Those who practice meditation tout the benefits of this practice, but is there any truth to the idea that meditation can influence one’s psychological health?

In a study conducted by the University of Massachusetts Medical School’s Center for Mindfulness, 16 healthy individuals were given MRIs two weeks before beginning a mindfulness-based stress reduction course. During this course, individuals took part in weekly classes, listened to guided meditation audio recordings, and logged the amount of time they meditation on their own each day, with the average being about 27 minutes. The same participants were given a second MRI two weeks after completing the course.

The brain scans showed some interesting findings. The hippocampus, important in learning and memory, showed an increase in brain cell mass. Other areas that showed an increase in brain cell mass were structures linked to self-awareness, introspection, and compassion. Some areas – such as the amygdala, which controls anxiety and stress –  showed a decrease in mass, an interesting finding since most participants rated themselves as less stressed after taking part in the program.

The study shows that the psychological benefits people are reporting are very real shifts in the biological structure of the brain. While the underlying mechanisms that cause the brain to change in response to meditation need further research, it is an important step to know that individuals practicing meditation can play an active role in their well-being.

To read more about this study, you can read more in the January 2011 issue of Psychiatric Research: Neuroimaging.

Do you use meditation with your clients? What kinds of outcomes have you witnessed?
Guidelines from the American Academy of Pediatrics released in October suggest that attention deficit hyperactivity disorder can be diagnosed and treated in children as young as age 4, two years younger than the previous minimum age set by AAP a decade ago.

Mark Wolraich, the lead author of the ADHD clinical practice guidelines and a professor of pediatrics at the University of Oklahoma Health Sciences Center, told the Wall Street Journal recently that ADHD in a preschool-aged child is very different from the typically active behavior seen in most young children (www.online.wsj.com, October 17). A child with ADHD often doesn’t play well with other children, is prone to accidents, and is overactive much of the time. “It's not the environmental things like parties triggering it,” Dr. Wolraich says.

According to the new guidelines, behavior management should be the first approach for treating preschool-aged children. But when behavioral interventions aren’t enough, the guidelines suggest that doctors consider prescribing methylphenidate (commonly known by the brand name Ritalin) for preschool-aged children with moderate to severe symptoms.

Other key recommendations include assessing children for other conditions that might coexist with ADHD, such as oppositional defiant and conduct disorders, anxiety, and depression.

“Treating children at a young age is important,” asserts Dr. Wolraich, “because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school.”

For more information, or to request a complete copy of the guidelines, visit www.aap.org.

What do you think about the new ADHD guidelines? Will they affect your practice? Join the conversation—leave a comment now!
PAR author Dr. Lisa Firestone will be presenting two CE workshops through the Massachusetts School of Professional Psychology.

“Suicide: What Professionals Need to Know” will be held on December 2, 2011. This workshop provides an in-depth understanding of the dynamics of suicide and of the legal, ethical, and case management issues that arise when dealing with suicidal individuals.

For more information or to register for this session, click here.

“A Developmental Understanding for Assessing and Treating Violent Individuals” will be held on December 3, 2011. This workshop provides an in-depth understanding of developmental issues contributing to violence, the triggers of violence, assessment, case management, and treatment of violent or potentially violent adults and adolescents.

For more information or to register for this session, click here.

Dr. Firestone is the author of the Firestone Assessment of Self-Destructive Thoughts and Firestone Assessment of Suicide Intent (FAST-FASI), the Firestone Assessment of Violent Thoughts™ (FAVT™) , and the Firestone Assessment of Violent Thoughts-Adolescent (FAVT-A).
If you’re looking for a good laugh (and sometimes, at the expense of the profession), Showtime’s new comedy, Web Therapy , may be just what you are looking for to blow off some steam after a tough day. Starring Lisa Kudrow as Fiona Wallice, a therapist who invented “web therapy,” the main character, who is sorely lacking in professional skills, makes her living by seeing clients via webcam.

While this is a fictional account of one therapist providing services online (as Fiona’s unique brand of therapy would never pass any kind of ethics codes), the area of telepsychology is a growing one. Although supporters of telepsychology tout a provider’s ability to serve clients all over the world, those who question the practice bring up issues related to licensure issues, privacy concerns, and the general effectiveness of outcomes.

Because the body of research on this practice is still evolving and best practices have not yet emerged, this year’s APA president, Melba J. T. Vasquez, PhD, has made a point to work on creating and adopting guidelines for telepsychology services.

Do you provide services via the web, e-mail, or telephone? How do you feel about the telepsychology movement? What do you think should be included in the guidelines?
In 2009, Congress passed a law that mandates the introduction of new, graphic warning labels on cigarette packs. By 2012, tobacco companies must incorporate into their packaging one of nine FDA-approved graphics—images that show the potential consequences of smoking, like diseased lungs and rotting teeth—along with a national quit-smoking hotline number. The FDA believes the warnings will prevent children from taking up the habit and help adults quit (Department of Health and Human Services).

Findings generally show that graphic warning labels are effective at increasing awareness of the health risks posed by smoking. In April, the authors of a study published in Health Education Research interviewed subjects both before and after the implementation of Taiwan’s new graphic cigarette warning label and smoke-free law. They found that “the prevalence of thinking about the health hazards of smoking among smokers increased from 50.6% pre-law to 79.6% post-law, [and] the prevalence rates of smokers who reported thinking of quitting rose from 30.2% pre-law to 51.7% post-law.”

A 2009 study looked at Australia’s graphic labels, which have been in use since 2006 and have relatively strict specifications (they must compose 30% of the front and 90% of the back of each pack). The warnings “increased reactions that are prospectively predictive of cessation activity. Warning size increases warning effectiveness and graphic warnings may be superior to text-based warnings.” Despite some wear-out of the message over time, “stronger warnings tend to sustain their effects for longer.” Another Australia-focused study looked at the media coverage surrounding the introduction of the new labels and found that, of 67 news stories, “85% were positive or neutral about the new warnings and 15% were negative” and that “smokers’ initial reactions [to the labels] were in line with tobacco control objectives.”

What do you think? Are these methods effective motivators in the long run? If so, will that translate into an increase in actual quitters? Are there drawbacks to this type of labeling? Let’s hear what you have to say.
One in 10 American adults experienced depression in 2010, making it one of the most common complaints of those seeking therapy services. In her October 11 webinar, "An Innovative Approach to Treating Depression," PAR author Dr. Lisa Firestone will present a method for helping treat depression that encourages clients to identify and combat their self-destructive thoughts.

According to Dr. Firestone, when someone is depressed, the hopelessness they feel clouds the lens through which they see the world; this lens is most harsh when it is turned on themselves. To begin challenging the roots of depression, therapists must help clients identify their self-destructive thoughts (“Critical Inner Voices”) and learn to take action in their own self-interest. In this webinar, Dr. Firestone will introduce a cognitive/affective/behavioral modality for bringing these thoughts to the surface, separating from them, and taking action against them. Clinicians will learn how to help clients challenge their Voices, show more self-compassion, and strengthen their sense of self.

To register for this webinar, click here. The webinar will be held October 11, from 7:00 to 8:30 p.m. EST, is worth 1.5 CE units, and costs $25.
When an important task requires your attention, do you get right to it or do you put it off? When you’re faced with a paper to write, a report to review, or a memo that needs a detailed response, does the laundry—or the latest YouTube video—suddenly emerge as a more interesting alternative? Procrastination is an occasional challenge for many of us. But chronic procrastination can be a real problem for students, significantly affecting their academic success.

In a study published recently in the Journal of Clinical and Experimental Neuropsychology*, authors Laura Rabin, Joshua Fogel, and Katherine Nutter-Upham look at procrastination and its connection to the self-regulatory processes that make up executive function.

Dr. Rabin and her colleagues examined nine clinical subscales of the Behavior Rating Inventory of Executive Functioning–Adult Version (BRIEF-A) in a sample of more than 200 college students. These subscales include measures of impulsivity, self-monitoring, planning and organizing, ability to “shift” behavior or mindset when necessary, initiative, task monitoring, emotional control, working memory, and organization of materials. The authors found that all nine of the clinical subscales measured by the BRIEF-A showed a significant correlation with higher academic procrastination.

What can be done to help students whose procrastination is hindering their success? In his Psychology Today blog “Don’t Delay: Understanding Procrastination” (http://www.psychologytoday.com/blog/dont-delay), Timothy A. Pychyl describes implications of the Rabin, Fogel, and Nutter-Upham study, summarizing some key strategies for students who struggle with procrastination. They include:

  • setting proximal sub-goals along with reasonable expectations about the amount of effort required to complete a given task;

  • using contracts for periodic work completion;

  • requiring weekly or repeated quizzes until topic mastery has been achieved;

  • using short assignments that build on one another with regular deadlines and feedback;

  • focusing on the problem of “giving in to feeling good” by developing an awareness of the problem and its subversive effects on achievement;

  • developing volitional skills, such as managing intrusive negative emotions and controlling impulses;

  • establishing fixed daily routines;

  • blocking access to short-term temptations and distractions such as social media; and

  • using peer monitoring and self-appraisal methods to improve academic conscientiousness.


Pychyl’s blog includes a podcast interview with Laura Rabin in which she describes how a neuropsychological perspective can inform our understanding of the role of executive function in procrastination. To listen to Dr. Rabin’s interview now, click on http://iprocrastinate.libsyn.com/a-neuropsychological-perspective-on-procrastination.

To learn more about how the BRIEF measures executive function, visit the PAR Web site (www.parinc.com) and navigate to the BRIEF product page.

*Rabin, L. A., Fogel, J., & Nutter-Upham, K. E. (2011). Academic procrastination in college students: The role of self-reported executive function. Journal of Clinical and Experimental Neuropsychology, 33, 344-357.
PAR is proud to support United Way! Last week, PAR employees took part in our annual fundraising campaign. For the 19th consecutive year, 100% of PAR staff participated in our annual United Way drive. We exceeded our fundraising goal, resulting in $105,993 being donated to help United Way continue its mission of helping others in our community.


For more information on how you can help United Way in your community, visit www.liveunited.org.

Yes or no, this or that… sometimes, having a lot of options isn’t all it’s cracked up to be. While you may think that you are just making decisions based on the options in front of you, according to new research, your decision-making abilities may fluctuate throughout the day. The well-thought-out choice you thought you were making? Well, it may just be a reflection of your mental state.

According to research from social psychologist Roy F. Baumeister (link to http://www.psy.fsu.edu/faculty/baumeister.dp.html),  there is a finite amount of energy allotted for self-control, meaning that the more decisions you make, the quicker you deplete this store. Decision-making saps willpower, making it easier and easier to give up on tasks as you go along. Think about the last time you had to make many decisions fairly quickly – after some time, most people begin to feel exhausted even though they aren’t doing much physical work.

According to a recent study by Shai Danziger, Jonathan Levav, and Liora Avnaim-Pesso, even people whose jobs are based on their decision-making abilities can fall victim to decision-making exhaustion. This group of researchers studied judicial decisions and found that legal reasoning could not sufficiently explain why judges choose what they do. By breaking a judge’s day into three decision-making sessions, punctuated by a break for food, the researchers found that the likelihood that a prisoner was granted parole was highly correlated to when they were seen by the judge. Researchers found that the percentage of favorable rulings drops from about 65 percent to nearly zero during each segment of a judge’s day. Essentially, those up for parole were most likely to be granted parole the earlier the individual was seen during each decision-making session; those who were scheduled just before a break had almost no statistical possibility of parole. Once the judge took a break, the possibility of a favorable judgment returned to about 65 percent.

It became clear that those suffering from decision-making exhaustion behave in one of two ways – they either behave recklessly (think about how many quarterbacks throw a wild pass late in the game) or they refuse to make any decisions at all, refusing to do anything risky (like releasing a prisoner on parole).

Have you ever made decisions that were affected by your mental fatigue? Knowing how your ability to make decisions wanes throughout the day, will you make any changes to your schedule?
Broader Definition of the Disease Could Help Doctors with Early Diagnosis and Intervention

In April of this year, the National Institutes of Health and the Alzheimer’s Association announced significant changes in the clinical diagnostic criteria for Alzheimer’s disease dementia. These revisions—the first in 27 years—are intended to help diagnose patients in the very early stages of the disease, allowing doctors to prescribe medication when it is most effective; that is, before a patient’s memory becomes compromised.

The new guidelines recognize two early stages of the disease: preclinical Alzheimer's, in which biochemical and physiological changes caused by the disease have begun; and mild cognitive impairment, a stage marked by memory problems severe enough to be noticed and measured, but not severe enough to compromise a person’s independence. The new guidelines also reflect the increased knowledge scientists have about Alzheimer’s, including a better understanding of the biological changes that occur and the development of new tools that allow early diagnosis.

William H. Thies, chief scientific and medical officer of the Alzheimer’s Association, explains, “If we start 10 years earlier and could push off the appearance of dementia by, say, five years … that could cut the number of demented people in the U.S. by half” (Los Angeles Times, April 25, 2011).

For more information about the updated guidelines, as well as a list of journal articles and answers to frequently asked questions for clinicians, visit the National Institute on Aging Web site at http://www.nia.nih.gov/Alzheimers/Resources/diagnosticguidelines.htm.