Category: research news

Researchers say girls more vulnerable to harmful effects of bullying

Girls are more often bullied than boys and are more likely to consider, plan, or attempt suicide, according to research led by a Rutgers University-Camden nursing scholar.

Teen girls more vulnerable to bullying than boys

Girls are more often bullied than boys and are more likely to consider, plan, or attempt suicide, according to research led by a Rutgers University-Camden nursing scholar.

"Bullying is significantly associated with depressive symptoms, suicidal ideation, suicide planning, and suicide attempts," says Nancy Pontes, an assistant professor at the Rutgers School of Nursing-Camden. "We wanted to look at this link between bullying victimization, depressive symptoms, and suicidality by gender."

In an examination of data from the Centers for Disease Control's nationally representative Youth Risk Behavior Survey from 2011-2015, Pontes and her fellow researchers conducted analyses of the data and found that more females are negatively affected by bullying.

Pontes says that, in general, girls are more often bullied than boys, and girls are also more likely to consider, plan, or attempt suicide compared with boys, regardless of being bullied or not -- although boys are more likely to die by suicide. In this study, Pontes and her fellow researchers looked at significant associations and not direct causal links.

Using two methods of statistical analysis, the researchers showed the probability of a link between bullying and depressive symptoms and suicide risk, and then compared the results of the two methodologies.

Through the more commonly used multiplicative interactions method, their findings matched the findings that some other researchers have used in previous studies, which showed no difference between males and females being bullied at school and having depressive symptoms or suicide risk behaviors.

However, when using the International Journal of Epidemiology-recommended methodology of additive interactions, Pontes and her team found the effects of bullying are significantly higher in females than males on every measure of psychological distress or suicidal thoughts and actions.

The study, "Additive Interactions between Gender and Bullying Victimization on Depressive Symptoms and Suicidality: Youth Risk Behavior Survey 2011-2015" by Pontes and her colleagues, is published in the journal Nursing Research.

"To our knowledge, our paper is the first in nursing to compare these two methodologies, and to challenge the status quo of analysis in our field," says Pontes.

The researchers acknowledge limitations with the study, such as the nature of its retrospective design and the inability to change or alter the design of the CDC study.

Pontes hopes the results of her team's examination will help draw attention to how researchers conduct analyses of data and how crucial it is to carefully consider which methods are the best fit, or to use both methods and compare them.

Bullying among boys is often physical. Pontes says while many schools are cracking down on physical bullying which people can see, those actions probably are preventing and stopping bullying that's more common among males.

Among females, Pontes says, the bullying is often the kind that's not visible. It's often relational bullying, such as excluding someone from activities and social circles, or spreading rumors about them. The actions are not overt, Pontes explains, so they could go on for a long time without anyone else knowing.

"Our school interventions should understand the differences in bullying and how we might better address females who are bullied," says Pontes.

The Rutgers-Camden nursing researcher believes that preventing bullying should begin at a young age. She says parents should start teaching preschool children that bullying is unacceptable.

"There are parents who see it as a rite of passage," says Pontes. "They say, 'Everyone gets bullied. You have to buck up. Stand up for yourself.'"

She says pediatricians and nurse practitioners should talk about the harmful effects of bullying with parents so that they can intervene early and reduce the victimization that causes adolescents to consider suicide, so they will be able to live happier and healthier lives.

Pontes' co-authors of the study are Rutgers School of Nursing-Camden colleague Cynthia Ayres and Manuel Pontes of Rowan University.

Nancy Pontes, the primary author, recently was honored with the Eastern Nursing Research Society's 2019 Nursing Research Authorship Award at the 2019 ENRS Annual Scientific Sessions held in Providence, R.I. A distinguished fellow and practitioner of the National Academy of Practice, she received her Ph.D. in nursing from Columbia University in 2003, and earned her master of science in nursing from the University of Florida in 1994. She received her bachelor's degree in nursing from Pensacola Christian College in 1985.


Story Source: Rutgers University. "Teen girls more vulnerable to bullying than boys." ScienceDaily. ScienceDaily, 7 May 2019. www.sciencedaily.com/releases/2019/05/190507110457.htm.


Dr. Holland's Perspective

"Boys experiences are often more rooted in the physical and what we can see." Dr. Holland explains. "For girls, everything is internal. Often they become the target of bullying and this persists over a period of time, because it is so insidious, it may not be seen or experienced as such. It is important that we educate our kids about the different kinds of bullying, and what we can do to stop it. We also need to actively teach them how to reach out for help. It is not often enough to tell A girl who was being bullied that you’re always there for them. It is important to come up with a plan. It is important that girls know how to reach out for help and when.

"We also need to give parents a hand in understanding the long term effects of bullying, symptoms that they can watch out for that might indicate their child is struggling, and help them to communicate effectively with their children. Parents can be helped by being made aware of signs of anxiety and depression in tweens and teens. Currently, suicide is the second leading cause of death in individuals between the ages of 10 and 24.Often, we are afraid to ask our kids questions, just in case we might be wrong, or experienced as intrusive. To this I say, “Better a dirty look, then no look at all."

It's important that parents understand the need to be direct with their children. It is my experience that when we ask directly, if they have thought of hurting themselves they feel relieved for being asked, because they don’t have to keep this big secret anymore, or follow through with it."

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Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Teaching people how to focus on positive emotions reduces anxiety and depression

Caring for family members with dementia -- which is on the rise in the U.S. -- causes significant emotional and physical stress that increases caregivers' risk of depression, anxiety and death. A new method of coping with that stress by teaching people how to focus on positive emotions reduced their anxiety and depression after six weeks, reports a new national Northwestern Medicine study. It also resulted in better self-reported physical health and positive attitudes toward caregiving.

"The caregivers who learned the skills had less depression, better self-reported physical health, more feelings of happiness and other positive emotions than the control group," said lead study author Judith Moskowitz, professor of medical social sciences at Northwestern University Feinberg School of Medicine. She also is director of research at the Osher Center for Integrative Medicine at Feinberg.

The positive-emotion intervention does not require a licensed therapist and can be widely implemented, making it accessible and affordable for busy caregivers. The paper will be published May 2 in Health Psychology.

"Nationally we are having a huge increase in informal caregivers," Moskowitz said. "People are living longer with dementias like Alzheimer's disease, and their long-term care is falling to family members and friends. This intervention is one way we can help reduce the stress and burden and enable them to provide better care."

Most current approaches to helping caregivers focus on education about dementia or problem solving around challenging behaviors but haven't specifically addressed reducing the emotional burden of providing care. The intervention designed by Moskowitz and colleagues included eight skills that evidence shows increase positive emotions. They include noticing and capitalizing on positive events, gratitude, mindfulness, positive reappraisal, personal strengths, attainable goals and acts of kindness. (More details below.)

Moskowitz wasn't sure how many caregivers would be able to complete the program because "they are such a stressed, burdened group. But they were engaged and committed, which speaks to how much they need programs like this," she said.

Currently there are 5.5 million people in the United States diagnosed with Alzheimer's disease, which could increase to 16 million by 2050. The average life expectancy post diagnosis is eight to 10 years, although some people live as long as 20 years. In the trial, 170 dementia caregivers were randomly assigned to either the intervention group in which they learned positive emotion skills such as recognizing a daily positive event and keeping a gratitude journal, or to a control group in which they filled out a daily questionnaire about their emotions. The positive emotion skill sessions, called LEAF (Life Enhancing Activities for Family caregivers), were presented by a facilitator via web conference, reaching caregivers across the U.S. The web delivery is especially important for caregivers who live in rural areas without local caregiver support services, Moskowitz said.

In addition to Northwestern, the study was conducted out of the University of California San Francisco (UCSF). Dr. Glenna Dowling of the UCSF School of Nursing was the co-principal investigator on the study. In six weekly sessions, caregivers reviewed positive emotion skills and then had daily homework to practice the skills, including audio recordings. If the topic was acts of kindness, for example, their homework was to go out and practice an act of kindness. All participants filled out a questionnaire about their depression, anxiety, physical health and caregiver burden at the start and completion of the study.

LEAF participants had a 7 percent greater drop in depression and a 9 percent greater drop in anxiety compared to the control group. Participants in the intervention group decreased from showing moderate symptoms of depression relative to the population norm, to falling within the normal range of depressive symptoms by the post-intervention assessment. In contrast, participants in the control condition showed a smaller decrease in depression scores and remained within the mild to moderate range.

One participant wrote, "The LEAF study and the techniques I learned by participating in it have brought about a serenity and calmness to my life and to that of my husband. We have both benefitted from my changed attitude."

Another commented, "Doing this study helped me look at my life, not as a big neon sign that says, 'DEMENTIA' in front of me, but little bitty things like, 'We're having a meal with L's sister, and we'll have a great visit.' I'm seeing the trees are green, the wind is blowing. Yeah, dementia is out there, but I've kind of unplugged the neon sign and scaled down the size of the letters."

Skills taught to participants in the study:

1. Recognizing a positive event each day

2. Savoring that positive event and logging it in a journal or telling someone about it

3. Starting a daily gratitude journal

4. Listing a personal strength each day and noting how you used this strength recently

5. Setting an attainable goal each day and noting your progress

6. Reporting a relatively minor stressor each day, then listing ways in which the event can be positively reappraised or reframed

7. Understanding small acts of kindness can have a big impact on positive emotion and practicing a small act of kindness each day

8. Practicing mindfulness through paying attention to daily experiences and with a daily 10-minute breathing exercise, concentrating on the breath

Moskowitz will launch a new study funded by the National Institute of Aging where she will compare the facilitated version of the intervention (the one shown to be effective in this study) to a self-guided online version of the intervention (without a facilitator). If the self-guided version is as effective as the facilitated one, the LEAF program can be implemented widely at relatively low cost to help the growing number of dementia caregivers in the U.S., she said.

This work was supported by grant R01NR014435 from the National Institute of Nursing Research of the National Institutes of Health.


Story Source: Materials provided by Northwestern University. Original written by Marla Paul. Note: Content may be edited for style and length. READ this article on Science Daily: Northwestern University. "Teaching happiness to dementia caregivers reduces their depression, anxiety: Simple positive emotion skills yield benefits in physical and emotional health." ScienceDaily. ScienceDaily, 2 May 2019. www.sciencedaily.com/releases/2019/05/190502075834.htm.


Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Low serotonin levels thought to influence gut health and spark depression

New study suggests that depression and GI trouble sometimes spring from the same source

For people with depression, gastrointestinal distress is a common additional burden, and a new study suggests that for some, the two conditions arise from the same glitch in neuron chemistry -- low serotonin.The study, conducted in mice, shows that a shortage of serotonin in the neurons of the gut can cause constipation, just as a serotonin shortage in the brain can lead to depression. The study also found that a treatment that raises serotonin in the gut and the brain may alleviate both conditions.

Up to a third of people with depression have chronic constipation, and a few studies report that people with depression rate their accompanying bowel difficulties as one of the biggest factors reducing their quality of life. Severe constipation can obstruct the GI tract and cause serious pain. The condition leads to 2.5 million physician visits and 100,000 hospitalizations each year. Though some antidepressants are known to cause constipation, medication side effects do not explain all cases.

"Ultimately, many patients with depression are faced with limited treatment options and have to suffer with prominent GI dysfunction," says study leader Kara Gross Margolis, MD, associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeon.

Similarities between the gut and the brain suggest the two conditions may also share a common cause. "The gut is often called the body's 'second brain,'" says Margolis. "It contains more neurons than the spinal cord and uses many of the same neurotransmitters as the brain. So it shouldn't be surprising that the two conditions could be caused by the same process."

Because low levels of serotonin in the brain have been linked to depression and serotonin is also used by neurons in the gut, the researchers studied mice to determine if a serotonin shortage also plays a role in constipation. The serotonin shortage in the gut, the researchers found, reduced the number of neurons in the gut, led to a deterioration of the gut's lining, and slowed the movement of contents through the GI tract.

"Basically, the mice were constipated," Margolis says, "and they showed the same kind of GI changes we see in people with constipation." (In previous studies, these same mice also showed depressive symptoms).

The treatment -- slow-release drug-delivery of 5-HTP, a precursor of serotonin -- works in part by increasing the number of GI neurons in study subjects. The discovery of this connection between a brain and a gastrointestinal disorder suggests that new 5-HTP slow-release therapies could treat related brain-gut conditions simultaneously. The study is also one of the first to show that neurogenesis in the gut is possible and can correct abnormalities in the gut. "Though it's been known for many years that neurogenesis occurs in certain parts of the brain, the idea that it occurs in the gut nervous system is relatively new," Margolis says.

Neurogenesis may help treat other types of constipation. "We see a reduction of neurons in the GI tract with age, and that loss is thought to be a cause of constipation in the elderly," Margolis says. "The idea that we may be able to use slow-release 5-HTP to treat conditions that require the development of new neurons in the gut may open a whole new avenue of treatment."

An immediate-release version of 5-HTP is available as a supplement, but it has not been proved scientifically to work and physiologically it should not, as it is too short-acting, Margolis says. 5-HTP is the immediate precursor to serotonin. Once ingested, 5-HTP is converted to serotonin, but the serotonin is rapidly inactivated before it can work effectively. The slow-release version of 5-HTP used in the current study produces constant administration of 5-HTP which has been demonstrated to remedy the limitations of currently available immediate-release 5-HTP. Clinical studies are already planned for testing a slow-release 5-HTP drug in people with treatment-resistant depression. Planning for testing a slow-release 5-HTP drug in constipation is in progress.

Story Source -- Read the full article on Science Daily: Materials provided by Columbia University Irving Medical Center. Note: Content may be edited for style and length. Columbia University Irving Medical Center. "A moody gut often accompanies depression: New study helps explain why." ScienceDaily. ScienceDaily, 7 May 2019. www.sciencedaily.com/releases/2019/05/190507080148.htm.


Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.