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Tuesday, February 2, 2016

Themes of This Blog Seen In Newspaper Advice Columns – Part III




This is the third in an occasional series of posts showing how several of the issues I discuss in this blog show up in letters to newspaper advice columnists. In order to assure themselves a wide readership, advice columnists must bring us problems that resonate with a fairly wide demographic, and they therefore provide us with another source of information about human behavior and cultural trends.

I follow Jeanne Phillips (Dear Abby), Carolyn Hax, Amy Dickinson (Ask Amy), and Marcy Sugar & Kathy Mitchell (Annie’s Mailbox).

Of course these letters leave out a lot of what might really be going on with the writer, and I will be admittedly speculating about how the behavior described in the letters may be examples of covert issues that are not being directly discussed.

Before each letter, I will discuss the blog subject that seems to be being discussed. I will also include a link to a related post. I am not including the columnist’s responses to the letters. 

*

In the following letter, a father pushes his son away by constantly telling him what a disappointment he is. The son has rejected the trappings of what the father considers successful living. It is quite likely in such situations that the "disappointing" son might be acting out the father's repressed or covert rebelliousness against the very standards the father seems to embrace. 

In such situations, the father probably does things on rare occasions that indicate to the son that the father is "getting off" on what the son is doing - but then the father rejects him as a way of rejecting that part of himself that he finds unacceptable. In actuality, those parts were unacceptable to his own family of origin.  The son then obliges by keeping his distance. Thus, this could be a possible example of the role of Avenger.

12/6/15, Carolyn Hax.  Dear Carolyn: Through the years, my husband has learned to let go of the hopes and dreams he had for his son, that he would achieve financial and social success as my husband defines it: white-collar job, nice house, nice cars, wife and family, membership to country club, all the trappings that he has achieved for himself and that represent success to him. His son, on the other hand, works in the restaurant trade (not in management), lives a pretty bohemian lifestyle but has neither been in trouble with the law nor abused drugs... Husband has never made it a secret that he feels son could have done better. Son has never married at age 40 but now finds himself the father of a child (he plans to take responsibility for the child). We want to be a part of this child’s life. At this point, the only expectations my husband has of his son is that he respond to his efforts to contact him. To no avail. Son responds on his own timeline or not at all despite repeated requests. My husband wants to draw a line in the sand over this. I think we should go with total capitulation for the sake of the future grandchild. How can I be supportive of my husband (“Yes, I understand how frustrating this communication thing is for you”) but still make it clear that I will not take part in any “line in the sand” stance? This is creating tension between my husband and me. - The Step Mother

*

In the States, we tend to think people are basically selfish and don't care what other people think, especially family members. We think kids growing up are more influenced by their peers and the media. Of course, the questions of which media a teen looks at and with which peers he or she chooses to associate with - and there is a large variety to choose from - is ignored in these formulations. The choices people make are no accident. Also, as I've pointed out many times, kids who appear to be oppositional to their parent's wants and values only do that because that is what they think the parents expect of them.

I believe people really are willing to sacrifice their own opinions and desires in order to please their parents. Of course, how much one can challenge parental values depends on how conflicted the parents are about them. In the following letter, a woman performs summersaults trying to both be her own person and please her parents at the same time. 

12/14/15. Ask Amy. Dear Amy: I have been with my partner for five years; he rents his own place and I live with my parents. My parents are old-fashioned and believe I can only live with him when we are married (I used to share this view, but now I don't). I have finished college and have moved back home to pay off my debt and save for a house (or wedding!). My partner's home is five minutes away from my workplace and my folks' house is one hour away (in good traffic), so I do frequent "sleepovers" at his place. This is causing tension in both households. I pay rent to my parents and I help out my partner by cleaning up after myself and buying bread, milk and eggs regularly. But he says that I'm using him, and that I'm just doing the minimum. He says I should be preparing dinners for both of us when I am there, doing washing, or helping by paying rent or at least one utility bill. Now I'm broke, tired and grumpy. I'm at his house cooking and cleaning, and then when I'm at my parents, I'm doing exactly the same thing to appease them because I've slept over at my partner's house. I've gone cold turkey and have slept only at one home, but then money is wasted on gas driving back and forth. I can't afford to move out and I don't want to get married just so we can live together. HELP!!! — Betwixt

*

When someone is playing a dysfunctional role within their family of origin, it can be difficult and painful. When seeking a spouse or partner, such people will often pick someone who will help them to continue to play the difficult role. They, in turn, help their spouses play a difficult role within the spouse's own family of origin. This is what I refer to as mutual role function support. It can be thought of as a form of mutual enabling.  

It is important to remember that the alcoholic enables the "co-dependent" to be a co-dependent as much as the co-dependent enables the alcoholic. The whole process is bidirectional - it goes both ways simultaneously. In the following letter, the son of a controlling mother marries a spouse who is also rather controlling, as even the advice columnist recognized. In a variation on this theme, the mother and the wife start competing with one another over who will have the most control over the poor guy. If the mother's need to control men were a bigger issue for her and her family, he might never have even become engaged in the first place.

12/15/15. Ask Amy.  Dear Amy: I have a controlling, manipulative, guilt-tripping mother-in-law-to-be! I know that each time I hear from her she is just trying to trap me into saying yes to something. These traps include trying to get me to change our wedding plans, and roping me into a jewelry party hosted by her friend (repeatedly pushing on that). She just can't understand the word "no." When I did say no she whined to my fiancé, saying it felt like a slap in the face (can you say "manipulation"?). This has to stop. My fiancé tried dealing with it by telling his mom that I will say no to some things, but I felt this was really his way of calling me "pushy." My fiancé tried the kid gloves approach and it didn't work. I decided to take matters into my own hands and texted her three examples of her overstepping her boundaries and letting her know it would no longer be tolerated. She had the nerve to say it made her "sad." Now he is having a hard time because his mom is upset. He doesn't understand that we have to back each other up, especially in situations like this. His mom is so bad that she needs a copy of his shift schedule at work because she wants to keep track of him. Maybe my approach is too direct, but so what? We are in our 40s and don't need to be under her thumb. I don't let my mom get away with this kind of behavior, and I'm certainly not letting a MIL do this. What is your opinion, Amy? — Upset

*

One of the most read posts on my Psychology Today blog, and the one which generated some of the most heated responses from reader, posed the question of whether parents who had been cut off by their adult children were really as clueless about the reasons that happened as they portray themselves to be in public. With my patients, unlike the followers of many psychotherapy schools, I always presume that people are never too stupid to notice that their repetitive behavior leads to bad outcomes - yet they continue to engage in it anyway.

The following letter is remarkable in that, while ostensibly asking advice, the mother of an alcoholic woman, who is also what I refer to as a Minnie the Moocher, admits as clearly as imaginable that "I know I've enabled my daughter for her entire life."

12/28/15. Annies' Mailbox.  Dear Annie: Our oldest daughter is married to a nice man and they have a sweet 2-year-old daughter. My son-in-law makes good money and my daughter can afford to stay home, but they never seem to have enough to get ahead. My daughter has been known to spend foolishly. They only have one car and it doesn't run half the time. They can't afford another. We let them live in our home for a year rent-free, so they could save enough to purchase their first house. I know I've enabled my daughter for her entire life. She is very spoiled and self-centered. We argue a great deal and exchange hurtful words. Regularly, I surrender to her selfishness and give her money or run errands for her, even though I work full-time. I do these things because she is a recovering alcoholic and drug addict, and I fear she will otherwise return to that life again. She doesn't attend her meetings anymore. I don't know how to handle her. I'm either forced to defend myself or give in to her whims. She never appreciates anything I do for her and she never does anything for me. Her husband is no better. He is selfish and spoiled by his mother, and he also enables my daughter. She's a good mother, but I babysit a lot. Her husband doesn't complain when she gets together with her friends, but he works long hours and they don't have much time together. I think he feels neglected. How do I know when to do things for her and when not to? How do I tell the difference between enabling and being a good mother? When she gets into one of her horrible, blaming moods, how do I handle that? This child has become a bitter pill to swallow, but I love her so much.  — Mother of a Narcissist

Tuesday, January 19, 2016

Research In Psychotherapy: Outcome Research Versus Process Research




In my Psychology Today blogpost about research in psychotherapy outcomes, and in my last book, I complained about the inflated claims of researchers in psychotherapy - particularly those made by purveyors of cognitive-behavioral therapy (CBT). They grossly overstate both the power and the significance of their results.

Unfortunately, a new report by the Institute of Medicine (IOM) falls for this baloney hook, line and sinker. The report on psychosocial interventions for mental illness and substance abuse has drawn a wide variety of responses from the field - including praise, recommendations for improvement, and some sharp criticism from psychiatrists and mental health professionals who are experts on psychotherapy. I am obviously sympathetic to the critics.

Of particular interest is that the report lauds the so-called "evidence-based psychotherapies" - code for those therapies which are "supported" by the incredibly weak psychotherapy outcome studies. One critic, Peter Roy-Byrne, M.D, summed up the criticisms of the report as follows:" In medicine, there is usually an array of different treatments for the same condition because of individual variability that is still poorly understood. Yet the field of medicine does not spend its time trying to understand what are the common elements between various effective treatments, though it will often explore comparative effectiveness as a way of improving care. It may well be that different kinds of individuals and problems demand different psychotherapeutic approaches rather than that there is one elemental Holy Grail that will be best for everyone.”

Of note is that, at least if you believe in free will as I do, patients always can choose to either respond favorably or unfavorably to any intervention a therapist makes. It is just not all that predictable, because everyone can choose to respond differently. In fact, the very same intervention given to seemingly very similar patients can lead to responses that are completely opposite from each other - in one case the patient improves on some dimension, while in the next the patient may get worse! In psychotherapy, patients are very different from one another in ways that vastly outnumber individual differences that affect treatment outcomes in any other field of medicine.

Holly Swartz, M.D., of the Department of Psychiatry at the University of Pittsburgh School of Medicine, brings up another criticism of the IOM report: “The recommendation to reduce highly complex interventions to their component parts, however, is misguided. A bias toward CBT and CBT-based interventions constitutes an essential flaw in the IOM report, placing affect-focused therapies such as IPT (interpersonal therapy) at risk for unfair negative evaluation and, ultimately, elimination from our therapeutic armamentarium. … [T]he IOM report should advance an inclusive research agenda that reflects and supports the diversity of psychosocial interventions that the IOM purports to represent.”

Yet another problem with the IOM report and similar viewpoints is that they completely ignore the fact that there is a vast literature within psychotherapy research that does not focus on outcomes but on process. Process research looks at the moment to moment interactions of patients and therapists within the context of their particular relationship.

As Les Greenberg, Ph.D, puts it, "Research on change processes is needed to help explain how psychotherapy produces change. To explain processes of change it will be important to measure three types of outcomes—immediate, intermediate, and final—and three levels of process—speech act, episode, and relationship. Emphasis will need to be placed on specifying different types of in-session change episodes and the intermediate outcomes they produce. The assumption that all processes have the same meaning (regardless of context) needs to be dropped, and a context-sensitive process research needs to be developed. Speech acts need to be viewed in the context of the types of episodes in which they occur, and episodes need to be viewed in the context of the type of relationship in which they occur.

Speech acts refers to the fact that speech does not merely convey information to, or exchange propositions with, a listener. Sentences do things that are frequently independent of the meaning of the actual words that are used. Speech causes others to perform acts. If I say, "I hear you're having a party Saturday," I am not describing only my recent experience of having heard about the party. I am probably fishing for an actual invitation. In all likelihood, I have made in advance a determination that this sort of statement is the best way to accomplish my goal of attend­ing the party. I have made a prediction about the future behavior of the listener. If this particular ploy leads to no response or a different response, I will consider alternative strategies.

Those who tout psychotherapy outcome studies, which study psychotherapy interventions as if they occurred in some sort of relationship vacuum devoid of context, seem to want to pretend that the highly significant process research literature does not even exist. In fact, the vast majority of articles published in the journal Psychiatric Research are process studies, not outcome studies.

Tuesday, January 5, 2016

Finally a Study on Borderline Personality Disorder That Looks at Family Dynamics


Karlen Lyons-Ruth, Ph.D.


When it comes to the study of personality disorders as described in medical journals, it seems like most of what's been published lately in the field looks at which superficial aspects of personality disorders and personality variables correlate with one another and to what extent, or how often some construct like "impulsive aggression" is found in various populations. Such correlations usually turn out to moderate at best and never ever close to being 100% predictive of anything. 

While group data like this may help therapists prioritize - to a minimal degree - which other issues in a patient's life on which to focus clinical attention whenever they happen to note one of these characteristics, it really tells us nothing about the individual patient. Not to mention that it neglects literally thousands of other important details that may apply only to the patient at hand.

IMO, such studies are just different ways of slicing up the same old bread, when it is the bakery that needs the attention. The bakery is the interpersonal environment in which personality disorder traits develop and flurish.

Of course, as readers of my blog know, it's very difficult to study the bakery "empirically," because a lot of what goes on involves subtexts or unspoken communication in family relationships. These subtexts not only change over time but, especially in the world of personality disorders, the subtexts of family interactions can contradict one another. To make matters even worse, some of these contradictory messages may show up only rarely, but become significant when seen in light of the history of the family over the lifetime of the participants as well as the family's history over several generations. All of this is almost impossible to quantify.

I was pleased to see in a recent issue of the Journal of Personality Disorders that, for the first time in a long time, some researchers tried to address these issues in at least a partially comprehensive way (Karlen Lyons-Ruth, PhD, Laura E. Brumariu, PhD, Jean-Francois Bureau, PhD, Katherine Hennighausen, PhD, and Bjarne Holmes, PhD: "Role Confusion And Disorientation In Young Adult-Parent Interaction Among Individuals With Borderline Symptomatology." Journal of Personality Disorders, 29(5), 641–662, 2015). 

Dr. Lyons-Ruth and her colleagues did their best to look at what they so nicely referred to as the "minute to minute fabric of interaction..."  Their data lent much support to my idea that, as a manifestation of what evolutionary biologists call kin selection, children sacrifice their own needs in order to stabilize unstable parents.

In fact, while I previously thought of so-called parent-child role reversal as applying only in cases in which children act more like parents to their childlike parents than the other way around, I realized one could conceptualize the spoiling behavior seen in borderline personality disorder (See the post The Family Dynamics of Patients with Borderline Personality Disorders) as just another form of children taking care of unstable parents - although a much more subtle and covert form.

In so called "empirical studies" to date, the quality of parent-child interaction has rarely been observed directly. In this study, 120 young adults were assessed for features of borderline personality disorder, for severity of childhood maltreatment through interviews and self-report measures, and for disturbances in parent-child interaction during a videotaped conflict discussion task. The last part addressess a huge criticism of the literature I have been making: no one actually looks directly at what is going on at home.  

Of course, the way the family behaves in a laboratory setting is only an approximation of what goes on when no one is watching, and much important behavior undoubtedly gets omitted under this type of observation (as oppposed to when Supernanny spends a couple of nights in the home) - but at least it is something that can be observed directly. To paraphrase a line from the movie The Big Short that showed how certain people were able to see through the fraud perpetrated by mortgage bankers prior to the burst of the housing bubble in 2008, "If you want to understand a process, actually looking at it is a very good place to start."

The conclusions of the study: Borderline traits, as well as suicidality and self-injury specifically, were associated with more role confusion and more disoriented behavior in interactions with the parent.

The definitions of these terms, quoting more from the article: In infancy, the term disorganized refers to the apparent lack of a consistent way of organizing attachment responses to the parent when under stress. The types of disorganized behaviors observed in infancy include apprehensive, helpless, or depressed behaviors, unexpected alternations of approach and avoidance toward the attachment figure, and other marked conflict behaviors such as prolonged freezing or stilling or slowed “underwater” movements.

Controlling children, on the other hand, “Actively attempt to control or direct the parent’s attention and behavior, and assume a role which is usually considered more appropriate for a parent with reference to a child. Controlling behaviors are thought to represent a compensatory attempt by the child to maintain the involvement and attention of the attachment figure by taking over direction of the parent-child relationship.

Two forms of this controlling behavior were observed. Controlling-caregiving behavior is characterized by organizing and guiding the parent or providing support and encouragement to the parent (e.g. child praises the parent or asks if a parent is all right). Controlling-punitive behavior is characterized by episodes of hostility toward the parent that are marked by a challenging, humiliating, cruel, or defying quality (e.g., child tells parent that the parent is terrible at doing a task). The study found that, among young adults with recurrent suicidality/self-injury, 40% displayed high levels of role confusion compared to 16% of those who were not suicidal. 

Neither form of disturbed interaction mediated the independent effect of childhood abuse on borderline symptoms. In other words, these patterns contributed to the development of the disorder in an additive fashion to the usual culprit of child abuse. As the authors say, "even when present, abuse events are often only the tip of the iceberg and index pervasive difficulties within the family in establishing caregiving routines, managing anger, and maintaining discipline"  (p.643) (Italics mine).

One interesting sidelight was noted on p. 656: with depression controlled (that is, subtracted as a factor in the mix), young adult-parent interaction associated with borderline traits included a particularly contradictory combination of role confused/caregiving behavior and punitive behavior. This contradictory mix is "similar to the mixed forms of childhood controlling behavior toward the parent that predict elevated BPD features in adulthood...", as had been noted by the first author in a previous work from 2013. This odd mixture of punitive and caregiving behavior "converges with the often-described shifts from idealizing to devaluing behavior experienced in therapeutic interactions with borderline patients."

This means that the so-called "splitting" seen in patients with BPD may be triggered by the demand characteristics of interactions with parents as they change over a period of time. This finding is highly consistent with what I have written about extensively.


Monday, December 28, 2015

Some Questions Answered About Family Dynamics in Borderline Personality Disorder


"Letters, we get letters
We get lots and lots of letters"





I had an interesting exchange with a reader who asked me some questions about my ideas about the family dynamics of people with borderline personality disorder. I thought other readers may have similar questions, and she gave me her permission to reproduce the exchange in a blogpost. So here t'is, with my answers in blue:

I think my mother has BPD. I am trying to make sense of it, and I am digging into my family's history, to see if I can find a possible cause for her BPD.

The mother of my mother seems to be like the mother in the movie Thirteen, that you commented on in your article. She is always stating she would do anything for her children, but at the same time she sometimes drops things like, 'I sacrificed my life for them." Which pretty much sounds like playing the victim, to me.

It is new to me, that parents who are not physically or emotionally abusive, can also provoke BPD in their offspring. Thank you for attracting my attention to that.  Researching more about this, I read an article that stated that parents who are 'over-involved' can do the same, because they don't allow their children to grow into beings with clear boundaries. Do you agree on this statement? If this is true, than the hypothesis, that BPD patients always have poor attachment to their primary care givers, doesn't stand? 

One last question is: Can patients who have BPD get cured without professional help? I am asking this question, because I realize that I also have had several traits of BPD during the course of my life - although they never co-occurred. Coming to a point where I am realizing that my mother probably has BPD, I am also evaluating my own personality, and if I am honest, I can see that, especially during my twenties, I have had several symptoms, though never more than one at the same time.

Can you please provide me with some clarity ? I would be most grateful. I however will understand if you don't have the time to answer.

In answer to your questions as they apply in general - I am not able to speculate about your situation in particular without having seen and extensively evaluated you and your family situation:

1. The family dynamics of BPD involve the parents being conflicted over the role of having kids. They go back and forth between hostile under-involvement and hostile over-involvement. In a given family, one of these sides may predominate most of the time, but if one waits long enough, the other side shows up.

2. BPD is not a "disease" but a combination of traits by which someone adapts to the above family behavior. Some people have a lot of these traits, some many fewer. The traits can range from very mild to very severe, and severity levels can change dramatically in a short period of time. They can also appear and disappear depending on what is going on in a person's family life at any given moment.

Even in people who show these traits most of the time, many of the traits may start to get better on their own as the person gets older, although certainly not in all cases. Their relationships may continue to be poor, however.  Professional help can be very useful, but whether it's absolutely necessary in every case , the answer is that it depends on a lot of different factors.

Family-oriented psychotherapy is hard to find.  The models I recommend are listed at the end of the post:  http://www.psychologytoday.com/blog/matter-personality/201205/finding-good-psychotherapist. I'm not sure which ones might be available where you are. In England, the most common one is cognitive-analytic therapy (CAT).

What if no other siblings had symptoms while living in this 'borderline producing family?' Does it make sense to develop symptoms only after having left the parental nest? (Because in this case, the 'spoiler' doesn't develop his behavior to balance the mother's moods: instead she only starts to be a spoiler once married, like my mum ... Then this behavior is of no use? (only to act out own frustrations maybe .. but it is not in the interest of balancing the family system). Does this make sense then ?

(Going to a family therapist in my/my mother's case is a non-option for my mother, so unfortunately I have to kind of figure these things out by myself.)

Again, many possible explanations, so I can't say anything about your situation in particular.

In general, in the type of situation you are describing, the person's spoiling behavior with the new spouse stabilizes his/her parents in some way, but is only needed by those parents when the adult child is in the context of a marriage. Often gender role conflicts and repressed anger are at the root of such a pattern - for example, a daughter might act out the mother's repressed rage about having to cater to her (the mother's) own inadequate husband (the daughter's father or step father). Through the daughter's behavior, the mom experiences vicarious satisfaction of her own rage as she watches her daughter frustrating the daughter's husband efforts to "take care" of her.

If a mother acts in a way that produces BPD in her offspring, is it always the case that the child will become a spoiler? In the particular case of my mother, everyone from her family of birth tells me how "good, quiet, well behaved..." she was. It is like she only started to have BPD symptoms when she got married and had kids. Does that make sense? 

No, not always. In fact, family dynamics are like the proverbial true-false test: nothing happens "always" or "never." There are an almost infinite number of other factors which may alter the developmental course of a child - especially other relationships including the other parent, other relatives, or supportive mentors. There is what they call a "chaos" effect - small differences in initial conditions can multiply into big differences later on. Also, in some families, only one sibling will volunteer and/or be chosen to be "it," while the others remain relatively unaffected. If the "it" child stops playing the spoiler, one of the other siblings may suddenly step into that role ("sibling substitution").  The more severe the parental internal conflict, the more additional siblings will be affected or recruited at the outset.

If BPD is not a disease, how is it that the amygdala in people with BPD seems to be different ?

The amygdala is subject to neural plasticity like many areas of the brain, which means that it normally changes in size and activity as it adapts to the environment - especially the social environment.  It's one of the bases for conditioned responses. See http://www.davidmallenmd.blogspot.com/2014/05/borderline-personality-disorder-why.html and http://www.davidmallenmd.blogspot.com/2013/02/neural-plasticity-and-error-management.html

Why do almost all of the experts state that BPD is as good as is incurable, even if the patient is willing to cooperate?

"Cure" is a strange word to use since it's not a disease. Borderline traits absolutely can go away, and the relationships of someone with BPD can change for the better, especially with treatment that focuses on family-of-origin behavior.

You say that the traits of BPD sometimes disappear with aging, as they are not needed anymore. But I thought that BPD primarily stems from a fear of abandonment. So I don't see how someone can get rid of this deeply rooted feeling, even when he doesn't live with his parents anymore / is not being abused by them anymore / or maybe they even died. If there is a 'hole' inside you because of non-attachment with your parents, I thought that this emptiness will always be there, and it will just manifest itself by clinging to - pushing away spouses instead of the parents, or the same behavior towards offspring.

The issue of what happens after the parents die is still somewhat of an open-ended question for me.  For some people, they are freed up for the most part, although the "emptiness" never completely goes away. Other people get worse than ever after the parents die, even if other family members do not seem to be feeding into their problems. I think it has something to do with PTSD-like effects. The more obsessive a patient starts out, the more likely they are to obsessively recreate conversations with their parents in their heads. 

I had one patient who got a lot better after seeing the movie A Beautiful Mind. She realized that even though she couldn't stop hearing those conversations in her head, she didn't have to believe them. She discovered the secret of "Acceptance and Commitment Therapy" (ACT) before it had been "discovered" and written about - although I don't think ACT really works if the parents are still feeding into the problem, as they are more powerful in shaping a person's behavior than any therapist.

Are there cases in which a person with BPD manifests traits towards her spouse, but not towards her children? What does it mean?

There are all kinds of different permutations and combinations, and plenty of traits of other personality disorders that can co-exist and come and go with any patient. The family issues that the patient's behavior is designed to solve determines this, and every family is different. The details matter.  The stuff I write about only represents prototypes or the most common patterns.

Tuesday, December 15, 2015

When Anecdotal Evidence is Sufficient Proof



Printed by Publish Any Damn Thing or Perish Press. Research funded by the Keep Unimaginative Academics Employed Foundation.


As I did on my posts of November 30, 2011,  October 2, 2012, September 17, 2013June 3, 2014, and February 24, 2015, it’s time once again to look over the highlights of the latest issue of one of my two favorite psychiatry journals, Duh! and No Sh*t, Sherlock. We'll take a look at the unsurprising findings published in the latest issue of Duh! My comments in bronze.

As I pointed out in those earlier posts, research dollars are very limited and therefore precious. Why waste good money trying to study new, cutting edge or controversial ideas that might turn out to be wrong, when we can study things that that are already known to be true but have yet to be "proven"? Such an approach increases the success rate of studies almost astronomically. And studies with positive results are far more likely to be published than those that come up negative.

May 7, 2105. Study: Bisexual And Gay Children More Likely To Be Bullied As They Grow Up


The AP (5/7, Stobbe) reports that a research letter published May 7 in the New England Journal of Medicine suggests that bisexual and gay children “are more likely to be bullied as they’re growing up – even at an early age.” Researchers found that “many of the nearly 4,300 students surveyed said they were bullied, especially at younger ages,” but 13 percent of the 630 bisexual and gay youngsters reported being bullied “on a weekly basis,” compared to just eight percent of the other children.
        HealthDay (5/7, Haelle) reports that “consequences of bullying can include physical injury, anxiety, low self-esteem, depression, suicidal thoughts, post-traumatic stress and negative school performance...said” the study’s lead author. 

This is just more propaganda from people advancing the gay agenda.

6/15/15. Small Study: Lisdexamfetamine May Improve Memory, Concentration Problems Associated With Menopause.


HealthDay (6/13, Haelle) reported that the stimulant medication lisdexamfetamine, which is “marketed for attention-deficit/hyperactivity disorder, might improve memory and concentration problems associated with menopause,” according to a study of 32 menopausal women published online June 11 in Psychopharmacology. The study, which received support from the NIH and Shire, the maker of lisdexamfetamine, revealed that “brain activities such as memory, reasoning, multitasking, planning and problem-solving,” improved while women were taking the medicine.

Hate to break this to the Pharma shills, but stimulants will do that for ANYBODY.


8/4/15. Pediatric brain injuries may be associated with attention issues

The Washington Post (8/4, Cha) “To Your Health” blog reports that youngsters who suffer a brain injury, even one considered minor, may be “more likely to experience attention issues,” according to a study published online Aug. 3 in Pediatrics. For the study, investigators included “113 children, ages six to 13, who suffered from traumatic brain injuries (TBIs) ranging from a concussion that gave them a headache or caused them to vomit, to losing consciousness for more than 30 minutes, and compared them with a group of 53 children who experienced a trauma that was not head-related.” HealthDay (8/4, Doheny) reports that the study found that “attention lapses” suffered by the kids with TBIs “led to lower behavior and intelligence ratings by their parents and teachers.” What’s more, the “loss of focus was apparent even when scans showed no obvious brain damage, the researchers said.”

Because injuries to the brain always improve its performance.

8/18/15. Family Problems Early In Life May Raise Boys’ Risk Of Depression, Anxiety.


HealthDay (8/18, Preidt) reports, “Family problems early in life might raise boys’ risk of depression and anxiety, which is also tied to altered brain structure in their late teens and” into early adulthood, according to a study published online Aug. 17 in JAMA Pediatrics. The study, which “included nearly 500 males, ages 18 to 21,” found that “those boys who faced family problems during” the years from birth to age six “were more likely to have depression and anxiety at ages seven, 10 and 13.” Such boys “were more likely to have lower volume of...’gray matter’ in the brain by the time they reached ages 18 to 21.”

What was Freud even THINKING?

8/31/15. Risky Behaviors May Be Signs Of High Suicide Risk In People With Depression.

 

HealthDay (8/30, Preidt) reported, “Risky behaviors such as reckless driving or sudden promiscuity, or nervous behaviors such as agitation, hand-wringing or pacing, can be signs that suicide risk may be high in depressed people,” research presented at the European College of Neuropsychopharmacology’s Congress suggests. The study, which involved some 2,800 people with depression, also revealed that “other warning signs may include doing things on impulse with little thought about the consequences.” People with depression “with any of these symptoms are at least 50 percent more likely to attempt suicide, the new study found.” 

This is just silly. We all know that people who are keen to die are risk averse.


10/7/15. Small Study: Older Adults Appear To Recover More Slowly From Concussion Than Younger Patients.


HealthDay (10/7, Preidt) reports that “older adults recover more slowly from concussion than younger patients,” according to a study published online Oct. 6 in the journal Radiology. Included in the study were “13 older adults, aged 51 to 68, and 13 young adults, aged 21 to 30.” All participants were evaluated at the four-week and 10-week mark following their concussions. While “a significant decline in concussion symptoms – such as problems with working memory – was seen among young patients between the first and second assessment,” researchers found “no such decrease in symptoms...in older patients.”

Aw come on. The body always improves with advanced age.


10/14/15.  Psychological Distress May Be Highly Prevalent In Caregivers Of Patients With Advanced Cancer.


Medscape (10/14, O'Rourke) reports that “psychological distress is highly prevalent in caregivers of patients with advanced cancer and is associated with both caregiver and patient factors, researchers said...at the Palliative Care in Oncology Symposium (PCOS) 2015.” Lead study author Ryan David Nipp, MD, said, “Caregiver characteristics that were significantly associated with caregiver depression were being female and having anxiety.” Dr. Nipp added, “Patient factors that were associated with caregiver depression included patients reporting depression, that the goal of their care was to cure their cancer, and using emotional support coping.”

The impending death of loved ones is always such a high!

10/21/15. Parental Involvement May Optimize Therapy For Kids With Disruptive Behavior Disorders.


Reuters (10/21, Rapaport) reports that having parents participate in therapy for youngsters with disruptive behavior disorders may help the children respond optimally to that treatment, according to a meta-analysis of 66 studies published online Oct. 19 in the journal Pediatrics.

Nonsense. We all know that being rude is genetic.

10/28/15. Cancer diagnosis may lead to loss of income, study indicates


The Washington Post (10/28, Blakemore) “To Your Health” blog reports that research indicates that cancer “can take a heavy toll on patients’ pocketbooks, even long after they recover.” The Los Angeles Times (10/28, Kaplan) reports in “Science Now” that researchers found that “in the second year after being diagnosed with cancer, survivors were earning up to 40% less than they had been before they became sick, on average.” The data indicated that “even in the fifth year after diagnosis, annual earnings still had not recovered to their precancer levels.”The findings were published in Cancer.

Because, thanks to the demise of unions, fewer and fewer folks get paid sick days from their job any more. (I'm not being funny).

11/10/15.  Study Supports Raising SSRI Doses in Patients Who Do Not Respond to Low-Dose Treatment


Using a higher dose of selective serotonin reuptake inhibitors (SSRIs) for major depressive disorder appears to be associated with an increased likelihood of response, according to a meta-analysis published today in AJP in Advance. This benefit, which is somewhat offset by decreased tolerability of SSRIs at high doses, appears to plateau at about 50 mg of fluoxetine (250 mg imipramine-equivalent dose). A team of researchers in the United States and London searched PubMed for randomized, placebo-controlled trials that examined the efficacy of SSRIs for treating adults with major depressive disorder and assessed improvement in depression severity at multiple time points.
       
Er- the first lesson in psychopharmacology 101, I believe.

11/20/15.  Opioid Addiction In Women May Often Start With Physician-Prescribed Medications.


Medscape (11/20, Brooks) reports that new research suggests that the upsurge in the number of women with opioid addiction may be attributed to prescription medicines. Researchers evaluated “sex differences in substance use, health, and social functioning among 266 men and 226 women receiving methadone treatment for opioid use disorder in Ontario.” The researchers found that over half of women (52%) and a third of men (38%) “reported physician-prescribed opioids as their first contact with the” medications. The findings were published online Nov. 9 in the journal of Biology of Sex Differences.

This can't be right. Addiction can only be caused by that evil weed gateway drug, marijuana. Or was that beer?