Tag Archives: mental health

By Ted Boscia
Reprinted from Cornell Chronicle, December 10, 2012

Exner-Cortens

Teenagers in physically or psychologically aggressive dating relationships are more than twice as likely to repeat such damaging relationships as adults and report increased substance use and suicidal feelings years later, compared with teens with healthy dating experiences, reports a new Cornell study.

The findings suggest the need for parents, schools and health care providers to talk to teenagers about dating violence, given its long-reaching effects on adult relationships and mental health, the researchers say.

Published online Dec. 10 in the journal Pediatrics, the paper is the first longitudinal study of a nationally representative sample to show links between teen dating violence and later multiple adverse health outcomes in young adults. The authors found that teen girls and boys reported aggressive experiences in relationships nearly equally, with 30 percent of males and 31 percent of females in the study showing a history of physical and/or psychological dating violence.

"Teens are experiencing their first romantic relationships, so it could be that aggressive relationships are skewing their view of what's normal and healthy and putting them on a trajectory for future victimization," said lead author Deinera Exner-Cortens, M.A. '10, a doctoral student in the field of human development in the College of Human Ecology. "In this regard, we found evidence that teen relationships can matter a great deal over the long run."

Exner-Cortens and her co-authors analyzed a sample of 5,681 American heterosexual youths ages 12-18 from the National Longitudinal Study of Adolescent Health who were interviewed as teens and approximately five years later as young adults about their dating experiences and mental and behavioral health. Participants were asked if a partner had ever used insults, name-calling or disrespect in front of others; had sworn at them; threatened violence; pushed or shoved them; or thrown objects that could hurt them. About 20 percent of teen respondents reported psychological violence only, 9 percent reported physical and psychological violence, and 2 percent reported physical violence alone.

In young adulthood, females who had experienced teen dating violence reported increased depression symptoms and were 1.5 times more likely to binge drink or smoke and twice as likely to have suicidal thoughts. Males who had experienced teen dating violence reported more anti-social behaviors, were 1.3 times more likely to use marijuana and twice as likely to have suicidal thoughts. The study controlled for pubertal development, child maltreatment history and a range of socio-demographic factors.

"In addition to clarifying potential long-term impacts of teen dating violence victimization, our study highlights the importance of talking to all adolescents about dating and dating violence," Exner-Cortens said. "This includes prioritizing teen dating violence screening during clinical visits and developing health care-based interventions for responding to adolescents who are in unhealthy relationships, in order to help reduce future health problems in these teens."

Study co-authors are John Eckenrode, Cornell professor of human development and director of the Bronfenbrenner Center for Translational Research, and Emily Rothman at the Boston University School of Public Health. The research was supported by the Canadian Institutes of Health Research and the National Institute on Alcohol Abuse and Alcoholism.

Ted Boscia is assistant director of communications for the College of Human Ecology.

By Ted Boscia
Reprinted from Cornell Chronicle, December 4, 2012

Whitlock

Non-suicidal self-injury (NSSI) -- deliberately harming one's body through such acts as cutting, burning or biting -- is a primary risk factor for future suicide in teens and young adults, finds a new longitudinal study of college students led by a Cornell mental health researcher.

The paper, published online Dec. 4 in the Journal of Adolescent Health, describes how NSSI, thought to be a coping mechanism for some individuals in distress, may also open the door to more dangerous actions by lowering one's inhibitions to suicidal thoughts and behaviors.

"While we can't conclude that self-injury leads to later suicide attempts, it is a red flag that someone is distressed and is at greater risk," said lead author Janis Whitlock, Ph.D. '03, a research scientist in the Bronfenbrenner Center for Translational Research (BCTR). "This is important because self-injury is a relatively new behavior that does not show up much in the literature as a risk factor for suicide. It also suggests that if someone with self-injury history becomes suicidal, having engaged in NSSI may make it much easier to carry out the physical actions needed to lethally damage the body."
 
In a longitudinal study of 1,466 students at five U.S. colleges, Whitlock, director of the Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults, and co-investigators found NSSI to precede or coincide with suicidal thoughts and behaviors in slightly more than 60 percent of cases observed.

Participants, most in their early 20s, answered a confidential mental health survey annually for three years that assessed their history of NSSI and suicidal thoughts and behaviors, along with demographic information and common protective and risk factors. Researchers found that, independent of other risk factors, people who had self-injured were nearly three times as likely to attempt or consider suicide, while those with a history of five or more instances of self-injury were four times more likely to do so. The study has implications for NSSI treatment and suicide prevention. Previous studies have shown as many as 20 percent of college students and 25-35 percent of teens have a lifetime history of NSSI. Given its prevalence, Whitlock noted that physicians and others who work with youth should be better trained to spot such behaviors and assess for suicide risk.

Of many protective factors considered, the study identified two that appear to help lower the suicide risk in young people with a history of NSSI. Participants who had confided in their parents about their distress and those who perceived meaning in life were significantly less likely to show suicidal thoughts and behaviors.

"Meaning in life as a protective factor is not so surprising, because many who attempt suicide report that they feel a deep and often chronic lack of life meaning," Whitlock said. "However, considering that we studied a college population, it's a surprise that the parents emerged as having such a powerful influence in young adults' mental well-being, especially since we looked at respondents' relationships with all kinds of people, including therapists. Treatments for people at risk for suicide should focus on strengthening these relationships when feasible."

Cornell co-authors on the paper include John Eckenrode, BCTR director and professor of human development, and Amanda Purington, BCTR research support specialist.

The research was supported by a grant from the American Foundation for Suicide Prevention.

Ted Boscia is assistant director of communications for the College of Human Ecology.

By Karene Booker
Reprinted from Cornell Chronicle, August 6, 2012
 
Evans

Evans

Such behavior problems in adolescence as aggression and delinquency are linked to chronic stress in early childhood, which interferes with children's development of self-control, reports a Cornell study published online in April in Developmental Psychology. 

To better understand the well-documented link between poverty and poor outcomes for children, the researchers analyzed data on risk factors, maternal responsiveness and child characteristics in 265 adolescents and their parents. 

The longitudinal study found that early exposure to the multiple risks linked with poverty -- such as poor living conditions, separation from family, single parenting and violence -- negatively affects children's self-regulatory abilities, critical skills needed to plan and control attention and behavior toward one's goals. These risks compromised children's self-regulation directly as well as indirectly when mothers could not provide sensitive, nurturing care. 

Lower self-regulation is, in turn, linked to more "externalizing" problems in adolescents, such as aggression and delinquency. "Internalizing" problems, such as depression and anxiety, were not similarly affected. 

"Our research examines the additive effects of multiple stressor exposures, rather than the typical focus on single variables such as divorce, abuse or housing," said Gary W. Evans, the Elizabeth Lee Vincent Professor of Human Ecology in Cornell's College of Human Ecology. He conducted the study with lead author Stacey N. Doan, Ph.D. '10, assistant professor of psychology at Boston University, and Thomas Fuller-Rowell, Ph.D. '10, a Robert Wood Johnson postdoctoral fellow at the University of Wisconsin-Madison. 

"One of the things that chronic stress seems to do in children is damage the body's ability to regulate the physiological response system for handling environmental demands with consequences for physical and mental health," Evans said. "By teasing apart two major subtypes of psychological well-being, internalizing and externalizing, we have shown that their predictors operate differentially." 

In other words, internalizing and externalizing problems may have different causes and be influenced by different factors. Temperament may be more predictive of internalizing problems, while environmental risk factors are more associated with externalizing problems, the authors say. 

"Overall, our results suggest that while it may not always possible to increase income or reduce all risk factors, by improving parenting skills or child self-regulation abilities we may be able to ameliorate some of the effects of poverty on children's mental health," Doan said. 

This research was funded by the W.T. Grant Foundation, the John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health, and the Robert Wood Johnson Foundation Health and Society Scholars Program. 

Karene Booker is an extension support specialist in the Department of Human Development.

By Susan Kelley
Reprinted from the Cornell Chronicle, June 25, 2012

Zayas

Selcuk

Here's another reason to keep a photo of a loved one on your desk. After recalling an upsetting event, thinking about your mother or romantic partner can make you feel better and reduce your negative thinking, according to a new Cornell study. Perhaps most important, it also may result in fewer psychological and physical health problems at least a month afterward.

"Our own memories can often be a significant source of stress. For example, thinking about a recent breakup or underperforming on an exam usually decreases positive mood and increases negative thinking," said co-author Vivian Zayas, assistant professor of psychology. "However, simply thinking about an attachment figure, whether it is one's mother or partner, by either recalling a supportive interaction with them or just viewing their photograph, helps people restore their mood and decreases the tendency to engage in negative thinking."

The research is the first to explore the benefits of thinking about a loved one when a person experiences stress they generate themselves. Previous research has focused on the benefits when a person experiences externally generated stress, such as physical pain.

"We're showing the effectiveness of a new technique to cope with negative memories," said co-author Emre Selcuk, a Ph.D. candidate in the graduate field of human development. "As compared to prior work, it is a much less effortful, automatic and spontaneous strategy."

Past research has also focused on emotion regulation strategies that can be employed before encountering an upsetting event. "This approach is similar to wearing a raincoat to prevent oneself from getting wet," Zayas said. "But, in everyday life, it is not always possible to pre-emptively deal with upsetting events. Our work shows that one way to regulate emotion after thinking about an upsetting event is by simply thinking about an attachment figure. It is akin to getting caught in a thunder shower and using a towel to dry yourself off after you are already wet."

The paper appears online and in a forthcoming edition of the Journal of Personality and Social Psychology.

To arrive at their conclusions, the authors designed a series of experiments in which they asked study participants to recall a negative memory and then think of a loved one. In the first experiment, participants were asked to think about a time when their mothers had been supportive. In the second, they looked at a photograph of their mothers, and in the third, they looked at a photograph of a romantic partner. In the control condition, participants were asked to think about an interaction with an acquaintance or look at a photograph of someone they didn't know.

After being reminded of their loved ones, people recovered faster and were less susceptible to negative thinking. At least one month after the experiment, those who benefited the most from being reminded of the loved ones reported fewer physical or psychological health problems.

The research has implications for mental and physical health, the authors say, because an inability to cope with negative memories -- that is, recalling them repeatedly -- is a major predictor of psychological and physical health problems from depression and general anxiety disorders to cardiovascular disease.

And the technique is easy to integrate into daily life, Selcuk said. "If you're moving to a new city, put a picture of your loved ones on the fridge. If you get a supportive text message from a loved one, just store it in your cell phone so you can retrieve it later."

The other authors are Cornell's Gül Günaydin, a Ph.D. candidate in the field of psychology, and Cindy Hazan, associate professor of human development, and Ethan Kross, assistant processor of psychology at the University of Michigan.

The research was supported by Cornell's Institute for the Social Sciences and the President's Council of Cornell Women.

By Karene Booker
Reprinted from Cornell Chronicle, February 20, 2012

Depue

Depue

Personality disorders could be more effectively diagnosed by identifying and targeting the disrupted neurobiological systems where the disorders originate, report Cornell researchers.

The way that these mental illnesses are now classified -- based on particular patterns of thought and behavior -- is misguided and has little hard evidence to support it, reports Cornell neuroscientist Richard Depue and his colleague in a special issue of the Journal of International Review of Psychiatry (23:3).

"The behavioral features used to diagnose personality disorders do not coalesce into coherent disorders in any research," says Depue, professor of human development in the College of Human Ecology, who co-authored the article with graduate student Yu Fu. "As currently defined, the different personality disorders have overlapping behavioral symptoms that also merge imperceptibly with normal behavior. A diagnosis should define a coherent behavioral pattern and predict a particular course, prognosis and treatment. No personality disorder diagnosis can do that."

Their findings fly in the face of current medical practice. Nearly one in 10 Americans suffers from a personality disorder, a group of disabling conditions characterized by serious, sometimes catastrophic, problems with relationships and work. Behavioral features can vary widely, from pervasive disregard for the law and the rights of others (antisocial personality disorder) to extreme mood instability (borderline personality disorder).

The researchers drew their conclusions by conducting a detailed review of the brain systems that underlie the major human personality traits.

Humans have about six major personality traits, each with its own neurobiological foundation that influences such behaviors as how anxious or impulsive we are, Depue notes. For example, the underlying systems and associated personality traits in their model include anxiety/stress-reactivity (thought to underlie neuroticism and negative emotionality) and neural constraint (thought to underlie conscientiousness), among others. The variety of behaviors associated with personality disorders arise from the influence of an individual's genetic make-up and environment on neurobiological functioning, they say.

In their multidimensional model, a person's personality traits can be plotted in three-dimensional space where the axes represent the underlying neurobehavioral systems. The patterns of behavior associated with personality disorders emerge from the interaction of extremely high or low values or levels of normal traits; such extremes lead to impaired interactions, they say.

"Our model links personality traits with the underlying neurobiology, which provides a better framework for understanding how and why personality disorders develop and how they can be treated," he says. "It allows us to better predict interventions, such as certain drugs and/or environmental interventions, which may be of benefit. We can also start thinking of treatments that modify multiple neurobiological variables, rather than just one or two."

And recent discoveries in neuroscience point to the important role environment plays, particularly during early childhood, in how genes are expressed, Depue says. "So, risks for personality disorders can be either magnified or reduced by the interaction of the individual's circumstances with their genetic make-up, in a process called epigenetics. We see evidence for this in personality disorders, which are much more prevalent in those who have suffered from a variety of childhood stresses and abuse."

Their theoretical analysis has implications for the criteria used for classifying personality disorders in the Diagnostic and Statistical Manual of Mental Disorders. It also contributes to a growing body of evidence that calls for a rethinking of the approach to classifying these illnesses, based on the underlying biochemical and neural processes that result in the symptoms.

The research was supported by a grant from the National Institute of Mental Health.

Karene Booker is an extension support specialist in the Department of Human Development.