Troubling
Charles Atkinson et al.
Lancet, 17 June 2013, Page S10
Background: The global burden of mental disorders and substance abuse has increased 38% in absolute terms (5·8% per capita) between 1990 and 2010, from 5·3% to 7·4% of total disability-adjusted life-years (DALYs). Given the increasing importance of mental disorders worldwide, particularly for young adults, how can we make meaningful comparisons to determine which countries' policies have been effective in reducing their burden? This research will demonstrate new methods for comparative analysis highlighting the burden of mental disorders in the USA.
Methods: Mental burden estimates were derived as part of the Global Burden of Disease Study (GBD) 2010. To make meaningful comparisons across time, age-standardised DALY rates were utilised to adjust for changes in population size and age structure.
Findings: Age-standardised DALY rates for mental disorders in the USA increased 13% between 1990 and 2010, from 3162 to 3576 DALYs per 100 000; by contrast, all developed countries increased 5% from 3016 to 3169. This increase in the USA was primarily due to substance abuse (65%) and major depression (13%). Across the 187 countries analysed, with highest rank indicating worst burden, the USA ranked 162nd for mental disorders in 2010. For specific conditions, ordered from highest to lowest burden, the USA ranked 56th for major depression (945 per 100 000), 183rd for drug use (743), 164th for anxiety (594), 138th for alcohol use (354), 179th for schizophrenia (242), and 52nd for bipolar disorder (186). Taking uncertainty into account, drug abuse was the only condition for which the USA performed significantly worse (p<0·0001) compared with the global mean.
Interpretation: The USA consistently ranks below other developed nations and many developing nations for mental disorders despite spending 17·6% (US$2·5 trillion) of its gross domestic product on health in 2010, with 5% of that on mental health, among the highest of any country. This makes a compelling case for re-examination of how the USA should reprioritise mental health policy and funding. For substance abuse, countries that emphasise harm reduction policies (Netherlands, Belgium, Germany) perform substantially better than do those focused on penalisation (USA, UK, Italy, Spain). For anxiety and depression, prescription of psychotropic drugs in lieu of the more effective types of psychotherapy may have led to little improvement despite large expenditure. Further data collection on prevalence and severity of mental disorders is necessary to improve comparisons between countries.
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Don't Worry, Be Sad! On the Cognitive, Motivational, and Interpersonal Benefits of Negative Mood
Joseph Forgas
Current Directions in Psychological Science, June 2013, Pages 225-232
Abstract:
This article reviews recent evidence for the benefits of negative affect for thinking and behavior, consistent with evolutionary theories suggesting an adaptive function for all affective states. Numerous experiments demonstrate that negative affect can improve memory performance, reduce judgmental errors, improve motivation, and result in more effective interpersonal strategies. These findings are interpreted in terms of dual-process theories that predict that positive affect promotes more assimilative, internally focused processing styles, whereas negative affect promotes a more accommodative and externally focused thinking strategy. The theoretical relevance of these findings for recent affect-cognition models is discussed, and the practical implications of recognizing the adaptive benefits of negative affect for social thinking and performance in a number of applied fields are considered.
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Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD?
Janet Currie, Mark Stabile & Lauren Jones
NBER Working Paper, June 2013
Abstract:
We examine the effects of a policy change in the province of Quebec, Canada which greatly expanded insurance coverage for prescription medications. We show that the change was associated with a sharp increase in the use of Ritalin, a medication commonly prescribed for ADHD, relative to the rest of Canada. We ask whether this increase in medication use was associated with improvements in emotional functioning and short- and long-run academic outcomes among children with ADHD. We find evidence of increases in emotional problems among girls, and reductions in educational attainment among boys. Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication use can have negative consequences given the average way these drugs are used in the community.
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Molecular genetics and subjective well-being
Cornelius Rietveld et al.
Proceedings of the National Academy of Sciences, 11 June 2013, Pages 9692-9697
Abstract:
Subjective well-being (SWB) is a major topic of research across the social sciences. Twin and family studies have found that genetic factors may account for as much as 30-40% of the variance in SWB. Here, we study genetic contributions to SWB in a pooled sample of ≈11,500 unrelated, comprehensively-genotyped Swedish and Dutch individuals. We apply a recently developed method to estimate "common narrow heritability": the fraction of variance in SWB that can be explained by the cumulative additive effects of genetic polymorphisms that are common in the population. Our estimates are 5-10% for single-question survey measures of SWB, and 12-18% after correction for measurement error in the SWB measures. Our results suggest guarded optimism about the prospects of using genetic data in SWB research because, although the common narrow heritability is not large, the polymorphisms that contribute to it could feasibly be discovered with a sufficiently large sample of individuals.
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Gestational Influenza and Bipolar Disorder in Adult Offspring
Raveen Parboosing et al.
JAMA Psychiatry, forthcoming
Importance: Gestational influenza has been associated previously with schizophrenia in offspring, but the relationship between this exposure and bipolar disorder (BD) is unclear. The identification of gestational influenza as a risk factor for BD may have potential for preventive approaches.
Design: Nested case-control study of a population-based birth cohort from the Child Health and Development Study (CHDS). From January 1, 1959, through December 31, 1966, the CHDS recruited nearly all pregnant women receiving obstetric care from the Kaiser Permanente Medical Care Plan, Northern California Region (KPNC). Data on treated maternal influenza from the CHDS were used. Potential cases with BD from the cohort were identified by database linkages of identifiers among the CHDS, Kaiser Permanente database, and a large county health care database; by a mailed questionnaire to the CHDS cohort with subsequent interviews; and from an earlier psychiatric follow-up study on this birth cohort.
Participants: Cases of BD (n = 92) confirmed by structured research interviews and consensus diagnosis among the 214 subjects (48% of those ascertained) who participated and control subjects (n = 722) matched on date of birth, sex, and membership in KPNC or residence in Alameda County.
Results: We found a significant, nearly 4-fold increase in the risk of BD (odds ratio, 3.82 [95% CI, 1.58-9.24; P = .003]) after exposure to maternal influenza at any time during pregnancy. The findings were not confounded by maternal age, race, educational level, gestational age at birth, and maternal psychiatric disorders.
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Ian Mitchell et al.
Journal of Forensic Psychiatry & Psychology, May/June 2013, Pages 309-318
Background: Cerebral levels of oxytocin, elevated by intranasal administration, can increase trust, empathy and altruism, and decrease fear. We hypothesised that low levels of these characteristics (found in some personality-disordered forensic patients), would be associated with reduced oxytocin levels.
Aims: To assess whether patients, with psychopathic characteristics associated with selfishness, callousness and the remorseless use of others, plus a chronically unstable, antisocial and socially deviant lifestyle, would show depressed levels of oxytocin.
Method: Basal urinary oxytocin levels (an indicator of cerebral oxytocin) were assessed in 47 forensic psychiatric patients. Levels were compared with those in 21 non-patient controls, and correlated with psychopathic characteristics.
Results: Oxytocin levels were markedly elevated in the patient sample compared to controls. Levels were also strongly correlated with traits associated with a socially deviant lifestyle.
Conclusions: The results point to oxytocin playing a role in antisocial, as well as prosocial behaviours.
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Transcranial Ultrasound (TUS) Effects on Mental States: A Pilot Study
Stuart Hameroff et al.
Brain Stimulation, May 2013, Pages 409-415
Background/Objective: Transcranial ultrasound (TUS) can modulate brain function. To assess possible TUS modulation of mental states, we investigated effects on subjective reports of pain and mood of sub-thermal TUS versus placebo applied to frontal scalp and brain of chronic pain patient volunteers.
Methods: With IRB approval and informed consent, subjects with chronic pain completed two visual analog scales for pain (NRS) and mood (VAMS/Global Affect), and their vital signs were recorded 10 min prior to, and 10 min and 40 min following exposure to either subthermal TUS (8 MHz) or placebo (in a double blind crossover study) using the 12L-RS probe of a LOGIQe ultrasound imaging machine (General Electric, USA). A physician, also blinded for TUS versus placebo, applied the probe (with gel) to scalp over posterior frontal cortex, contralateral to maximal pain, for 15 seconds. A second investigator operated the ultrasound machine, randomizing TUS versus placebo. The process was then repeated, applying the opposite modality (TUS or placebo).
Results: Subjective reports of Mood/Global Affect were improved 10 min (P = 0.03) and 40 min (P = 0.04) following TUS compared with placebo. NRS pain reports slightly improved following TUS (P = 0.07) at 40 min.
Conclusion: We found improvement in subjective mood 10 min and 40 min after TUS compared to placebo. TUS can have safe neurophysiological effects on brain function, and is a promising noninvasive therapy for modulating conscious and unconscious mental states and disorders. We suggest TUS acts via intra-neuronal microtubules, which apparently resonate in TUS megahertz range.
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Karim Kassam & Wendy Berry Mendes
PLoS ONE, June 2013
Abstract:
Measurement effects exist throughout the sciences - the act of measuring often changes the properties of the observed. We suggest emotion research is no exception. The awareness and conscious assessment required by self-report of emotion may significantly alter emotional processes. In this study, participants engaged in a difficult math task designed to induce anger or shame while their cardiovascular responses were measured. Half of the participants were asked to report on their emotional states and appraise their feelings throughout the experiment, whereas the other half completed a control questionnaire. Among those in the anger condition, participants assigned to report on their emotions exhibited qualitatively different physiological responses from those who did not report. For participants in the shame condition, there were no significant differences in physiology based on the self-report manipulation. The study demonstrates that the simple act of reporting on an emotional state may have a substantial impact on the body's reaction to an emotional situation.
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Veronica Gomez, Alexander Grob & Ulrich Orth
Journal of Research in Personality, forthcoming
Abstract:
Despite remarkable stability of life satisfaction across the life span, it may be adaptive to perceive change in life satisfaction. We shed new light on this topic with data from 766 individuals from three age groups and past, present, and future life satisfaction perceptions across the life span. On average, participants were most satisfied with their current life. When looking back, satisfaction increased from past to present, and when looking ahead, satisfaction decreased into the future. Trajectories were best fitted with a curvilinear growth model. Neuroticism and extraversion predicted the level of trajectories, but none of the Big Five predicted the slope. We conclude that humans have an adaptive capacity to perceive the present life as being the best possible.
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An Econometric Assessment of the Effect of Mental Illness on Household Spending Behavior
Arati Dahal & Angela Fertig
Journal of Economic Psychology, August 2013, Pages 18-33
Abstract:
This paper examines the relationship between individuals' mental health status and their spending behavior. Compared to individuals without mental health problems, individuals with mental health problems may have higher discount rates and derive greater utility from spending (i.e., retail therapy). If the mentally ill have these characteristics, we would expect them to purchase goods and services that give immediate enjoyment, sacrificing longer-term savings goals. However, mental health disorders may result in a sense of worthlessness and lethargy such that less utility is derived from spending and less energy is available for spending, which would give us the opposite prediction. Using the Panel Study of Income Dynamics, we generally find a negative effect of mental illness on household spending, although the specific effects vary by the measure of mental illness, by the expenditure category, and by gender and couple status. Of particular concern, single and married women with mental illness reduce spending on education, which suggests a long-term financial cost of mental illness. In addition, we find some evidence of retail therapy with respect to a mental health screen for single and married women and with respect to a mental diagnosis for married men.
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Lauren Human et al.
Journal of Personality, June 2013, Pages 249-260
Abstract:
Personality change is emerging as an important predictor of health and well-being. Extending previous research, we examined whether two types of personality change, directional and absolute, are associated with both subjective and objective indicators of health. Utilizing the longitudinal Midlife in the United States survey (MIDUS) data, we examined whether both types of change over 10 years were associated with psychological well-being, self-reported global health, and the presence of metabolic syndrome (MetS) components and diagnosis. Socially undesirable personality change (e.g., becoming less conscientious and more neurotic) and absolute personality change were independently associated with worse perceived health and well-being at Time 2. Notably, absolute personality change, regardless of the direction, was also associated with having a greater number of MetS components and a greater probability of diagnosis at Time 2. In sum, too much personality change may be bad for one's health: Socially undesirable and absolute personality change were both associated with worse psychological health and worse metabolic profiles over 10 years. These findings suggest that personality change may contribute to psychological and physical health, and provide initial insight into potential intermediate links between personality change and distal outcomes such as mortality.
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Gray matter abnormalities in patients with narcissistic personality disorder
Lars Schulze et al.
Journal of Psychiatric Research, forthcoming
Background: Despite the relevance of narcissistic personality disorder (NPD) in clinical settings, there is currently no empirical data available regarding the neurobiological correlates of NPD. In the present study, we performed a voxel-based morphometric analysis to provide initial insight into local abnormalities of gray matter (GM) volume.
Methods: Structural brain images were obtained from patients with NPD (n = 17) and a sample of healthy controls (n = 17) matched regarding age, gender, handedness, and intelligence. Groups were compared with regard to global brain tissue volumes and local abnormalities of GM volume. Regions-of-interest analyses were calculated for the anterior insula.
Results: Relative to the control group, NPD patients had smaller GM volume in the left anterior insula. Independent of group, GM volume in the left anterior insula was positively related to self-reported emotional empathy. Complementary whole-brain analyses yielded smaller GM volume in fronto-paralimbic brain regions comprising the rostral and median cingulate cortex as well as dorsolateral and medial parts of the prefrontal cortex.
Conclusion: Here we provide the first empirical evidence for structural abnormalities in fronto-paralimbic brain regions of patients with NPD. The results are discussed in the context of NPD patients' restricted ability for emotional empathy.
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Attentional bias for performance-related words in individuals with narcissism
Yuanbo Gu, Ning He & Guoqin Zhao
Personality and Individual Differences, forthcoming
Abstract:
In this study, dot probe tasks were employed to present performance-related or interpersonal-related words paired with neutral words, we examined the attentional bias of narcissists as well as its mechanism. Results showed that the narcissistic individuals demonstrated significant attentional bias for performance words. Specifically, they were highly vigilant to failure words and had difficulty disengaging from success words, and there was no such bias for the category of interpersonal ones. Non-narcissists, on the other hand, exhibited significant difficulty disengaging from negative words, including failure words and rejection words. From this data, it would appear that attentional bias may be a built-in cognitive attribute of narcissism. The limitations of the present study and future research directions are also discussed.
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Sad music induces pleasant emotion
Ai Kawakami et al.
Frontiers in Psychology, June 2013
Abstract:
In general, sad music is thought to cause us to experience sadness, which is considered an unpleasant emotion. As a result, the question arises as to why we listen to sad music if it evokes sadness. One possible answer to this question is that we may actually feel positive emotions when we listen to sad music. This suggestion may appear to be counterintuitive; however, in this study, by dividing musical emotion into perceived emotion and felt emotion, we investigated this potential emotional response to music. We hypothesized that felt and perceived emotion may not actually coincide in this respect: sad music would be perceived as sad, but the experience of listening to sad music would evoke positive emotions. A total of 44 participants listened to musical excerpts and provided data on perceived and felt emotions by rating 62 descriptive words or phrases related to emotions on a scale that ranged from 0 (not at all) to 4 (very much). The results revealed that the sad music was perceived to be more tragic, whereas the actual experiences of the participants listening to the sad music induced them to feel more romantic, more blithe, and less tragic emotions than they actually perceived with respect to the same music. Thus, the participants experienced ambivalent emotions when they listened to the sad music. After considering the possible reasons that listeners were induced to experience emotional ambivalence by the sad music, we concluded that the formulation of a new model would be essential for examining the emotions induced by music and that this new model must entertain the possibility that what we experience when listening to music is vicarious emotion.
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Marlene Gubata et al.
Journal of Psychosomatic Research, July 2013, Pages 43-48
Objective: Mental health disorders contribute substantially to medical and occupational morbidity. The role of fitness and physical activity in the prevention of mental health disorders is not well established, but epidemiologic data suggest that physical activity can protect against anxiety and depression.
Method: The analyses presented in this report, from a prospective cohort study, evaluate the association between fitness (as measured by a 5-minute step test), and being overweight (defined as exceeding weight and body fat allowances) at military entrance, with subsequent onset of mental disorder diagnosis in the first year of service. The association between risk factors and mental disorder diagnosis was analyzed using multivariate Poisson regression with the adjusted incidence rate ratio (aIRR) as the measure of association.
Results: Among weight-qualified participants, factors associated with increased incidence of mental disorder included failing the physical fitness test (aIRR: 1.36, p < 0.0001), female sex (aIRR: 2.17, p < 0.0001), and smoking (aIRR: 1.49, p < 0.0001). Among fit participants, being overweight was not significantly associated with mental disorder (aIRR: 1.11, p = 0.1540).
Conclusions: This test has potential military utility as an adjunct part of the medical examination process. Additional research is needed among civilians to determine if similar associations exist. If so, intervention studies should be conducted to determine if improving physical fitness reduces subsequent psychiatric disorder risk, particularly among young adults entering into stressful situations.