The negative effects of poor sleep habits have been well documented; however, research has also revealed a little-known negative effect—repeated nights of sleep deprivation can lead to problems with self-control. There is a complex relationship between glucose levels, glucose utilization, and the human capacity for self-control. Lack of sleep interferes with the brain cells’ ability to absorb glucose and, thus, to control impulses.

According to researchers at Clemson University, a sleep-deprived individual is at an increased risk for lack of self-control, which leads to impulsive desires, poor attention capacity, and compromised decision making. Self-control allows individuals to monitor responses; make decisions when presented with conflicting desires; forego temporary pleasure to meet long-term goals; and control damaging social behavior such as addictions, excessive gambling, and overspending.

The Controlled Attention Model maintains that sleep-deprived individuals suffer from low performance on tasks that require too much effort to complete. One study indicates that, when given a choice, sleep-deprived persons will choose less demanding activities to accommodate for decreased capacity. Therefore, good sleep habits could enhance a person’s ability to choose and tackle difficult tasks.

In the same way that physical activity depletes physical energy, self-control exertion depletes mental energy. Not only that, but the energy resources that allow for better self-control are more quickly depleted than replenished. This means that the capacity for self-control can vary as each day progresses. Because sleep restores physiological energy resources, a good night’s rest replenishes the ability for self-control and helps provide the necessary willpower to make better decisions, such as choosing a healthier snack, being more honest, or resisting temptation.

Individuals prone to lack of self-control can evaluate their sleep habits and pay attention to red flags such as the inability to fall asleep, poor sleep quality, inconsistent sleep times, and excessive sleep deprivation. Preventative measures for any of these issues begin with implementing good sleep hygiene, which comprises regulating sleep and wake-up times, preparing an environment conducive to sleep, avoiding caffeine and exercise close to bedtime, limiting or avoiding naps throughout the day, and engaging in relaxing activities to wind down at night.

Sleep and self-control have long been viewed as separate processes but can now be seen as a more integrated system. Scientists in the sleep field and scientists in the cognitive-based self-control field who once worked separately can now work together. By combining studies of sleep and self-control, we can better understand how the interaction among good sleep habits, physiological energy reserves, and an individual’s personal choices impact self-control, providing a valuable means to improve long-term health and productivity.

Although early onset bipolar disorder (EOBD) was first described in 150 AD, the diagnosis remains surrounded in controversy because no such diagnosis exists. A person either meets the criteria for bipolar disorder set forth in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or not. The problem is that, as with DSM-IV, the criteria describe bipolar disorder as it exists in adults. The child phenotype differs markedly from adult onset bipolar disorder. Children with this disorder exhibit a more chronic form of irritability, more rapid mood swings, intense emotional outbursts, and impulsive aggression.

An additional complication when making the diagnosis in children is that most of the symptoms associated with EOBD also exist in ADHD, OCD, and ASD. Moreover, children with EOBD also have high rates of comorbid conditions.

Though it was hoped that DSM-5 would resolve the main concerns, the following issues remain unaddressed:

1. Technically, EOBD diagnosis still does not exist.


2. Teens and children must meet adult criteria to be diagnosed as bipolar.


3. Many children who would have received a diagnosis of bipolar disorder prior to the publication of DSM-5 will now receive a diagnosis of disruptive mood dysregulation disorder (DMDD).

Despite the hope for some consensus, experts in the field have yet to reach agreement on (a) what symptoms constitute the core features of EOBD, (b) how to differentiate bipolar disorder from other childhood disorders, and (c) how best to manage children who have the disorder.

When Drs. Richard M. Marshall and Berney J. Wilkinson began seeing children who exhibited severe symptoms of bipolar disorder, they used omnibus rating scales as part of their initial diagnostic assessment. To their surprise, many of the scales completed by parents and teachers had ratings in the normal range even though the children had symptoms of bipolar disorder. An item analysis revealed that existing rating scales did not contain a sufficient number of items associated with the disorder. To address these shortcomings, Marshall and Wilkinson developed the Pediatric Behavior Rating Scale (PBRS), a standardized, norm-referenced parent and teacher rating scale for use with children ages 3 to 18 years.

Rather than providing specific diagnoses, the PBRS enables clinicians to identify the core features of EOBD, thereby serving as the critical first step in differential diagnosis and intervention planning. The PBRS provides clinical researchers with another tool to assist in (a) defining this disorder, (b) differentiating EOBD from related disorders, and (c) evaluating the efficacy of interventions aimed at alleviating its symptoms.

Approximately 20% of our nation’s 50 million K–12 students meet diagnostic criteria for a mental disorder, and 10% experience significant functional impairments at home, at school, and with peers. Nevertheless, children exhibiting such symptoms are often punished for willful disobedience rather than receiving effective treatment. In fact, 80% of children with mental illness remain undiagnosed and untreated, resulting in increased risk for suicide, school failure, and criminal behavior. Accurate differential diagnoses of EOBD and related disorders is the key to effective interventions.

Unless otherwise cited, source material is attributed to:
Marshall, M. M., & Wilkinson, B. J. (2008). Pediatric Behavior Rating Scale. Lutz, FL: PAR.

What do you think? PAR wants to hear from you, so leave a comment and join the conversation!

In April 2013, President Obama announced the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative. During the speech, he said, “We have a chance to improve the lives of not just millions, but billions of people on this planet through the research that's done in this BRAIN Initiative alone.”

The BRAIN Initiative’s purpose is to help researchers better understand brain disorders such as Alzheimer’s and Parkinson’s diseases, depression, and traumatic brain injury. It will allow researchers to produce dynamic pictures of how the brain records, processes, uses, stores, and retrieves vast quantities of information and shed light on the complex links between brain function and behavior.

According to National Institutes of Health (NIH) Director Francis S. Collins, “The human brain is the most complicated biological structure in the known universe. We’ve only just scratched the surface in understanding how it works—or, unfortunately, doesn’t quite work when disorders and disease occur… This is just the beginning of a 12-year journey, and we’re excited to be starting the ride.”

Many technology firms, academic institutions, and scientists, such as the NIH, the Food and Drug Administration, and the National Science Foundation (NSF), have committed to advancing this initiative. The NSF has partnered with NBC Learn to produce a video series entitled “Mysteries of the Brain,” which draws on research conducted through the White House for the BRAIN Initiative. The series will discuss how the brain develops, controls emotions, and creates memories.

This eight-part video series will include the following segments:

• Searching for Answers—Discusses how new research has begun to decipher the unsolved mysteries of the brain.


• Thinking Brain—Discusses how the brain can store and process large amounts of information.


• Evolving Brain—Discusses how the basic movements of a tiny fish can teach us big ideas about how the brain's circuitry works.


• Emotional Brain—Discusses using a virtual reality room to study how the brain reacts to positive and negative emotions.


• Brain States and Consciousness—Discusses the study of a fruit fly to understand how the brain's cells communicate to control sleep patterns.


• Building a Brain—Discusses how the brains of tadpoles help us understand how neural circuits develop and absorb information from the surrounding environment.


• Perceiving Brain—Discusses how functional magnetic resonance imaging allows researchers to view the brain and determine how it distinguishes important information from every day scenes.


• Brain-Computer Interface—Discusses how devices can monitor and extract brain activity to enable a machine or computer to accomplish tasks, from playing video games to controlling a prosthetic arm.

The "Mysteries of the Brain" series is available for free viewing at NBCLearn, Science360, and the White House Blog. The National Science Teachers Association is developing lesson plans for middle and high school students, which will be available later this summer.

Did you watch the series? If so, what did you think? PAR wants to hear from you, so leave a comment and join the conversation!

Children lie. They lie to get out of trouble, they lie for fun, or they lie out of habit. Parents everywhere admonish their children to tell the truth, but lying has its benefits, according to a study conducted by the Journal of Experimental Child Psychology. More than 100 6- and 7-year-old children were given tests to evaluate their verbal working memory, and then they were invited to play a trivia game consisting of three questions. Each question was written on an index card, along with four possible answers. The correct answer and a picture were placed on the back.

The first two questions were easy to answer correctly; however, the third question was about a fake cartoon. The children were asked, “What is the name of the boy in the cartoon Spaceboy?” After posing the question, the researcher left the room, leaving the card with the correct answer face down on the table and instructing the children not to look at it.

Video cameras recorded the children’s varying reactions, and approximately 25% of them peeked at the card even though they were told not to. The researcher then returned and asked the children to provide the correct answer and to guess the picture on the back of the card. Those who had ignored the instruction not to look at the card answered both questions correctly, and some of them were able to lie convincingly about how they had arrived at the correct answers.

The good liars were the same children who had scored highest on the verbal memory test, and high working memory scores mean their brains can store and process a higher volume of information than their more truthful peers. These children have the language skill and creativity it takes to lie, cover up the lie, and remember all of its details. According to professors M. J. Kane and R. W. Engle, differences in working memory capacity can predict intelligence and the speed with which a particular skill can be learned.

A child with good verbal memory isn’t necessarily more disposed to lie, but good liars generally have good verbal memory. While parents will likely never condone lying, they can at least see it as evidence of a brilliant mind at work.

What do you think? Are liars really smarter? PAR wants to hear from you, so leave a comment and join the conversation!

Pixar’s Inside Out is a movie about being a child and all the emotions that accompany this tumultuous time. Director Pete Doctor and producer Jonas Rivera chose the movie’s core emotions based on research from Dr. Paul Ekman. Dr. Ekman identifies six primary emotions that are universal throughout various cultures—happiness, sadness, anger, surprise, disgust, and fear—and all but one of these appear in the film.

Eleven-year-old Riley’s parents have just moved from Minnesota to San Francisco, and she must come to terms with leaving her old school, best friend, and extracurricular activities. Although Riley is the story’s protagonist, the real characters are her emotions: Joy, Sadness, Anger, Disgust, and Fear, which are personified inside her brain.

The film teaches that emotions play a significant role in the development of Riley’s personality. Joy is the leader—Riley’s predominant emotion—and she strives to protect Riley from Sadness. Later, Joy tries to banish one of Riley’s negative memories, and, as a result, she and Sadness get thrown out of Headquarters, the emotional control center. Only Fear, Anger, and Disgust remain, leaving Riley moody and irritable. Conflict ensues as each emotion grapples for control.

During the challenges of trying to return to Headquarters, Joy and Sadness learn important lessons as each begins to empathize with the emotion of the other. By the movie’s conclusion, Joy understands that she and Sadness must learn to coexist. In a Newsweek article, child psychologist Dr. Fadi Haddad comments, “I thought that was a brilliant ending in the movie, to see the importance of having a feeling like Sadness. That’s what connects us many times to families, to sad events, to friends, to understanding the meaning of empathy.”

The acceptance of Sadness leads to a breakthrough for Riley, who then shares with her parents her pain about leaving Minnesota, which in the movie is also a symbol for leaving behind her childhood. Riley’s emotions are reunited, and they begin working together, leading to Riley’s emotional healing.

For a children’s movie, Inside Out is surprisingly mature, accurately depicting how emotions interact, how they change during adolescence, and how they affect memory. It is a scientific yet kid-friendly portrayal of how the brain works, emphasizing the importance of all emotions—both the good and the bad. Emotions can be very complex for adults, and even more so for children. However, Inside Out has made them more accessible.

Do you think Inside Out accurately depicted the psychology of emotions? PAR wants to hear from you, so leave a comment and join the conversation!

Wrongful conviction stories abound in the news these days as DNA evidence is being used more frequently to reopen cases, some of them decades-old. Groups like The Innocence Project are drawing attention to those who have been wrongly convicted of crimes and helping to exonerate them. In many of these stories, those falsely accused of crimes maintained their innocence, filing appeals and talking to anyone who would listen in an effort to have their cases heard.

But what about convictions in which the accused has confessed to the crime and believes in his or her own guilt? How could an innocent person be persuaded to confess to a crime he or she didn’t commit?

Quite easily, according to a new study by Julia Shaw, a lecturer in forensic psychology from the University of Bedfordshire, and Stephen Porter, a forensic psychologist at the University of British Columbia. In an article in the January 2015 issue of the journal Psychological Science, Shaw and Porter describe the method by which they were able to implant false memories of committing a crime into the minds of college-age adults who volunteered for their study.

Participants were screened to exclude those who had any previous history of law-breaking. Shaw and Porter sent questionnaires to participants’ parents to gather background information (e.g., the names of friends, details about their hometowns) that the researchers could use in the stories they fabricated about the “crime.” During the course of the experiment, which included three 45-minute interviews several days apart, participants were not permitted to communicate with their parents.

In the interviews, Shaw asked each participant to talk about a true, emotional experience from his or her early teen years; then, she prompted participants to “remember” an invented crime such as assault that led to an encounter with the police. During the interviews, Shaw maintained a friendly, nonthreatening rapport, offering to help jog memories about the false crime with details from the true event and information gleaned from the parent questionnaire.

The results surprised even the researchers: of 30 participants in the study, 21 developed a false memory of the event, and 11 reported elaborate details of their interactions with the police following their imagined crimes. “We thought we’d have something like a thirty percent success rate, and we ended up having over seventy,” Shaw said in a March 5, 2015 interview with The New Yorker. “We only had a handful of people who didn’t believe us.” In one example, a participant developed a detailed story about a love triangle that turned into a rock-throwing incident. “It was very emotional,” Shaw said. “Each time she’d re-enact the event, the rock would fill her hand a little bit more.”

The study has serious implications for law enforcement. “No department wants the image of locking up innocent people,” said Albie Esparza, public information officer for the San Francisco Police Department, responding to questions about the study from NPR’s Nathan Siegel. Esparza asserts that the “good cop, bad cop” routine is mostly a figment of Hollywood’s imagination, and that police departments are highly motivated to find the real perpetrators of crime. Yet the methods used by Shaw—gathering background information about the accused, drawing connections between that information and a crime, and even lying about facts and witnesses—are all perfectly legal for use by law enforcement in the U.S.

It seems that even when the stakes are high, people are still very susceptible to the influence of an authority figure who is questioning them. In their study summary, Shaw and Porter conclude, “It appears that in the context of a highly suggestive interview, people can quite readily generate rich false memories of committing crime.”

What do you think? What are the implications of police officers using suggestive interview techniques, and when do those techniques cross the line into coercion? PAR wants to hear from you, so leave a comment and join the conversation!

What does the science of cognitive neuropsychology—brain research—have to say about why kids struggle to read? Plenty! But it can be very time-consuming for busy professionals to sift through the research, assess kids’ brain functioning, and choose interventions that target their specific needs. This is where the Feifer Assessment of Reading™ (FAR™), a new product from PAR, can help.

The FAR was developed using a brain-based educational model of reading. Research using neuroimaging techniques has clearly shown that specific neural networks in the brain are associated with different aspects of the reading process, such as phonemic awareness, fluency, decoding, and comprehension. This means that interventions for reading disorders vary depending on the specific dyslexic subtype of the individual reader.

Reading expert Dr. Steven Feifer developed the FAR to identify the four most common dyslexic subtypes: dysphonetic dyslexia, surface dyslexia, mixed dyslexia, and reading comprehension deficit. Comprising 15 subtests to measure highly differentiated aspects of reading, the FAR generates five index scores:

• the Phonological Index, including phonemic awareness, decoding, and positioning sounds;


• the Fluency Index, including orthographic processing plus both visual perception and verbal fluency;


• the Comprehension Index, including semantic concepts, word recall, and morphological processing;


• the Mixed Index (a composite of Phonological and Fluency Index scores); and


• the FAR Total Index (a composite of all subtest scores).

Clearly, the science is there. But many districts use a Response to Intervention (RTI) approach, with teams of educators planning interventions for kids and monitoring progress to see what’s been most effective. Where does brain science come into play?

RTI is about looking at the evidence—the individual student’s reading behaviors—and designing interventions that address his or her specific needs. Evidence-based interventions require evidence-based assessments. The FAR allows practitioners to conduct an in-depth assessment that provides information about how a child learns and processes information—not a label.

The RTI approach has many strengths, but often it is not sufficient on its own to identify or diagnose a learning disability. Also, remediation strategies are too often “one size fits all” when they haven’t taken into account the reasons behind a student’s reading difficulties. The FAR can support RTI by identifying learning disabilities, thereby reducing the risk of delaying diagnosis or denying students’ eligibility for much-needed services. The included Screening Form is perfect for a quick assessment of student progress—it takes just 15 minutes to complete.

The FAR is designed to integrate cognitive neuropsychology research into the RTI approach, supporting RTI while filling some of the gaps—especially in terms of dyslexia identification and differentiation—that RTI can miss. The FAR offers solutions for school psychologists, reading specialists, and teachers—and most importantly, the potential for real improvements in student reading.

To learn more about the FAR, visit www.parinc.com.

A nervous laugh when someone has tripped and fallen, or tearful congratulations to the happy couple at a wedding: Many of us can remember an event when a seemingly inappropriate emotional response emerged, unbidden, at exactly the wrong moment. Screaming—normally a sign of acute distress—is common among teenagers at a concert when their idol steps onto the stage. And in the presence of an adorable baby, some people respond by growling or pinching the baby’s cheeks. Oriana Aragon, a post-doctoral associate in the department of psychology at Yale University, wanted to learn more about this common but often misunderstood phenomenon, and especially about the psychological purpose it might serve. Her findings were published in the March 2015 issue of the journal Psychological Science.

Aragon and her colleagues conducted a series of experiments in which they exposed subjects to highly emotional stimuli—for example, a reunion between loved ones or a beautiful, vulnerable baby—and then measured the subjects’ responses. The researchers conclude that negative responses to positive stimuli may be a way for people who are overwhelmed by an emotion to regulate their response. Aragon believes that people have an emotional limit, and when that limit is reached, they ease their response by expressing the opposite emotion.

“People may be restoring emotional equilibrium with these expressions,” says Aragon in a recent interview in the Yale News online newsletter. “They seem to take place when people are overwhelmed with strong positive emotions, and people who do this seem to recover better from those strong emotions.”

The researchers observed that subjects who expressed negative reactions to positive news were able to moderate intense emotions more quickly. They also found that people who tend to express these dimorphous reactions do so regardless of whether the original stimulus was positive or negative—either way, they tend to balance their emotions with seemingly opposite responses. That is, people who typically cry at a weddings also tend to laugh at a sad event, such as a funeral.

“These insights advance our understanding of how people express and control their emotions, which is importantly related to mental and physical health, the quality of relationships with others, and even how well people work together,” said Aragon in the Yale News interview.

What do you think? Do people express dimorphous reactions in order to restore emotional balance, or are other factors in play? PAR wants to hear from you, so leave a comment and join the conversation!

We are used to thinking of alcohol dependence as black or white: Either someone is or isn’t an alcoholic. Dr. John Mariani, who researches substance abuse at Columbia University, says that the field of psychiatry now recognizes shades of gray between someone who doesn’t drink at all and someone who suffers from an alcohol addiction.

At least 38 million adults drink too much. Binge drinking, high weekly use, and any alcohol use by pregnant women or people under the age of 21 are included in this category. In the United States each year, about 88,000 deaths are alcohol related, and alcohol abuse costs the U.S. economy about $224 billion each year.

A recent study by the Centers for Disease Control and Prevention (CDC) showed that 90% of excessive drinkers were unlikely to need addiction treatment, and another revealed that only 1 in 6 adults talk with their doctor, nurse, or other health professional about their drinking. Among adults who binge drink 10 times or more a month, only 1 in 3 have discussed drinking. And only 17% of pregnant women have talked about drinking.

The CDC recommends that physicians and other health providers include basic alcohol screening and brief counseling as part of routine medical practice by:

• talking directly with patients about how much and how often they drink;


• providing information about the health dangers of drinking too much;


• offering options for patients who may want to stop drinking, cut down, maintain their current level of drinking, or seek further help; and


• referring patients who need specialized treatment for alcohol dependence.

Screening and brief counseling have been proven to work by reducing how much alcohol a person drinks on an occasion by 25% and by improving health and saving money in the same way that blood pressure screening, flu vaccines, and cholesterol or breast cancer screening do.

Drinker’s Checkup, an online confidential screening tool, is a good resource to share with clients; it provides detailed, objective feedback for people who aren’t sure whether their drinking is excessive and provides help with making a decision about whether to change drinking habits. An app called Moderate Drinking can be downloaded to help monitor drinking habits; its effectiveness has been demonstrated in a study published in the Journal of Consulting and Clinical Psychology.

In the context of mental illness, the word “asylum” conjures, for many of us, some very negative images. We picture a scene with characters like the abusive Nurse Ratched from the movie “One Flew over the Cuckoo’s Nest,” or even worse, tragic true stories of the overcrowded, understaffed psychiatric hospitals of the last century where healthy, sick, disabled, and poor patients alike were locked away for years with no effective treatment or hope of release.

These images may be the reason that a JAMA viewpoint published last month has garnered so much attention: Bioethicists from the Perelman School of Medicine at the University of Pennsylvania are calling for a return to asylums for long-term psychiatric care.

At Penn, Dominic Sisti, PhD, Andrea Segal, MS, and Ezekiel Emanuel, MD, PhD, have been studying the current system for treating the chronically mentally ill and the evolution over the past half-century away from inpatient psychiatric hospitals. They observe that although the United States population has doubled since 1955, the number of inpatient psychiatric beds has been cut by nearly 95 percent to just 45,000—a very small number when compared to the 10 million U.S. residents who are currently coping with serious mental illness.

According to Sisti and his colleagues, the result of this trend has not be “de-institutionalization” but rather “trans-institutionalization.” That is, people with chronic mental illness are being treated in hospital emergency rooms and nursing homes at best, and more often receiving no treatment and living on the street. “Most disturbingly, U.S. jails and prisons have become the nation’s largest mental health care facilities,” say the authors, in a January 20 Penn Medicine press release. “Half of all inmates have a mental illness or substance abuse disorder; 15 percent of state inmates are diagnosed with a psychotic disorder…. This results in a vicious cycle whereby mentally ill patients move between crisis hospitalization, homelessness, and incarceration.”

As a solution, the authors propose a modern and humane asylum—but they use the word in its original sense, that is, a place of safety, sanctuary, and healing. In addition, they advocate reforms in the psychiatric services offered in such institutions, including both inpatient services, for those who are a danger to themselves and others, as well as outpatient care for those with milder forms of mental illness.

The proposal has been controversial, to say the least.  Some in the mental health community find the idea of a return to asylums misguided and even frightening. In her article called “Asylum or Warehouse?” author Linda Rosenberg, President and CEO of the National Council for Behavioral Health, asserts that although Sisti and his colleagues accurately describe the problems of the current mental health system, their solution is to “just simply lock some people up” and that “the simple solution offered, recreating asylums, is not helpful—it’s dangerous.”

Others have viewed the proposal in a more positive light. Christine Montross, a staff psychiatrist at Butler Hospital in Providence, Rhode Island and author of “Falling into the Fire: A Psychiatrist’s Encounters with the Mind in Crisis” wrote an op-ed piece in the February 18 New York Times in support of a move toward modern asylums.

“The goals of maximizing personal autonomy and civil liberties for the mentally ill are admirable,” says Montross. “But as a result, my patients with chronic psychotic illnesses cycle between emergency hospitalizations and inadequate outpatient care. They are treated by community mental health centers whose overburdened psychiatrists may see even the sickest patients for only 20 minutes every three months. Many patients struggle with homelessness. Many are incarcerated. A new model of long-term psychiatric institutionalization, as the Penn group suggests, would help them.”

What do you think? Are modern, reimagined asylums a potential solution for the chronically mentally ill, or has history proven that institutions cannot work? PAR wants to hear from you, so leave a comment and join the conversation!