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!

 

This week’s blog was contributed by PAR Author Adele Eskeles Gottfried, PhD. Dr. Gottfried is the author of the Children’s Academic Intrinsic Motivation Inventory (CAIMI). The study she describes in this blog is part of a broader investigation in which she examines the importance of home environment and parental stimulation on the development of children’s academic intrinsic motivation.

In a longitudinal study spanning 28 years, new research just published in Parenting: Science and Practice examined the long-term effect of children’s home literacy environment during infancy and early childhood on their subsequent reading intrinsic motivation and reading achievement from childhood through adolescence and their educational attainment during adulthood. This type of motivation, which is the enjoyment or pleasure inherent in the activity of reading, is found to relate to various aspects of children’s literacy behaviors.

Literacy environment was assessed from infancy through preschool using the amount of time mothers read to their children and the number of books and reading materials in the home. Analyzing the data using a statistical model, the study examined literacy environment as it related to children’s reading intrinsic motivation (measured with the Reading scale of the CAIMI) and reading achievement across childhood through adolescence and their educational attainment during adulthood. Results demonstrated that it was the amount of time mothers spent reading to their children—not the number of books and reading materials in the home—that significantly related to reading intrinsic motivation, reading achievement, and educational attainment. Specifically, when mothers spent more time reading to their children across infancy through early childhood, their children’s reading intrinsic motivation and reading achievement were significantly higher across childhood through adolescence. In turn, higher reading intrinsic motivation and reading achievement were significantly related to educational attainment during adulthood. These findings were found regardless of mothers’ educational level.

The implications for practice are clear: Reading to children during infancy and early childhood has significant and positive long-term benefits, and this information must be disseminated. Mothers, fathers, and other caregivers need encouragement and support to read to infants and young children, and they need to know what a difference it will make to children’s intrinsic motivation to read and learn.

If you are ambitious in the workplace, new research suggests that you will more likely achieve your goals if you have a spouse who is also conscientious.

Several previous studies have examined how personality predicts workplace success. One such project, by Paul Sackett and Philip Walmsley and published in Perspectives on Psychological Science, used the Five Factor Model (FFM) of personality traits— neuroticism, extraversion, openness, agreeableness, and conscientiousness—to examine which of these traits companies value most when hiring. Conscientiousness is at the top of most companies’ lists, but Sackett and Walmsley wanted to see whether this was really the best indicator of employees’ future success.

It turns out that it is. After examining the relationship between personality traits and three work performance criteria— whether an employee is able to complete their work to satisfaction, how often an employee goes above and beyond at work, and how often they engage in negative behaviors—conscientiousness topped the list of traits needed to accomplish these goals, with agreeableness being a close second.

Now a study out of Washington University in St. Louis reveals even more about how important conscientiousness may be to workplace success: you have an increased chance of achieving greater goals in your career if your spouse is also conscientious.

Brittany Solomon and Joshua Jackson examined more than 4,500 heterosexual married participants to measure the effect their spouse’s personality has on their own job satisfaction, income, and likelihood of being promoted. The researchers used the FFM personality traits as their guide.

Their work revealed that job satisfaction, pay increases, and promotions were all more likely for those people who had a spouse (male or female) with high scores on one particular personality trait: conscientiousness.

“Our findings indicate that highly conscientious partners help improve their spouses’ occupational success, as measured by job satisfaction, income, and promotion. This benefit does not arise from partners doing their spouses’ work; rather, it is due to partners creating conditions that allow their spouses to work effectively,” Solomon and Jackson reported.

A short video by TouchVision gives an entertaining explanation of their findings.

What personality traits do you think are most important in an employee?

They say a picture is worth a thousand words. But an image is not always a true representation of reality. From Instagram, Facebook, and Tumblr to fashion magazines and reality shows, we are bombarded with images that have been created, filtered, manipulated, and staged. And it’s often very difficult to sift through what’s real and what’s not.

This is precisely why Dove began its Campaign for Real Beauty—to start a global discussion surrounding the definition of real beauty. It first conducted a study titled “The Real Truth About Beauty: A Global Report,” which revealed that less than 2% of women worldwide considered themselves beautiful. In a Dove Real Sketches video, participants were asked to describe themselves to an artist, who drew them behind a curtain, using only their descriptions of themselves as a guide. Then the same women returned to describe fellow participants. The difference between the two drawings was astonishing, and it revealed how hard we are on ourselves versus how others see us.

According to the National Eating Disorder Association (NEDA), 30 million people will be affected by an eating disorder during their lifetime. A full 69% of American school-age girls who read magazines say that the pictures they see influence how their concept of an ideal body shape. Boys are also affected, and largely because of cultural bias and stereotypes, they are much less likely to seek treatment. In addition, teen athletes are more at risk of developing an eating disorder or having a negative body image.

It is daunting to compete with society and media, so the NEDA has developed an Educator’s Toolkit to help those in schools reach out to students suffering from an eating disorder. It covers everything from myths surrounding these disorders (e.g., that eating disorders are a choice; p. 6) to school strategies for assisting these students (p. 11). NEDA also has a Feeding Hope Fund, which grants funding to researchers who are seeking out new ways to combat this illness.

Some of the most groundbreaking work has been done related to connecting genetics to eating disorders, according to Amy Novotny in an article published in the American Psychological Association publication the Monitor. One study by Kelly Klump in Psychological Medicine demonstrates that heritability influences disordered eating most when estrogen levels are highest, and another suggests that in some females, bulimia may be hard-wired.

Organizations like Project Heal are contributing to the healing process in a different way: the organization, started by two women who suffered from eating disorders, provides scholarship funding for those who can’t afford treatment. And still others are trying innovative interventions, including art therapy and yoga, which could encourage participants to view their bodies in a more compassionate way.

The NEDA Web site offers a plethora of resources, including a resource page with contact information and a helpline (1-800-931-2237) for those who may know someone who suffers from an eating disorder. Visit NEDA’s Get Involved page to learn more about how to raise awareness.

Most of us can remember reading a book that changed our lives. Whether it was a comforting childhood favorite, a college assignment that surprised or shocked us, or a novel that resonated at a particular stage in our adult lives, books clearly have the power to change our thinking and expand our points of view.

Taking it a step further, recent research from Emory University suggests that the act of reading a novel produces measurable changes in the brain itself, specifically, improvements in resting-state connectivity that can persist for days after reading.

“We already knew that good stories can put you in someone else’s shoes in a figurative sense. Now we’re seeing that something may also be happening biologically,” said neuroscientist and lead author Gregory Berns in a recent interview with Emory University’s eScience Commons online newsletter.

The study was published last month in the journal Brain Connectivity. Emory students—twelve women and nine men—participated in the experiment, which was conducted over a 19-day period. The students read Pompeii, a novel by Robert Harris based on the eruption of Mount Vesuvius in ancient Italy. For the first five days, participants came in each morning for a baseline scan of their brains using a functional magnetic resonance imaging (fMRI) device. Starting on the sixth day, they were asked to read a section of the novel each evening and come in the following morning for another fMRI scan. After completing all nine sections of the novel, the participants returned for five more mornings to undergo additional scans in a resting state. On the mornings following the reading assignments, the participants showed heightened connectivity in the left temporal cortex, an area associated with receptivity for language, and in the central sulcus, the primary sensory motor region of the brain. “Even though the participants were not actually reading the novel while they were in the scanner, they retained this heightened connectivity,” Berns says. “We call that a ‘shadow activity,’ almost like a muscle memory.” The neural changes persisted not only in the morning after the reading but also for five days after participants completed the novel. “It remains an open question how long these neural changes might last,” Berns says. “But the fact that we’re detecting them over a few days for a randomly assigned novel suggests that your favorite novels could certainly have a bigger and longer-lasting effect on the biology of your brain.”

This study may have implications for counselors and educators who work with developing readers; the benefits of focused reading time may extend to the brain itself, helping to improve a student’s “wiring” and therefore his or her receptivity to other learning.

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

 

The link between musical expertise and linguistic working memory has been well established in the literature. However, new research from the University of Texas at Arlington suggests that musicians may have additional memory advantages, including enhanced visual/pictorial memory and better long-term memory.

In their study, lead author Heekyeong Park, assistant professor of psychology at UT Arlington, and graduate student James Schaeffer measured the electrical activity of neurons in the brains of both musicians and non-musicians using electroencephalography (EEG) technology, noting differences in frontal and parietal lobe responses.

“Musically trained people are known to process linguistic materials a split second faster than those without training, and previous research also has shown musicians have advantages in working memory,” said Park in a recent statement. “What we wanted to know is whether there are differences between pictorial and verbal tasks and whether any advantages extend to long-term memory.”

Study participants included 14 musicians, who had been playing classical music for 15 years or more, as well as 15 non-musicians. To test working memory, participants were shown both pictorial and verbal items and then asked to identify them among a group of similar foils. At the end of the session, long-term memory was tested by asking participants to identify test items they had already encountered versus completely new items.

On the working memory tasks, the musicians outperformed non-musicians in EEG-measured neural responses. In terms of long-term memory, however, musicians performed better in memory for pictorial (nonverbal) items only. Although the study does not establish the reason for this improvement in pictorial memory, the authors speculate that learning to read music may enhance an individual’s ability to process visual cues.

Dr. Park hopes to test more musicians soon to strengthen her findings. “Our work is adding evidence that music training is a good way to improve cognitive abilities,” she says. “If proven, those advantages could represent an intervention option to explore for people with cognitive challenges.”

The researchers presented their initial results last month at Neuroscience 2014, the international meeting of the Society for Neuroscience, in Washington, D.C. To learn more about Dr. Park’s work, visit her Web page on the UT Arlington Web site.

Researchers at Johns Hopkins University have discovered a chemical alteration in a single human gene that is linked to the risk of a suicide attempt. According to study leader Zachary Kaminsky, PhD, an assistant professor of psychiatry and behavioral sciences at the JHU School of Medicine, the results of this study could be a first step in developing a simple blood test that will help doctors predict suicide risk.

Described in The American Journal of Psychiatry, the study suggests that chemical changes in a gene involved in the function of the brain’s response to stress hormones plays a significant role in suicide risk. These changes can turn a normal reaction to everyday stress into suicidal thoughts and behaviors.

“Suicide is a major preventable public health problem, but we have been stymied in our prevention efforts because we have no consistent way to predict those who are at increased risk of killing themselves,” explains Kaminsky in a press release from Hopkins Medicine. “With a test like ours, we may be able to stem suicide rates by identifying those people and intervening early enough to head off a catastrophe.”

A blood test that accurately predicts suicide risk would be good news for the U.S. military, which has experienced an alarming increase in the number of suicides among veterans over the past few years, particularly males under the age of 30.

“What we envision, potentially, is using this test in psychiatric emergency rooms. For example, it could dictate closeness of monitoring and treatment options, and drive potentially more fast acting treatment in someone who is really high risk,” said Kaminsky in an interview with The Huffington Post.

To read the abstract or to download the full article, visit the American Journal of Psychiatry Web site.

Scientists have found a way to replicate human brain cells for use in Alzheimer’s research, according to an article in the New York Times this week. Lead researcher Rudolph E. Tanzi of Massachusetts General Hospital in Boston and his colleagues were able, for the first time, to grow human brain cells in a petri dish, where the neurons formed networks as they do in an actual brain. Their study was published in the online version of the journal Nature.

The researchers have resolved a long-standing problem with Alzheimer’s research, the New York Times reports. Previously, drugs had to be tested in mice, which have a different form of the disease. With human brain cells grown in a gel, the cells form the same kinds of networks that they do in a real brain. After implanting the cells with Alzheimer’s genes, the researchers began to see plaques and tangles develop—the telltale signs of Alzheimer’s.

“It is a giant step forward for the field,” said Dr. P. Murali Doraiswamy, an Alzheimer’s researcher at Duke University, in a recent interview. “It could dramatically accelerate testing of new drug candidates.”

This discovery will allow researchers to quickly test drugs that could slow or stop the progression of the disease. In fact, Dr. Tanzi and his colleagues have started to test 1,200 drugs currently on the market as well as 5,000 experimental ones. This huge project would have been impossible using mice, but with the new petri dish system, says Dr. Tanzi, “we can test hundreds of thousands of drugs in a matter of months.”

The full text of Dr. Tanzi’s study, along with videos showing Alzheimer’s brain cells in the culture, can be found online in the current issue of Nature.

Editor’s Note: On Saturday, November 1, an enthusiastic team of PAR employees will be participating in the Walk to End Alzheimer’s here in Tampa, Florida—one of a series of walks to benefit the Alzheimer's Association, which is the largest voluntary health organization in Alzheimer’s care, support, and research. To find a walk near you, click on the link and visit their Web site today!

According to new research conducted at Walter Reed Army Institute of Research in Silver Spring, Maryland, the proportion of soldiers using mental health services nearly doubled between 2003 and 2011. Furthermore, researchers found a small but significant decrease in the perceived stigma associated with seeking mental health services.

In 2003, only about 8 percent of soldiers sought mental health services. In 2011, about 15 percent of soldiers did so. Even with the increase in the number of soldiers seeking mental health help, researcher Phillip Quartana stated that two-thirds of soldiers with post-traumatic stress (PTSD) or major depression symptoms did not seek treatment between 2002 and 2011. More than 25 percent of active infantry soldiers from the conflicts in Afghanistan and Iraq, dating back to the beginning of the conflicts in 2001, met self-reported criteria for these diagnoses. While the number of soldiers seeking help has increased and the stigma associated with seeking mental health services has decreased, these results demonstrate that more progress is needed to increase soldiers’ use of mental health care services.

Researchers used data from active-duty personnel who completed Health-Related Behavior Surveys between 2002 and 2011. This study is the first to empirically examine trends concerning utilization of services and stigma across multiple wars.

The study was published online in the American Journal of Public Health.

Adele Eskeles Gottfried, PhD, author of the Children’s Academic Intrinsic Motivation Inventory (CAIMI), will be presenting a paper at the 2014 APA Annual Conference in Washington, DC this week. Entitled, “From Parental Stimulation of Children’s Curiosity to Science Motivation and Achievement,” Gottfried’s longitudinal research shows that when parents encourage their young children’s curiosity, those children have higher academic intrinsic motivation in science subjects and higher science achievement across childhood through adolescence. Overall, the importance of academic intrinsic motivation for children’s subsequent academic competence is demonstrated. This study is part of Gottfried’s ongoing research on longitudinal aspects of parental stimulation’s role in children’s academic intrinsic motivation, and it highlights the importance of the CAIMI in being able to delineate these findings.

Gottfried’s presentation will be part of the “Role of Others in Promoting Students’ Motivation, Learning, and Well-Being” session on Sunday, August 10, at 1:00 p.m. in Convention Center Room 115. Please confirm dates and times in your convention program when you get to APA—and be sure to stop by the PAR booth (#438) as well!