Posts tagged childhood
Articles and news from the latest research reports.
Study on ADHD, Provide New Insight Into Prevalence and Treatment Needs
Attention Deficit Hyperactivity Disorder is both under and over diagnosed.
That’s the result of one of the largest studies conducted on ADHD in the United States, published in the Journal of Attention Disorders.
A substantial number of children being treated for ADHD may not have the disorder, while many children who do have the symptoms are going untreated, according to the 10-year Project to Learn about ADHD in Youth (PLAY) study funded by the National Center on Birth Defects and Developmental Disabilities of the Centers of Disease Control and Prevention
"Childhood ADHD is a major public health problem. Many studies rely on parent reporting of an ADHD diagnosis, which is a function of both the child’s access to care in order to be diagnosed, and the parent’s perception that there is a problem," said Robert McKeown, of the University of South Carolina’s Arnold School of Public Health, who led the South Carolina portion of the study.
"Further complicating our understanding of the prevalence of ADHD and its treatment is that the diagnosis often is made by a clinician who has little experience assessing and diagnosing mental disorders. As a result, ADHD is both under and over diagnosed," said McKeown, distinguished professor emeritus in the department of epidemiology and biostatistics.
The study, conducted between 2002-2012, was a collaborative research project with the University of South Carolina’s Arnold School and School of Medicine and the University of Oklahoma’s Health Sciences Center.
"To our knowledge, this is the largest community-based epidemiologic study of ADHD to date," McKeown said.
Decreased Gene Activity Is Likely Involved in Childhood Risk for Anxiety and Depression
Decreased activity of a group of genes may explain why in young children the “fear center” of the anxious brain can’t learn to distinguish real threats from the imaginary, according to a new University of Wisconsin study.
The study, published this week in the Proceedings of the National Academy of Sciences (PNAS), lays out evidence that young primates with highly anxious temperaments have decreased activity of specific genes within the amygdala, the brain’s fear center.
The authors hypothesize that this may result in over activity of the brain circuit that leads to higher risk for developing disabling anxiety and depression.
This may be particularly important since the genes involved play a major role in forming the brain connections needed for learning about fears. While all children have fears and anxieties, the authors suggest that children with low levels of activity of these genes develop anxious dispositions because they fail to learn to cope by overcoming their early childhood fears.
“Working with my close collaborator and graduate student, Drew Fox, we focused on understanding the function of genes that promote learning and plasticity in the amygdala,” says Dr. Ned H. Kalin, chair of psychiatry at the University of Wisconsin School of Medicine and Public Health, who led the research. “We found reduced activity in key genes that could impair the ability to sculpt the brain, resulting in a failure to develop the capacity to discriminate between real and imaginary fears.”
Kalin says the study helps support the need for early intervention in children identified as excessively shy and anxious. It may also point a way to better treatments aimed at decreasing the likelihood of children developing more severe psychiatric problems. Anxiety in children is quite common and can lead to anxiety and depression in adolescence and often precedes anxiety disorders, depression and substance abuse in adults.
Most small children go through a phase when they’re frightened of many things, including monsters or new social situations, Kalin says, but their maturing brains soon learn to distinguish real threats from the imaginary. But some children do not adapt, generalize their fears to numerous situations, and may later develop serious anxiety and mood disorders. These children tend to be more sensitive to stress, produce more stress hormones and have heightened nervous-system activity.
Kalin, Fox and co-authors wondered whether some differences in the developing amygdala prevent it from learning how to regulate and adapt to anxiety. Kalin’s earlier work identified a subset of young monkeys, similar to extremely shy children, with an inherited anxious disposition. Using brain imaging, the authors showed that high levels of amygdala activity predicted trait-like anxiety in anxious young primates. Like their stable and enduring anxious dispositions, these individuals also had chronically elevated levels of amygdala activity.
“We believe that this pinpoints a critical region in the brain that determines an individual’s level of trait anxiety,’’ Kalin explains.
In examining a specific part of the amygdala, the central nucleus, the researchers analyzed gene expression, which reflects both environmental and inherited influences. Within the central nucleus of the amygdala the authors found that anxious individuals tended to have decreased expression of a gene called neurotrophic tyrosine kinase, receptor, type 3 (NTRK3). Low levels of this gene that encodes for a brain cell surface receptor may be why the amygdala of an anxious monkey or child is chronically overactive and unable to overcome anxiety and fears.
“This is the first demonstration that the early risk to develop anxiety and depression may be related to the underactivity of particular genes in the developing primate amygdala,’’ Kalin says. “These findings have provided the basis for our hypothesis that can explain the early childhood risk to develop anxiety and depression. It also suggests some creative ways to help children with extreme anxiety by developing new treatments focused on increasing the activity of specific genes involved in facilitating the brain development that underlies fear learning and coping.”
(Source: newswise.com)
A new study by University of North Carolina School of Medicine pediatrics researchers finds a surprising difference in the eating habits of overweight children between ages 9 and 17 years compared to those younger than 9.
Younger children who are overweight or obese consume more calories per day than their healthy weight peers. But among older overweight children the pattern is reversed: They actually consume fewer calories per day than their healthy weight peers.
How to explain such a seemingly counterintuitive finding?
“Children who are overweight tend to remain overweight,” said Asheley Cockrell Skinner, PhD, assistant professor of pediatrics at UNC and lead author of the study published online Sept. 10, 2012 by the journal Pediatrics.
“So, for many children, obesity may begin by eating more in early childhood. Then as they get older, they continue to be obese without eating any more than their healthy weight peers,” Skinner said. “One reason this makes sense is because we know overweight children are less active than healthy weight kids. Additionally, this is in line with other research that obesity is not a simple matter of overweight people eating more — the body is complex in how it reacts to amount of food eaten and amount of activity.”
“Emotion Detectives” Uncover New Ways to Address Youth Anxiety and Depression
26 July 2012
Emotional problems in childhood are common. Approximately 8 to 22 percent of children suffer from anxiety, often combined with other conditions such as depression. However, most existing therapies are not designed to treat coexisting psychological problems and are therefore not very successful in helping children with complex emotional issues.
To develop a more effective treatment for co-occurring youth anxiety and depression, University of Miami psychologist Jill Ehrenreich-May and her collaborator Emily L. Bilek analyzed the efficacy and feasibility of a novel intervention created by the researchers, called Emotion Detectives Treatment Protocol (EDTP). Preliminary findings show a significant reduction in the severity of anxiety and depression after treatment, as reported by the children and their parents.
“We are very excited about the potential of EDTP,” says Ehrenreich-May, associate professor of psychology in the College of Arts and Sciences at UM and principal investigator of the study. “Not only could the protocol better address the needs of youth with commonly co-occurring disorders and symptoms, it may also provide additional benefits to mental health professionals,” she says. “EDTP offers a more unified approach to treatment that, we hope, will allow for an efficient and cost-effective treatment option for clinicians and clients alike.”
Emotion Detectives Treatment Program is an adaptation of two treatment protocols developed for adults and adolescents, the Unified Protocols. The program implements age-appropriate techniques that deliver education about emotions and how to manage them, strategies for evaluating situations, problem-solving skills, behavior activation (a technique to reduce depression), and parent training.
In the study, 22 children ages 7 to 12 with a principal diagnosis of an anxiety disorder and secondary issues of depression participated in a 15-session weekly group therapy of EDTP. Among participants who completed the protocol (18 out of 22), 14 no longer met criteria for an anxiety disorder at post-treatment. Additionally, among participants who were assigned a depressive disorder before treatment (5 out of 22), only one participant continued to meet such criteria at post-treatment.
Unlike results from previous studies, the presence of depressive symptoms did not predict poorer treatment response. The results also show a high percentage of attendance. The findings imply that EDTP may offer a better treatment option for children experiencing anxiety and depression.
“Previous research has shown that depressive symptoms tend to weaken treatment response for anxiety disorders. We were hopeful that a broader, more generalized approach would better address this common co-occurrence,” says Bilek, doctoral candidate in clinical psychology at UM and co-author of the study. “We were not surprised to find that the EDTP had equivalent outcomes for individuals with and without elevated depressive symptoms, but we were certainly pleased to find that this protocol may address this important issue.”
The study, titled “An Open Trial Investigation of a Transdiagnostic Group Treatment for Children with Anxiety and Depressive Symptoms,” is published online ahead of print in the journal Behavior Therapy.
The team is currently recruiting participants for a randomized controlled trial comparing the EDTP to another group treatment protocol for anxiety disorders. For more information, please contact the study coordinators at www.miami.edu/childanxiety.
Source: ScienceBlog