Hallucinations, a new book by Oliver Sacks, MD, hit store shelves (and e-readers) this month, and—like many of his other books—it is sparking conversations not only in the scientific community but also more widely among the reading public.

Sacks is a clinical neurologist and professor at New York University School of Medicine. He is best known for his books that examine case studies from his own research and practice, including The Mind’s Eye, Musicophilia, Uncle Tungsten, The Man Who Mistook His Wife for a Hat, and Awakenings (which inspired the 1990 feature film starring Robert De Niro and Robin Williams).

In this new book, Sacks asserts that, contrary to popular belief, hallucinations are not the sole purview of the mentally ill. In fact, they are surprisingly common among individuals with sensory deprivation (e.g., blindness) or medical conditions such as migraine, epilepsy, or Parkinson’s. Many healthy people experience hallucinations in the moments before sleep or upon waking, according to Sacks. Strong emotions associated with major life changes can trigger hallucinations, for example, when a bereaved spouse experiences a “visit” from his or her lost loved one. And of course, hallucinations can be a side effect of medication or intoxicants.

Hallucinations is a collection of fascinating stories, anecdotes, and case studies. Sacks describes a woman who hears not spoken voices, but music; a man who smells roast beef when he feels a migraine coming on; and a respected botanist who walks into his lab, only to see himself already at work. Drawing on history, art, religion, and popular culture, Sacks seeks to describe and better understand the experience of hallucination. As a clinician and researcher, he also delves into the biology of the brain and the neurological reasons behind many types of hallucinations.

With this book, Sacks hopes to ameliorate some of the stigma associated with hallucinations. In a recent interview with Slate magazine, he said, “I think there’s a common view, often shared by doctors, that hallucinations denote madness—especially if there’s any hearing of voices. I hope I can defuse or de-stigmatize this a bit. This can be felt very much by patients. There was a remarkable study of elderly people with impaired vision, and it turned out that many had elaborate hallucinations, but very few acknowledged anything until they found a doctor whom they trusted.”

In a 2009 TED Talk entitled “What Hallucination Reveals About Our Minds,” Sacks provides an introduction to his subject, along with some background on the work that led to his recent book. The 20-minute TED Talk is available free online, so take a look—and let us know what you think. PAR wants to hear from you, so leave a comment and join the conversation!
A new study from researchers at Northwestern University helps to better understand the powerful impact words have on infants.

While babies were watching the researchers intently, an experimenter used her forehead to turn on a light. She then allowed the infants to play with the light themselves to see if they would imitate this novel action. In a second group, the experimenter announced what she was doing, naming the activity with a nonsense word (“I’m going to blick the light”), before using her forehead to turn on the light. In this group, the infants were more likely to imitate the behavior. Researchers believe that the subjects in the study were more likely to see the behavior as an intentional event when it was paired with language, and thus, imitate it.

This points to the idea that infants as young as 14 months of age coordinate what they know about human behavior with their knowledge of language when they choose which actions to imitate. Infants’ observation skills, when paired with language, heighten their ability for understanding of intentions and actions. Without language to convey meaning, infants do not imitate these “strange” actions, allowing language to unlock a bigger world of social actions.

To read more about this study, see Developmental Psychology.
Imagine seeing someone’s life turn around before your eyes. A woman who has struggled, financially and emotionally, is preparing for a long-awaited job interview. She has come quietly into a shop and is browsing through a selection of professional clothing. For the first time in her life, she tries on a business suit and emerges tentatively from the dressing room. Looking in the mirror, her face suddenly changes. She has a new look of confidence because she can see it now: She can imagine herself in a professional environment. She is ready to take her life in a new direction. This woman is what Dress for Success is all about—and she is the reason that PAR is delighted to support the DFS Tampa Chapter.

Founded in 1997, Dress for Success is a not-for-profit organization offering services designed to help clients find and retain good jobs. At the Tampa chapter, Dr. Heather Ureksoy, a member of PAR’s Research and Development team, has been an active volunteer, serving not only as a volunteer coordinator and shop manager but also organizing an apparel drive here at PAR that garnered more than 300 articles of gently used professional clothing for women making a fresh start in the job market. In October this year, Heather organized an Excess Inventory Sale to raise funds for the purchase of more plus-sized suits for the DFS boutique. During the two-day sale, PAR employees donated their time to work at the event, while others came to shop.

“Our clients are referred to DFS through various service agencies in the Tampa Bay area,” Heather explains. “In 2012 so far, we have suited approximately 950 clients—and we have also expanded our career center to accommodate more mock interviews, résumé consultations, and technology classes.”

Since its inception almost 35 years ago, PAR has been giving back to the community, and employees are actively engaged in a wide range of community service projects. When Heather came to PAR two years ago, she was happy to be part of an organization that supported her volunteer work. “I knew I wanted to do something to give back,” she says, “but I had no idea how much I would love it! PAR provides a paid day off for employees to do volunteer work. Bob and Cathy [Smith, founders of PAR] have created a real culture of giving throughout the company.”

Clearly, Dress for Success is about much more than just finding appropriate clothing for a job interview. “It’s very personal,” says Heather. “The women we serve want to tell their story. They’ve all had some sort of struggle, and they’re getting back on their feet. Tears are shed! It can be exhausting, but it’s so rewarding. And when they find the right suit—their whole face transforms. It’s really beautiful.”

To learn more about Dress for Success, visit www.dressforsuccess.org and click on the Locations link to find your local chapter.
A great deal of research over the years has focused on the devastating effects of bullying on the mental health of its victims. However, a recent study also suggests that children with mental disorders such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and depression are much more likely to engage in bullying behavior toward others.

Lead author Dr. Frances Turcotte-Benedict, a Brown University masters of public health student and a fellow at Hasbro Children’s Hospital in Providence, presented the findings at the American Academy of Pediatrics’ national conference in New Orleans on October 22. Turcotte-Benedict and her colleagues reviewed data provided by parents and guardians on mental health and bullying in the 2007 National Survey of Children’s Health, which included nearly 64,000 children ages 6 to 17 years.

In the survey, 15.2 percent of children were identified as a bully by their parent or guardian. Children with a diagnosis of depression or ADHD were three times as likely to be identified as bullies; children diagnosed with ODD were identified as bullies six times more often than children with no mental health disorders. The study found no noticeable differences between boys and girls—both were at increased risk for bullying when a mental health disorder was present.

Traits associated with ODD, such as aggression and revenge-seeking, appear to be clear risk factors for bullying. The connection between bullying and ADHD may be less obvious. “Even though, by definition, these children [with ADHD] aren’t angry or aggressive toward their peers, they do display traits that would increase the likelihood of having impaired social interactions,” explains Dr. Steven Myers, a professor of psychology at Roosevelt University in Chicago, in an October 22 interview with the Huffington Post. “If you’re not really thinking through the consequences of your actions on the playground, you might not have the self-monitoring or restraint to hold back from bullying.”

“These findings highlight the importance of providing psychological support not only to victims of bullying, but to bullies as well,” concludes Turcotte-Benedict. “In order to create successful anti-bullying prevention and intervention programs, there certainly is a need for more research to understand the relationship more thoroughly, and especially, the risk profile of childhood bullies.”

What do you think? Should bullying prevention programs do more to address the mental health problems of the bully? PAR wants to hear from you, so leave a comment and join the conversation!
It’s an age-old question, but now there’s science to give us an answer.

No, men and women cannot just be friends.

However, the reasons may be more complicated than you imagine. According to researchers at the University of Wisconsin-Eau Claire and published in the Journal of Social and Personal Relationships, attraction between members of cross-sex friendship is a common event. Furthermore, these “platonic” friendships have potential negative consequences for the individuals’ long-term romantic relationships.

Researchers surveyed more than 80 male-female pals and found that men were more attracted to their female friend than women were to their male friend. Men also tended to consistently (and mistakenly) believe that their female friend was more attracted to them than they actually were. Even if the woman in the pair was involved in a romantic relationship with another person, this did not deter most men – even if their gal pal was taken, this had no impact on their attraction.

Women, though, reported much less desire to date their male friends if they were already involved in a relationship. Younger females and middle-aged participants who reported more attraction to an opposite-sex friend also reported less satisfaction in their current romantic relationship.

In another survey conducted by the researchers, men reported that there was more to gain from attraction in friendships, while women felt that there was more to lose.

Do you have a successful cross-gender platonic friendship? Do you think that men and women can ever really just be friends?
New research has made the famous 1972 marshmallow test even more compelling. The original Stanford University study on delayed gratification, which promised children an extra marshmallow if they could resist the one in front of them for 15 minutes, analyzed whether a child’s ability to delay gratification had any correlation on future success. Today, researchers have taken that information a step farther – finding that a child’s ability to resist temptation isn’t innate, but highly influenced by environment.

Researchers from the University of Rochester gave five-year-olds used crayons and one sticker to decorate a piece of paper. One group of children was told they would receive a new set of art supplies, but never received it. For the second group, however, researchers made good on their promise and provided the children with new crayons and better stickers. Both groups were then given the marshmallow test.

The children who were promised the supplies and never received them waited an average of three minutes before eating their marshmallows. The children who had received the supplies promised resisted temptation for an average of 12 minutes, leading researchers to believe that experience plays into a child’s ability to delay gratification. Wait times reflected not just the child’s self-control abilities, but suggest a child’s reasoning of the stability of the world around them and their understanding of whether waiting to delay gratification would ultimately pay off. According to researcher Celeste Kidd, delaying gratification is only a rational choice if the child believes that the second marshmallow is likely to appear. Though children do not monitor every single action of the adults around them, they do have an overall sense of the reliability or unreliability of the people around them.

The group found that children may have more sophisticated decision-making abilities based on their environments than originally thought.
The CPT code numbers that mental health professionals use for billing psychotherapy services to insurance carriers will change on January 1, 2013. In addition to the code changes, Medicare reimbursement rates will also be revised. The AMA will publish the new codes and rates later this fall.

The American Psychological Association’s Practice Central Web site outlines some of the anticipated changes, which include:

1.  Outpatient and inpatient psychotherapy codes will be replaced by a single set of codes that can be used in both settings.
2.  The new psychotherapy codes will have specified times rather than ranges:


  • 30 minutes, not 20-30 minutes

  • 45 minutes, not 45-50 minutes

  • 60 minutes, not 75-80 minutes


3.  The single psychiatric diagnostic evaluation code will be replaced by two codes: one for a diagnostic evaluation and the other for a diagnostic evaluation with medical services.


What practical steps do you need to take now in order to prepare for these changes? According to the American Psychiatric Association, the pharmacologic management code will no longer exist, so it is important for practitioners to start familiarizing themselves with the medical evaluation and management (E/M) codes for medication management. Practitioners should also review any contracts they have with insurers to make sure that the contracts don’t limit them to specific codes in the psychiatry section that may be replaced as of January 1. HIPPA requires that insurers use current CPT codes, so these companies should be updating contracts in the coming months.

For the latest information about these changes and how they may affect your practice, visit the American Psychological Association’s Practice Central Web site or call its Practitioner Helpline at 1.800.374.2723.
On October 15, PAR author Lisa Firestone, PhD, will be hosting a CE Webinar with violence expert Dr. James Gilligan on the topics of understanding and preventing violence. For more information on the Webinar, visit Dr. Firestone’s blog. To register for the Webinar, click here.
Adults with disabilities, particularly mental illness, have been found to be at an increased risk of being a victim of violence, according to a study funded by the World Health Organization’s Department of Violence and Injury Prevention and Disability. This finding, a meta-analysis of 21 studies, found that one in four people with a mental illness experience some type of violence in a given year – a much higher rate than that experienced by the general population.

The chance that a person with a mental illness will experience physical, sexual, or domestic violence was found to be 3.86-fold higher than the odds of an adult without any disabilities at all. However, violence against individuals with other disabilities was common – it was found that individuals reporting any disability were 50 percent more likely to experience physical, sexual, or intimate partner violence in the prior 12 months than those individuals without a disability, and 60 percent higher for people with intellectual impairments.

Researchers believe that their inclusion criteria probably underestimated the prevalence of violence against people with disabilities because many of the studies were based in high-income countries with lower reported rates of violence. Furthermore, there were no studies of violence against individuals with intellectual disabilities in institutional settings or studies of individuals with sensory impairments included in the analysis.

Approximately 15 percent of adults worldwide have a disability.
While every baby is different, the sleepless nights are something that most parents of infants can’t escape.

Sleepless nights don’t just equal tired parents, though. Sleep deprivation can double mom’s risk of suffering from depression and can lead to marital strife. But how should tired parents teach their babies to sleep?

While some parents believe letting their child “cry it out” will teach self-soothing behaviors, other parents believe that letting their child cry will cause their little one to feel insecure and abandoned. However, exhausted moms and dads have some new research on their side that can (hopefully) afford them a little shut eye.

A new study released in the journal Pediatrics followed 225 babies from seven months old until age 6 to compare the difference between parents who were trained in sleep intervention techniques and those who were not. The sleep intervention group was told to select either “controlled crying,” which had them respond to their infant’s cries at increasing time intervals, or  “camping out,” which asked them to sit with their child until he or she fell asleep, removing themselves earlier each night over a three-week period.

Families in the sleep training group reported improved sleep. Mothers were also less likely to experience depression and emotional problems. Furthermore, it was determined that those children in the sleep training group were not harmed by letting them cry it out. Researchers found no differences between these children and the children in the control group in matters of mental and behavioral health, sleep quality, stress, or relationship with their parents at age six. Allowing babies to cry for limited periods of time was found to help the entire family sleep better without causing psychological damage. Furthermore, an earlier study found that sleep training does work – babies learn to go to sleep easier and stay asleep longer than their counterparts.

No matter which method parents choose, they can feel better knowing that while it may seem that their infant is stressed when he or she is crying, researchers believe that it is good stress and it will have no lasting impact on the parent-child bond.