Psychological Impact of Child Abuse

The Mayo Clinic just issued the following news release:

Mayo Clinic Researchers Examine the Psychological Impact of Child Abuse

SAN FRANCISCO, May 21 — According to a new Mayo Clinic study, a history
of child abuse significantly impacts the wide range of challenges facing
depressed inpatients.

Included are an increase in suicide attempts, prevalence of substance
use disorder, and a higher incidence rate of personality disorder.

Additionally, these victims also had an earlier onset of mental illness
and an increase in psychiatric hospitalizations for psychiatric issues.

The study was presented at the American Psychiatric Association 2009
Annual Meeting in San Francisco.

The impact of child abuse already is known to increase the risk of
suicide; however, the literature about other characteristics of
depressed victims of child abuse is scarce.

Although the findings of the Mayo study do not confirm causality, the
information stresses the importance of more aggressive approaches from
the public health perspective to prevent child abuse.

“A history of child abuse makes most psychiatric illnesses worse,”
according to Magdalena Romanowicz, M.D., lead author of the study.

“We found that it significantly impacts the wide range of
characteristics of depressed inpatients, including increased risk of
suicide attempt, substance abuse, as well as earlier onset of mental
illness and more psychiatric hospitalizations.

This new information serves as a reminder of the importance of child
abuse prevention from a public health perspective.”

Dr. Romanowicz says plans are under way to further examine the
association between child abuse and metal illness in a larger study of
patients.

Other authors of this Mayo Clinic study include: Gen Shinozaki, M.D.;
Victoria Passov, M.D.; Simon Kung, M.D.; Renato Alarcon, M.D.; and David
Mrazek, M.D.

Courtesy of Ken Pope

 

Link between depression and cardiovascular disease: belly fat

Rush University Medical Center issued the following news release:

Depression linked with accumulation of visceral fat

Study explains association between depression and cardiovascular disease

Numerous studies have shown that depression is associated with an
increased risk of heart disease, but exactly how has never been clear.

Now, researchers at Rush University Medical Center have shown that
depression is linked with the accumulation of visceral fat, the kind of
fat packed between internal organs at the waistline, which has long been
known to increase the risk of cardiovascular disease and diabetes.

 

Family Ties Provide Protection Against Young Adult Suicidal Behavior

The University of Washington issued a news release about
research to be presented later this week at the annual meeting of the
American Association of Suicidology.  Some excerpts:

Adolescents and young adults typically consider peer relationships to be
all important. However, it appears that strong family support, not peer support, is
protective in reducing future suicidal behavior among young adults when
they have experienced depression or have attempted suicide.

New research that will be presented here April 17 at the annual meeting
of the American Association of Suicidology shows that high school
depression and a previous suicide attempt were significant predictors of
thinking about suicide one or two years later. But, those individuals
who had high levels of depression or had attempted suicide in high
school were less likely to engage in suicidal thinking if they had
strong family support and bonds.

In addition, having a current romantic partner also reduced suicidal thoughts.

By bonding, the researchers are referring to a person’s closeness with
his or her family, or a partner, enjoying spending time with them, and
the ability to talk with them about important issues.

“Our findings suggest that the protective quality of family support and
bonding, or having an intimate partner, are not replaced by peer support
and bonding in emerging adulthood. “

 

Childhood abuse associated with later psychosis – in women

King’s College London issued the following news release:

Childhood abuse associated with onset of psychosis in women

Researchers at the Institute of Psychiatry, King’s College London have
published new research which indicates that women with severe mental
illness are more likely to have been abused in childhood that the
general population.

But the same association has not been found in men.

The researchers believe their findings point to differences in the way
boys and girls respond to traumatic and upsetting experiences.

The paper which is published in the April issue of the British Journal
of Psychiatry compared two groups of adults with all the participants
were aged between 16 and 64, and lived in either south-east London or
Nottingham.

Those in the first group had experienced psychotic symptoms, such as
hallucinations or delusions and received treatment for depression, mania
or schizophrenia. Those in the second group had no mental health
problems, and acted as a control sample. Both groups were asked whether
they experienced physical or sexual abuse during their childhood.

Women with psychosis were twice as likely to report either physical or
sexual abuse compared to healthy women. But no such association was
found in men.

The researchers suggest that one explanation for this is that girls are
more likely to ‘internalise’ difficulties than boys. In other words,
girls who are abused may distance themselves from other people, and
become overly suspicious of other people’s behaviour. This may put them
at greater risk of psychotic symptoms in the future, such as paranoid
delusions.

In contrast, boys may be more likely to ‘act out’ following physical
abuse and potentially be at greater risk for antisocial behaviour.

The lead author on this paper, Helen Fisher, Researcher in Psychosis at
the Institute of Psychiatry at King’s said: “These findings do not mean
that if a child is abused they will develop psychosis; but women with
such disorders are more likely to reveal a background which included
childhood abuse.

“These findings point to the need for gender-specific interventions for
abused children to prevent later mental health and behavioural problems.”

“We also know that there are psychological, biological and genetic
factors that may contribute to this condition in women and more
attention needs to be given to understanding how adult psychosis
develops. Excitingly we have just been awarded a Wellcome Trust grant to
repeat this original study on a larger scale to enable us to investigate
the factors involved in this link between childhood abuse and psychotic
disorders.”

The paper entitled: “Gender differences in the association between
childhood abuse and psychosis” is published in the British Journal of
Psychiatry, 194: 319-325.

The authors were: Fisher H, Morgan C, Dazzan P, Craig TK, Morgan K,
Hutchinson G, Jones PB, Doody GA, Pariante C, McGuffin P, Murray RM,
Leff J and Fearon P (2009)

 

Healthy Boundaries

Healthy Boundaries

What are boundaries?

The word boundary in the American Heritage Dictionary is defined as “an indicated border or limit.” In relationships boundaries are often defined as the line that indicates where one person ends and the other begins. People with healthy boundaries have developed an identity separate and distinct from others and are not dependent upon others to nurture their personal and spiritual growth. Consider the following illustrations below:

Figure 1 illustrates healthy boundaries. In this relationship, the line between partners is easily identifiable. They are independent beings, yet they are close enough to be connected and to have an impact on each other’s life. In healthy relationships boundaries are flexible. They grow and change. Boundaries can be lowered to promote intimacy or extended to promote safety.

In Figure 2, it is difficult to distinguish one partner from the other. This is called enmeshment or collapsed boundaries. Partners in an enmeshed relationship generally try to merge with the other in order to avoid the emptiness they feel when alone. This is troublesome, because partners either seek to lose themselves in the other or expect their partner to become lost in them.

Figure 3 illustrates a relationship where each partner is completely self-contained, having very little impact on the other and very little emotional connection. This is called an emotionally detached relationship or rigid boundaries. The boundaries in this relationship tend to be more like walls and prevent intimacy.

What kind of boundaries do you have?

Look at the following characteristics to determine what kinds of boundaries you have:

HEALTHY BOUNDARIES

• You can say no or yes, and you are ok when others say no to you.
• You have a strong sense of identity. You respect yourself.
• You expect reciprocity in a relationship-you share responsibility and power.
• You know when the problem is yours and when it belongs to someone else.
• You share personal information gradually in a mutually sharing/trusting relationship.
• You don’t tolerate abuse or disrespect.
• You know your own wants, needs and feelings. You communicate them clearly in your relationships.
• You are committed to and responsible for exploring and nurturing your full potential.
• You are responsible for your own happiness and fulfillment. You allow others to be responsible for their own happiness and fulfillment.

• You value your opinions and feelings as much as others.
• You know your limits. You allow others to define their limits.
• You are able to ask for help when you need it.
• You don’t compromise your values or integrity to avoid rejection.

COLLAPSED BOUNDARIES

• You can’t say no, because you are afraid of rejection or abandonment.
• Your identity consists of what you think others want you to be. You are a chameleon.
• You have no balance of power or responsibility in your relationships. You tend to be either overly responsible and controlling or passive and dependent.
• You take on other’s problems as your own.
• You share personal information too soon. . .before establishing mutual trust/sharing.
• You have a high tolerance for abuse or being treated with disrespect.
• Your wants needs and feelings are secondary to others’ and are sometimes determined by others.
• You ignore your inner voice and allow others expectations to define your potential.
• You feel responsible for other’s happiness and fulfillment and sometimes rely on your relationships to create that for you.
• You tend to absorb the feelings of others.
• You rely on others opinions, feelings and ideas more than you do your own.
• You allow others to define your limits or try to define limits for others.
• You compromise your values and beliefs in order to please others or to avoid conflict.

RIGID BOUNDARIES

• You are likely to say no if the request involves close interaction.
• You avoid intimacy (pick fights, stay too busy, etc.)
• You fear abandonment OR engulfment, so you avoid closeness.
• You rarely share personal information.
• You have difficulty identifying wants, needs, feelings.
• You have few or no close relationships. If you have a partner, you have very separate lives and virtually no shared social life.
• You rarely ask for help.
• You do not allow yourself to connect with other people and their problems.

How do I change?

Understand that developing healthier boundaries (as with any life change) is a process, not an event. Thus, it will take time and practice. There are no quick fixes. However, healthy boundaries will lead to improved self-esteem and increased intimacy in your relationships. So the payoff is big, if you are persistent! Below are a few suggestions to help you stay on track in the process:

1. Identify the ways in which your boundaries are unhealthy. Make a list of how they express themselves in your life.

2. Write letters to yourself encouraging change and addressing the fears that work to prevent change. Nurture your right to have boundaries!

3. Make a list of personal rights (i. e. boundaries) in your relationships and paste it where you can read it often.

4. Keep a journal and record the pain associated with not maintaining healthy boundaries in your relationships. (Sometimes pain is a great motivator.)

5. Write an entry in your journal answering the question “Who Am I?” Do this periodically.

6. Look for role models of healthy boundaries in your life or in the media. When confronting a boundary challenging situation ask yourself “What would my role model do?” Better yet, if your role model is a part of your life, ask them!

7. Build in time for yourself away from your relationship on a regular basis. This will include alone time, time with your close friends, time for spiritual growth, and time to attend to life’s little responsibilities.

8. If you have difficulty saying ‘No,” look for opportunities to practice. If you have difficulty saying “Yes” to any activity that involves interacting with others, look for opportunities to practice.

9. Seek counseling to examine the roots of your unhealthy boundaries.

- author unknown at this time –

 

Healthy emotional boundaries – links to learn more

Emotional Boundaries

A successful relationship is composed of two individuals each with a clearly defined sense of her or his own identity, our emotional boundaries …
www.hiddenhurt.co.uk/Articles/boundaries.htm – 25k -

Boundaries Introduction

Boundaries. What are They — Why do I Need Them. Enforcing appropriate boundaries is the single most powerful thing that you can do unilaterally to improve …
www.bpd411.org/boundariesintro.html – 14k -

Developing Healthy Boundaries – Maggie Down, Counsellor …

Cottesloe Counselling Centre in Perth, Western Australia. Counselling and psychotherapy for those experiencing personal, relationship and work related …
www.cottesloecounselling.com.au/developing_healthy_boundaries.html – 20k -

Relationship Advice for Healthy Boundaries

Helpful relationship advice and resources for improving boundaries and restoring relationships. Links to resources to help with relationship difficulties …
www.healthyboundaries.com/ – 18k -

Forgiveness

A successful relationship is composed of two individuals each with a clearly defined sense of her or his own identity. Without our own understanding of self …
www.drbalternatives.com/articles/si7.html – 21k -

Boundaries & Relationships – Communication – Relationships …

Where do you end and others begin? Do you believe that others are responsible for your feelings and behaviors and vice versa?
www.familyresource.com/relationships/communication/boundaries-and-relationships – 25k -

Characteristics of Healthy Relationships – John Cloud, PhD

1 Nov 2008 … For those who are starting to venture out, here are some guidelines; they may save you some pain. The fact is that there are probably …
www.bpdfamily.com/bpdresources/nk_a114.htm – 34k -

Boundaries Essential to Healthy Relationships | Santa Monica & Los …

What are boundaries and how do they help relationships, how do they help us in everyday life. Licia Ginne, Licensed Marriage and Family Therapist …
www.latherapists.com/articles_boundaries.html – 21k -

What Are Boundaries and Why are They Important?

If your life is filled with more of what you don’t want and not enough of what you do want, it’s time to set your boundaries. …
ezinearticles.com/?What-Are-Boundaries-and-Why-are-They-Important?&id=124319 – 49k -

Relationship Deal Breakers – Non Negotiable Boundaries

How many relationship deal breakers do you have on your list? Do you even have a relationship deal breaker list? What about your now-dating teenage ch.
www.tellinitlikeitis.net/2008/01/relationship-deal-breakers-non-negotiable-boundaries.html – 78k

Setting Boundaries in Relationships

Setting Boundaries in Relationships By Judy H. Wright Platinum Quality Author. Judy H. Wright Level: Platinum Judy is a parent educator, family coach, …
ezinearticles.com/?Setting-Boundaries-in-Relationships&id=212273 – 50k -

Boundaries

Telling all. I consider the other person’s level of interest and caring before opening up to them. Talking at an intimate level on the first meeting. …
www.howard.edu/services/counseling/Boundaries.htm – 25k -

Boundaries: Respect in Relationships by D. Scott Miller -Youth …

Teens can help foster healthy relationships by placing boundaries on their emotions, time, privacy and bodies.
www.americancatholic.org/newsletters/yu/ay0903.asp – 47k -

Establish Boundaries That Honor You.

Boundaries are imaginary lines that help you protect yourself both physically and emotionally. They keep other’s actions and behaviors from hurting, …
www.mommd.com/settingboundaries.shtml – 32k -

About Boundaries

18 Sep 2004 … Thoughts on personal boundaries, healthy and unhealthy personal relationships and about the power of healthy boundaries.
www.ybrt.org/bounder.html – 23k

Relationships : A Checklist on Boundaries in a Relationship

Heathly boundaries allow a person to experience comfortable interdependence with other people, resulting in generally functioning relationships and positive …
www.yourpotential.net/3/5/A_Checklist_on_Boundaries_in_a_Relationship.html – 24k -

What are boundaries?

www.adfam.org.uk/pdf/adfam_setting_and_keeping_boundaries.pdf

What Are Boundaries? – Archive – parenting.org

As an adult, you should be familiar with the concept of boundaries. Boundaries are the limits you set for relationships. They help you to recognize what is …
www.parenting.org/archive/tween/life_lessons/2003/Sep03_boundaries.asp – 22k -

Setting Healthy Boundaries: How to Say No, Yes, and Never – And …
behavioural-psychology.suite101.com/article.cfm/setting_healthy_boundaries – 38k –

 

Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar Depression

Press Release
April 02, 2007
Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar Depression
Patients taking medications to treat bipolar disorder are more likely to get well faster and stay well if they receive intensive psychotherapy, according to results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH). The results are published in the April 2007 issue of the Archives of General Psychiatry.

Bipolar disorder is a debilitating illness marked by severe mood swings between depression and mania that affects 2.6 percent of Americans in any given year. “We know that medication is an important component in the treatment of bipolar illness. These new results suggest that adding specific, targeted psychotherapy to medication may help give patients a better shot at lasting recovery,” said NIH Director Dr. Elias A. Zerhouni.

“STEP-BD is helping us identify the best tools-both medications and psychosocial treatments-that patients and their clinicians can use to battle the symptoms of this illness,” said NIMH Director Thomas R. Insel, M.D.

Psychotherapy is routinely employed as a means to treat bipolar illness in conjunction with medication, but the extent to which psychotherapy is effective has been unclear. In addition, most psychotherapeutic studies have been limited to a single site and compared only one type of treatment to routine care. Thus, in addition to examining the role of medication, STEP-BD set out to compare several types of psychotherapy and pinpoint the most effective treatments and treatment combinations.

With 293 participants, David Miklowitz, Ph.D., of the University of Colorado and colleagues set out to test the effectiveness of three types of standardized, intensive, nine-month-long psychotherapy compared to a control group that received a three-session, psychoeducational program called collaborative care. The intensive therapies were

* family-focused therapy, which required the participation and input of patients’ family members and focused on enhancing family coping, communication and problem-solving;
* cognitive behavioral therapy, which focused on helping the patient understand distortions in thinking and activity, and learn new ways of coping with the illness; and
* interpersonal and social rhythm therapy, which focused on helping the patient stabilize his or her daily routines and sleep/wake cycles, and solve key relationship problems.

All participants were already taking medication for their bipolar disorder, and most were also enrolled in a STEP-BD medication study reported in the New England Journal of Medicine on March 28, 2007. The researchers compared patients’ time to recovery and their stability over one year.

Over the course of the year, 64 percent of those in the intensive psychotherapy groups had become well, compared with 52 percent of those in collaborative care therapy. Patients in intensive psychotherapy also became well an average of 110 days faster than those in collaborative care. In addition, patients who received intensive psychotherapy were one and a half times more likely to be clinically well during any month out of the study year than those who received collaborative care. Discontinuation rates among the groups were similar-36 percent of those in the intensive programs discontinued and 31 percent of those in collaborative care discontinued. None of the three intensive psychotherapies appeared to be significantly more effective than the others, although rates of recovery were higher among those in family-focused therapy compared to the other groups.

“Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person’s chances for recovering from depression and staying healthy over the long term,” said Dr. Miklowitz. “It should be considered a vital part of the effort to treat bipolar illness.”

Reference

Miklowitz D. et al. Psychosocial Treatments for Bipolar Depression. Archives of General Psychiatry. Apr 2007; 164.

[Press release from US National Institute of Health  http://www.nih.gov/]

 

Buying Experiences, Not Possessions, Leads To Greater Happiness

San Francisco State University issued the following news release:
Buying Experiences, Not Possessions, Leads To Greater Happiness
Can money make us happy if we spend it on the right purchases? A new psychology study suggests that buying life experiences rather than material possessions leads to greater happiness for both the consumer and those around them.
The study demonstrates that experiential purchases, such as a meal out or theater tickets, result in increased well-being because they satisfy higher order needs, specifically the need for social connectedness and vitality — a feeling of being alive.
“These findings support an extension of basic need theory, where purchases that increase psychological need satisfaction will produce the greatest well-being,” said Ryan Howell, assistant professor of psychology at San Francisco State University.
Participants in the study were asked to write reflections and answer questions about their recent purchases. Participants indicated that experiential purchases represented money better spent and greater happiness for both themselves and others. The results also indicate that experiences produce more happiness regardless of the amount spent or the income of the consumer.

Experiences also lead to longer-term satisfaction. “Purchased experiences provide memory capital,” Howell said. “We don’t tend to get bored of happy memories like we do with a material object.”People still believe that more money will make them happy, even though 35 years of research has suggested the opposite,” Howell said. “Maybe this belief has held because money is making some people happy some of the time, at least when they spend it on life experiences.”
“The mediators of experiential purchases: Determining the impact of psychological need satisfaction” was conducted by Ryan Howell, assistant professor of psychology at San Francisco State University and SF State graduate Graham Hill.
These findings were presented at the Society for Personality and Social Psychology annual meeting on Feb. 7.

 

Gradually reduce antidepressant to reduce withdrawal

Taper off Effexor XR to minimize withdrawal symptoms
Joe Graedon, Teresa Graedon, The People’s Pharmacy
March 23, 2009

Patient: “I have been on Effexor XR for the last seven years for depression. I decided to wean myself off it, since it wasn’t a good mix with another drug.

The third day I was completely off Effexor, my head started spinning. I felt as if I were on a Tilt-A-Whirl. After two days of this, I ended up in the ER getting CT scans and MRIs of my brain. The doctors decided all this was from Effexor withdrawal. They gave me one tablet, and the spinning stopped within an hour.”

Pharmacist: “The whirling sensation you experienced also has been described as “head in a blender.” When people suddenly stop taking antidepressants like Celexa (citalopram), Cymbalta (duloxetine), Effexor (venlafaxine), Paxil (paroxetine) or Zoloft (sertraline) they may experience dizziness, nausea, sweating, insomnia, headaches, nervousness and electrical shock-like sensations.

Gradual tapering of the dose over several months may be the best way to minimize the unpleasant symptoms of withdrawal. Careful medical supervision is essential.”

 

Depression almost doubles the risk of developing heart disease

By Marilyn Elias, USA TODAY

Depression almost doubles the risk of developing heart disease over 12 years, according to a long-term study of twins. The findings are to be reported today at the American Psychosomatic Society meeting in Chicago.

Mounting evidence has found that depression makes people more vulnerable to heart trouble. Recent studies, though, find that some genes that increase the risk of heart disease also may make people more prone to depression, which has raised the question of whether the depression-heart disease link is genetic.

But the twins study, which followed more than 1,200 middle-aged men, teases out the influence of genetics and finds that depression takes a huge toll on the heart that can’t be chalked up to a roll of the genetic dice.

Depression contributes to the risk of heart disease as much as diabetes, high cholesterol or obesity does, says study leader Jeffrey Scherrer of Washington University and the Veterans Affairs Medical Center in St. Louis. None of the men in his study – who were tracked from their early 40s to their mid-50s – had heart disease at the start, and Scherrer controlled for key factors, such as high blood pressure, that can lead to heart problems.

Twins offer a unique way to find out how much genetics influences health because identicals share 100% of their genes, and fraternal twins have 50% of genes in common. The study included both kinds of twins.

“This study tells us you can’t explain away the role of depression in heart disease by saying it’s all due to genetics,” says Jeanne McCaffery, a psychologist at Brown University Medical School who has done gene studies on the question.

There’s no evidence yet that treating depression will make adults less likely to have heart attacks, adds François Lesperance, a psychiatrist at the University of Montreal. He did the pioneering studies linking depression and cardiac problems.

But so much research has confirmed the link that it justifies more vigorous medical monitoring of heart patients with depression, Lesperance says.

He points to one study that showed a brief mental health screening could identify heart patients with depression, who turned out to be less likely to take medication.

“Clearly, they need to be checked up on more often,” he says.

One big hole in research on depression, heart disease and genetics is that study participants are overwhelmingly male, McCaffery says. “It’s very important to look at whether you’d get these effects in women, because we just don’t know.”