Greetings from LA.,

The attached includes information on a class I am doing, "The Psychology of
Hate." Please pass this along to anyone that this might be of interest to.

Thanks,


Ed Dunbar





Program Announcement for:

The Intercultural Communication Institute

Greetings,

The Summer Institute for Intercultural Communication is now in its
twenty-third year, and has provided professional training and development to
thousands of persons who work in multicultural and international environments
around the world. In 1999, SIIC offers workshops in both foundational
intercultural topics and cutting-edge issues that face practitioners today,
and continues its effort to bring together international and domestic
interculturalists.

The learning experience of SIIC is characterized by its intensity, its
relevance to the professional development of the participants, a balanced
emphasis on knowledge and skills, and the respectful and supportive
atmosphere in which it takes place. By focusing on one topic per session,
participants receive in-depth training that relates to their work situations.
The content of each workshop blends theories and concepts with the techniques
and resources for the professional needs of the participants.

You will find the 1999 SIIC brochure in its entirety on our web site. The
address is: www.intercultural.org. You will not be able to register
electronically from the site, however we will send a registration form via
email upon request. You can either email or fax it to us after completing the
form.

We strongly suggest you contact us for advising about which workshop(s) is
most useful and appropriate for your needs.

You can also find information about the Master's Degree in Intercultural
Relations program and the Intercultural Development Inventory Qualifying
Seminars via the same web site

The SIIC 1999 workshop listings are attached below. Please don't hesitate to
contact us if you have questions.


Dates for SIIC 1999:
Session I July 14-16
Session II July 19-23
Session III July 26-30

1999 SCHEDULE
SESSION I Concurrent Workshops: July 14-16, 1999
1. Foundations of Intercultural Communication (3 sections)
     1a. David Bachner; 1b. Donna Stringer, Andy Reynolds; 1c. Margaret Pusch,
       Jaime Wurzel
2. Foundations of Intercultural Conflict Resolution-Ken Hawkins
3. Foundations of Diversity Training-Lee Gardenswartz, Joy Hawkins
4. Methods of Intercultural Training- Dianne Hofner Saphiere, Kathryn Sorrells
5. European American Culture, Identity, and Race-Judith Martin, Parker Johnson
6. Cultural Impacts of Space, Nature, and the Built Environment -John Condon,
Richard Harris
7. Power and Cultural Stratification in Intercultural Relations-Troy Duster
8. Developing Leadership for Campus Diversity-Lee Knefelkamp
9. *The Psychology of Hate-Edward Dunbar
10. *Art and Culture-Sandra Mumford Fowler, Fanchon Silberstein
11. *Multicultural Health Care Delivery-Anita Rowe, Nagesh Rao

SESSION II Concurrent Workshops: July 19-23, 1999
12. Applying the Intercultural Perspective-Judith Martin, Dorothy Sermol
13. Teaching Intercultural Communication-Stella Ting-Toomey, Leeva Chung
14. Effective Leadership in International Educational Exchange-Gary Althen,
Kay Thomas
15. Racial and Cultural Identity Development-William Cross, Terrell Jones
16. Creating Intercultural Consciousness-Milton Bennett
17. Negotiating Intercultural Conflict-Mitch Hammer, Noriko Ogami
18. Training for International Transitions-Bruce La Brack, Margaret Pusch
19. Training Design for International and Multicultural Programs-Janet
Bennett, Michael Paige
20.*Interactive Experiential Strategies for Multicultural Training-Sivasailam
"Thiagi" Thiagarajan
21. Implementing Diversity: A Strategic Approach-Lee Gardenswartz, Anita Rowe
22. Cultures at Work: Understanding Global Corporations-Martin Bennett,
Patricia Digh
23. Cross-Cultural Training in International Corporations-George Renwick,
Rita Bennett
24. Hispanic/Latino Patterns of Communication-John Condon, Carmen DeNeve
25. Japanese Mindscapes and Patterns of Communication-Muneo Yoshikawa
26. Advanced Seminar: Development of the Multicultural Self-Lee Knefelkamp

SESSION III Concurrent Workshops: July 26-30, 1999
27. Teaching Intercultural Communication-Judith Martin, Franki Trujillo-Dalbey
28. Developing a Multicultural Vision-Carlos Cortés
29. Facilitating Intercultural Discovery-John Condon, Nagesh Rao
30. Counseling Across Cultures-Kay Thomas, Teresa Harrell
31. Southeast Asian Patterns of Communication-Prany Sananikone
32. *Exploring Biracial/Bicultural Identity-Valerie White
33. *Leadership Across Contexts and Cultures-Lee Knefelkamp
34. *Practicing Intercultural Training-Bruce La Brack, Margaret Pusch, Pamela
Leri
35. Managing Intercultural Interactions in Transnational Corporations-Kichiro
Hayashi
36. *Re-inventing Management in Transnational Organizations-André Laurent
37. Reconciling Diversity in Organizations-Charles Hampden-Turner
38. Training for Intercultural Competence in Organizations-Janet Bennett,
Milton Bennett
39. Training Design for International and Multicultural Programs-Michael
Paige, Donna Stringer
40. Advanced Seminar: Intercultural Conflict Resolution-Michelle LeBaron,
Mark McCrea
41. Advanced Workshop for Experienced Trainers-George Renwick
       *indicates new workshop for 1999

INTERNSHIP SESSION: July 8-24, 1999


Fees for the 1999 Summer Institute:
SESSION I:
Tuition only - $610
Tuition, Double room, board - $760
Tuition, Single room, board - $805
Tuition, Single Deluxe room, board - $845

SESSION II & III (each)
Tuition only - $995
Tuition, Double room, board - $1,240
Tuition, Single room, board - $1,285
Tuition, Single Deluxe room, board - $1,350


The Intercultural Communication Institute
8835 SW Canyon Lane, Suite 238
Portland, Oregon 97225
phone: (503) 297-4622
fax: (503) 297-4695
email: ici@...
web site: www.intercultural.org


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EMBARGOED FOR RELEASE: 21 JUNE 1999 AT 17:00:00 ET US
University of California, San Francisco
http://www.ucsf.edu/

Gladstone/UCSF team discovers interaction of two brain proteins may be key
factor in development of Alzheimer's disease

A team of San Francisco scientists studying Alzheimer's disease has found the
interaction of two brain proteins may be a critical factor in development of
the debilitating disorder.

Both proteins have been the focus of intense scientific scrutiny because of
their independent roles in different diseases and basic cell biology. The
current study reveals a novel interaction between the two that could help
explain the death of nerve cells associated with Alzheimer's disease, or AD.
Understanding this process could lead to development of better treatments to
prevent or slow the degeneration of nerve cells that causes memory loss or
disturbed thinking that are symptoms of the illness.

The research, conducted by researchers from the Gladstone Institute of
Neurological Disease (GIND) and the University of California San Francisco, is
reported in the new issue (June 22) of the Proceedings of the National Academy
of Sciences.

One of the proteins, amyloid precursor protein, or APP, is normally found at
high levels in the brain, but its function is largely unknown. The second
protein is p53, which under certain conditions turns on an internal cell
suicide process that leads to the death of the cell. In the case of nerve
cells, this process can be devastating to the brain because most of these cells
are irreplaceable.

Mutant forms of APP are associated with certain forms of AD, but how they cause
the death of brain cells has been a mystery. Now the new research findings
provide some clues.

The researchers, led by Gladstone staff research scientist Xiao Xu, MD, PhD,
and Lennart Mucke, MD, director of the GIND and associate professor of
neurology and neuroscience at UCSF, found that normal APP--known as "wild-type"
APP--provides a protective function against nerve cell death, inhibiting the
p53-induced suicide process in cell cultures. Findings showed mutant forms of
APP do not provide this protection.

AD is a disorder of the central nervous systems that affects some four million
Americans and is the fourth leading cause of death among adults in the U.S. It
causes progressive mental deterioration that culminates in dementia, robbing
people of their ability to think and share thoughts with others. There is no
cure, and current treatments offer only limited hope of alleviating the
devastating effects of the disease.

The cells in this study were neurons, which are necessary for the processing
and storage of information in the brain. They had been genetically altered to
express wild-type human APP or a mutant APP found in a type of early-onset AD
that runs in families. When the neurons were exposed to stimuli that induce
cell death, wild-type APP--but not mutant APP--protected the cells by
inhibiting the ability of p53 to switch on the cell suicide machinery. "The
inability of mutant APP to control p53 activation may help to explain, at least
in part, why Alzheimer's-linked APP mutations result in the early onset of
neurodegenerative disease," Mucke said. "The next step will be to determine if
the APP mutations directly impair the protective function of APP or rather
counteract it by increasing a neurotoxic APP breakdown product."

The new research findings relate to an earlier study by Mucke, Roger Nicoll,
MD, UCSF professor of pharmacology and physiology, and their colleagues in the
UCSF neuroscience program. Published in the March 1999 issue of PNAS, it
focused on the amyloid-beta peptide, or A-beta, a breakdown product of APP.

Production of A-beta is increased by AD-linked APP mutations. The peptide
accumulates in the brains of Alzheimer's victims, forming roundish deposits,
called plaques, which have long been suspected of causing the memory loss and
disturbed thinking that characterize the disease.

A correlation between cognitive decline and accumulation of A-beta in brain
plaques has been reported by some researchers, but many other scientists have
failed to find such a relationship. The Gladstone and UCSF researchers found
that high levels of A-beta can be neurotoxic even without plaque formation.
Mucke noted, "These results could provide a circuit-level explanation for the
discrepancies observed between plaque load and functional deficits in people
with AD."

In this earlier study, Mucke and his collaborators used genetic engineering to
produce transgenic mice with mutant human APP and A-beta in the brain. Their
findings showed that high levels of A-beta disrupted the structure and function
of nerve cell circuits in the hippocampus, a brain region that is essential for
the formation of memories. In addition, they found that amyloid proteins
induced degeneration of synaptic connections and impeded the ability of neurons
to transmit nerve impulses. These abnormalities increased with age, similar to
the pattern in AD.

"Remarkably, the amyloid-induced disruption of memory circuits was found in the
transgenic mice even before they developed AD-like amyloid plaques. This
demonstrates that plaque formation is not required for amyloid peptides to
impair the communications between nerve cells in the brain," said Nicoll, who
directed the electrophysiological analysis of the mice.

According to Mucke, the findings have important implications for the design of
new treatments for AD. "Inhibiting plaque formation alone may not be enough to
prevent A-beta toxicity in the brain. Inhibition of A-beta production may be
required to achieve this therapeutic goal," he said.

In addition to Mucke and Xu, co-investigators of the June 22 PNAS paper are
Daseng Yang, PhD; Tony Wyss-Coray, PhD; Jim Yan, BS; and Li Gan, PhD, all from
the Gladstone Institute of Neurological Disease and UCSF Department of
Neurology, and Yi Sun, MD, PhD, of Parke-Davis Pharmaceutical Research. This
research was supported by grants from the National Institute on Aging and from
the Alzheimer's Disease Program of the State of California.

Co-investigators with Mucke and Nicoll on the March 1999 PNAS paper were lead
author Albert Y. Hsia, PhD, a UCSF neuroscience graduate student; Robert
Malenka, MD, PhD, UCSF Department of Physiology and now with Stanford
University; Eliezer Masliah, MD, UC San Diego Departments of Neurosciences and
Pathology; and Lisa McConglogue, PhD; Gwen Tatsuno, MS; Kang Hu, BS, and Dora
Kholodenko, MS, of Elan Pharmaceuticals. This research was supported by grants
from the National Institutes of Health, the Human Frontiers Science Program,
the McKnight Endowment Fund for Neuroscience, and the Office of Naval Research.


###
The Gladstone Institute of Neurological Disease, established in 1998, focuses
on research directed at understanding the biological mechanisms of AD and other
major diseases of the central nervous system. The Institute is one of three
that make up the J. David Gladstone Institutes, a private biomedical research
institute affiliated with UCSF.



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EMBARGOED FOR RELEASE: 21 JUNE 1999 AT 17:00:00 ET US
Weizmann Institute
http://www.weizmann.ac.il/home_all.html

Weizmann researchers find evidence that links molecular mechanism to
Huntington's Disease

Weizmann researchers have found evidence that an enzyme called transglutaminase
(TGase) may be the "smoking gun" behind the deadly disease Huntington's disease
(HD). Their study is reported in the June 22 issue of the Proceedings of the
National Academy of Sciences.

TGase occurs naturally throughout the body, and is catalyst for processes
associated with healing, such as skin formation and wound healing. But a 1993
study by Prof. Howard Green (now of the Department of Cell Biology, Harvard
Medical School, Boston) suggested that because of their polymerizing
properties, they might also act as a catalyst for aggregating a protein
associated with HD called Huntingtin (htt). Prof. Lawrence Steinman (then of
the Weizmann Institute's Department of Immunology, now of Stanford University's
Department of Neurological Science), together with Weizmann graduate student,
Marcela Karpuj and a team of researchers in the United States, have now
provided clear evidence of elevated TGase activity in the postmortem brains of
HD patients.

Patients who suffer from HD have aggregations "visible clumps"of htt in their
brains, but not in other tissues. This makes aggregated htt a good pathological
indicator for the disease. Steinman, Karpuj, and the other members of the team
decided to look for a correlation between clumps of htt and TGase among
patients with HD. They found elevated TGase activity in the cortex, the
cerebellum, and the brain nuclei--all areas in the brain where htt gets
concentrated into nuclear inclusions. Correspondingly, they found reduced TGase
activity in lymphoblastoid cells--areas where htt does not aggregate. TGase,
therefore, appears to be the "smoking gun" that leads to the formation of
nuclear inclusions (htt aggregations) in HD patients.

Their research is unique, because for the first time, researchers were able to
report on TGase activity in the brains of HD patients rather than in guinea
pigs or rats. They compared five postmortem brains of HD patients of different
ages to those of a control group of non-HD patients between the ages of 30 and
80.

"Karpuj was determined to measure transglutaminase activity in authentic brain
tissue from HD patients at the site where the aggregates occurred in the brain
nuclei," says Steinman, Karpuj's mentor. "No one had attempted such
measurements before, not even Prof. Green, who first had proposed that
transglutaminase was the culprit back in 1993."

Although Steinman doubted that such measurements could be done on real brain
specimens, Karpuj's persistence and her ability to modify techniques to measure
TGase activity in human brain tissue were soon rewarded.

In fact, Steinman and Karpuj's novel findings appear to counter earlier, highly
publicized findings, conducted in vitro, which linked the disease to the
formation of amyloids (extracellular fibrillar protein deposits) in the brain.
According to Steinman, the current research found no evidence of amyloids in
nuclear inclusions in the HD brains, and no evidence of the much-publicized
protein zipper.

Karpuj had argued that TGase would not aggregate the HD protein into orderly
sheets but rather into a very chaotic clump. Together with Hideki Garren, a
post-doc in the Steinman laboratory at Stanford University, Karpuj tested the
ability of TGase to aggregate htt in vitro, where they found that the clumps
were indeed very chaotic.

When neuropathologists Profs. Donald Price, Chief of Neuropathology at Johns
Hopkins School of Medicine, Baltimore, and Mark Becher, Chief of Neuropathology
at the University of New Mexico Health Sciences Center, Albuquerque examined
the HD brains, they saw the identical pattern, confirming Karpuj's findings.

Huntington's disease is an inherited, neurological, degenerative disease for
which there is currently no medical treatment. The disease, which usually
appears in young or middle-age adults, causes severe, involuntary muscle
twitches. It progresses until it affects the entire body, leading to mental
deterioration and death. The latest research results may eventually lead to the
development of new treatments for patients suffering from HD and similar
diseases, by inhibiting TGase activity in their brains.


###
Yeda Research and Development Co Ltd., which deals with the commercialization
of Weizmann Institute research, has filed for worldwide patents on a method for
treating HD and other neurodegenerative conditions using TGase inhibitors.

Funding for this study was provided by a grant from the U.S. National
Institutes of Health, the Hereditary Disease Foundation, the Abraham and Sonia
Rochlin Foundation (Reno, NV), the Wolfson Foundation (United Kingdom),
Neurocrine Biosciences, Inc. (San Diego, CA), and the Weizmann Institute of
Science. The research team also included Hilda Slunt of Johns Hopkins School of
Medicine, Baltimore, MD, and Prof. James Gusella, Chief of the Neurogenetics
Laboratory, Harvard Medical School, Cambridge, MA.




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Geography of feeling

-----Will new scientific discoveries about our
-----emotional life make Freud's unconscious obsolete?

BY ANDREAS KILLEN

April 7, 1999 | We interrupt this broadcast for a word from the unconscious ...

There's an old joke in which one psychoanalyst says to another: "Boy, I made
the most embarrassing Freudian slip the other day." His colleague asks what
happened, and the first explains that the awkward incident had occurred while
having dinner with his mother. "What I meant to say, was, 'Mother, would you
please pass the salt,'" he explains, "but what actually came out was, 'You
bitch, you ruined my entire life.'"

It's easy to make fun of psychoanalysts and their earnest enthusiasm for hidden
and not-so-hidden meanings. For Freud, as everyone knows, the unconscious had a
way of breaking through the surface of consciousness in slips of the tongue,
double-entendres, cigar jokes and so forth. At the time he came up with this
notion, it seemed radical, but in our current, post-repressive society there's
something quaintly Victorian about it. Who is shocked by unintended meanings
nowadays?

In the '70s, a group of neuroscientists led by Roger Sperry conducted research
on split-brain patients that suggested a simpler way of understanding the
scenario described above. Working with patients whose two brain hemispheres had
lost the ability to communicate with one another, this research demonstrated
that the emotional meaning of the stimulus "mom" ("You bitch") can reside in a
part of the brain completely separate from the perceptual awareness of "mom"
("Mother, please pass the salt"). Like Freud's binary theory of consciousness
and unconsciousness, this neurological discovery suggested there were indeed
two channels of human experience ... but it has also thrown the Fruedian
worldview into question.

Since then, researchers in the field of cognitive neuroscience have continued
recasting psychoanalytic ideas in anatomical terms. Slowly but surely these
researchers are forcing their way into the stronghold of the Freudian
worldview: the unconscious. What's at stake in this is nothing less than a
revolution in the way we understand our emotions and psychological defense
systems.

Read the complete article at Salon Magazine:

http://www.salonmagazine.com/books/it/1999/04/07/neurology/index.html

Ian Pitchford <Ian.Pitchford@...>
Centre for Psychotherapeutic Studies
School for Health and Related Research
University of Sheffield, S10 2TA, UK
http://www.human-nature.com/


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From the current issue of Archives of General Psychiatry
http://www.ama-assn.org/sci-pubs/journals/most/recent/issues/psyc/letter_2.htm
Letters to the Editor - June 1999

Candidate Genes and Behavioral Traits-Candidly!

There are countless reports-some in this ARCHIVES-about the association
between candidate genes (genes encoding products with neurobiological
function such as dopamine receptors, tyrosine hydroxylase, and tryptophan
hydroxylase) and a host of behavioral traits ranging from normal personality
variants to psychopathologic conditions. Although conflicting results and
other inconsistencies have spawned wary commentaries,[1-7] the tide of
'positive' results continues unabated. In what follows, I highlight pivotal
issues in the design and interpretation of association studies, with an eye
toward potential pitfalls.

First and foremost, the low prior probability of selecting the 'right'
candidate gene renders the odds of detecting a true-positive finding
vanishingly small.[1-3] This stems from the fact that, all genes expressed
in the human brain are potential candidates for behavioral traits; there are
tens of thousands of such genes. Assuming 20,000 potential candidate loci
and a trait governed by 5 vulnerability genes,[1] the P values most commonly
encountered in association studies can lead to prohibitive rates of
false-positive results: even a relatively stringent P value of .001 would
yield an 80% false-positive rate. And like P values in studies involving
hundreds (and even thousands) of subjects may still lead to unacceptable
false-positive rates[3]; needless to say, samples of this magnitude are
extremely rare, underscoring the tenuous results with samples of a more
'realistic' size.

The prior odds against a true-positive finding are compounded by inflated P
values due to multiple test effects. For example, in an attempt to uncover
'significant' trait-gene marker associations, most studies examine myriad
permutations based on behavioral variables, sex, and the constellation of
alleles (or genotypes) at the candidate gene locus. In many instances, a
proper correction for multiple testing would all but erase any semblance of
statistical significance.

A further complication is population stratification (or admixture) due to
ethnic variation. Marker allele frequencies can differ dramatically as a
function of the ethnic composition of the sample, leading to spurious
trait-marker associations. Family-based association studies-as opposed to
the far more common case-control studies of unrelated individuals-can
circumvent population stratification because the family unit serves as its
own control. However, the family-based design is not immune to
stratification in populations where admixture can occur even within
families.

Some of the reported associations are claimed to be supported by replication
studies. For the most part, however, purported replications are subject to
the same statistical constraints. And attempts to ascribe contradictory
evidence to the 'low statistical power' of nonconfirmatory studies are
generally less persuasive than the alternative explanation; namely, that the
'positive' results are spurious, for the reasons enunciated earlier.

Is the candidate gene approach doomed, then, to perennial skepticism?
Probably, unless the older paradigm (the single gene case-control design) is
supplanted by more systematic strategies. In particular, studies with
candidate genes can be best interpreted in the context of a total genome
scan, including all human genes along with actual polymorphisms. With the
advent of the human genome projects, genome-wide association studies may
become a reality in the foreseeable future. The advantage of this approach
is 2-fold: it takes stock of all possible candidate genes, and it allows a
more incisive look at signal-to-noise ratio across the genome. To further
enhance the robustness of the test results, the following steps must be
considered[4] : (1) family-based association studies, using ethnically
homogeneous samples; (2) assuming genes of modest effect, the required
sample size may have to be well over 1000 subjects (possibly thousands); and
(3) to counter false-positive results due to multiple testing, significance
levels far more stringent than those proposed earlier[1,[3] may be required.

A complementary strategy, with its own rules of statistical rigor,[8]
entails a genome-wide scan using linkage analysis in families with
individuals who display the trait of interest. This permits the
identification of the chromosomal region (or regions) containing the
susceptibility gene (or genes). Once a sufficiently narrow region is
demarcated, it can serve as a signpost for identifying candidate genes
within its boundaries. This can be accomplished by testing all potential
candidate genes known to reside in the region for association (linkage
disequilibrium) with the trait being studied. The advantage of this method
over the genome-wide association studies is that it is less labor
intensive-in the initial scan, the number of marker loci required to flag
the regions of interest across the genome is in the hundreds (as opposed to
tens of thousands in the other strategy); densely spaced markers are
included subsequently, and only in the target genomic segments. The
disadvantage is that linkage mapping is not well suited for genes of minor
effect, which likely contribute to behavioral traits; such genes may be more
readily detectable using association studies.

Would the ease with which 'positive' allelic associations can be observed
stem the tide of 'older paradigm' studies with candidate genes? Probably
not: the allure of seizing the right gene, however slim the odds, coupled
with the fact that most research groups do not command the resources needed
for the 'brute force' systematic studies described earlier, would ensure the
vitality of this 'convenient'-though not necessarily 'correct'-science. At
the very least, then, potential pitfalls should be made explicit and
alternative strategies given their due.

Whatever the strategy, direct proof of biological significance will require
further molecular evidence, eg, functional polymorphisms of physiological
relevance to the trait being studied.

Miron Baron, MD
Department of Psychiatry
Columbia University College of Physicians and Surgeons
Department of Medical Genetics
New York State Psychiatric Institute
1051 Riverside Dr, Unit 06
New York, NY 10032

References
1. Crowe RR. Candidate genes in psychiatry: an epidemiological perspective.
Am J Med Genet. 1993;48:74-77.

2. Kidd KK. Association of disease with genetic markers: dejas vu all over
again. Am J Med Genet. 1993;48:71-72.

3. Carey G. Genetic association study in psychiatry: analytic evaluation and
a recommendation. Am J Med Genet. 1994;54:311-317.

4. Risch N, Merikangas K. The future of genetic studies of complex human
diseases. Science. 1996;273:1516-1517.

5. Owen MJ, Holmans P, McGuffin P. Association studies in psychiatric
genetics. Mol Psychiatry. 1997;2:270-273.

6. Paterson AD. Case-control association studies in complex traits-the end
of an era? Mol Psychiatry. 1997;2:277-278.

7. Baron M. Association studies in psychiatry: a season of discontent. Mol
Psychiatry. 1997;2:278-281.

8. Lander E, Kruglyak L. Genetic dissection of complex traits: guidelines
for interpreting and reporting linkage results. Nat Genet. 1995;11:241-247.

(Arch Gen Psychiatry. 1999;56:582-583)


Ian Pitchford <Ian.Pitchford@...
Centre for Psychotherapeutic Studies
School for Health and Related Research
16 Claremont Crescent, SHEFFIELD, S10 2TA, UK
http://www.human-nature.com/







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Memories Are Made of This

Did That Happen to Me, or to Little Red Riding Hood?

Reading an emotional story about a child could make you think, at least
temporarily, that it happened to you as a youngster.

By Claudine Chamberlain
ABCNEWS.com

On the presidential campaign trail in 1980, Ronald Reagan was fond of telling
the story of a World War II pilot whose plane had been badly hit, forcing the
crew to bail out. When one of his gunners was too injured to jump, the pilot
stayed with him, pledging, "We'll ride it down together."

There was just one problem with the heart-wrenching story - it wasn't real.
Instead, it was a scene from the 1944 movie, A Wing and a Prayer. Reagan
remembered the details, but not where they came from.

Harvard psychologist Daniel Schacter uses the Reagan example in his book
Searching for Memory to show how certain stories we've heard can start to seem
like real life. And now a new study from the University of Washington in
Seattle shows just how malleable our memories really are.

Reality Bites

Psychology student Liz Sanders found that after simply reading a story about
something mildly traumatic happening to a child, people were more likely than
people who hadn't read the story to think they had experienced the trauma
themselves as children, even when they hadn't.

"We need to be careful as to what we assume our autobiographical memory to be,"
Sanders says. "Maybe we can make the error of believing that we did something
when we only read about it."

Sanders's experiment was born of similar work done at the University of
Washington by memory expert Dr. Elizabeth Loftus - most notably the famous
"Lost in the Shopping Mall" experiment of the early 1990s.

In that research, Loftus showed that, with a little coaxing and help from a
back-up "eyewitness," 25 percent of people could become falsely convinced they
had suffered the upsetting experience of being lost in the mall as a youngster,
even embellishing the story with added details.

No Power of Persuasion

In the 15 years leading up to the "mall" study, Loftus had shown in several
other experiments that the power of suggestion could prompt people to remember
all sorts of things inaccurately. As a result, she has become one of the
country's most sought-after experts in criminal trials for casting doubt on the
accuracy of eyewitness testimony, and a pariah among child-abuse survivors for
questioning so-called recovered memories.

In this latest study, Sanders, who was assisted by Loftus, cut out the element
of persuasion. She merely asked people to read a one-page story about a child's
experience - either getting lost in a mall or being picked on by a bully.

One week later, when asked a seemingly unrelated question about their
childhoods, half of the subjects thought they had lived through a similar
experience themselves. Among students who hadn't read the story, only 27
percent thought such a thing had happened to them.

And, surprisingly, the effect was stronger when people read stories about
children of the opposite sex. Sanders said she had been expecting more false
memories when women read stories about girls, and men read about boys, but the
opposite was true. So far, she says, she has no theories as to why that
happened.

Just as Loftus's original work was used to suggest that psychotherapists might
be implanting false memories of childhood abuse into their patients' minds,
this latest study might have implications for anyone who undergoes group
therapy or watches a lot of TV.

Fabrications Large and Small?

For example, Loftus says, therapists who work with traumatized war veterans
have told stories of how one veteran might inadvertently "borrow" a harrowing
combat tale from another vet who's in the same support group. "It's the
familiarity effect," she says. "It feels familiar, but then you misattribute
that to your own life."

In Sanders's experiment, the memory effect seemed to fade after two weeks. When
quizzed 15 days after they initially read the story, only 39 percent of the
students thought the event had happened to them.

Harvard psychiatrist Dr. Judith Herman, who treats trauma survivors, is
skeptical that such experiments apply to real life. "It's easy to convince a
certain percentage of people to fabricate a memory that's plausible in the
context of normal life," she says. "The question is, can you generalize from
that to implanting a memory of being raped by your dad? That's an awful big
leap."

Whether studies like this can be used to cast doubt on memories of severe
childhood trauma is still controversial, but at the very least it has the
unsettling effect of making you wonder how much of your life story is truly
yours.

http://www.abcnews.go.com/sections/living/InYourHead/allinyourhead.html





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The New England Journal of Medicine -- June 3, 1999 -- Vol. 340, No. 22
Use of Alternative Medicine -- A Marker for Distress?
-------------------------------------------------------------------------------
-

In this issue of the Journal, Burstein and colleagues give us surprising new
information about women who begin to use alternative medicine after receiving a
diagnosis of breast cancer. (1) The investigators studied 480 patients with
newly diagnosed early-stage breast cancer and found that 28 percent of them
began to use alternative medical therapies as an adjunct to conventional
therapy. There is much confusion about the definition of alternative medicine,
(2) but the main point is that the women chose to use several (an average of
2.5) different forms of alternative medicine, including psychological and
healing therapies, (3) in addition to the conventional treatment they were
receiving.

Burstein et al. carried out a much-needed prospective study of how
psychological, physical, and quality-of-life factors influenced the use of
alternative medicine after the diagnosis of breast cancer. The women all had
similar quality-of-life scores at base line, and all women can be expected to
have physical and psychological problems after receiving a diagnosis of breast
cancer. (4) Nonetheless, the surprising finding was that three months after the
diagnosis, new users of alternative medicine could be differentiated from
nonusers and from women who had used alternative therapies in the past: they
had more evidence of depression, lower levels of sexual satisfaction, a greater
fear of recurrence of disease, and more frequent and more severe somatic
symptoms. By 12 months after the diagnosis, all the women in the study reported
less psychological distress, but the new users continued to have diminished
sexual satisfaction and greater fears of recurrence of cancer.

These results contrast starkly with the widely held image of the woman who
seeks help from alternative medicine as self-assertive, psychologically strong,
and well-adjusted -- a woman who likes the sense of control and empowerment she
gains from finding products used in alternative medicine on the Internet, in
on-line chat rooms, and in health-food stores. These new data call into
question the stereotype of the seeker of alternative medicine. The women in the
study by Burstein et al. were not psychologically strong. On the contrary, they
turned to alternative medicine to alleviate their distress. A study of patients
with brain tumors had similar findings. (5)

Payne and colleagues, using a paper-and-pencil questionnaire, found that one
third of women attending breast-cancer clinics reported a degree of anxiety or
depression, or both, that would have qualified them for a diagnosis of a
psychiatric disorder. (6) Although results vary among psychological studies,
about one third of patients with cancer experience considerable anxiety and
depression, which are often undetected and unrecognized. (7) Because physicians
fail to identify psychological problems in their patients, they also fail to
refer them for psychological counseling, which is available in most cancer
centers.

Why are distressed patients with cancer not referred for treatment? One reason
is the "don't ask, don't tell" practice that prevails in busy oncology clinics.
Doctors just do not ask about distress; they focus on the physical issues and
fear that asking about distress will open Pandora's box. Patients do not say
that they are distressed, because they fear diverting the doctor from the
treatment of their cancer, and they are also embarrassed about bothering the
doctor by talking about such a problem. Furthermore, in the opinion of many
patients, words like "psychological" and "psychiatric" are still stigmas to be
avoided. For these reasons, referral to a mental health professional is not
often made. No wonder patients seek their own therapies outside of conventional
cancer care. What they turn to is alternative medicine, because they believe it
is natural, harmless, and psychologically supportive. But, ideally, the care of
their distress should be an integral part of the treatment they are receiving
for cancer.

A panel of the National Comprehensive Cancer Network has been formed to
establish standards of care and guidelines for the management of patients'
distress. (8) The members of the panel believe that "distress" is a more
acceptable term than "depression" or "anxiety," since it can describe feelings
ranging from the normal distress that follows a diagnosis of cancer to more
serious levels that may reflect true depression or serious anxiety. Referral
should be made to a mental health professional, social worker, or pastoral
counselor, depending on the cause of the distress. Multidisciplinary committees
are needed to implement these standards of care in cancer centers and to raise
awareness among staff members and patients of the fact that the patient's
mental well-being is an essential part of his or her care.

Burstein and colleagues found one hopeful result: most women who used
alternative medicine informed their doctors about it. This means that there was
a dialogue between doctor and patient about alternative medicine. It is
important that oncologists begin to ask routinely about the use of alternative
medical treatments because so many people are using them and because they may
complicate conventional therapy for cancer. Now there is another reason to ask:
the use of such treatments may identify distressed patients. A positive answer
should prompt questions about coping with the illness, fears, and depression.
If such feelings are present, prompt referral to a mental health professional,
preferably one familiar with the problems of patients with cancer, is
warranted.

The study by Burstein et al. has exposed a fault line in our medical care
system. Oncology teams in the clinics must ask patients about their use of
alternative medicine and about any distress they are experiencing. We must
reassert the principle that we treat the person, not the disease alone. This
basic principle seems in some jeopardy today, when at least some patients, for
whatever reason, do not tell us about their distress and do not expect that we
will treat it as part of their conventional medical care.


Jimmie C. Holland, M.D.
Memorial Sloan-Kettering Cancer Center
New York, NY 10021
http://www.nejm.org/content/1999/0340/0022/1758.asp




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Pharmacogenetics Expected To Revolutionize Treatment
Genetic testing will change the future of medicine by allowing physicians to
tailor drug therapy to the individual patient and by facilitating the
development of more precise and potent drugs, according to Ira Herskowitz,
Ph.D., Herzstein Professor of Genetics, Department of Biochemistry and
Biophysics, Head of the Graduate Program in Genetics and Co-Director of the
Program in Human Genetics, University of California San Francisco.
Herskowitz discussed the fledgling, but growing, practice of pharmacogenetics
in San Francisco June 10 at an American Medical Association media briefing on
genetics.
Pharmacogenetics is a relatively new component of pharmaceutical sciences that
studies how an individual's genotype can influence drug usage and dosing.
Understanding the genetic basis of drug response and disease will make it
possible to tailor safe and effective therapies for different subsets of
patients and will also provide valuable information on the genetic makeup of a
disease (or subset of that disease) to target therapy directly to the condition
needing treatment.
"With a better definition of disease and how an individual responds to a
particular candidate drug, drug trials can be carried out on just the right
people who will metabolize the drug properly," Herskowitz said. "This,
therefore, greatly increases the chances of having a successful outcome for a
clinical trial."
Genetic testing's original promise was thought to be the ability to provide
information on whether a person is at risk for succumbing to a particular
disease. But in the not-too-distant future, it will provide information for
more directed and individualized therapy.
Genetic tests will be developed to show who may be susceptible to adverse side
effects of a particular drug or who may benefit from a higher or lower dose of
a drug, for instance. The information to develop these tests will become
available due to the knowledge gained from the Human Genome Project.
One aspect of genetic testing that will bring more accuracy to pharmaceutical
therapies is determining a person's ability to metabolize a drug. Depending on
whether the modification activates or inactivates the drug, this information
will be able to indicate:
* Whether a person metabolizes a drug too quickly for it to be effective; or
* Whether a person metabolizes a drug too slowly, which may lead to high toxic
levels of the drug building up.
Beyond bringing more certainty to the complexities of therapy and dosing by
preventing unwanted side effects, pharmaceutical treatments in the near future
will be tailored to the individual's genotype using a particular drug or a
combination of drugs that is best suited for a person's genetic type and/or the
genetic profile of the particular disease.
Currently, when a drug is an effective cancer treatment, even for only 20
percent of the patients, it has been common practice to give that drug to every
cancer patient to determine if it will work for him or her. A genetic test
designed to determine the subgroup that this drug will work for best eliminates
this trial-and-error approach.
"Suppose that a particular drug is 20 percent effective against breast cancer,"
says Herskowitz. "Because breast cancer is a collection of different forms of
the disease, you'd like to know if the drug is 20 percent effective against all
types of breast cancer or whether it is 100 percent effective against a
particular kind of breast cancer.
"It would obviously be very useful to have a genetic definition of the
different types of breast cancer. One kind of breast cancer is accompanied by
the over-expression of a particular protein, HER-2 [human epidermal growth
factor receptor-2]. This type of cancer is estimated to be responsible for 25
percent to 30 percent of breast cancers. It is this kind of cancer that
responds to treatment with trastuzumab (Herceptin®).
"That's the principle of using genetic information. Tailoring the drug to the
particular disease."
"Some cases are now known in which a particular drug works for most people, but
cannot be metabolized by a significant percentage of people, who may have
strong adverse effects," noted Herskowitz. "An important example is a
particular enzyme that metabolizes antidepressants (which include tricyclic
antidepressants). Five percent of people lack this particular enzyme, called
cytochrome P450 2D6 for genetic reasons. So, medically speaking, it's
relatively common."
Beyond testing for potential adverse side effects and detecting problems with
metabolizing and absorbing the active ingredients in drugs, genetic testing
also will provide information for the best dose for each individual. In the
past, if a certain dose worked for the majority of participants in a research
study, that became the standard dose.
Thanks to an increased understanding of genetics, this is changing. Future
drugs and vaccinations will take into consideration a person's genetic makeup,
as well as information on a person's sex, age, height and weight.
Some speculate that the more personalized the therapy, the higher the costs.
But these costs will likely be offset by the savings brought about by not
spending money treating patients for the complications caused by adverse
effects of drugs and by not treating patients with drugs that are ineffective
(the trial-and-error method).
This changing approach will also require some adjustments by the pharmaceutical
industry: "Drug companies will have to retool their financial plans to think in
terms of smaller markets for individual drugs, but they may have more drugs in
their pharmacopeia," says Herskowitz.
In the future, genetic testing will allow for the treatment of disease before
unwelcome conditions start. By knowing a person's risk for developing a
disease, a physician could begin treating a patient for hardening of the
arteries, for example, well before there is any detectable sign of the disease.

The preventive measures would be designed for the particular type and
manifestation of the disease that a given patient's genotype makes them
susceptible to.
"It's like sending the fire engines out before the fire," says Herskowitz.
"That's happening now for inherited conditions that lead to high cholesterol
and heart disease. There are a lot more things like this that we will discover.

Although the relationship of genetics to disease can be quite complex, growing
knowledge precipitated by collaborative efforts of researchers are offering a
greater understanding of genes, drugs and disease. Herskowitz sees these
collaborations growing.
"This is a very exciting time because pharmaceutical scientists are now talking
to human geneticists and vice-versa. Discoveries are made when people think new
thoughts -- something we can expect to happen when pharmaceutical scientists
and geneticists communicate and share ideas."
Not only are many diseases and problems with drug interactions caused by
multiple genes or multiple gene defects, clinicians and researchers must always
consider the other biological factors that contribute to a drug therapy's
effectiveness or toxicity.
"A lot of disease and therapeutics is a mixture of genotype (the genetic makeup
we are born with) and environmental interactions (smoking, eating habits, drugs
that we take)," says Herskowitz. "That's the complex interplay. We are up to
the challenge of understanding this interplay. This is the future and the
future has really arrived."
14-Jun-1999
http://unisci.com/stories/19992/0614996.htm


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FOR IMMEDIATE RELEASE: 17 JUNE 1999
Sandia National Laboratories
http://www.sandia.gov/

The dark side of telemedicine

Improved on-line medical "architecture" to thwart hackers, assemble like
home-stereo system, lower health care cost

Albuquerque, N.M. People worry that the string of numbers that identify their
credit card accounts, if sent via the Net, could be intercepted by hackers to
finance the purchases of strangers.

A worse problem is the potential for illegal access and misuse of online
medical or psychiatric data, whether in transit or stored.

People with long-term diseases like diabetes, or even those only genetically
predisposed to them, could lose job opportunities and be rebuffed for insurance
if information stolen from data banks were sold to corporate bidders.

Politicians and celebrities would be particularly susceptible to scandals and
blackmail arising from intercepted data. More distant in time, patients relying
upon intravenously delivered medicine, remotely controlled via the Net, could
have their lives threatened by a cyber attacker who altered their medicinal
flow rate.

Yet because of its versatility, online medicine has the potential to widen
health care choices, cut costs, and provide maximum care to a large number of
people.

Because the amount of medical data sent across the Net is increasing,
researchers at Sandia National Laboratories, a U.S. Department of Energy
research facility, have developed and now applied for an intellectual property
patent on a computer "architecture" that incorporates built-in security
mechanisms to protect information sent between medical system components.

In addition, the Sandia framework, rather than relying on turn-key systems,
encourages hospitals and individual patients to buy and assemble off-the-shelf
medical equipment--that is, only the equipment needed --the same way home
stereo components are bought individually and assembled. Competition between
suppliers of subcomponents should lower prices and rescue consumers from the
need to buy all the features manufacturers of entire systems might incorporate.
Sandia researchers are interested in the storage and transmission of medical
information because they believe that the capability to use the Net to send
uncorrupted medical data throughout the United States will substantially reduce
the potentially large numbers of civilian casualties that could be expected
from a natural disaster or terrorist event.

Given the current state of online medical security, according to Dr. Leon
Hoffman, spokesperson for the American Psychoanalytic Association, "We
recommend not sending out identifiable data over the Net. We are fighting so
hard over the privacy issue. It's a terribly frightening proposition for people
to have records out there in cyberspace."

Dr. Dena McFadden, deputy medical director of the Massachusetts region of
Brookline-headquartered Harvard Pilgrim Health Care, described the effect of an
incident reported several years ago in which a patient discovered detailed
mental health notes in his own electronic record, along with physical health
data. Since then, she says, "We've put in audit trails to tell us who's
accessed what, we've enhanced passwords and installed encryption, firewalls and
dedicated lines. One of the things we've learned is that in addition to all of
that, we need to manage the human factor and put in controls around
unauthorized access by authorized users."

The Sandia architecture deals with that "very difficult problem" by enforcing
strict role-based access, says Sandia project leader Steve Warren.

Equipment complying with the Sandia architecture will be used at New Orleans's
Alton Ochsner Medical Foundation in the care of patients suffering from
hypertension. The formal clinical tests, conducted over the next eight months,
will be used in part to evaluate the cost-effectiveness and diagnostic
feasibility of telemedicine in this arena.

"When I started this project four years ago, I wanted to identify a strong
medical partner to complement our expertise in sensors and information
systems," says Sam Varnado, director of Sandia's Energy and Critical
Infrastructure Technology Center. "We selected Ochsner after a competitive
bidding process, and they have been truly outstanding partners."

Some of the technological issues were detailed in papers presented in April in
Rockville, Maryland, at the "Workshops on Future Medical Devices: Home Care
Technologies for the 21st Century," and in early May at the "Toward An
Electronic Patient Record -99" conference in Orlando, Florida.

Lowered costs, better security
The reason for interest in plug-and-play--a term for adding or subtracting
computer components at will--is driven by the high expense of current
telemedicine systems. As Sandia authors wrote in the abstract of a paper
delivered in early May, "Most telemedicine systems are custom-designed and do
not inter-operate with other commercial offerings. Users are limited to a set
of functionality that a single vendor provides and must often pay high prices
to obtain this functionality, since vendors in this marketplace must deliver
entire systems in order to compete. Besides increasing corporate research and
development costs, this inhibits the ability of the user to make intelligent
purchasing decisions regarding best-of-breed technologies."

The second goal is to demonstrate that proper use of security technology can
allow medical information to be transmitted electronically, maintaining strict
patient confidentiality while information is in transit to a physician, billing
agency, or other medical entity.

Says Sandia researcher Richard Craft, lead architect for the project, "We have
leading-edge cryptography libraries. These will strengthen the toolkit of
telemedicine security algorithms. The Sandia-proprietary telemedicine
architecture will be licensed for off-the-shelf devices manufactured by a large
number of companies. We are currently laying the ground rules for how
telemedicine devices will talk with one another within this secure environment.
It's like a card game: first you lay the ground rules, then you play."

Service areas that are supported within the Sandia-designed telemedicine
architecture include user interfaces; medical devices for acquiring patient
data, delivering therapy, or analyzing specimens; electronic patient records
that store information collected by devices; processing services that can
analyze and interpret data; communication mechanisms and the supporting
directory services; protocols that dictate orders of operation for medical
instruments; and a backplane, a service similar to an operating system that
stitches the other service areas together.

Benefits of online medicine
Telemedicine uses technology to provide an alternative to traditional,
in-person physician visits, and provide medical care at a patient's location,
regardless of the location of the medical team.

Computer scientists familiar with the medical field believe that within the
next five years, computers at remote locations will control vital sign
monitoring and limited types of medical treatment. Medical care will travel
with patients, whether they are in the home, the office, or on travel, so their
electronic medical records must be accessible from any location.

"Sensors attached to patients will transmit signals to computers, either in the
home or at a remote location, for state-of-health analysis," says Warren.
"Because these vital-signs sensors will be non-invasive and comfortable to
wear, they will acquire medical information from the patient around the clock
instead of a few times a day. This approach to continuous physiological
monitoring and trend analysis will lead to a preventive health care model where
the future health of an individual will be predicted based on information
acquired from these sensors. This differs from the primary care delivery model
employed today, where a patient visits a physician only after suffering
discomfort or experiencing a health emergency."

The ongoing effort
The research team at Ochsner Clinic is currently using a commercial, turnkey
telemedicine system manufactured by TelAssist Corporation, Ridgefield, NJ, for
its hypertension study. Sandia, in an effort to test the effectiveness of the
"plug-and-play" approach to telemedicine, is renovating that commercial system
for use on Sandia's secure telemedicine device architecture. The new system
will be tested jointly by Sandia and Ochsner Clinic in a controlled clinical
study that assesses the cost-effectiveness and diagnostic feasibility of the
approach.


###
Principal investigator Dr. Richard N. Re and Dr. Marie A. Krousel-Wood lead the
Ochsner effort.

The work is supported by the Telemedicine and Advanced Technology Research
Center, U.S. Army Medical Research and Materiel Command, Fort Detrick,
Frederick, Md.

Sandia is a multiprogram DOE laboratory, operated by a subsidiary of Lockheed
Martin Corp. With main facilities in Albuquerque, N.M., and Livermore, Calif.,
Sandia has major research and development responsibilities in national
security, energy, and environmental technologies.



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EMBARGOED FOR RELEASE: 17 JUNE 1999 AT 09:00:00 ET US
University of Pittsburgh Medical Center
http://www.upmc.edu/

Interpersonal and social rhythm therapy may offer patients with bipolar
disorder an improved chance of long-term health

PITTSBURGH, June 17 -- In research findings presented today at the Third
International Conference on Bipolar Disorder, doctors at the University of
Pittsburgh School of Medicine found that interpersonal and social rhythm
therapy (IPSRT) may have an important role in improving the quality of
long-term remission in patients with bipolar disorder.

In a study comparing two maintenance treatments for the illness, the Pitt
researchers found that drug therapy combined with interpersonal and social
rhythm therapy (IPSRT) did a better job of keeping patients free from
depressive symptoms. The researchers learned both approaches were able to
keep the majority of patients free of manic symptoms.

According to principal investigator Ellen Frank, Ph.D., professor of
psychiatry and psychology at the University of Pittsburgh School of
Medicine, patients participating in IPSRT plus drug therapy were more likely
to maintain a normal state over time, while those involved in drug therapy
in combination with intensive clinical management (ICM) were more likely to
experience a depressive state.

"We are now beginning to break down some of the barriers that have made the
treatment of bipolar disorder so challenging," commented Dr. Frank. "One of
the main obstacles facing doctors and their patients is the presence of
chronic, low-level depression. This study shows that there are ways to alter
that picture considerably."

Bipolar disorder is also known as manic depressive illness and affects from
2 to 3 million Americans. The illness is characterized by mood swings from
deep depression to mania.

While traditional treatments for the disorder, including lithium and other
mood stabilizers, work well in the short term, doctors have found they meet
with limited long-term success. Because of its strong biological basis, for
decades since the discovery of lithium, bipolar disorder was not thought of
as a condition in which psychotherapy had a role. A series of landmark
studies presented during the Second International Conference on Bipolar
Disorder in 1997 introduced a way to improve the relatively poor long-term
prognosis for many with the disease. Dr. Frank and others reported that
people with bipolar disorder were vulnerable to new episodes of the disease
when they experienced disruptions to their daily routines or social rhythms,
in everything from sleeping to working to eating meals. Conversely, they
found patients with the illness who did not experience such disruptions
tended to fare much better.

This latest research builds on Dr. Frank's 1997 work, using techniques
focused on regularizing daily routines and improving interpersonal relations
to dampen depressive symptoms, thereby improving the quality of long-term
remission they experience.

"Clearly, there is a benefit to using interpersonal and social rhythm
therapy as part of a long-term treatment plan," added Dr. Frank. "Our
results show that it is possible for people with bipolar disorder to have a
much better quality of life."



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FOR IMMEDIATE RELEASE: 16 JUNE 1999
French National Institute for Health and Medical Research (INSERM)
http://www-inserm.u-strasbg.fr/servcom/servcom.nsf/Documents/Page+Principale

Coffee: a cause of neonatal seizures?

Epidemiological observations raised the possibility that coffee was deleterious
for newborn babies. For the last ten years the American Food and Drug
Administration (FDA) has therefore recommended that pregnant women limit their
consumption of coffee.

The first underlying cerebral mechanisms have just been elucidated, by the use
of a particular animal model, by INSERM unit 29.

The researchers based their investigations on two observations. First, caffeine
contained in the coffee drunk by mothers crosses the fetal blood-brain barrier.
On arriving in the brain, the caffeine binds specifically to neuronal adenosine
receptors.

Second, fetal oxygenation frequently declines during delivery, especially when
contractions last a few minutes, with a risk of hypoxia and severe
complications.

It is these two phenomena (caffeine and oxygen starvation) that the researchers
reproduced on neurons of the hippocampus, a particular brain structure that
appears to be the site of memorization processes. In the presence of caffeine
at a concentration equivalent to a few cups of coffee, and in the absence of
oxygen (for 3-4 minutes), nerve cells in the hippocampus showed paroxystic
electrical activity: in other words, they all fired at the same time, as during
epileptic fits. Nothing happened if caffeine was not added to the preparation.
Moreover, in the presence of oxygen, caffeine alone failed to produce such
neuronal activity. It is therefore the combination of these two factors that
induces fits.

Schematically, the caffeine molecule binds to adenosine receptors, thereby
blocking the action of adenosine, the endogenous neuromediator, which plays an
important role in handling stress. During stressful episodes such as oxygen
starvation, adenosine protects the nerve circuits from uncontrolled excitation,
which can be detrimental. Caffeine takes the place of adenosine and prevents it
from playing its normal role.

This experiment illustrates the detrimental effects of caffeine present in the
brain of a hypoxic fetus.

Caffeine is routinely administered to premature babies to suppress episodes of
apnea. Moreover, theophylline, a drug used to treat patients with certain types
of asthma, belongs to the same family as caffeine. In the light of their
results, the researchers are now beginning to investigate the potential adverse
effects of these two drugs in particular neonatal conditions.




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EMBARGOED FOR RELEASE: 16 JUNE 1999 AT 12:00:00 ET US
University of Texas Southwestern Medical Center at Dallas
http://www.swmed.edu/

UT Southwestern researcher finds genetic cause for Gulf War syndrome

DALLAS - June 16, 1999 - A genetic trait can predispose people to Gulf War
syndrome, a new study has found.

In an article published in today's issue of Toxicology and Applied
Pharmacology, a UT Southwestern Medical Center at Dallas researcher shows why
some veterans of the Gulf War may have gotten ill from certain chemical
exposures while others did not.

Dr. Robert Haley, UT Southwestern's chief of epidemiology, led the study with
assistance from Dr. Bert La Du and Scott Billecke from the University of
Michigan Medical School.

"One of the biggest questions about Gulf War syndrome has been why one person
got sick when the person next to him didn't," Haley said. "That is one of the
major puzzles that made many people think the symptoms were just due to stress.

"But now we know that there appears to be a genetic reason why some people got
sick and others didn't, and this genetic difference links the illness to damage
from certain chemicals."

Haley's study showed that people with a gene that causes them to produce high
amounts of a particular enzyme did not get sick after exposure to certain
chemicals in Operation Desert Storm, while others who produce low amounts of
the same enzyme did get sick.

The culprit gene is the one that controls production of type Q paraoxonase, or
PON-Q, an enzyme that allows the body to fight off chemical toxins by
destroying them. This particular enzyme is highly specific for the chemical
nerve agents sarin and soman as well as for the common pesticide diazinon.

In some people, the gene causes the body to produce high levels of PON-Q,
allowing their bodies to fight off toxins like nerve gas. But in others the
gene directs the production of low levels of PON-Q, meaning a person cannot
fight off even low levels of these toxic chemicals well.

Blood levels of a genetically similar enzyme PON-R, which destroys other
chemicals more effectively than nerve agents, were no different in the sick and
well Gulf War veterans.

"In our earlier studies when we found strong statistical links between Gulf War
syndrome and veterans' reports of exposure to combinations of chemicals like
pesticides and low-level chemical nerve agents, we predicted it might be due to
a PON-Q deficiency, and now that's what we have found," Haley said. "The sick
veterans in our study have low PON-Q levels in their blood, and the well ones
have high PON-Q levels.

"We have found a genetic marker that appears to explain what made many of these
veterans sick."

In 1997, Haley and a group of other UT Southwestern researchers published a set
of three scientific papers in The Journal of the American Medical Association,
which concluded that some veterans suffer from brain damage caused by exposure
to various combinations of chemicals during the Gulf War.

They linked three different neurological syndromes to the use of
pesticide-containing flea collars, highly concentrated insect repellant and
pyridostigmime bromide anti-nerve gas tablets, as well as exposure to low-level
chemical nerve agents.

The current study examined the same group of men, members of the 24th Naval
Mobile Construction Battalion, used in the 1997 studies. Because these studies
were conducted in a single battalion of naval reservists, Haley and colleagues
have planned a nationwide survey to see how strongly the new neurotoxicity
syndromes are associated with low-level PON-Q enzyme levels in a random sample
of Gulf War-era veterans.

Haley, who has been researching Gulf War syndrome since 1994, has published
more than 100 scientific papers. He is an associate professor of internal
medicine with a specialty in epidemiological research.

La Du, a professor of pharmacology and anesthesiology, is an expert on the
genetics of enzymes that destroy chemical toxins, including the PON family of
enzymes. Billecke performed the laboratory work.

The Department of Defense and the Perot Foundation provided funding for the
study.





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FOR IMMEDIATE RELEASE: 11 JUNE 1999
University of North Carolina School of Medicine
http://www.med.unc.edu/

Study shows anxiety predicts greatest risk for persistent depression

CHAPEL HILL, N.C. - Symptoms of major depression are most likely to persist in
people who also have an anxiety disorder, according to a study headed by a
psychiatrist at the University of North Carolina at Chapel Hill.

The new findings can help primary care doctors target patients needing more
aggressive treatment for depression, says Dr. Bradley Gaynes, assistant
professor of psychiatry and director of the Psychiatric Consultation Service at
UNC-CH.

Gaynes points out that primary care doctors - typically family physicians and
internists - provide nearly half of the outpatient care for people in the
United States diagnosed with depression. "And they provide at least as many
anti-depressant prescriptions annually compared to psychiatrists," he says.

"Major depression accounts for somewhere between 5 percent and 13 percent of
the primary care population, making it more common than high blood pressure,
and the problems associated with it match or exceed that associated with most
of the common chronic medical conditions," he says.

Depression among primary care patients generally is not as severe as in
psychiatric settings, and a certain proportion of depressed patients in primary
care get better whether or not they receive the appropriate treatment for their
psychiatric problem. Still, as Gaynes explains, primary physicians are in a
difficult position regarding the problem largely due to the time crunch per
patient associated with managed care.

"They average on the order of 10 minutes per visit and must deal with a large
number of medical issues per patient. So it becomes a challenge to decide which
of their depressed patients do they need to worry about," he says. "Namely, in
which patients might symptoms of major depression persist at least one year to
potentially cause serious difficulties?"

In a report published June 15 in General Hospital Psychiatry, Gaynes and
co-authors from Duke University Medical Center and the National Institute of
Mental Health decided to focus on "coexisting anxiety disorder" as a key
indicator of that risk.

According to the study team, several reasons account for their choice. First,
anxiety disorders have been identified as a predictor of persistent depressive
illness among patient in mental health settings. Second, anxiety disorders
commonly coexist with major depression in primary care settings -- in 28-66
percent of patients, studies show. Also, depression among people with
coexisting anxiety disorders, such as panic disorder, tends to worsen.

This 12-month study involved 85 Duke family practice patients for whom
diagnostic interviews indicated major depression. Of these, 43 had a coexisting
anxiety disorder (38 with social phobia) and 42 depression only. There were no
substantial demographic differences between the groups, nor were there any
differences in severity of medical illness, severity of depressive illness, or
number of workdays lost due to disability.

All patients were followed-up at three-month intervals. "The risk for
persistent depression at 12 months was 44 percent greater in those with
coexisting anxiety," the authors state. And in those without an anxiety
disorder, only 57 percent had a depressive illness at the one-year follow-up.

Gaynes says the findings point to a course of action in the primary care
setting. "Patients who present with a depressive disorder should also be
screened for anxiety symptoms. If a coexisting anxiety disorder is present,
those patients are the primary care group that physicians need to worry about
because their depressive illness is more likely to persist."

He also says that having depression coexistent with anxiety can alter the form
of treatment. These patients may be much more susceptible to the
anxiety-related effects of the newer antidepressant medications, the serotonin
selective re-uptake inhibitors, or SSRIs, such as Prozac.

"One of the primary side effects of SSRIs is they tend to agitate and make
people anxious. It could lead depressed people with coexisting anxiety to stop
taking the medication. This group would benefit from a lower initial dose of
SSRIs and may need a more gradual increase in their dose," he says. "One of the
greatest problems in treating depression in primary care clinics is
noncompliance within the first three months. They just stop taking the
medication because it's not working or making them feel worse."

In addition, the presence of coexisting anxiety might suggest the need for
"adjunctive treatment" in addition to the anti-depressant. "Patients may also
need anti-anxiety medication or they might benefit from a referral to a
psychologist or psychiatrist for some form of psychotherapy," Gaynes says.




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University of Iowa
Release: June 10, 1999

UI researchers develop efficient personality disorder screen

IOWA CITY, Iowa -- The diagnosis of personality disorders usually involves a
lengthy and expensive interview, making it unwieldy for routine use. However, a
brief yet sensitive test developed by University of Iowa Health Care
researchers shows promise as a quick and effective substitute.

Personality disorder screens are used in both research and clinical settings to
determine whether people have lifelong personality traits that cause persistent
or recurrent problems in their personal, social or occupational lives. The Iowa
Personality Disorder Screen (IPDS) is an interview of up to 19 questions and
covers 11 different symptoms that seem to be at the core of personality
disorders. The IPDS takes only five minutes to administer, in marked contrast
to much longer, comprehensive interviews that consist of more than 100
questions and take hours to complete.

"We hope the screen will allow for more efficient diagnosis of personality
disorders in both psychiatric research and day-to-day psychiatric practice,"
said Douglas R. Langbehn, M.D., Ph.D., UI assistant professor of psychiatry and
one of the study's lead investigators. "The longer tests aren't practical to
use with every patient or research subject. The IPDS takes only about five
minutes to conduct. It can help researchers or clinical caregivers pick out
people who may need more careful assessment with the longer, established
tests."

Langbehn said the current "gold standards" for diagnosing personality problems
are detailed interviews that must be conducted by specially trained
interviewers. One of these comprehensive tests was developed by Bruce M. Pfohl,
M.D., UI professor of psychiatry and the other lead investigator. Eight other
researchers also contributed to the project. The team analyzed 1,203
comprehensive personality interviews conducted at the UI and five other
institutions in the United States, Canada and Italy to determine which
questions among hundreds would best screen for personality disorders.

"The most important questions that emerged focused on social avoidance and
anxiety," Langbehn said. "These seem to be common underlying problems for most
people with personality disorders."

The team tested the effectiveness of the IPDS questions by conducting telephone
interviews with 52 patients who originally had been diagnosed using one of the
longer, face-to-face screens. The validation interviews showed that five of the
questions are particularly effective at indicating whether a person is likely
to have a personality disorder.

Some of the IPDS questions are, "Do you generally feel nervous or anxious
around people?" and, "Do you avoid situations where you have to meet new
people?" Langbehn cautioned that not everyone who answers an isolated question
positively has a personality disorder.

Personality disorders are long-term problems. They include such conditions as
borderline personality disorder, in which a person has an unstable perception
of the world and self and may experience many moods - anger, depression or
euphoria - over the course of one day.

"We hope that having an efficient screen will help others conduct more research
involving these psychiatric disorders," Langbehn said. The UI team will use the
brief screen in a future study, and the University of Missouri plans to use it
in a study on the psychiatric problems and needs of people who are HIV
positive. The screen is also being considered for inclusion in a large national
survey that periodically estimates the frequency of various health problems in
Americans.

"We don't yet know how well the screen works in general community settings,"
Langbehn said. "Primary care physicians and nurse practitioners - for whom
psychiatry is not a specialty - sometimes have trouble identifying psychiatric
problems in patients. But we hope this short screen, which should be easy to
include in the clinical setting, will help non-specialists identify people who
have a high probability of having a personality disorder. The information could
help health care professionals carry out further assessment or make appropriate
referrals."

The IPDS findings were published in the spring issue of the Journal of
Personality Disorders. The study was supported in part by a Psychiatry
Epidemiology and Biometry Training Grant from the National Institutes of Mental
Health. The University of Minnesota Press provided a grant that allowed
reimbursement to study subjects.

http://www.uiowa.edu/~ournews/current/News/1999/Jun99/Hea/0610disorders.html


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FOR IMMEDIATE RELEASE: 15 June 1999 at 00:00:00 ET US
Washington University School of Medicine
http://medinfo.wustl.edu/

Depression may shrink key brain structure

St. Louis, June 15, 1999 -- Investigators at Washington University School of
Medicine in St. Louis have found that a key brain region is significantly
smaller in people who have suffered from clinical depression. Reporting in the
June 15 issue of The Journal of Neuroscience, they say people who have been
depressed have smaller volumes in a seahorse-shaped brain structure called the
hippocampus that is important in learning and memory.

Using three-dimensional magnetic resonance imaging (MRI), the scientists found
that otherwise healthy women with a history of depression had smaller
hippocampal volumes than those who never had been depressed.

"In a previous, smaller study, we found a relationship between depression and
loss of volume in the hippocampus, so we anticipated this finding," said lead
author Yvette I. Sheline, M.D., assistant professor of psychiatry, radiology
and neurology. "But we also expected to see an effect from aging. We thought
the hippocampus would be somewhat smaller in our older subjects who had never
been depressed, but instead we saw significant volume loss only in patients
with a history of depression."

The investigators scanned the brains of 48 women ranging in age from 23 to 86.
Half had a history of clinical depression. The others never had been depressed.
None from either group had hypertension, diabetes, substance abuse or other
conditions linked to destruction of brain cells. By excluding people with those
conditions, Sheline expected to see only the effects of depression and aging in
the hippocampus. Instead, there was volume loss only in those who had been
depressed.

Women with a history of depression had hippocampal volumes between 9 percent
and 13 percent smaller than never-depressed controls. Those with a history of
depression also scored lower on tests of verbal memory, a process linked to hip
pocampal function.

Hippocampal volumes were even smaller in patients who had been depressed more
often. Although none of the subjects was clinically depressed at the time of
testing, the average woman in the study had experienced almost five episodes of
depression in her lifetime, with one subject having lived through 18 bouts of
clinical depression.

"The finding that depression can result in volume loss and that more depression
can result in even greater volume loss underscores the importance of treating
and preventing depression," Sheline said. "Treatment not only can prevent
suffering and restore quality of life. It also appears that treating depression
may limit long-term damage."

Although Sheline and colleagues found significant loss of volume in the
hippocampus, total brain volume was unchanged.

The researchers also found loss of volume in part of the amygdala, a brain
structure associated with emotion. Again, while the total volume of the
amygdala was the same, the volume in the region called the amygdala core
nucleii was smaller in those who had been depressed.

Other investigators have found that depressed patients make too much cortisol,
a stress hormone or glucocorticoid important to proper hippocampal function.
Sheline and others believe excessively high levels of glucocorticoids may have
toxic effects on the hippocampus. But she cannot yet rule out the possibility
that a person at risk for depression may start with a smaller hippocampus.

"If I were to speculate, I would say that the fact that multiple episodes of
depression produce greater volume loss in the hippocampus suggests that there
probably is some sort of damaging effect from depression," she said. "It also
is possible that there is some other variable - genetic perhaps - that would
predispose vulnerable people to this sort of damage. That also may be the case.
But to prove it, we would need to take MRI scans of people before they have
ever had depression."

Sheline and colleagues are beginning to re-scan some of the subjects from this
study to learn whether hippocampal volumes fluctuate over time. They also are
looking at seretonin receptors in the hippocampus and other brain structures.
The seretonin receptor on neurons is one of the sites where antidepressant
drugs are likely to work. Sheline wants to clarify the extent to which
depression contributes to a decline in the number of seretonin receptors in the
hippocampus and other brain structures even when the number of neurons in those
regions remains the same.


###
Sheline YI et al. Depression Duration but not Age Predicts Hippocampal Volume
Loss in Medically Healthy Women with Recurrent Major Depression. The Journal of
Neuroscience, vol. 19, no. 12, pp. 5034-5043, June 15, 1999.

This work was supported by grants from the National Institute of Mental Health.

Note: Last October, Joseph L. Price. Ph.D., professor of anatomy and
neurobiology, reported that patients with inherited depression have fewer cells
in the subgenual prefrontal cortex, a thumbnail-sized area of the brain behind
the mid-forehead.

The full-time and volunteer faculty of Washington University School of Medicine
are the physicians and surgeons of Barnes-Jewish and St. Louis Children's
hospitals. The School of Medicine is one of the leading medical research,
teaching and patient care institutions in the nation. Through its affiliations
with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine
is linked to BJC Health System.




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FOR IMMEDIATE RELEASE
DATE: June 3, 1999

Teaching emotional control could be the best Father's Day present

With Father's Day just weeks away, American men might consider the idea of
giving their children a gift instead of receiving one. Perhaps the best present
they could give in a society concerned with growing teen-age violence is
emotional control, a skill scientists believe fathers help foster in powerful
ways

Fathers are critical in children's development of emotional control, according
to University of Washington psychologist John Gottman, author of "Raising an
Emotionally Intelligent Child." Gottman and a panel of other prominent
psychologists will participate in a Saturday symposium on "Emotional Regulation
Across the Life-Span" at the annual meeting of the American Psychological
Society in Denver. The symposium will begin at 3:10 p.m. at Adam's Mark Hotel.

Other participants in the symposium include psychologists Robert Levenson and
Philip Cowan of the University of California, Berkeley, Carroll Izard of the
University of Delaware, Laura Carstensen of Stanford University and Daniel Hart
of Rutgers University.

In studying emotional regulation, Gottman said psychologists look at such
things as a marriage, a parent-child relationship or a child-to-child
relationship to see if emotions are mediated by physiology. A regulated system
works like a thermostat that comes back to a set temperature when a room gets
too hot or cold. People with good emotional regulation recover from stressful
or trying situations faster and are better able to manage their emotional
responses.

"How parents feel about basic emotions is the key," he said. "Do they see
emotions as being positive or do they dismiss emotions as something from the
devil?"

Gottman's research has found that some parents who view emotions as a positive
force actually coach or teach their children how to become emotionally
intelligent. Emotional intelligence is a person's awareness of their own and
other people's emotions and the ability to control his or her feelings. In the
long run, emotional coaching pays off in children who score higher on math and
reading achievement tests, have longer attention spans and have fewer behavior
problems in school, at home and with friends. His research also showed these
children had lower heart rates and levels of stress hormones in urine samples.

"Unfortunately, punishing kids for having an emotion is fairly common," he
said. "Take the example of a 4-year-old girl who is drawing and gets angry
because her crayon breaks. A parent shouldn't punish the child for getting
angry in this situation, but many do. Instead, the parent needs to recognize
the emotions the child is feeling, the context, give understanding to the child
and give the child the words for the emotions she is feeling. Words to describe
emotions are power and the emotionally intelligent parent is empowering the
child."

By the time they are 8, emotionally coached children are acting differently. A
boy might be reading at a table when another comes up, wants his attention and
pulls the book away. According to Gottman, an emotionally coached child
probably would say the action made him angry, explain that he's trying to read
and ask the other child to stop and please give the book back. The uncoached
child would probably just hit the other youngster.

"The uniqueness of fathers is their ability to engage in high-energy play. Men
just seem to do it more than women. Fathers do it naturally, like tossing a
baby into the air and catching it. Mothers are uncomfortable or horrified by
some of this playing. High-energy play teaches emotional regulation. When dads
are crappy or poor emotional coaches they stimulate a child and won't stop the
play until the child gets upset. A good father knows when to stop and helps the
child to calm down. This is early emotional coaching," he said.

Gottman has found that fathers have different teaching styles with their
children. When a child is around 4, he's noted that emotionally intelligent
fathers teach by giving information. Then they don't interfere, wait for the
child to do something right and then praise the child. Other fathers who are
connected to their child also give information. But they get involved as the
child attempts to use the information and criticize the child when he does
something wrong or makes a mistake.

A child's performance "goes in the tube" with criticism, according to Gottman.
However, children react differently depending on whether the criticism comes
from a usually-positive or usually-negative father.

"We were surprised to find that with a positive parent a child's heart rate
goes up faster, but recovers faster from a zinger from dad or someone else.
What these children are doing is calming themselves faster. The heart rates of
children with negative dads don't spike as sharply, but their heart rate stays
higher longer before returning to normal. They are not as well-regulated
physiologically," he said.

http://www.cac.washington.edu/newsroom/news/1999archive/06-99archive/k060399.ht
ml





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EMBARGOED FOR RELEASE: 14 JUNE 1999 AT 12:00:00 ET US
Center for the Advancement of Health
http://www.cfah.org/

Preschoolers who sleep less have more behavior problems

Fewer minutes and hours of sleep add up to more problems in the daytime
behavior of children aged two to five, according to new research.

Two- and three-year-old children sleeping less than 10 hours in a 24-hour
period were consistently at greatest risk for behavior problems such as
oppositional or noncompliant behavior, "acting out" behaviors, and aggression,
reported the team of Northwestern University scientists conducting the study.

Preschoolers who sleep less at night have almost 25 percent greater chance of
psychiatric diagnosis, according to the study, published in the June issue of
Developmental and Behavioral Pediatrics.

Measuring the relationship between sleep and daytime behavior on the Child
Behavior Checklist, the researchers found lower amounts of total 24-hour sleep,
including daytime naps, were related to increased behavior problems. Links with
anxiety, depression and other internalizing behavior problems were not
significant, however, they reported.

The scientists found that specific "doses" of lengths of sleep were most
strongly related to behavioral problems in children two and three years old but
this threshold effect faded out with the four and five year olds.

The study of 510 children from two to five years old did not attempt to
determine causal relationships between sleep and behavior problems, cautioned
John V. Lavigne, Ph.D., who headed the seven-member team of researchers
conducting the study.

Lavigne said, "The relationship between sleep and daytime behavior problems may
exist because less sleep causes children to have those problems. Or because
daytime behavior problems cause children to sleep less. Or because of a third
variable such as the child's temperament, the parents' ability to structure
sleep arrangements and daytime behavior. Or because there is some interaction
effect that produces a reciprocal influence between sleep and behavior
problems. There could also be a direct effect, biochemical, for example. Or a
psychological mediator between sleep and daytime behavior, such as increased
daytime irritability producing more tantrums."

"It's an area that is relatively unexplored, compared with what is known about
young children's sleep patterns, for example," says Lavigne. "Those sleep
patterns decline from an average of 13 hours per night at age two to 9.5 hours
at age six."

Funding support for the study was provided by the National Institute of Mental
Health.


###
The Journal of Developmental and Behavioral Pediatrics is published bimonthly
by the Society for Developmental and Behavioral Pediatrics. For information
about the Journal, contact: Mary Sharkey at 212-595-7717.

Posted by the Center for the Advancement of Health http://www.cfah.org.




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EMBARGOED FOR RELEASE: 27 MAY 1999 AT 17:00:00 ET US
Molecular Psychiatry

A Genetic Marker Of Panic Disorder

Panic disorder is a psychiatric condition characterized by frequent episodes of
severe panic attacks. The biology and genetics of panic disorder are being
intensively studied. Cholecystokinin (CCK) is a peptide that is found in the
gut and in the brain; Intravenous injection of CCK tetrapeptide (CCK4) induces
symptoms similar to those of panic attacks. Genes involved in the regulation of
CCK function have therefore been logical candidates for association studies in
panic disorder. In the current issue of Molecular Psychiatry, Kennedy and
colleagues at the University of Toronto?s Clarke Institute report a study of
the genes regulating CCK function in 99 patients with panic disorder and age-
and sex-matched controls. They found that panic disorder is highly associated
to a highly polymorphic marker on the regulatory region of the CCK-B receptor.
Thus, variations in CCK receptor function could be a risk factor for panic
attacks, and could be useful in the diagnosis and future therapeutic approaches
to panic.

JL Kennedy, J Bradwejn, D Koszycki, N King, R Crowe, J Vincent, O Fourie.
Investigation of cholecystokinin system genes in panic disorder. Mol Psychiatry
1999;4:284-285.

Researchers from the Clarke Institute and University of Toronto, and University
of Iowa College of Medicine contributed to the study.


###
For further information on this work, please contact Dr. James L. Kennedy,
Neurogenetics Section, Clarke Division, Centre for Addiction and Mental Health,
Toronto, ON, Canada M5T 1R8 Tel: 1-416-979-4987; Fax: 1-416-979-4666; email:
KENNEDYJ@...

Molecular Psychiatry is an independent, peer-reviewed journal published by the
Nature Publishing Group. Editorial decisions and publication in Molecular
Psychiatry do not constitute endorsement by the National Institute of Mental
Health, the National Institutes of Health or any branch of the government of
the United States of America.

Editor: Julio Licinio, M.D.; phone: 301-496-6885; FAX: 301-402-1561; e-mail:
licinio@...

Pre-prints of this article can be obtained from Ms. Julie Vianello; phone:
301-496-6979; FAX: 301-402-1561; e-mail: j.vianello@...

Molecular Psychiatry
http://www.stockton-press.co.uk/mp/index.html


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Experts spot anti-social behavior by age 3

Copyright © 1999 Nando Media
Copyright © 1999 Scripps Howard News Service

By LEE BOWMAN

(May 27, 1999 1:00 a.m. EDT http://www.nandotimes.com) - Each recent outbreak
of carnage at an American school has been followed by much the same musing over
what influences had led to adolescents becoming sociopathic killers. No one
knows what all the elements may be, but researchers are becoming increasingly
confident that anti-social behavior - as opposed to more routine, albeit
unsettling, toddler behavior - can be identified by age 3.

"We're talking about serious, aggressive behavior. This is not just the
terrible 2s," said University of Chicago psychiatrist Kathryn Keenan.

Many experts believe that if anti-social behavior patterns aren't modified by
the end of third grade, they can become chronic, only to be managed by costly
sustained interventions involving juvenile authorities as well as school
counselors.

By some estimates, as many as 6 million schoolchildren have been identified as
anti-social on the basis of recurrent aggression, hostility, defiance and
destructiveness. Many, but not all, also have a learning disability or have
attention deficit disorder. Some may be suffering more serious psychological
problems, mania lurking beneath defiant exteriors.

Researchers from around the nation who study and try to react to the early
precursors of anti-social behavior gathered this week at the National Academy
of Sciences in Washington. Though it seems extraordinarily timely, the session
was planned more than a year ago as part of an ongoing series of workshops on
child welfare issues.

"We want to look not only at what contributes to anti-social behavior, but also
what goes on to contribute to pro-social behavior," said Dr. Renee Jenkins,
head of pediatrics at Howard University Hospital in Washington and organizer of
the meeting.

They discussed both the warning signs and risk factors in children and their
parents that can set toddlers on a course for disaster, ranging from parental
indifference or abuse to unusual irritability in infants and a lack of empathy
in pre-schoolers.

"There are many complex ingredients, but early aggression before age 5 is the
strongest predictor of anti-social behavior later on," said Stephen Hinshaw, a
psychologist at the University of California-Berkeley.

But they also admitted that most research has focused on children from
low-income, inner city, minority families that may not exactly translate to
more affluent suburban or small-town environments that have been the scenes of
recent shootings.

"And while there are now well-established predictors of anti-social behavior,
such identification does not mean any certainty of outcome," said Janet
Lauritsen, a criminologist at the University of Missouri, St. Louis.

While individual children and their families may overcome a disadvantaged
neighborhood, risks are higher in areas where adults are unwilling or unable to
collectively supervise and discipline each other's youngsters, Lauritsen said.

There were divisions among the researchers about how to go about helping. Some
argued for more individualized treatment, including psychotherapy and drug
interventions. Others urged that more focus be placed on improving parents' and
teachers' skills in steering children away from aggression.

"Why do we think that parenting changes at age 7 or 8 from what's been going on
at 1 and 2? If we want to change these patterns, we need to be in there early,"
said Daniel Shaw, a psychologist at the University of Pittsburgh. "If the
parents aren't on board, if we can't fix parenting skills, then the
interventions aren't likely to take."

A number of programs to boost parents' ability to deal with difficult children
have been started in child care and Head Start centers, focusing on giving
positive feedback and reinforcing good behavior, while ignoring obnoxious
activities and only stepping in if a child becomes destructive or tries to hurt
others.

"But we've learned that many parents don't value emotional intelligence. They
use aggression themselves. The standard mode of response is too often 'I'll pop
'em.' So we need to sell them on the value of changing their own behavior as
well as others," said Janis Kupersmidt, a University of North Carolina
psychologist. "And we need to keep re-enforcing the lessons parents, caregivers
and teachers have learned with periodic boosters."

Ann Kaiser, a professor of special education and psychology at Vanderbilt
University in Nashville, reported that for many children, intervention also
requires boosting underdeveloped language skills, allowing a child to express
things with words rather than tantrums and to more easily socialize with
others.

"We know that targeting these skills can help with learning problems, but very
little work has been done on how this affects behavior problems."

Researchers also said that school and day-care communities need to become more
aware of how easily and frequently children can be rejected and put down by
their peers, and seek to modify school culture to foster respect and compassion
for others.

"Everyone from the principal and teachers to the cafeteria workers and janitors
need to be in tune with what kids are saying and doing to each other," said
Steven Asher, an educational psychologist at the University of Illinois at
Urbana-Champaign. "You don't have to hang out in school very long to see some
pretty hurtful things happen."

Schools at all levels need to put more emphasis on helping students learn how
to handle social and emotional tasks, from refusing a dare or dealing with
anger to entering a group or coping with teasing, Asher said.

Lee Bowman is a reporter for Scripps Howard News Service and can be reached at
bowmanl@....

http://www.nandotimes.com/noframes/story/0,2107,53361-85537-603865-0,00.html



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America's Children: Key National Indicators of Child Well-Being 1998
http://childstats.gov/ac1998/ac98.htm

Highlights

America's Children: Key National Indicators of Well-Being, 1998 presents in a
single document 23 key indicators on important aspects of children's lives,
including their economic security, health, behavior and social environment, and
education. This report also presents data on six key demographic measures and
includes two measures of child well-being as special features. This is the
second annual effort to monitor the overall status of the nation's children.
Highlights include the following:

Several indicators show an improving picture of the well-being of most
children, but not all children share in this improvement. The well-being of
children living below the poverty line continues to compare unfavorably to
those living above the poverty line. For example, children living below the
poverty line are more likely to suffer from poor general health, to have high
levels of blood lead, and to have no usual source of health care. They are also
more likely to experience housing problems and hunger, less likely to be
enrolled in early childhood education, and less likely to have a parent working
full-time all year.

In addition to the differences in well-being by poverty status, there is also
disparity in well-being for different race and ethnic groups. Black children
continue to fare less favorably than white children, and Hispanic children also
fare less favorably than white non-Hispanic children on some indicators, such
as high school completion.

Part I: Population and Family Characteristics

In 1997, children under age 18 numbered 69.5 million, or 26 percent of the
population, down from a peak of 36 percent at the end of the baby boom. In each
age group-0-5, 6-11, and 12-17 years-there were approximately equal numbers,
about 23 million per group.

The ethnic diversity of America's children continues to increase. The
proportion of Hispanic children is increasing rapidly, relative to children in
other racial and ethnic groups. Hispanic children now slightly outnumber black,
non-Hispanic children.

Part II: Indicators of Children's Well-Being

Economic Security Indicators

The poverty rate of children is holding steady at 20 percent, about where it
has been since 1981. However, since 1980, the percent of children living in
families with medium income has fallen, while the percent of children living in
families with high income and the percent of children living in families with
extreme poverty have risen. These shifts show an increase in income disparity
among children.

Children under 18 continue to represent a very large segment of the poor
population (40 percent) even though they are only about one-fourth of the total
population. Children under age 6 living in female-householder families are
particularly at risk for living in poverty. In 1996, 59 percent of these
children were living below the poverty line, compared with 12 percent of
children under 6 living in married-couple families. In 1996, 10 percent of
white, non-Hispanic children lived below the poverty line, compared to 40
percent of black children and 40 percent of Hispanic children.

The number of children who had no health insurance at any time during 1996 grew
to 10.6 million or 15 percent of all children from the 1995 levels of 9.8
million and 14 percent, respectively.

Health Indicators

Most children in the United States are healthy. In 1995, about 81 percent of
children were reported by their parents to be in very good or excellent health,
and this percentage remained stable between 1984 and 1995. Child health varies
by poverty status. In 1995, about 65 percent of children in families below the
poverty line were in very good or excellent health, compared with 85 percent of
children in families living at or above the poverty line.

In 1996, low birthweight rates were the highest in two decades. However,
despite the frequency of low birthweight, infant mortality continues to
decline, primarily because the likelihood for the highest-risk infants to
survive has improved substantially. Black infants continue to be at much higher
risk of low birthweight and infant mortality than infants of other races.

In 1996, 77 percent of children ages 19 to 35 months were up to date with their
immunizations. Children in poor families were less likely to be up to date with
their immunizations than children with family incomes at or above the poverty
level (69 percent compared to 80 percent).

Death rates among adolescents ages 15 to 19 are on the decline after increasing
during the late 1980s and early 1990s. Firearm deaths, mostly homicides, which
increased during this period and peaked in 1994, accounted for the growth in
death rates in earlier years.

Birth rates among adolescent females declined between 1991 and 1996. This drop
in adolescent birth rates was especially large among black females ages 15 to
17. In 1996, 85 percent of births to 15- to 17-year-olds were to unmarried
mothers, compared to 62 percent in 1980.

Behavior and Social Environment Indicators

The percentages of 8th, 10th, and 12th graders who smoked daily, drank heavily
or used illicit drugs have increased during the 1990s.
In recent years there has been a decline in the rates for which youth ages 12
to 17 were either victimized by serious violent crime or were the perpetrators
of serious violent crime. In 1993, the victimization rate was 44 per 1,000; in
1996, that rate fell to 33 per 1,000, lower than the rate in 1980 (38 per
1,000). Between 1993 and 1996, the violent crime rate fell from 52 to 36 per
1,000, compared to a rate of 35 per 1,000 in 1980.

Education Indicators

In 1996, 57 percent of children ages 3 to 5 were read aloud to by a family
member every day in the last week, up slightly from 53 percent in 1993.
Sixty-four percent of white, non-Hispanic children, 44 percent of black,
non-Hispanic children, and 39 percent of Hispanic children were read to every
day in 1996.

Between 1982 and 1996, average math scores increased for 9-, 13-, and
17-year-olds, with 9-year-olds experiencing the largest increase. Since 1980,
average reading scores have not improved among 13- and 17-year-olds and have
declined among 9-year-olds. White, non-Hispanic students consistently have had
higher reading and math scores than either black, non-Hispanic or Hispanic
students.

The high school completion rate for 18- to 24-year- olds has increased slightly
since 1983, when it was 84 percent; in 1996, it was 86 percent.

The proportion of young adults obtaining a high school diploma through an
alternative method such as taking a General Education

Development test increased by 5 percentage points in 3 years, from 5 percent in
1993 to 10 percent in 1996. In contrast, the proportion earning a regular
diploma decreased about 5 percentage points over the same period.

College completion rates rose between 1995 and 1997. The percentage of high
school graduates ages 25 to 29 who completed a bachelor's or more advanced
degree was 26 percent in 1980, rose to 28 percent in 1995, and increased again
to 32 percent in 1997.

Special Features

Blood lead levels in children ages 1 to 5 have declined dramatically. In
1976-80, 88 percent of children ages 1 to 5 had an elevated level of blood
lead. By 1988-94, this percentage had decreased to 6 percent. This huge
decrease in blood lead levels resulted from legislation banning lead from paint
and plumbing supplies and from the phasing out of lead in gasoline.

In 1995, 6 out of 10 children under the age of 6- more than 12.9 million-who
had not yet entered kindergarten were receiving some type of child care and
education on a regular basis from persons other than their parents.





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EMBARGOED FOR RELEASE: 13 JUNE 1999 AT 18:00:00 ET US
American Psychological Association
http://www.apa.org/

Exercise helps keep your psyche fit

Research shows exercise to be a viable, cost-effective treatment for depression
and may help in the treatment of other mental disorders

Washington - A new review of psychological research shows that exercise is an
effective but underused treatment for mild to moderate depression. The review,
published in the June issue of Professional Psychology: Research and Practice,
a journal published by the American Psychological Association, also shows there
is some evidence that regular exercise may help in the treatment of
schizophrenia, alcohol dependence and as a singular treatment for some anxiety
disorders and for people suffering from body image problems.

The authors reviewed studies since 1981 in which exercise was used as an
intervention in treating individuals with the following clinically diagnosed
psychiatric disorders: depression, anxiety, developmental disabilities,
schizophrenia, psychosomatic disorders and substance abuse.

The review of research concludes that regular exercise is a viable,
cost-effective treatment for mild to moderate depression and may be useful in
the comprehensive treatment of more severe episodes of the disorder. Nonaerobic
forms of exercise such as strength training are as effective as aerobic
exercise in treating depression. The researchers also found that less strenuous
forms of regular exercise, such as walking, may be sufficient to demonstrate
significant treatment effects, however they note more research is needed to
confirm this initial finding.

Other findings from the review include the following: Evidence that exercise is
an effective short-term treatment for the reduction of disruptive behavior and
for increasing work performance in some people with developmental disabilities

Regular exercise appears to be a necessary ingredient in behavioral treatment
programs that effectively reduce pain frequency and intensity in people with
mild to moderate chronic pain

Regular exercise is more effective than placebo pills, but not chlomipramine,
in reducing symptoms of anxiety in patients with panic disorder

Case studies suggest that regular exercise may be an important part of
treatment programs for people with schizophrenia, although more research is
needed to confirm that finding.

As for the role exercise may play in the treatment of alcohol dependence and
smoking-cessation treatment programs, the evidence was inconclusive. The
researchers say there was some limited evidence that regular exercise may be an
effective tool in the treatment for alcohol dependence, but more research is
needed.

Considering the evidence that exercise is a viable, cost-effective treatment
for depression and chronic pain, the researchers say they are somewhat
surprised that it has not become a more popular treatment alternative and
suggest that it be more commonly used as part of a therapist-structured
treatment program. Article: "Exercise Therapy for Patients With Psychiatric
Disorders: Research and Clinical Implications," Gregg A. Tkachuk, M.A. and
Garry L. Martin, Ph.D., University of Manitoba, Professional Psychology:
Research and Practice, Vol. 30, No. 3. Full text of the article is available
from the APA Public Affairs Office

Gregg Tkachuk, M.A. can be reached at 204-667-1630, email
tkachuk@...


Garry Martin, Ph.D. can be reached at 204-474-8589, email
gmartin@...



###
The American Psychological Association (APA), in Washington, DC, is the largest
scientific and professional organization representing psychology in the United
States and is the world's largest association of psychologists. APA's
membership includes more than 159,000 researchers, educators, clinicians,
consultants and students. Through its divisions in 50 subfields of psychology
and affiliations with 58 state, territorial and Canadian provincial
associations, APA works to advance psychology as a science, as a profession and
as a means of promoting human welfare.



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U.S. Newswire
8-Jun-99

Description: Although many Americans still hold misconceptions about mental
illness, an overwhelming majority support adequate health insurance coverage of
mental health, according to a new survey sponsored by the National Mental
Health Association.

NMHA Poll Shows Myths, Misunderstanding Surround Mental Illness

Contact: Lea Ann Browning-McNee of the National Mental Health Association,
703-837-4783;
Web site: http://www.nmha.org

ALEXANDRIA, Va., June 5 /U.S. Newswire/ -- Although many Americans still hold
misconceptions about mental illness, an overwhelming majority support adequate
health insurance coverage of mental health, according to a new survey sponsored
by the National Mental Health Association. The survey, released today in
anticipation of Monday's White House Conference on Mental Health, also reveals
a significant portion of the American public has first-hand experience with
mental illness.

According to the NMHA poll, nine out of ten (90 percent) Americans say that
health insurance companies should provide coverage for mental illness that is
more than or equal to that provided for physical illness or injury. One in four
Americans have an immediate family member who is suffering from a mental
illness diagnosed by a physician.

"Mental illness is a serious health problem in this country, touching millions
of American families each year, but most of our nation's health insurance plans
don't reflect that reality," said Michael Faenza, president and CEO of the
National Mental Health Association. "The public understands the seriousness of
mental illness and wants health insurance that provides coverage on an equal
basis with other illnesses, but insurance companies do not provide it."

However, the poll also revealed that many American's still believe some of the
myths surrounding mental illness. A majority of Americans (57 percent) disagree
with the fact that mental illness can be diagnosed as accurately as physical
illness. Large numbers (45 percent) of those who do not currently have a family
member with a mental illness believe the myth that depression is a normal part
of life that can be worked through without medication; 43 percent believe that
people with mental illnesses are more violent than the general population.

"These findings point to serious gaps in the American public's understanding of
mental illnesses," said Faenza. "Clearly, advances in treatment and services
have outpaced many public attitudes and policies."

Additional findings from the NMHA poll include the following:

-- Nearly six in ten (57 percent) do not know that most companies offer workers
mental health benefits as part of their health insurance programs.

-- Seven in ten (70 percent) of Americans reject the idea that
psychiatric/psychological treatment is just for the rich.

-- Eight in ten (81 percent) rightly disagree that people have mental illnesses
because they do not have the will power or self-discipline to deal with their
problems.

-- More than two-thirds (76 percent) appropriately reject the notion that if
one keeps busy and has a good family and close friends that one probably will
not develop any mental illness.

-- A majority (70 percent) rightly rebuff the idea that childhood mental health
problems are really the result of poor parenting.

-- Eight in ten (79 percent) know that people with mental illnesses can be
treated and get better.

-- Eight in ten (78 percent) recognize that homeless people who have mental
illnesses can be treated if mental health care is made available to them.

-- Half of Americans (49 percent) say their community mental health services
are fair, poor or very poor; 17 percent just do not know. People with mental
illness in their family rated services lower.

-- Almost half of all Americans (45 percent) falsely believe that medicines
given to those with serious mental illnesses, such as schizophrenia, are given
just to keep the patients calm and are not capable of making them better.

The telephone poll was conducted on May 10-18, 1999, in conjunction with Mental
Health Month. The survey, commissioned by the National Mental Health
Association and conducted by RSM Inc., consisted of a sample of 1,029 adults 18
years of age and older. The margin of error for a survey of this size is
plus-or-minus 3 percent.

For more information on mental illnesses and their treatments, the public may
call the NMHA Information Center at 800-969-6642.

------
Established in 1909, the National Mental Health Association is America's
leading mental health advocacy organization dedicated to improving
understanding, treatment and services for adults and children with mental
health needs.

-0-

/U.S. Newswire 202-347-2770/
06/05 10:15

Copyright 1999, U.S. Newswire
http://www.newswise.com/articles/1999/6/MHMYTHS.USN.html


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EMBARGOED FOR RELEASE: 13 JUNE 1999 AT 16:00:00 ET US
Brown University
http://www.brown.edu/Administration/News_Bureau/

Vigorous exercise helps women quit smoking and stay smoke free

Women who exercised vigorously while trying to quit smoking were twice as
likely to kick the habit and gained about half the weight of women who also
tried to quit but didn't do the workouts, says a new study.

Fear of gaining weight is the primary reason many women give for not quitting
smoking. The findings suggest that women may be more likely to stop smoking and
to stay smoke free if they exercise.

Physical exertion limits weight gain and may help smokers to better handle
stress, said Bess Marcus, lead author of the "Commit to Quit" study in the June
14 issue of Archives of Internal Medicine. She is an associate professor of
psychiatry and human behavior in the Brown University Center for Behavioral and
Preventative Medicine in the School of Medicine. The research was conducted
through the Center and the Division of Cardiology, both located at The Miriam
Hospital in Providence, R.I.

The study of 281 healthy but sedentary female smokers investigated the effects
of combining a smoking cessation program with vigorous exercise. The women
ranged in age from 18 to 65 and had smoked regularly for at least a year.

Of the 281 women in the study, a control group of 147 attended a weekly smoking
cessation program and three-times-per-week wellness sessions for 12 weeks. The
other 134 women attended the smoking cessation program and participated in
supervised exercise sessions three times weekly for 12 weeks.

The researchers found that exercise subjects were twice as likely as those not
exercising to quit smoking and to stay smoke free. At the end of 12 weeks, 19.4
percent of exercisers had kicked the habit for at least two months compared to
10.2 percent of the control group; three months later, 16.4 percent vs. 8.2
percent, respectively, were still smoke free; and one year following treatment,
11.9 percent vs. 5.4 percent remained smoke free. In addition, by the end of
treatment, the women who exercised had gained about half the weight of those in
the control group, and were in significantly better physical shape.

The powerful effect of exercise was most obvious among women who attended most
of the workouts. Of these women, 47.2 percent had ceased smoking and stayed
cigarette-free compared to 28.9 percent of the non-exercise group at the end of
12 weeks. A year after the program ended, 27.8 percent of women who had adhered
to the exercise regimen had not smoked compared to 18.1 percent of
non-exercisers.

The findings are comparable to some of the best behavioral and pharmacological
studies, the authors said. Because the study did not use any nicotine
replacement therapy, such as gum or a patch, the results mean that exercise can
be an effective alternative regimen for smokers who may not wish to use
nicotine replacement therapy, they said.

"The study results clearly indicate that smoking cessation programs designed
for women can be significantly more successful than generic programs," said
Marcus. "We can build in measures to help women cope with fears of gaining
weight if they stop smoking."

Marcus said that men trying to quit smoking would also benefit from exercise.
She urges physicians to recommend exercise to both female and male patients who
want to quit smoking. Marcus is involved in several projects that help
physicians counsel patients to include exercise in their daily routines. "There
are numerous health benefits to participating in an exercise program," she
said. "For starters, exercise helps you manage weight, stress, mood, anxiety,
depression and blood lipids."

The project was supported by a grant from the National Cancer Institute and
funding from the Office of Research on Women's Health.

The researchers are currently recruiting women for a new eight-week study to
examine the effects of combining moderate intensity exercise with a smoking
cessation program.




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http://chronicle.com/weekly/v45/i38/38a01801.htm

The Chronicle of Higher Education
From the issue dated May 28, 1999

Conservative Groups Blast Psychology Journal Over Paper on Sexual Abuse

    By JENNIFER K. RUARK

    Religious groups and conservative members of Congress are condemning
    the American Psychological Association for publishing a paper in which
    researchers argued that not all instances of sex between adults and
    children cause psychological harm to the children. The critics say the
    association condones the sexual abuse of children; the group says the
    attacks could chill future research.

    The paper, which appeared last July in Psychological Bulletin, a
    bimonthly journal published by the association, recommended that some
    behaviors now defined by scientists as abuse be reclassified as
    "adult-child sex."

    The authors were Bruce Rind, of Temple University; Philip Tromovitch,
    of the University of Pennsylvania; and Robert Bauserman, formerly at
    the University of Michigan and now a state-government consultant on
    AIDS prevention.

    The Christian Coalition last week called the study "repugnant and
    socially irresponsible" for saying that minors may in some cases
    consent to, or enjoy, sex with adults. "It is imperative that we
    protect our children from an ominous and encroaching campaign to harm
    them and ruin their innocence," the coalition said in a statement
    urging President Clinton to denounce the A.P.A. and the report.
    Four Republican Congressmen -- Representatives Tom DeLay, of Texas;
    Joseph R. Pitts, of Pennsylvania; Matt Salmon, of Arizona; and Dave
    Weldon, of Florida -- are sponsoring a resolution (H.C.R. 107) harshly
    criticizing the association's decision to publish the paper.

    The report also elicited angry commentary from the Family Research
    Council, a national group that says it promotes "the traditional
    family unit and the Judeo-Christian value system upon which it is
    built," and the popular radio psychologist Laura Schlessinger.
    The psychology association and the authors of the paper say it in no
    way condones sex between children and adults.

    The report, they point out, explicitly distinguishes between moral or
    legal views of abuse -- that is, "wrongfulness" -- and scientific
    definitions of the term, or "harmfulness."

    The report said psychologists had a history of "conflating morality
    and law with science," and noted that behaviors such as cunnilingus,
    fellatio, homosexual sex, masturbation, and promiscuous sex were once
    defined as pathological.

    The authors wrote that by putting in the same category such behaviors
    as a father's repeated rape of his 5-year-old daughter and the willing
    sexual involvement of a 15-year-old boy with an unrelated adult, the
    current broad scientific definition of abuse obscured its causes and
    effects.

    The findings "do not imply that moral or legal definitions of or views
    on behaviors currently classified as [childhood sexual abuse] should
    be abandoned or even altered," the report said.

    The critics also misunderstood what the article meant by "consent,"
    the authors said. "We neither stated nor implied that children can
    give informed consent to such experiences." Rather, psychologists have
    used the word "consent" to mean the victim's own perception of his or
    her level of participation, a factor that bears on the resulting
    mental health of the victim, the authors explained.

    The article, "A Meta-Analytic Examination of Assumed Properties of
    Child Sexual Abuse Using College Samples," reviewed 59 studies of
    college students who reported having had sexual relations with adults
    when they were younger than 18, or with other children when physical
    force was involved.

    The sexual encounters included acts such as the invitation to do
    something sexual, exhibitionism, fondling, masturbation, oral sex,
    attempted intercourse, and completed intercourse.

    Finding that two-thirds of sexually abused men and more than a quarter
    of sexually abused women had reported neutral or positive reactions,
    the authors concluded that scientists should not assume that sexual
    abuse always causes pervasive, intense harm.




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EMBARGOED FOR RELEASE: 10 JUNE 1999 AT 16:00:00 ET US
National Science Foundation
http://www.nsf.gov/

'Altered state' may be responsible for creating important brain chemicals

Twenty years after visualizing a surprising left-handed form of the DNA double
helix, Massachusetts Institute of Technology researcher Alexander Rich has
found that this altered form of genetic material is involved in some important
biological activities, including creating proteins essential for normal brain
function. Rich's work is funded in part by the National Science Foundation
(NSF).

In the 1970s, when Rich and his colleagues solved for the first time the
three-dimensional structure of a DNA crystal fragment, they were puzzled.
Instead of looking like the right-handed double helix Watson and Crick had
described in 1953, the structure was a left-handed double helix with an
irregular zig-zag backbone.

Is this unusual form of DNA, dubbed Z-DNA by the researchers, an oddity or is
it biologically significant? In this week's issue of the journal Science, Rich
and colleagues partly resolve the issue. They describe how the
three-dimensional structure of Z-DNA binds to a portion of an enzyme. The
enzyme binds to Z-DNA with great specificity, leading scientists to conclude
that the two serve a biological function. The enzyme creates a modified protein
that is used by the brain as a receptor for serotonin, among other things. Yet
another striking example of nature's ability to perform many functions with the
same materials, the protein bound to Z-DNA is closely related in
three-dimensional structure to a family of proteins known to bind to
right-handed DNA.

"This work clearly demonstrates that DNA structure is not symmetric or
regular," explains Kamal Shukla, program director for biophysics at NSF.
"Rich's results will be important to a better understanding of gene expression,
viral DNA packaging and many other important biological functions."

Adds Rich, "Twenty years after first visualizing a left-handed form of the DNA
double helix, it may now be possible to see ways in which nature uses this
altered form of the molecule to carry out important biological activities."

Much has been learned about Z-DNA since it was first discovered. It turns out
that Z-DNA is found only transiently when genes are actively being transcribed.
It occurs mainly in specialized sequences of nucleotides, the building blocks
of genetic material, and is stabilized by processes that partially unwind the
normal right-handed DNA double helix. The main process that produces such an
unwinding is transcription (the synthesis of messenger RNA), which is used as a
template for assembling proteins in biological systems.

The system works this way: When the enzyme making RNA, called RNA polymerase,
moves along the DNA double helix, it leaves behind underwound DNA. Selected
sequences in this DNA temporarily become left-handed Z-DNA, like a stretched
phone cord coiling backwards on itself.

When the RNA polymerase stops moving, other enzymes relax the DNA and it
reverts to its normal right-handed form. Like a stretched phone cord that is
released, it snaps back into its usual shape.

Rich's work is also funded by the National Institutes of Health.




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Crimes of Passion

SARA ABDULLA

The lengths that the males of some species will go to get the upper hand in the
mating game are frankly, outrageous. For example, evidence has been growing for
some time now that adult male primates of several species will even stoop to
infanticide. What possible advantage could they gain from that, I hear you cry?

Carola Borries of the Deutsches Primatenzentrum, Göttingen, Germany, and
colleagues indicate in the June 1999 issue of Proceedings of the Royal Society
of London that they may have found an answer. Apparently, in langur monkeys
(Presbytis entellus), male animals kill other males' babies, not because of
crowded living conditions, as some had hypothesised, but in order to free up
female maternal energy for their own reproductive advantage. For a female
langur without a dependent infant is, effectively, back in the sexual arena in
a way that a tired, responsible mother is not (a phenomenon many a human mother
will relate to).

The researchers reached this conclusion via 37 000 hours worth of studies of
the Hanuman langurs of Southern Nepal. As well as logging attacks, injuries,
deaths and other violent behaviour, the team carried out paternity tests on the
animals by extracting DNA from their faeces.

This enabled them to study, for the first time in a primate group, the familial
relationships between the attackers, their victims and post-attack infants born
to the females concerned.

What emerged is that on the relatively rare occasions when they do indulge in
infanticide, male monkeys, unsurprisingly, spare their own offspring. They are
not, however, so merciful with young monkeys sired by others. Furthermore, the
DNA analysis revealed that, in 80% of cases, the mother of a murdered infant
went on to have her next child by the suspected killer.

Although a larger sample size will be necessary to corroborate these
preliminary findings, Borries' team feels that their study does indicate that
"a male's chances of gaining a reproductive advantage via infanticide are very
high." In other words, perverse as it may seem, it looks like evolution may
well have looked kindly on baby-killers.


© Macmillan Magazines Ltd 1999 - NATURE NEWS SERVICE
http://helix.nature.com/nsu/990610/990610-8.html



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EMBARGOED FOR RELEASE: 12 JUNE 1999 AT 13:00:00 ET US
Johns Hopkins Medical Institutions
http://hopkins.med.jhu.edu/

Hopkins study shows combined hormone therapy increases muscle, decreases fat in
postmenopausal women

A combined hormone therapy of estrogen and androgen may improve body
composition in postmenopausal women, according to results of a Johns Hopkins
study to be presented at 1 p.m., June 12, at ENDO 99, the 81st annual meeting
of The Endocrine Society in San Diego.

Adrian S. Dobs, M.D., senior author of the study and an associate professor of
endocrinology and metabolism at Hopkins, led researchers comparing the effects
of estrogen supplements versus combined testosterone/estrogen supplements. A
group of 40 postmenopausal women took an estrogen supplement for three months
and estrogen plus androgen for the next four months.

After four months on the combined medication, the women had an average 2 to 4
percent reduction in body fat and an average 4 to 6 percent increase in muscle
mass. By contrast, estrogen alone yielded slight increases in both fat and
muscle.

"Postmenopausal women often experience an increase in fat tissue and a decrease
in muscle tissue," Dobs says. "These data show that estrogen-androgen therapy
may improve body composition in healthy women, but further study is necessary
to determine if this therapy is effective in other groups, including women with
chronic conditions such as diabetes or cancers."



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NIH-National Institute on Alcohol Abuse and Alcoholism

NIAAA-Led study verifies environment-dependent behavioral variation in
genetically identical mice

John Crabbe, Ph.D., Portland Veterans Affairs Medical Center and Oregon Health
Sciences University, Department of Behavioral Neuroscience, with colleagues in
three widely separated laboratories report in this week's Science that animals
with the same genes performed differently on a variety of behavioral tests
depending on the animals' location. This was true although a long list of
environmental influences was equalized among the three sites.

"The conclusion that unknown, subtle environmental features have profound
effects on the behaviors of isogenic animals reinforces the idea that, for
behaviors like alcoholism, genes will define risk, not destiny," said NIAAA
Director Enoch Gordis, M.D. As one of 15 U.S. sites for interdisciplinary
research on certain aspects of alcohol disorders and alcohol-related problems,
the NIAAA-supported Alcohol Research Center at Portland, directed by Dr.
Crabbe, focuses on genetic determinants of neuroadaptation to alcohol.

"Behaviors known to be strongly genetically influenced, such as alcohol
preference in C57BL/6J and alcohol avoidance in DBA/2J mice, were least
susceptible to site-specific environmental effects, " said Dr. Crabbe. "More
susceptible were behaviors with smaller genetic effects, especially behavioral
effects thought to be the result of a single gene knockout."

Dr. Crabbe's laboratory and laboratories at the University of Alberta in
Edmonton, Alberta, Canada, and the State University of New York at Albany
confirmed a long-held assumption among scientists that tests of genetically
influenced mouse behaviors are affected by the laboratories in which they are
studied. Researchers traditionally have tried to mitigate these effects by
repeating an experiment at multiple sites.

Dr. Crabbe and his colleagues conclude that for small genetic effects,
especially those believed to be the result of a single gene mutation,
researchers should replicate tests locally, then conduct multiple tests of a
single behavioral domain (e.g., multiple tests of anxiety-related behavior) in
multiple laboratories. It is not clear that standardization of behavioral tests
across laboratories improves matters, write the authors.

For the current study, Dr. Crabbe and his colleagues simultaneously
administered six behavioral tests using seven genetic mouse strains and a
mutant strain that lacks a single neurotransmitter receptor gene. Apparatus,
test protocols, and many aspects of animal husbandry were standardized across
sites.

While results for some behavioral tests were consistent across the three labs,
other test results showed significant environmental differences. Individual
mouse strains also performed differently depending on where they were tested,
with the mutant strain evidencing the greatest degree of difference at the
separate sites.

"Our hope is to generate discussion and then action to identify and reduce
individual laboratory influences," Dr. Crabbe said. "Only after site-specific
environmental influences are accounted for can scientists conclude that a
specific gene influences a specific behavioral domain."

The Office of Behavioral and Social Sciences Research, National Institutes of
Health, supported the study through supplements to grants by the National
Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug
Abuse. NIH is the Nation's lead agency for biomedical and behavioral research.
For additional alcohol research information and publications, visit
http://www.niaaa.nih.gov.










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NIH-National Institute on Alcohol Abuse and Alcoholism

NIAAA-Led study verifies environment-dependent behavioral variation in
genetically identical mice

John Crabbe, Ph.D., Portland Veterans Affairs Medical Center and Oregon Health
Sciences University, Department of Behavioral Neuroscience, with colleagues in
three widely separated laboratories report in this week's Science that animals
with the same genes performed differently on a variety of behavioral tests
depending on the animals' location. This was true although a long list of
environmental influences was equalized among the three sites.

"The conclusion that unknown, subtle environmental features have profound
effects on the behaviors of isogenic animals reinforces the idea that, for
behaviors like alcoholism, genes will define risk, not destiny," said NIAAA
Director Enoch Gordis, M.D. As one of 15 U.S. sites for interdisciplinary
research on certain aspects of alcohol disorders and alcohol-related problems,
the NIAAA-supported Alcohol Research Center at Portland, directed by Dr.
Crabbe, focuses on genetic determinants of neuroadaptation to alcohol.

"Behaviors known to be strongly genetically influenced, such as alcohol
preference in C57BL/6J and alcohol avoidance in DBA/2J mice, were least
susceptible to site-specific environmental effects, " said Dr. Crabbe. "More
susceptible were behaviors with smaller genetic effects, especially behavioral
effects thought to be the result of a single gene knockout."

Dr. Crabbe's laboratory and laboratories at the University of Alberta in
Edmonton, Alberta, Canada, and the State University of New York at Albany
confirmed a long-held assumption among scientists that tests of genetically
influenced mouse behaviors are affected by the laboratories in which they are
studied. Researchers traditionally have tried to mitigate these effects by
repeating an experiment at multiple sites.

Dr. Crabbe and his colleagues conclude that for small genetic effects,
especially those believed to be the result of a single gene mutation,
researchers should replicate tests locally, then conduct multiple tests of a
single behavioral domain (e.g., multiple tests of anxiety-related behavior) in
multiple laboratories. It is not clear that standardization of behavioral tests
across laboratories improves matters, write the authors.

For the current study, Dr. Crabbe and his colleagues simultaneously
administered six behavioral tests using seven genetic mouse strains and a
mutant strain that lacks a single neurotransmitter receptor gene. Apparatus,
test protocols, and many aspects of animal husbandry were standardized across
sites.

While results for some behavioral tests were consistent across the three labs,
other test results showed significant environmental differences. Individual
mouse strains also performed differently depending on where they were tested,
with the mutant strain evidencing the greatest degree of difference at the
separate sites.

"Our hope is to generate discussion and then action to identify and reduce
individual laboratory influences," Dr. Crabbe said. "Only after site-specific
environmental influences are accounted for can scientists conclude that a
specific gene influences a specific behavioral domain."

The Office of Behavioral and Social Sciences Research, National Institutes of
Health, supported the study through supplements to grants by the National
Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug
Abuse. NIH is the Nation's lead agency for biomedical and behavioral research.
For additional alcohol research information and publications, visit
http://www.niaaa.nih.gov.






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