their lives. [Relationships] are critical to physical and mental health.” Rather than discounting them, it may be worth exploring how to improve them, while teaching teens to balance their desire for acceptance with an appreciation of associated risks.

Understanding the Rise in ADHD Diagnoses: 11% of U.S. Children Are Affected

Psycological Health

Understanding the Rise in ADHD Diagnoses: 11% of U.S. Children Are Affected

2013-04-03

Adderall is a medication often prescribed to children diagnosed with ADHD, but it has side effects

The rates of U.S. children affected by attention-deficit/hyperactivity disorder (ADHD) are skyrocketing, according to a recent report, but experts caution that the latest numbers require a bit of decoding.

That information shows that 11% of children ages 4 to 17 were diagnosed with ADHD, a 16% increase since 2007, the last time that researchers at Centers for Disease Control and Prevention (CDC) did a comprehensive survey for the prevalence of the neurobehavior disorder. The rise was especially dramatic among boys, with an estimated 1 in 5 boys in high school diagnosed with ADHD. What’s more, about two-thirds of the children diagnosed were treated with stimulant medications that can improve attention but also come with side effects.

Are rates truly climbing at such an alarming rate? Possibly. But many experts believe that’s unlikely. The data was collected by the CDC and analyzed and reported by the New York Times; the CDC plans to publish its own report on the data in the coming months.

To start, the information on ADHD rates came from parents reporting on the diagnosis for their children during telephone interviews. Such reports are useful but not as reliable as the verified diagnoses from medical or school records, says Dr. William Barbaresi, director of the developmental-medicine center at Boston Children’s Hospital.

Second, such records-based data suggests that ADHD rates among children may be somewhere between 7.5% and 9.5%, with boys at the higher end of the range, not 11%. In its previous round of analysis, CDC found that ADHD diagnoses rose by 22% between 2003 and ’07, based on the same telephone surveys of 76,000 families in the U.S., climbing by an average of 3% to 6% each year between 2000 and ’10. But the latest figures, which included responses collected between 2011 and ’12, show a far higher prevalence that hints at classrooms full of hyperactive and impulsive kids. “By definition, ADHD requires that symptoms have to have a significant effect on life,” says Barbaresi. “To say that a tenth of all children have a biologic condition that affects their life enough to call it a disorder just does not make sense.”

If that’s the case, then a significant proportion of these children may also be mistreated with medications that they don’t need. “This report and others raises questions about whether we may not be overdiagnosing ADHD and overusing medications,” says Thomas Power, director of the center for management of ADHD at Children’s Hospital of Philadelphia.

That could have serious implications for children’s long-term mental and physical health since ADHD drugs such as Ritalin and Adderall have been linked to dramatic weight loss and suppressed growth. And some experts have voiced concern that early use of the behavior-modifying drugs could alter the natural arc of children’s social and creative development.

The apparent rise in the prevalence of ADHD highlights several shortcomings in the way that not only ADHD but also mental-health issues in general are diagnosed and treated in the U.S., says Barbaresi. Most children are labeled with the disorder by their pediatrician or family doctor, who aren’t always trained in providing the in-depth evaluation that a reliable diagnosis requires. “Symptoms are not and should not be sufficient,” says Ruth Hughes, CEO of Children and Adults With Attention-Deficit Hyperactivity Disorder. “The symptoms have to occur every day for a long period of time, and, more importantly, these symptoms have to lead to major disruption or impairment in at least two areas of a person’s life, such as at school or in relationships.”

While the American Academy of Pediatrics (AAP) recently provided an updated guideline on the criteria for a proper ADHD diagnosis, including reports not only from parents but also from teachers and other day-care personnel about a child’s hyperactive, impulsive and inattentive behavior, not all physicians have the time to carefully collect and vet the input from these sources.

In addition, in order to properly identify a child affected by ADHD, Barbaresi, for example, conducts a medical and psychological assessment that takes several hours and requires the child and the parents to complete questionnaires about how the child responds to different situations, which factors seem to trigger hyperactive behavior or inattentiveness, as well as how disruptive these episodes are to the child’s daily activities. Unfortunately, most insurers do not reimburse for such evaluations, and that pushes already busy doctors to take the path of least resistance — prescribing medications such as Ritalin or Adderall. “That’s the big elephant in the room — pediatricians and the family practitioner are being asked to sort out a complex situation in an inadequate amount of time without access to data from psychological assessments they need to make these fine distinctions,” says Barbaresi. “So it’s a setup for inappropriate decisions to be made.”

And those include not just misdiagnosis and overmedication of children but mistreatment and even underdiagnosis in some situations. In rural and urban areas where mental-health services are scarcer and more stigmatized, rates of ADHD diagnoses are slightly lower than in affluent areas, and children in these areas are less likely to be treated properly. That could have implications for the long-term health of these children, since studies also show that about 60% of children with ADHD have a learning disability, and that 60% will go on to develop another mental illness by age 19. So a proper diagnosis of ADHD doesn’t just provide opportunities to treat behavior problems but potentially mental illnesses as well. That’s why “it’s clearly inappropriate to do these superficial assessments,” says Barbaresi.

Being too quick to diagnose the disorder also means doctors may be bypassing effective, nondrug treatments that may benefit many children, especially the youngest. The AAP recommends that children younger than 6 start with behavior therapy before beginning medications, but writing a prescription is far easier than monitoring a series of sessions that involve training and a commitment of time and effort from parents and family members. “The problem we face is that behavioral, psychosocial and nonpharmacologic interventions are not sufficiently available to people,” says Power. “When I talk to pediatricians and primary-care physicians, they tell me they don’t want to be diagnosing ADHD as often as they are, and they don’t want to be using medications as often as they are, but they don’t have many other options available. It’s difficult to get kids into mental-health treatments and psychosocial treatments that they believe many of these children and their families need.”

These programs are designed to assess what factors trigger and sustain inappropriately impulsive and hyperactive behavior, he says, by involving parents and helping them modify environmental factors or interactions with their children to change their behavior. Playing and engaging more directly with children on a regular basis, for example, tends to calm them down, and setting limits and educating children about the consequences of their actions can also help. In groups that Power has conducted with his patients, parents have reported that such behavioral interventions are effective in improving children’s relationships with their parents as well as with their teachers and classmates in school.

But these programs don’t work in a vacuum, and ideally, parents, doctors and teachers should coordinate their efforts to ensure that the appropriate behavior is being positively reinforced among children with ADHD. “The best treatment is a combination of parent training, behavioral intervention, school interventions and medication where needed,” says Hughes. All too often, current therapies aren’t taking advantage of the full power of this recipe.

@aliceparkny

Alice Park is a staff writer at TIME and covers health, medicine, nutrition and fitness.

Sex Mistakes for Men to Avoid

Sexual Health

Sex Mistakes for Men to Avoid

2013-04-01

By Stacy Lloyd
Both genders are guilty of sex mistakes, according to FoxNews.com. In the article FOXSexpert: The Top 10 Sex Mistakes That Men Make, though, well-known sex experts were sharing ways that men can avoid common sex mistakes with women.

Just because a man is ready for sex doesn’t mean the woman is. This is the single, biggest mistake men make, iVillage sex expert Tracey Cox told NBC News.

They underestimate how long women take to orgasm. Remember foreplay isn’t a luxury, it’s a necessity.

Thinking foreplay begins in the bedroom. Foreplay is best approached as an all-day affair Dr. Yvonne Kristín Fulbright, sex educator, relationship expert and author, wrote on FoxNews.com.

Don’t assume what pleases one woman works for all women. Every woman responds differently to sensation and every woman’s anatomy is a bit different.

What feels amazing to one may do nothing – or even cause discomfort – for another, Tristan Taormino, author of The Secrets of Great G-Spot Orgasms and Female Ejaculation told WebMD.

Don’t ignore the clitoris. Many men think a woman’s orgasmic ability is due to penetration, Fulbright wrote in FoxNews.com. More than 70 percent of women experience clitoral orgasm when it comes to maximum reaction.

WebMD said that the whole body of the clitoris including the glans, is packed with nerves and highly sensitive. Note however that for many women, the glans is actually too sensitive to touch.

Don’t miss the G-spot. Found on the front wall of the vagina, a woman’s G-spot may be more to one side than the other, or a little higher or lower, than is often depicted, said Fulbright. Its size may also vary, from as small as a pea to as large as a quarter wrote FoxNews.com.

Remember her “other” erogenous zones. AskMen.com wrote that it’s easy to forget a woman’s body is full of less obvious erogenous zones. Try kissing her collar bone, back, hips and go from there.

Talk about sex. Most couples don’t talk to each other about sex.

Often that’s because they don’t have the words, sex therapist Chris Donaghue told WebMD. If it’s hard for your partner to say what she wants sexually, try asking her specific rather than open-ended questions, Taormino said on WebMD.

She’s not a porn star. As seen in porn films, many men expect their lovers to fulfill their every fantasy. Remember porn is fantasy, not reality, wrote FoxNews.com.

Don’t think of sex as a mission. It’s much more than that.

Erection, foreplay, penetration – all are aimed at achieving the main objective: orgasm. It’s a mistake to focus solely on orgasm since sometimes it doesn’t happen even for men, said WebMD. When this happens, people can end up feeling bad about sex that was most likely good in other ways.