The Controversy

The media has continued to highlight the high-stakes battle that pharmaceutical companies have waged to make a profit by convincing doctors to prescribe antidepressants. Recent articles have focused more on the fact that pharmaceutical companies were not made to release studies that failed to demonstrate effectiveness of their products. Some articles have focused more on the failure of manufacturers to reveal potential adverse reactions or side effects.

This unbalanced media coverage has the potential to undermine effective treatment of psychiatric disorders. While the pharmaceutical companies stand to profit by convincing people that mental health conditions are medical conditions, the potential to profit does not necessarily mean that their facts are wrong.

Depression as medical illness

Depression is a medical condition. Studies of the brains and the biology of persons with depression have proven that there are real functional and physical changes that take place when a person is struggling with depression.  Depression, and 7 other mental health conditions, are identified by the World Health Organization as among the top 10 most disabling medical conditions worldwide.

Depression can be treated effectively. Studies have consistently shown that medications can treat depression. It is not a one-drug-suits-all approach. Treatment requires some trial and error. But the same is true for the treatment of hypertension. In addition, much like changes in one’s life circumstances can alter a person’s severity of hypertension, so, too can a change in one’s life circumstances make depression better–or worse! Some psychotherapeutic interventions, such as cognitive behavioral therapy or mindfulness based cognitive therapy have been shown to improve depression as well.

The controversy that exists about antidepressant medications is not about whether they are effective, but instead about whether the drive for profit has resulted in overarching assertions that these medications are THE ANSWER for EVERYONE.  While the controversy continues, people continue to experience depression at alarming rates, and many people seek help to minimize the impairment that their depression produces. It remains very difficult to analyze the data to determine whether antidepressants will for an individual patient.

So, what is the depressed person to do?

Find a provider that is willing to listen, to ask for details, and to take the time necessary to assess whether an individual patient is responding to the treatment efforts.

Find a provider who is willing to provide education and answers about their treatment decisions, and to include the patient’s preferences in their decision making.

Find a provider who can be flexible and adaptive  in their approach, willing to try something different if a patient is not responding, and who is willing to obtain consultations from other experts when necessary.

In May 17, 2010, the U.S. Supreme Court ruled on Graham v. Florida that sentencing Florida juveniles to life in prison without parole for crimes less than murder was unconstitutional.  Graham v. Florida was the first time the court had applied the 8th Amendment’s prohibition against “cruel and unusual punishment” to anything other than the death penalty. In its ruling, the Supreme Court declared that juveniles were ineligible for life without parole because they were different than adults who committed the same crime. They were not yet fully developed human beings mentally, emotionally and physiologically. The parts of the teenage brain that rule impulse, the ability to think ahead, the understanding of consequences, is not yet fully formed.

The justices made a distinction between teens who commit crimes as part of their “transient immaturity” and those who are permanently “incorrigible.” The decision as to whether a juvenile criminal is one or the other can’t be made while they are still teenagers, but it can be determined after they’ve fully matured, the court said in its 6-3 ruling.

The court’s ruling meant juveniles who were sentenced to life without parole for crimes such as armed robbery, assault, rape and attempted murder needed to be resentenced. Of the dozens of juveniles serving life sentences in the United States at the time of the Graham decision, more than half of them were in Florida.

Barry University law professor, Gerry Glynn, established the Juvenile Life Without Parole Defense Resource Center  in June 2010,  to coordinate efforts to represent the Florida inmates who were sentenced as juveniles to life without parole.  There are 115 cases of juveniles sentenced to life in Florida, and the cases are extremely complex.

In preparing for a resentencing hearing, the defense resource center must help attorneys tell judges about three important aspects of the inmate: the life of the juvenile before the crime, the crime itself and the inmate’s life behind bars.Attorneys must be able to show the dangerous juvenile who committed the crime has changed inside prison into a mature, reformed adult. They must explain why the juvenile committed the crime and why that same person, years later, is no longer a threat to society

Juveniles convicted of serious crimes must be given a “second look” after they have achieved full maturity to determine whether they have outgrown the impulsive, thoughtless, risky behavior typical of teenagers — or whether they remain dangers to society. One way to determine whether that change has taken place, the court ruled, is to see whether juvenile inmates took advantage of education, vocational and rehabilitative opportunities while in prison. However, the problem for inmates sentenced to life in Florida is that they do not have access to educational and vocational programs, since the Department of Corrections gives priority to those inmates who are within 3 years of being released.

There aresome inmates who, having  no chance of release, have engaged in self-motivated rehabilitation. For example, a  41-year-old Hillsborough inmate sentenced to life without parole at 17 for attempted murder and sexual battery in 1989 has completed 20 self-improvement programs, including three he created himself.

Gainesville State Attorney Bill Cervone argues that the relatively small number of juveniles sentenced to life without parole reflects the atrocity of their crimes and their continued threat to public safety. He believes that the crimes they committed are very serious  and that these behaviors indicate the risk they pose to the community.

Those who support the Supreme Court decision agree that there are people in prison who committed crimes at 16 who will continue to be a danger to society later, but that each youth deserves the chance to be evaluated.

Thus far,  a handful of Graham-eligible inmates have been resentenced under the court’s ruling, and none has been released from prison. The resentences vary from 30 years to 107 years. No one has been resentenced yet in Central Florida courts, but among those who are eligible is Michael S. Johnson, who was 16 in 2005 when he and two others kidnapped, robbed and raped two women.

In a similar case in St. Petersburg, Jose Walle was 13 when he participated with two others in the kidnapping, robbing and raping of two waitresses. In November 2010, Walle was resentenced to 65 years by a judge who rejected the Supreme Court’s opinion that life without parole for juveniles was cruel and unusual.  Walle, now 16, will begin serving his 65 year sentence after completing 27 years for another Pinellas County rape. Under the consecutive sentences, Walle will be eligible for release when he is 91. His attorneys say they will appeal the sentence as violating the intent of the Graham decision.

Read more in the article by Jeff Kunerth, Orlando Sentinel

orlandosentinel.com/news/local/crime/os-life-without-parole-barry-20110402,0,5418922.story

Many teens enjoy keeping in touch with their friends on social networking sites like Facebook and Twitter, but there are both risks and benefits to the use of these sites.  Overuse/Misuse of social media has been linked to mental health issues including depression and eating disorders.

Now, a  report from the American Academy of Pediatrics describes a new phenomenon called “Facebook depression,” in which children and teenagers spend an inordinate amount of time on social networking sites, then develop symptoms of depression.

Facebook depression is UNCOMMON–most children benefit from the use of facebook because they are able to maintain ties with friends and feel a connection with their community, according to Scott Campbell, an assistant professor of communication studies at the University of Michigan.

Heavy use of  Facebook can have serious consequences, so it’s important that parents are aware of their children’s media use, as well as remaining aware of their social lives away from the computer.

Dr. Michael Brody, Chair of the Media Committee for the American Academy of Child and Adolescent Psychiatry, and who was involved with the American Academy of Pediatrics report,  notes that relationships with peers become critical during adolescence, and that Facebook facilitates social engagement with friends.  “Kids become are very competitive, and kids want to be chosen,” said Dr. Brody.  Since facebook allows adolescents to see the number of friends their peers have, some youth may perceive that they are not as popular if they have fewer facebook “friends”. They may also perceive by reading the status updates of their facebook “friends” that they are not having as much fun as their peers. “I think the idea of envy and jealousy becomes very magnified through this medium,” says Brody.

Dr. Brody points out that causation is not suggested by the study.  The evidence does not suggest that Facebook leads to depression. It could be that certain adolescents who are already depressed are prone to spending too much time online, Brody said.

The study is consistent with previous findings of internet use–that depression and loneliness are associated with extremely heavy users of the internet–and also linked with a much lower rate of OFFLINE social connections.

Humans are social creatures, and studies have continued to demonstrate that having a healthy “social rhythm” is protective against mood disorders. It is important to engage with other people in real, offline, socially interactive ways.

Dr. Brody advises that parents encourage their children to engage in a variety of activities, and this can facilitate a healthy social rhythm:

I think kids who have a balanced life, who do schoolwork, who do after-school activities, who are in teams, who are in clubs, who do community service have a much lesser chance of becoming depressed

For three days next week,, Yale Law School will pilot a program allowing its students to check out a “therapy dog” for up to 30 minutes at a time. A memo written by the law librarian, Blair Kaufman, to students noted that therapy dog visits have resulted in  “increased happiness, calmness and overall emotional well-being”.  The program is requesting the students’ feedback to determine whether this program should be a permanent and ongoing program.

What you say to your child is important.
Here are some tips to assure that what you say won’t damage your child

Sticks and stones will break my bones,
But names will never hurt me.

Many of us who are now parents understand that this children’s rhyme does not provide true comfort, and that the words of playmates DID hurt us.

Words can hurt children, and the damage inflicted on a child by the thoughtless remarks of a parent or other adult can torment a child–for their lifetime.

In fact, emotional abuse, though it is often ignored, can be far more devastating than the physical abuse that so often captures media headlines.

The emotional abuse of harsh words, spoken thoughtlessly, can lead a child feeling berated, belittled, demoralized. The impact this has on a child’s emotional development is insidious. A child’s spirit can be destroyed, and they may lose any positive sense of self. Emotional abuse destroy’s a child’s ability to feel loveable, to love himself or herself, and has a negative effect on a child’s ability to care for and get along with others. Emotional abuse increases self-destructive and antisocial behavior. Emotional abuse has been linked to eating disorders, promiscuity and suicide.

None of us is perfect, and many of us can recall a time when we’ve lost our self-control, and said something hurtful and demoralizing to our children, over something minor. We might say things like: “You clumsy idiot! You can’t do anything right!”

When words like these are repeated often enough, the child’s sense of self-esteem plummets and he or she begins to agree with his parents’ assessment of him: he or she really is dumb, a jerk, an idiot, a moron. The child begins to learn that love is not without conditions. And since it seems impossible to meet his or her parent’s expectations, the child becomes satisfied with settling for the “loser” role.

In too many homes today, the lights are on but no one is there. People are home but not home. Inattentive and verbally abusive parents are producing children who seem normal but are not what they should be, what they could have been.

There are studies that demonstrate that this abusive, humiliating and demeaning parenting behavior is transmitted from generation to generation, meaning that adults who had abusive parents tend to parent their own children the same way. This pattern will continue until a parent is willing to change their behaviors, change the dynamics, and find a way to interact differently with their own children. They must be willing to see and acknowledge that they are saying and doing to their children.

To change this pattern, treatment often requires treating the parent and the child, helping the parent feel respected and empowered, and allowing them to change the ways they respond to their child.
The problem of verbal abuse is REAL, and COMMON, but difficult to document, and, therefore, difficult to intervene to prevent. Certain stressors can increase the problem of verbal abuse, job loss, marital problems, financial concerns. Often, adults attempt to cope with these stressors using alcohol and other drugs, but this tends to make matters worse. Parents then lose their inhibitions, and may say terrible things to their children that they later regret.

How can you be sure your words build up rather than destroy your children?

† Guard your vocabulary. There are some words that people in a family should never say to each other. Words like stupid, dummy, jerk, idiot, worthless and freak have no place between parents and their children.

† Avoid absolute statements such as “You never . . . ” Or “You always . . . ” Have a sense of good manners with your family. This doesn’t mean that you must avoid all conflict or that you can’t set limits.

† Separate the child’s actions from the child. Instead of responding to a tantrum with a barrage of abusive language, let him know that you love him — but not his actions, which are unacceptable.

† When things happen that can set off an explosion, take time out. Wait. And then wait some more. When you hold your tongue until the heat of the moment has passed, it’s a lot easier to respond with love rather than anger.

† Be available. Be willing to stop and peek in on your child’s world. He or she will feel more valuable because of it. Don’t start interrogating the minute the child walks in the door.

Wait until you’re relaxed and instead of probing about his day, why not share your day? Instead of accusing, compliment. Instead of insisting, be silent.

† Active listening refers to a kind of listening and a response that does not judge, ridicule or order. And the more we listen without judging, the more we help our children to accept their feelings, we improve their problem-solving ability and increase their willingness to listen to us.

† Teach by example. Let your kids hear you acknowledge your mistakes. Risk being humble. Dare to say, “I’m sorry” to your children when appropriate. Apologizing reveals that the truth is larger than your ego and their feelings are more important than your pride.

If you can accept yourself in spite of your limitations, all the while working to be the best you can be, you’ve gone a long way to help your kids value themselves.

Based on the work of Jean Guarino, free-lance writer.

Attorney General Eric Holder  Spoke at the National Association of Counties Legislative Conference in Washington, D.C. ~ Monday, March 7, 2011

He noted that the Association of Counties, and the Department of Justice have common goals, of doing more and more to serve our citizens while resources diminish. He identified two specific priorities for the Justice Department:

“how we can improve the effectiveness of our juvenile justice system, and how we’re going to ensure that every American can access the legal services they need and deserve.”

He noted that “one of the most important lessons I learned as a federal prosecutor, as a judge, as a United States Attorney, as Deputy Attorney General, as Attorney General – and, above all, as a father of three children: that the work of protecting, assisting, and empowering our young people could not be more urgent.   “

He noted that:

• The nation’s juvenile justice system is in need of change, that it doesn’t spend resources as wisely as it should, and does not improve as many lives as it could.

• Although African-American youth make up 16 percent of the overall youth population, they make up more than half of the juvenile population arrested for committing a violent crime.

• Abused and neglected children are 11 times more likely than their non-abused and non-neglected peers to be arrested for criminal behavior.

• That so many of those who enter our juvenile justice system either can’t afford – or do not know to ask for – access to legal guidance.

• Some youth even plead guilty to criminal offenses without the advice of a lawyer.

• Even though many of those who are incarcerated enter the juvenile justice system for non-violent offences, they often emerge violent – or, at the very least – traumatized.

• A scientific review of nine “Scared Straight” programs around the country showed that children ordered into these programs are nearly 30 percent more likely to offend than youths who are not.

• In another study, 12 percent of the adjudicated youth in state-operated and large locally or privately operated juvenile facilities reported experiencing at least one incident of sexual victimization while incarcerated.

“A recent Utah Youth Suicide Study reported that young victims of suicide had nearly a seven in ten chance of an association with the juvenile justice system, calling us to question whether the current system is improving lives – or devastating them.”

TRANSITIONING OUT OF JUVENILE JUSTICE

• Each year, 100,000 young people exit formal custody.   And some of them have nowhere to go.   Too many of these young people return to unstable homes – or end up in shelters, on the streets, or in other potentially dangerous, or violent, situations.   And many are not welcomed back to their community school and struggle to find educational opportunities.
• Within a year of reentry, one study found that only 30 percent of previously incarcerated youth are involved in either school or work.   The unfortunate fact is that many end up in our jails and prisons.

Robert Kennedy believed that the link between justice and children could never be broken without compromising our founding ideals – and our most sacred principles.   He was right.

Mr. Holder noted that justice in the juvenile system is a moral issue that makes good fiscal sense:

• “How we treat our children answers the question of who we are as a nation.”
• “Better serving our young people makes good economic sense by keeping them out of over-stressed and under-funded corrections facilities and saving precious law enforcement resources.”

Mr. Holder advised that we

• Broaden our approach to juvenile justice and ensure that sound research and respected analysis are a part of our decision-making process”.
• Transition from a prosecution-and-punishment model to a prevention-and-intervention paradigm.  Adopt  a comprehensive plan of action that engages law-enforcement partners, medical professionals, social services providers, lawyers, parents, teachers, coaches, mentors, and community leaders.

Mr. Holder talked about the success of the Safe Start Program, and  the launch of the Defending Childhood Initiative – the federal government’s most comprehensive effort ever to address and overcome the crisis of childhood exposure to violence, that President Obama pledged $25 million to this initiative in his budget proposal.

Mr. Holder talked about alternatives to juvenile justice involvement for youths involved in minor offenses.

• He mentioned specifically, the Civil Citations program in Miami-Dade County where youth who commit minor misdemeanors are  referred to targeted interventions aimed at reducing delinquent behavior and providing positive social outlets instead of arresting them and placing them in the juvenile justice system.  This program has reduced recidivism to 3 percent  and arrests by 30 percent for youth that participate in the program.

In addition to his emphasis on intervention and prevention over punishment, Mr. Holder also addressed the failure of our justice system to provide juveniles (as well as adults) with access to legal services.

According to The Office of Juvenile Justice and Delinquency Prevention’s Survey of Youth in Residential Placement :

• Only one half of young people in detention facilities have a lawyer.
• In many jurisdictions, youth are encouraged – whether explicitly or implicitly – to waive their right to counsel.
• When juveniles assert their right to have a lawyer, court-appointed lawyers often enter the picture too late.
• Across the country, too many public defender officers are underfunded and understaffed

Mr. Holder discussed his Department’s new Access to Justice Initiative:

• An office established in an effort to ensure that quality legal representation is available, affordable, and accessible to all Americans.
• Includes an agenda to help counties face the “impossible choice between funding critical health and human services or upholding core Constitutional rights.”

The  Office of Justice Programs is also working to implement solutions for indigent defense and juvenile justice reform by:

• Establishing the Indigent Defense Hiring Project
• Working with the National Juvenile Defender Center to establish a National Fellowship Program for law school graduates to become public defenders for three years.

The relentless pursuit of happiness–when defined as the experience of pleasure or positive feelings–may be doing us more harm than good. Researchers have found that  this sort of happiness does less to improve our  important  physical health than the type of well-being that comes from engaging in meaningful activity, termed “eudaimonic well-being.” “Eudaimonia” is a Greek word associated with Aristotle and often mistranslated as “happiness”—which has contributed to misunderstandings about what happiness is. Some experts say Aristotle meant “well-being” when he wrote that humans can attain eudaimonia by fulfilling their potential.

Before the world wars, psychologists were interested in the study of psychological health in addition to psychological illness. The intense needs of populations adversely affected by war, meant that most research dollars that were available were available for the study of psychological illness.  Now, “positive psychology” is a rapidly growing area of science once again.

Positive psychologists study “happiness”, “resilience” and human strengths. Some of their research  suggests that people who focus on living with a sense of purpose as they age are more likely to remain cognitively intact, have better mental health and even live longer than people who focus on achieving feelings of happiness.

In fact, in some cases, too much focus on feeling happy can actually lead to feeling less happy, researchers say.

The pleasure that comes with, say, a good meal, an entertaining movie or an important win for one’s sports team—a feeling called “hedonic well-being”—tends to be short-term and fleeting. Raising children, volunteering or going to medical school may be less pleasurable day to day. But these pursuits give a sense of fulfillment, of being the best one can be, particularly in the long run.

Today, the goal of understanding happiness and well-being, beyond philosophical interest, is part of a broad inquiry into aging and why some people avoid early death and disease. Psychologists investigating eudaimonic versus hedonic types of happiness over the past five to 10 years have looked at each type’s unique effects on physical and psychological health.

For instance, symptoms of depression, paranoia and psychopathology have increased among generations of American college students from 1938 to 2007, according to a statistical review published in 2010 in Clinical Psychology Review. Researchers at San Diego State University who conducted the analysis pointed to increasing cultural emphasis in the U.S. on materialism and status, which emphasize hedonic happiness, and decreasing attention to “community” and “meaning” in life, as possible explanations.

Since 1995, Dr. Carol Ryff,  professor and director of the Institute on Aging at the University of Wisconsin, Madison. and her Wisconsin team have been studying some 7,000 individuals and examining factors that influence health and well-being from middle age through old age in a study called MIDUS, or the Mid-Life in the U.S. National Study of Americans, funded by the National Institute on Aging. Eudaimonic well-being “reduces the bite” of risk factors normally associated with disease like low education level, using biological measures, according to their recently published findings on a subset of study participants.

Illustration by J.D. KingSource: Pew Research Center, Social and Demographic Trends Project

Participants with low education level and greater eudaimonic well-being had lower levels of interleukin-6, an inflammatory marker of disease associated with cardiovascular disease, osteoporosis and Alzheimer’s disease, than those with lower eudaimonic well-being, even after taking hedonic well-being into account. The work was published in the journal Health Psychology.

David Bennett, director of the Alzheimer’s Disease Center at Rush University Medical Center in Chicago, and his colleagues showed that eudaimonic well-being conferred benefits related to Alzheimer’s. Over a seven-year period, those reporting a lesser sense of purpose in life were more than twice as likely to develop Alzheimer’s disease compared with those reporting greater purpose in life, according to an analysis published in the journal Archives of General Psychiatry. The study involved 950 individuals with a mean age of about 80 at the start of the study.

In a separate analysis of the same group of subjects, researchers have found those with greater purpose in life were less likely to be impaired in carrying out living and mobility functions, like housekeeping, managing money and walking up or down stairs. And over a five-year period they were significantly less likely to die—by some 57%— than those with low purpose in life.

The link persisted even after researchers took into account variables that could be related to well-being and happiness, such as depressive symptoms, neuroticism, medical conditions and income.

Evidence suggests that HOW a person confronts life’s challenges can have a lot to do with HOW a person feels in terms of their health and happiness.

There is some evidence that people high in eudaimonic well-being process emotional information differently than those who are low in it. Brain-imaging studies indicate people with high eudaimonic well-being tend to use the pre-frontal cortex more than people with lower eudaimonic well-being, says Cariem van Reekum, researcher at the Centre for Integrative Neuroscience and Neurodynamics at the University of Reading in the U.K. The pre-frontal cortex is important to higher-order thinking, including goal-setting, language and memory.

It could be that people with high eudaimonic well-being are good at reappraising situations and using the brain more actively to see the positives, Dr. van Reekum says. They may think, “This event is difficult but I can do it,” she says. Rather than running away from a difficult situation, they see it as challenging.

The two types of well-being aren’t necessarily at odds, and there is overlap. Striving to live a meaningful life or to do good work should bring about feelings of happiness, of course. But people who primarily seek extrinsic rewards, such as money or status, often aren’t as happy, says Richard Ryan, professor of psychology, psychiatry and education at the University of Rochester.

Simply engaging in activities that are likely to promote eudaimonic well-being, such as helping others, doesn’t seem to yield a psychological benefit if people feel pressured to do them, according to a study Dr. Ryan and a colleague published last year in the Journal of Personality and Social Psychology..

There’s nothing wrong with trying to feel happy, psychologists say. Happy people tend to be more sociable and energetic, which may lead them to engage in meaningful activities. And for someone who is chronically angry or depressed, the goal should be to help this person feel happier, says Ed Diener, a retired professor at the University of Illinois who advises pollster Gallup, Inc., on well-being and positive psychology.

Surveys have shown the typical person usually feels more positive than neutral, yet it isn’t clear he or she needs to be any happier, Dr. Diener says. But there is such a thing as too much focus on happiness. Ruminating too much about oneself can become a vicious cycle.

Being happy doesn’t mean feeling elated all the time. Deep stress is bad, but the “I don’t have enough time” stress that many people feel while balancing work, family and other demands may not be so bad. THe important thing is to focus on relationships with people you care about, and to do work that you love.

Free time is not always a fun time for people with autism. Giving them the power to choose their own leisure activities during free time, however, can boost their enjoyment, as well as improve communication and social skills, according to an international team of researchers.

“For many of us, we look at recreation as a time to spend on activities that are fun and that are designed for our enjoyment,” said John Dattilo, professor of recreation, park and tourism management, Penn State. “But for some people with disabilities, particularly those who have autism, these activities can be a source of frustration, simply because they didn’t have a chance to make their own leisure choices.”

Dattilo said that a group of 20 autistic adults who participated in a yearlong recreation program that offered them a chance to choose activities, scored higher on personality tests that measure social and communication skills than the control group of 20 autistic adults who were randomly assigned to the program’s waiting list. Participants met for two hours each weekday and could choose among several activities that promoted engagement and interactivity, including games, exercises, crafts and events.

The researchers, who released their findings in the current issue of Research in Autism Spectrum Disorders, said that after completing the program, participants showed significant improvement at recognizing and labeling emotions. The participants scored about 24 percent higher than the control group in the ability to recognize emotions in a person in a picture. The score of the participants’ ability to label those emotions correctly was 50 percent higher than the control group’s score.

Since people with autism are less willing to interact socially, caregivers are particularly interested in programs that help improve social and communication skills, according to Dattilo, who worked with Domingo Garcia-Villamisar, professor of psychopathology, Complutense University of Madrid, Spain.

“The big measure for us in this program was the improvements in social behavior and interaction,” said Dattilo. “The defining quality of people with autism is that they have difficulty in social situations.”

The participants also improved their ability to carry out executive functions, such as setting goals and maintaining attention.

Dattilo said recreation programs that encourage people with autism to make their own leisure choices create a cycle of increasing independence, rather than a pattern of reliance on caregivers to provide recreational activities.

“While people are learning, you can also give them choices,” said Dattilo. “And as they make those choices, they are also learning and are empowered to make even more choices.”

The works of University of Rochester psychologist Edward Deci and author and psychologist Mihaly Csikszentmihalyi inspired the researchers to pursue the experiment, Dattilo said. Deci and Csikszentmihalyi emphasize self-determination as a critical component of human fulfillment.

SOURCE: http://live.psu.edu/story/51689

A joint research project between Harvard University and University of Utah scientists has resulted in the development of a new biological test for autism.

The test  uses magnetic resonance imaging (MRI) to measure deviations in brain circuitry, and  is an objective way of identifying individuals with the disorder that could someday replace the subjective methods that are currently used.

Today, Autism is diagnosed  with clinical interviewing  and  observation of the child for another hour or so.  It is hoped that this MRI will provide a more definitive way of determining autism early on, by pointing to something in the brain that is biologically based

Dr. Lange, Nicholas Lange, ScD, associate professor of psychiatry at Harvard Medical School,  was the senior study author, and with  Janet E. Lainhart, MD, from the University of Utah, Salt Lake City, and other colleagues, they set out to explore the hypothesis that study of white matter microstructure in regions of the brain responsible for language, emotion, and social cognition would further the understanding of autism neuropathology.

Diffusion tensor imaging measures white matter microstructure by mapping directions of water diffusion in a local brain tissue frame of reference.

Other types of MRI scans, such as those that compare the sizes of various parts of the brain between healthy individuals and individuals with a particular brain disorder,have not shown much difference in autism.

The researchers took white matter microstructure measurements from the superior temporal gyrus and temporal stem in 30 males aged 7 to 28 years who were diagnosed as having autism by the standard subjective scoring system and in 30 matched controls.

In the subjects with autism, less information was being exchanged in the key areas of the brain responsible for language, social functioning, and emotional behavior.

The test was able to detect autism in this study with 94% accuracy, by identifying less organized wiring.

The findings correlate with the clinical impairments of autism, such as the inability to read body language, and the resulting lack of friendships.

“There appears to be a lack of ordered directional diffusion along the axons to help them make those connections, and we were able to pinpoint just where this is occurring through this brain circuitry imaging,” Dr. Lange noted.

Dr. Lange is hopeful that this test will someday be used clinically to make  accurate and prompt diagnoses in young children.

Early diagnosis may allow intensive, individualized, and early interventions to minimize the impact of the disorder.

This test is NOT YET ready for clinical use. At the present time, child and adolescent clinicians must continue to rely upon careful clinical assessments to diagnosis Autism.

The study was sponsor by the National Institutes of Mental Health. Dr. Lange and Dr. Lainhart have disclosed no relevant financial relationships.

Autism Res. Published online November 29, 2010.

New research by scientists at the University of Cambridge suggests that the neurotransmitter serotonin, which acts as a chemical messenger between nerve cells, plays a critical role in regulating emotions such as aggression during social decision-making.

Serotonin has long been associated with social behavior, but its precise involvement in impulsive aggression has been controversial. Though many have hypothesised the link between serotonin and impulsivity, this is one of the first studies to show a causal link between the two. The research also provides insight into clinical disorders characterized by low serotonin levels, such as depression and obsessive compulsive disorder (OCD), and may help explain some of the social difficulties associated with these disorders.

These findings highlight why some of us may become combative or aggressive when we haven’t eaten.The only way to build serotonin in the brain is by consuming tryptophan in our diet, through foods such as poultry or chocolate. Serotonin levels are lower when a person has not eaten.  Since serotonin levels naturally decline when we don’t eat,  the researchers took advantage of this effect in designing their experiment.

• The researchers were able reduce brain serotonin levels in healthy volunteers for a short time by manipulating their diet.
• They used a situation known as the ‘Ultimatum Game’ to investigate how individuals with low serotonin react to what they perceive as unfair behaviour. In this game one player proposes a way to split a sum of money with a partner. If the partner accepts, both players are paid accordingly. But if he rejects the offer, neither player is paid.
• Normally, people tend to reject about half of all offers less than 20-30% of the total stake, despite the fact that this means they receive nothing – but rejection rates increased to more than 80% after serotonin reductions.
• Other measures showed that the volunteers with serotonin depletion were not simply depressed or hypersensitive to lost rewards.

These results suggest that serotonin plays a role in social decision making.

• Normally, serotonin keeps aggressive social responses in check.
• Changes in diet and stress cause fluctuations in serotonin levels, and this study suggests that the fluctuations in serotonin affect every day decision-making
• This study suggests that patients with depression and anxiety disorders may benefit from therapies that teach them strategies for regulating emotions during decision making, particularly in social scenarios.

This research was  funded by the Wellcome Trust and the Medical Research Council.