Journal Digest
Exercise Support Doesn’t Improve Depression
Researchers at England’s University of Bristol have reported that they found no evidence that offering patients physical exercise support improved depression outcomes in adults, and it did not reduce the use of antidepressants.
They studied 361 adults aged 18 to 69 who had recently consulted their general practitioner about symptoms of depression. In addition to usual care, intervention participants were offered up to three face-to-face sessions and 10 telephone calls with a trained physical-activity facilitator over eight months.
At four, eight, and 12 months follow-up, there was no evidence that those offered exercise support were any less depressed, although the group did report increased physical activity compared with the control group. The researchers said the main implication of their results is that offering advice and encouragement to increase physical activity is not an effective strategy for reducing symptoms of depression. “Although our intervention increased physical activity, the increase may not have been sufficiently large to influence depression outcomes,” they wrote.
Chalder M, Wiles N, Campbell J, et al. “Facilitated Physical Activity as a Treatment for Depressed Adults: Randomised, Controlled Trial.” BMJ. 2012. June 6 [Epub ahead of print]. www.bmj.com/content/344/bmj.e2758
Nicotine Activates Brains of PTSD Smokers Different From Nonsmokers
In an effort to further evaluate evidence that individuals with post-traumatic stress disorder (PTSD) may smoke in part to regulate negative affect, researchers at Duke University Medical Center have published the results of a pilot fMRI study of the effects of nicotine on emotional information processing in smokers with and without PTSD.
Eleven adult smokers, with and without PTSD, completed three sessions—one screening/diagnostic and two scanning sessions. PTSD diagnosis was based on the Clinician Administered PTSD Scale. For the scanning sessions, participants were administered either nicotine or placebo and then performed an experimental task during fMRI scanning. The task was a modified version of a face-viewing task previously shown to increase activation in brain regions underlying emotion processing.
Scan results indicated that nicotine increased brain activation in response to fearful/angry faces (compared with neutral faces), but different brain regions were activated in the PTSD participants compared with the non-PTSD participants. PTSD was associated with larger brain responses to emotional face stimuli in amygdala and prefrontal regions.
The researchers noted that their sample size was small and predominantly female. Their future work will examine the effects of nicotine and smoking in larger samples of smokers with PTSD, control for sex differences, and among females control for time in menstrual cycle and then relate these findings to smoking-related outcomes (for example, smoking cessation success/failure).
Froeliger B, Beckham J, Dennis M, et al. “Effects of Nicotine on Emotional Reactivity in PTSD and Non-PTSD Smokers: Results of a Pilot fMRI Study.” Adv Pharmacol Sci. 2012. June 3 [Epub ahead of print]. www.hindawi.com/journals/aps/2012/265724/
Physical Punishment Leads to Mental Disorders
Canadian researchers report results of a study in which they found that harsh physical punishment, even in the absence of child maltreatment, is associated with mood disorders, anxiety disorders, substance abuse/dependence, and personality disorders when those children become young adults.
They examined data from the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 and 2005, a survey conducted with a representative U.S. adult population sample aged 20 or older (n=34,653).
After adjusting for sociodemo-graphic variables and family history of dysfunction, they found that approximately 2 percent to 5 percent of Axis I disorders and 4 percent to 7 percent of Axis II disorders were attributable to receiving harsh physical punishment.
“It is important for pediatricians and other health care providers who work with children and parents to be aware of the link between physical punishment and mental disorders based on this study, which adds to the growing literature about the adverse outcomes associated with exposure to physical punishment,” the researchers wrote.
Afifi T, Mota N, Dasiewicz P, et al. “Physical Punishment and Mental Disorders: Results From a Nationally Representative U.S. Sample.” Pediatrics. 2012. July 2 [Epub ahead of print]. http://pediatrics.aappublications.org/content/early/2012/06/27/peds.2011-2947
Young Adults Make Risky Decisions Even When Using Alcohol Subsyndromally
Researchers at the University of Minnesota Medical Center examined the cognitive effects of alcohol in young adults at varied levels of usage and on several factors. They selected 155 young adults (mean age 21.15, 25.8 percent of them female) who were free from nonalcohol-related psychiatric diagnoses and drug use, and gave them selected tests from the Cambridge Neuropsychological Test Automated Battery in conjunction with the Barratt Impulsivity Scale, Eysenck Impulsivity Questionnaire, and Tri-dimensional Personality Questionnaire. The participants were grouped according to frequency of alcohol use: nondrinkers, at-risk drinkers (subsyndromal alcohol usage), and those with alcohol use disorder.
Results indicated that at-risk drinkers and individuals with alcohol use disorders bet significantly more overall on the Cambridge Gambling Task than nondrinkers. Individuals with alcohol use disorders endorsed higher impulsivity than at-risk and non-drinkers on the Barratt Impulsivity Scale and Eysenck Impulsivity Questionnaire. Individuals with alcohol use disorders and at-risk drinkers also endorsed higher venturesomeness than nondrinkers on the Tridimensional Personality Questionnaire.
The researchers concluded that “even at a subsyndromal level, young adults make risky decisions that mirror those seen in individuals with alcohol use disorders.”
Harvanko A, Odlaug B, Schreiber L, et al. “Cognitive Task Performance and Frequency of Alcohol Usage in Young Adults.” J Addict Med. 2012. 6: 106–111. www.ncbi.nlm.nih.gov/pubmed/22124290
Rates of Nonsuicidal Self-Injury in Youth
A study of 665 young people in the third, sixth, and ninth grades (ages 7 to 16) found patterns of nonsuicidal self-injury that vary by age and gender. Nonsuicidal self-injury (NSSI) was defined as intentionally injuring one’s skin or body without the intent to die, a behavior that affects many youth and appears to increase across development. NSSI was measured in the participants by using the Self-Injurious Thoughts and Behaviors Interview, a structured clinical interview that assesses NSSI engagement and behavioral methods used.
Overall, 53 (8.0 percent) of the 665 youth reported engaging in NSSI; 9.0 percent of girls and 6.7 percent of boys reported NSSI actions; 7.6 percent of third graders, 4.0 percent of sixth graders, and 12.7 percent of ninth graders reported NSSI behaviors. There was a significant grade-by-gender interaction; girls in the ninth grade (19 percent) reported significantly greater rates of NSSI than ninth-grade boys (5 percent).
Behavioral methods of NSSI differed by gender. Girls reported cutting and carving skin most often, whereas boys reported hitting themselves most often.
“As possible inclusion of an NSSI diagnosis in the DSM-5 draws near, it is essential to better understand NSSI engagement across development and gender,” the researchers said.
Barrocas A, Hankin B, Young J, et al. “Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample.” Pediatrics. 2012. June 11 [Epub ahead of print]. http://pediatrics.aappublications.org/content/early/2012/06/06/peds.2011-2094.abstract
