NEW YORK ― "Love addiction," a condition characterized by severe pervasive and excessive interest toward a romantic partner, may actually be a form of attachment disorder, new research suggests.
A new literature review of studies using the terms "love addiction," "pathological love," and "behavioral addiction" showed possible involvement of the brain reward dopaminergic system as well as attachment-related biological systems.
"We wondered where does love, a feeling of well-being, devolve into addiction? And what might be the criteria for love addiction and its destructive and dysfunctional behaviors?" asked Vineeth P. John, MD, associate professor of psychiatry and behavioral health at the University of Texas Health Science Center in Houston, during a press briefing here at the American Psychiatric Association 2014 Annual Meeting.
Still, he told Medscape Medical News that it is important not to medicalize normal, albeit deep, love. Instead, clinicians should be concerned if patients stay in a relationship despite danger or if have severe pining long after a breakup despite knowing the relationship is over.
"There is an urgent need for a better conceptualization of [love addiction] from a nosological and neurobiological perspective," the investigators note.
"This would be the first step in devising controlled studies aiming at properly assessing the efficacy of different psychosocial and pharmacological interventions in the treatment of this intriguing condition."
Lack of Control
Dr. John reported that the researchers wanted to question whether being addicted to love was possible and if so, whether it could be a diagnosable disorder.
Dr. Vineeth John
They defined love addiction as a pattern of maladaptive behaviors and intense interest toward 1 or even more romantic partners at the detriment of other interests and resulting in a lack of control and significant impact on functionality.
Although it can occur simultaneously with substance dependence or sex or gambling disorders, it can also be considered an addiction behavior itself, a part of a mood or obsessive-compulsive disorder, or even a part of erotomania.
"It is thought that it affects as many as 3% of the population. And in certain subsets of young adults, it may even go up to 25%," said Dr. John.
He added that individuals who are most at risk for the condition include those with an immature concept of love, a maladaptive social environment, or high levels of impulsivity and anxiety; are anxious-ambivalent or "seductive narcissists"; or have structural affective dependence.
Results from the analysis showed that a picture of a participant's "beloved" elicited activation in the brainstem, the right ventral tegmental area (VTA), and the caudate nucleus regions. These areas have been shown to be central to the brain's reward, memory, and learning functions and have been implicated in substance abuse.
In addition, addiction and attachment disorders share overlapping neural circuits, through the VTA to the nucleus accumbens.
"So basically, what we might be looking at is an attachment problem," he said.
Love Molecules
He also reported that 4 possible "molecules of love" include dopamine (which incites desire and facilitates repetition of love behavior), oxytocin (which mediates social behavior), the opioid hormone (which activates pleasure sensations), and vasopressin (which affects protective behaviors).
Interestingly, men who carried the "allele 334 for the gene coding for vasopressin receptor (AVP R1A)" showed less stable relationships.
"But the most plausible and practical aspect of love addiction would be to look at how to treat it," said Dr. John.
Because they found few studies examining benefits of psychotherapy and no studies assessing the efficacy of medications for this condition, the investigators came up with hypothetical guidelines for target symptom interventions.
For psychosocial treatments, they suggested self-help groups, cognitive-behavioral therapy, psychodynamic psychotherapy, or enrolling in Sex and Love Addicts Anonymous.
In addition, they suggested using selective serotonin reuptake inhibitors and/or antidepressants to treat obsessive thoughts about a romantic partner; mood stabilizers to treat mood instability or seeking out multiple partners; mood stabilizers, antipsychotics, naltrexone, or buprenorphine for treating impulsive seeking of romantic partners; and oxytocin or vasopressin for treating impaired attachments.
"It might be possible to devise drug-based therapies for the treatment of difficult love, based on neurobiological substrates," said Dr. John.
"But this is clearly a futuristic concept. We cannot medicalize noble human emotions. This particular addiction has to be harmful, disruptive, and destructive and cause significant psychological distress. And the treatment has to be totally voluntary," he added.
"Overall, it's time to think about our patients, or at least a small subset of them who are clearly suffering with what is probably an attachment problem."
Worth Pursuing
"I think this is a very important area of study," said Jeffrey Borenstein, MD, president and CEO of the Brain and Behavior Research Foundation in New York City.
Dr. Jeffrey Borenstein
"The issue of attachment is extremely important because it relates to other conditions that we treat, including some of the personality disorders," he added.
Dr. Borenstein, who was not involved with this research, was moderator of the press briefing.
He noted that the investigators' approach of looking specifically at the question of love addiction was interesting.
"Obviously Dr. John is not saying that we have pills for this or even that we should be treating this. But I think it's an area of study worth learning more about," concluded Dr. Borenstein.
The study authors report no relevant financial relationships.
American Psychiatric Association's 2014 Annual Meeting. Abstract NR8-35. Poster presented May 6, 2014.
Over the past two decades, the use of antidepressants has skyrocketed. One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four.
Experts have offered numerous reasons. Depression is common, and economic struggles have added to our stress and anxiety. Television ads promote antidepressants, and insurance plans usually cover them, even while limiting talk therapy. But a recent study suggests another explanation: that the condition is being overdiagnosed on a remarkable scale.
The study, published in April in the journal Psychotherapy and Psychosomatics, found that nearly two-thirds of a sample of more than 5,000 patients who had been given a diagnosis of depression within the previous 12 months did not meet the criteria for major depressive episode as described by the psychiatrists’ bible, the Diagnostic and Statistical Manual of Mental Disorders (or D.S.M.).
Elderly patients were most likely to be misdiagnosed, the latest study found. Six out of seven patients age 65 and older who had been given a diagnosis of depression did not fit the criteria. More educated patients and those in poor health were less likely to receive an inaccurate diagnosis.
The vast majority of individuals diagnosed with depression, rightly or wrongly, were given medication, said the paper’s lead author, Dr. Ramin Mojtabai, an associate professor at the Johns Hopkins Bloomberg School of Public Health.
Most people stay on the drugs, which can have a variety of side effects, for at least two years. Some take them for a decade or more.
“It’s not only that physicians are prescribing more, the population is demanding more,” Dr. Mojtabai said. “Feelings of sadness, the stresses of daily life and relationship problems can all cause feelings of upset or sadness that may be passing and not last long. But Americans have become more and more willing to use medication to address them.”
By contrast, the Dutch College of General Practitioners last year urged its members to prescribe antidepressants only in severe cases, and instead to offer psychological treatment and other support with daily life. Officials noted that depressive symptoms may be a normal, transient reaction to disappointment or loss.
Ironically, while many patients in the United States are inappropriately diagnosed with depression, many who actually have it suffer without treatment. Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University Medical Center, noted that from the time they develop major depression, it takes Americans eight years on average to seek care.
Diagnosing depression is an inherently subjective task, said Dr. Jeffrey Lieberman, the president of the American Psychiatric Association.
“It would be great if we could do a blood test or a lab test or do an EKG,” Dr. Lieberman said, noting that similar claims of overtreatment have been made about syndromes like attention deficit hyperactivity disorder. “A diagnosis is made by symptoms and history and observation.”
The new study drew 5,639 individuals who had been diagnosed with depression from among a nationally representative sample of over 75,000 adults who took part in the National Survey of Drug Use and Health in 2009 and 2010. The subjects were then interviewed in person with questions based on the D.S.M.-4 criteria.
Only 38.4 percent of the participants met these criteria for depression during the previous year, Dr. Mojtabai said.
It’s possible some of the participants did not appear to be depressed because they had already been successfully treated, said Dr. Jeffrey Cain, the president of the Academy of Family Physicians. Their improved mood may also have colored the way they responded to questions about the past.
“If I’m checking people who are being treated for high blood pressure and taking medication, I would expect it to be better when I’m checking them,” Dr. Cain said.
According to the D.S.M., a diagnosis of major depressive episode is appropriate if the patient has been in a depressed mood and felt no interest in activities for at least two weeks, and also has at least five symptoms that impair functioning almost every day. These include unintentional weight gain or loss, problems sleeping, agitation or slowed reactions noticed by others, fatigue and low energy, feelings of excessive guilt or worthlessness, difficulty concentrating and recurrent thoughts of death.
“We’re not just talking about somebody who’s having a bad day or got into an argument with their spouse,” Dr. Lieberman said. “We’re talking about something that is severe, meaning it’s disabling and distressing and is not transient.”
One 50-year-old New York City woman said her doctor prescribed an antidepressant a few weeks after her husband died, even though she thought her feelings of shock and sadness were appropriate.
“He told me, ‘You have to function, you have to keep your job, you have a daughter to raise,’ ” said the woman, who asked that her name be withheld because few friends or family members knew she was taking antidepressants.
Most of the study participants were not receiving specialty mental health care, but Dr. Cain pointed out that it was not clear who was making the misdiagnoses: a psychiatrist, non-psychiatrist physician or other provider, like a nurse practitioner.
But while a psychiatrist may spend up to 90 minutes with a patient before making a diagnosis, patients often are more comfortable with their primary care doctors, who rarely have that kind of time.
Dr. Lieberman suggested watchful waiting may be appropriate in some cases, and more integrated forms of health care may soon make it easier to send patients to a mental health provider “down the hall.”
Doctors need to improve their diagnostic skills, Dr. Mojtabai said, and must resist the temptation “to take out the prescription pad and write down an antidepressant and hand it to the patient.”
Posted by: Dr. Dan L. Boen AT 04:04 pm
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This Month’s Expert: Michael Posternak, M.D., on Choosing Antidepressants
By Michael Posternak, M.D.
TCR: Dr. Posternak, thank you for agreeing to speak with us and I also want to thank you for having collaborated on a series of research articles that have been extremely useful to clinicians. I’d like to start with your article about factors that we use when we are selecting antidepressants (Zimmerman, Posternak, et. al., Am J Psychiatry 161:1285-1289, July 2004). How did that study come about?
Dr. Posternak: Most psychiatrists pretty much agree that all antidepressants are more or less equally effective. So if you start with that premise and you have 10-15 antidepressants out there, why are you picking one versus another? And what algorithm are we all using? Dr. Zimmerman developed a questionnaire for psychiatrists to fill out immediately after they wrote antidepressant prescriptions. We asked, “What influenced you to choose that medication?”
TCR: And what were your findings?
Dr. Posternak: We found that there were three compelling factors: The first was avoiding specific side effects, the second was the presence of comorbid psychiatric disorders, and the third was the presence of specific clinical symptoms. For example, many people wanted to avoid sexual side effects or weight gain and would choose meds based on this. And if a patient had depression plus panic disorder, for example, we would lean toward the SSRIs. And if someone’s clinical profile included both insomnia and poor appetite, we might choose Remeron (mirtazapine). As you can see, there was nothing terribly earth shattering about any of these findings, but they give us insight into what factors people are actually considering when they prescribe an antidepressant.
TCR: Do you find that there is much research support for the validity of these factors?
Dr. Posternak: No, because there isn’t much research to begin with. For example, if you look for papers on antidepressant efficacy for patients with comorbidity (and comorbidity is the norm rather than the exception) there is almost nothing out there. Most treatment trials assessing depression exclude patients with comorbid disorders or do not assess for them. A prototypical example would be the common practice of avoiding bupropion in patients with depression and significant anxiety. And yet John Rush and colleagues have published three papers showing no difference between Wellbutrin and sertaline in efficacy for anxiety in depressed patients (see, for example, J Clin Psychiatry 2001; 62:776-781).
TCR: You and Dr. Zimmerman have also written about the concept of “remission,” which has become the gold standard for antidepressant trials lately. How do you suggest we decide when a patient has responded well enough to an antidepressant?
Dr. Posternak: I think that is a terrific question. Even from a research standpoint, there is something problematic about using “remission” as the endpoint of a study. The problem is that, both in clinical trials and in our practices, patients start off with different degrees of depression. So let’s say you define your endpoint as a HAM-D score of 7 or less. A patient who starts at a HAM-D of 26 and has a 50% improvement will not meet criteria for remission, but will nonetheless feel much better than when they started the medication. Many patients may not reach the formally-defined point of remission, and may have residual symptoms and yet you and your patient may decide that you are satisfied with that response and you don’t want to keep pushing the dose or switching medications.
TCR: What research instruments would you suggest for use in our practices?
Dr. Posternak: Over the years, I have come to conclude that the CGI (Clinical Global Impression) is a pretty good judge. I ask patients, “Do you think your depression is partially improved or much improved since starting medication?” Usually if they are “much improved,” this corresponds with a greater than 50 percent improvement on the HAM-D, and most of us are not going to switch medications at that point. You might still try to tweak the regimen to help them sleep or improve their energy, but generally we would say that we have found something that seems to be worth sticking to.
TCR: And what are your favorite medication manipulations for tweaking the regiment to enhance response?
Dr. Posternak: The two that I use the most, and that I think are the simplest and most effective are: 1) Ensuring that patients get adequate sleep, and 2) Enhancing energy.
TCR: Tell me a bit about sleep. Why is this so important in resolving depression?
Dr. Posternak: When people don’t sleep it affects many other things like energy, concentration and mood, often leading to irritability. So one of the simplest interventions that I can do for my patients is to help them get a good night’s sleep. Some people are reluctant to take a sleep medicine and if so, I say to them, “This is important for your depressive illness, because if you don’t sleep well the research studies have demonstrated that you are going to be at higher risk for relapse.”
TCR: What are your “go-to” agents for insomnia?
Dr. Posternak: Well I often start with trazodone, because it is safe, it generally doesn’t lead to tolerance, and people like the fact that it has no addictive potential. I usually start at 25 mg because I don’t want them to get turned off from being groggy in the morning. If it doesn’t work at that dose, I will titrate the dose fairly aggressively until they are either sleeping well or they have limiting side effects. You can safely go up to 600 mg, which is an antidepressant dosage.
TCR: What do you do if trazodone doesn’t work?
Dr. Posternak: I like Remeron, but very often this is not an option because people are concerned about weight gain, so then I will move to benzodiazepines.
TCR: What about the non-benzo’s, like Ambien or Sonata?
Dr. Posternak: I rarely go to these next for a very simple reason, which is cost. I generally stick with the generics. I think that they are at least as effective and they are a fraction of the cost. My sense is that the non-benzos are marketed based on their lower risk of dependence or addiction, and yet I find in my clinical practice that people do not get addicted to sleeping pills. It just doesn’t happen, so why should we spend so much money on these other medications? I explain that to patients.
TCR: What benzos do you usually use?
Dr. Posternak: I simply use Valium (diazepam), 5-10 mg.
TCR: Why Valium and not Ativan (lorazepam) or Restoril (temazepam), or the others?
Dr. Posternak: Lorazepam is short-acting, so I find it less effective. Xanax (alprazolam) is the same thing; it is a very short-acting medication. It may help them fall asleep. It may even help the first few nights, but I find if I am treating more long-term insomnia that tolerance builds up. Restoril should be as effective as Valium in theory based on half-life, but in clinical practice I haven’t found that to be the case.
TCR: What about Klonopin?
Dr. Posternak: Klonopin I find is less sedating, which is useful for a daytime anxiolytic but I find that it is just not as effective as a hypnotic.
TCR: You also mentioned enhancing energy?
Dr. Posternak: Yes, and what I use for this, and what I feel is underutilized, is psychostimulants. A lot of times people are depressed, are not as happy as they would like, because they are not as focused or their energy isn’t as good. Like sleeping pills, stimulants have an immediate effect, which is nice and it is quite dramatic.
TCR: And then which specific medication do you like to use?
Dr. Posternak: Well, being boring and simple, I start with plain old generic Ritalin (methylphenidate) and I dose it 5 to 10 mg twice a day, early morning and early afternoon.
TCR: And what do you tell patients when you give it to them about potential side effects?
Dr. Posternak: I tell them that it is very well-tolerated, that its purpose is to increase their energy and help their concentration, and that we can increase the dose if it doesn’t work. As far as side effects, I’ll say, “You might get a tremor, it could increase your anxiety, it could cause insomnia, it could increase your heart rate, but in general people tolerate it very well.”
TCR: Do you see problems with stimulant abuse?
Dr. Posternak: A small minority of my patients report that they tended to get euphoric on stimulants and then crash afterwards. But this is rare.
TCR: How do you deal with prescribing stimulants long term?
Dr. Posternak: Once they are stable and I want to see them every three months I give them two post-dated prescriptions.
TCR: Is there anything else that you have been doing lately for antidepressant augmentation?
Dr. Posternak: Yes, we just completed a randomized trial of T3 (triidothyronine, trade name “Cytomel”) augmentation, and we found that it accelerated antidepressant response in comparison to placebo augmentation.
TCR: What dose did you use?
Dr. Posternak: 25 mcg QD.
TCR: Many psychiatrists are tempted to use Cytomel but are concerned about causing medical problems by adding thyroid hormone to our patients’ systems. What are your thoughts about that?
Dr. Posternak: I don’t think that they have to be concerned about that. If someone has an arrhythmia, I wouldn’t use it, but otherwise 25 mcg. is a very low dose; it is quite safe and you really don’t have to be concerned about that from a clinical standpoint.
TCR: And before you start, do you recommend that we get any particular labs?
Dr. Posternak: No, it is not necessary. If you use T3 and it works, then you will want to get a TSH at some point just to make sure you are not affecting the thyroid gland. But if it doesn’t work, you’ll just stop the medication and you’ll save your patient a blood draw.
This article originally appeared in: Click on the image to learn more or subscribe today!
This article was published in print 1/2006 in Volume:Issue 4:1.
APA Reference The Carlat Psychiatry Report. (2013). This Month’s Expert: Michael Posternak, M.D., on Choosing Antidepressants. Psych Central. Retrieved on August 7, 2013, from http://pro.psychcentral.com/2013/this-months-expert-michael-posternak-m-d-on-choosing-antidepressants/002640.html
Last reviewed: By John M. Grohol, Psy.D. on 30 Jul 2013
Posted by: Dr. Dan L. Boen AT 08:39 am
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Communities that pull together in a crisis are happier.
What has happened to people's happiness all around the world as they've faced the economic crisis? How have they coped with job losses, less money coming in, the sense of despair and lack of control over a nightmare that seems to have no end?
That's the question that Helliwell et al. (2013) ask in a new paper in the Journal of Happiness Studies.
They guessed that one answer is one of the oldest in human civilisation: by pulling together.
Pulling together, though, has a new fancy name: social capital. Here are the kinds of things which tell you whether a group of people have 'social capital':
How many people do volunteer work in the community?
How many people have done a favour for a neighbour in the last month?
How many people have given a little money to charity (about $25)?
How many people regularly have meals together as a family?
These go on and on, but you get the general idea. It's essentially doing nice things for other people around you; they don't have to be that dramatic like donating a liver, just little boyscout-type activities count.
They then looked at a huge amount of data on both social capital and happiness across 255 metropolitan areas in the US and drew this conclusion:
"...communities with greater social engagement are happier than otherwise equivalent communities and that life evaluations fell by less, in response to unemployment increases, in those communities with high levels of a broad measure of social engagement."
So social capital has a protective effect: by pulling together through doing little things for each other, people helped keep their spirits up during the economic crisis.
Happy countries
Helliwell et al. (2013) also found the same when they compared between countries, not just between US metropolitan areas. They divided countries into those which had become happier since the crisis, those which remained about the same and those that had become less happy.
In the group of countries with falling levels of happiness (which includes the US but not the UK):
"We saw that average happiness drops were far greater than could be explained by their lower levels of GDP per capita, suggesting that social capital and other key supports for happiness were damaged during the crisis and its aftermath."
In contrast, South Korea is a country whose average levels of happiness have rocketed up since the economic crisis. This is partly because the economy has recovered remarkably well, but maybe also because of policies that have encouraged social capital. Here's the President of South Korea explaining:
"Korea has already proposed a new way forward from the global crisis. [...] We decided to share the burden. Employees chose to sacrifice a cut in their own salaries and companies accepted to take cuts in their own profits because they wanted to save their employees and co-workers from losing their jobs."
More than social: pro-social
The explanation for these effects is that humans are fundamentally pro-social so:
"...they get happiness not just from doing things with others, but from doing things both with and for others. Despite a wealth of findings that those who do things for others gain a bigger happiness boost than do the recipients of generosity, people underestimate the happiness gains from unselfish acts done with and for others"
→ This site is written by psychologist and author, Jeremy Dean. It is completely free. Please help it continue by spreading the word. Thank you.
Making Habits, Breaking Habits
In his new book, Jeremy Dean--psychologist and author of PsyBlog--looks at how habits work, why they are so hard to change, and how to break bad old cycles and develop new healthy, creative, happy habits.
Can belief in God predict how someone responds to mental health treatment? A recent study suggests it might.
Researchers at McLean Hospital in Belmont, Mass., enrolled 159 men and women in a cognitive behavioral therapy program that involved, on average, 10 daylong sessions of group therapy, individual counseling and, in some cases, medications. About 60 percent of the participants were being treated for depression, while others had bipolar disorder, anxiety or other diagnoses.
All were asked to rate their spirituality by answering a single question: “To what extent do you believe in God?”
The results, published in The Journal of Affective Disorders, revealed that about 80 percent of participants reported some belief in God. Strength of belief was unrelated to the severity of initial symptoms. Over all, those who rated their spiritual belief as most important to them appeared to be less depressed after treatment than those with little or no belief. They also appeared less likely to engage in self-harming behaviors.
“Patients who had higher levels of belief in God demonstrated more effects of treatment,” said the study’s lead author, David H. Rosmarin, a psychologist at McLean Hospital and director of the Center for Anxiety in New York. “They seemed to get more bang for their buck, so to speak.”
One possible reason for this, he said, is that “patients who had more faith in God also had more faith in treatment. They were more likely to believe that the treatment would help them, and they were more likely to see it as credible and real.”
Of the 56 people who expressed the strongest belief in God, 27 also had very high expectations for the treatment, while nine had very low expectations. In contrast, of the 30 patients who said they had no belief in God or a higher power, only two had high expectations for the treatment.
“It’s one of the first studies I’ve read that actually looks at perhaps a mechanism” for “why we see some correlation between the strength of religious commitment or the strength of spiritual commitment and better outcomes,” said Dr. Marilyn Baetz, a psychiatrist at the University of Saskatchewan who studies the effects of religion and spirituality on mental health. An earlier yearlong study by Dr. Baetz and her colleagues found that people with panic disorder who rated religion as “very important” to them responded better to cognitive behavioral therapy, showing less stress and anxiety, than those who rated religion as less important.
Assessing how religious practices affect health is difficult, in part because researchers can’t randomly assign people to embrace religion or not, the way they might assign participants in a drug test to take a new medication or a placebo. Most studies of this relationship are observational, and people who are more or less religious may differ in other important ways, making it difficult to know whether religious faith is actually causing the effect or if it is a result of to some other factor.
But teasing out the effects of faith on treatment outcomes may be an important goal. Most Americans believe in God — 92 percent, according to a 2011 Gallup poll, though the percentage among mental health professionals may be considerably lower. One study from 2003 found that 65 percent of psychiatrists said they believed in God, compared with 77 percent of other physicians.
Previous research has associated church attendance with increased life expectancy and, in some studies, a reduced risk of depression. But this study looked not at how often the participants went to church or at their religious affiliation but at their belief in a higher power.
“I think it’s a scientifically sound way of measuring things that have to do with people’s experience of spirituality,” said Torrey Creed, a psychologist at the Beck Institute for Cognitive Behavior Therapy, near Philadelphia. “I think about this as a study of cognitive styles, that there’s a pattern of thinking that helps people get better in treatment. And two examples of this pattern of thinking are ‘I believe in treatment’ and ‘I believe in God.’”
Randi McCabe, director of the Anxiety Treatment and Research Center at St. Joseph’s Healthcare in Ontario, said, “People’s belief that something is going to work will make it work for a significant proportion of people,” similar to the placebo effect.
“Your belief that you’re going to get better, your attitude, does influence how you feel,” Dr. McCabe continued. “And really, in cognitive behavior therapy, that is really what we’re trying to change: people’s beliefs, how they’re seeing their world, their perspective.”
Dr. Rosmarin offered further explanation for why religious faith might aid psychiatric treatment. “There’s a vulnerability associated with physicality,” he said. “I think people, psychiatric patients in particular, might recognize that vulnerability and recognize that things can’t be counted on.
“Sometimes medications don’t work, and sometimes psychotherapy doesn’t work,” he continued. “But if someone believes in something that is metaphysical, if someone believes in something spiritual, which would ostensibly be eternal, permanent, unwavering, omnipotent, then that could be an important resource to them, particularly in times of emotional distress.”
Posted by: Dr. Dan L. Boen AT 01:10 pm
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As a girl, Father's Day underscored the other 364 days of the year, bringing a blaring reminder there was no father around to celebrate. The absence of that single, critical male relationship didn't just make me feel lonely and left out, it impacted my understanding of the world and my place in it. .
After reflecting on how my father's absence has impacted me as a girl and now woman, wife and mother in my memoir, The Artist's Daughter, others have shared with me similar stories of abandonment and struggle. Our collective stories confirm what statistics scream: that the bond from father to child is essential. Whether our dads were good, bad, or not there at all, this relationship shapes our understanding of our very identities.
Yet, we live in a country where too many of us have broken relationships with Dad. In America, 1 in 3 kids live apart from their biological fathers. A recent Washington Post article addressed the dad dilemma with the eye-catching title: The new F-Word – Father. In it, Kathleen Parker addresses a question being asked as we discuss the latest stats on America's female breadwinners: In the evolving 21st-century economy, "what are men good for?"
Parker concludes:
Women have become more self-sufficient (a good thing) and, given that they still do the lion's share of housework and child rearing, why, really, should they invite a man to the clutter? Because, simply, children need a father… . Deep in the marrow of every human child burbles a question far more profound than those currently occupying coffee klatches: Who is my daddy? And sadly these days, where is he?
While single mothers may have enough grit, love, and know-how to raise us, the absence of Dad will still have its effect. Study after study shows that a children with absent fathers are more likely to live in poverty, drop out of high school, have a failing marriage, even be incarcerated than those whose fathers are involved in their lives. The data confirms how much a father matters to a child's physical and emotional wellbeing and development. Fatherhood, it turns out, is a social justice issue.
But that's unfortunately where the church often ends the conversation. We lament the shift in the family structure, express outrage at the latest statistics. We bring absent fathers into the culture wars, wrapping them up with changing definitions of marriage and family. As we preach and debate, Father's Days go by and millions of children remain without the single, most influential male relationship that will continue to shape their identity throughout their lives.
If we take James' words seriously and see true religion as caring for orphans and widows (James 1:27), we must see strong parenting, orphan prevention, as part of the call. How do we practically support the idea of children maintaining relationships with their fathers, if the ultimate responsibility lies on the father himself?
We can—without fanfare—support the fathers we know, including those that live with their children and those that do not. As Christians, we can offer dads opportunities to connect with their kids. That doesn't mean plan another church carnival or father-daughter dance, though those are nice events.
Instead, as Christian families and communities, we should help foster organic relationships between fathers and children. Though relationships can be redeemed at any stage, the earlier the father-child bond is cultivated the larger the benefit is to the child. We can invite a dad and his kids into our lives, the things we are already doing, so they can experience life together. We support fathers as we ask a family over for dinner, ask them to go camping with us or signing up for T-ball together. Putting on the father-daughter dance is easier to execute because at the end of the night it's over, while organic relationships are open-ended. It's this side-by-side kind of journey that presents father and child the opportunity to be together.
We support mom and dad's relationship, despite the cultural shifts around marriage. Many couples choose to have kids before deciding if they will marry; the latest figures show 48 percent of all first births are to single women. While plenty of single or remarried dads remain committed to their children despite not being in a relationship with their mother, that arrangement becomes more difficult and more complicated. Quite simply, a father is more likely to be involved a child's life if he and the child's mother are together.
So, as Christians who care about fatherhood, we need to affirm the importance of the relationship between mom and dad, even if they aren't married. For some of us this is uncomfortable territory, to support relationships that may not look like we'd like. We can practically support these couples so they don't feel isolated. When we offer to babysit for friends to go to counseling or out to dinner, we are we are helping build healthier relationships—both between parenting partners and between parent and child. When we pray with and for couples who are struggling, when we openly discuss our own struggles in marriage we are modeling sticking it out in the difficult and that in turn supports fathers who are present.
Sadly, we must acknowledge that not every father is a safe person, and a severed relationship is in the child and mother's best interests. However, in the cases where connection and reconciliation is possible, we can extend our support.
We do it all clothed in love. Our goal is not to fight a culture war, but to love God with our whole hearts and to love others as we want to be loved. Our goal is to care for orphans and widows, to foster loving earthly families that reflect the love of our Divine Father. To do this, we as Christians must act clothed in love for parents and kids. Supporting fatherhood does not require a project or political campaign, but something much more meaningful: actual relationships with people in our midst. We should acknowledge and be grateful for the responsible, caring fathers we know. We should be patient and helpful with men working towards being better fathers. We should encourage reunion and reconciliation for fathers who live away from their children or who have grown distant over time.
God refers to himself as "Father" on purpose. The title embodies trust, provision and security. Let us help one another move closer to that holy representation, knowing we will always be stumbling and always fall short, but it is a critical relationship worth nurturing.
Alexandra Kuykendall is Mom and Leader Content Editor at MOPS International (Mothers of Preschoolers) a ministry to moms of young kids. Her memoir, The Artist's Daughter, explores her own journey of identity development and significance from childhood to marriage and motherhood. Connect with her at AlexandraKuykendall.com
Posted by: Dr. Dan L. Boen AT 10:27 am
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Meditation That Eases Anxiety? Brain Scans Show Us How
Rick Nauert PhD
By Rick Nauert PhDSenior News Editor Reviewed by John M. Grohol, Psy.D. on June 5, 2013
Research and technology have advanced to the point where scientists can observe the way in which meditation affects the brain to reduce anxiety.
Using special imaging technology, researchers from Wake Forest Baptist Medical Center report that they have determined the way in which meditation affects or acts upon certain brain mechanisms.
“Although we’ve known that meditation can reduce anxiety, we hadn’t identified the specific brain mechanisms involved in relieving anxiety in healthy individuals,” said Fadel Zeidan, Ph.D., the lead author of the study.
“In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief.”
In the study, published in the journal Social Cognitive and Affective Neuroscience, researchers followed 15 healthy volunteers with normal levels of everyday anxiety. Participants did not have previous meditation experience or diagnosed anxiety disorders.
All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation.
In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.
Both before and after meditation training, the study participants’ brain activity was examined using a special type of imaging — arterial spin labeling magnetic resonance imaging — that is very effective at imaging brain processes, such as meditation.
In addition, anxiety reports were measured before and after brain scanning.
The majority of study participants reported decreases in anxiety. Researchers found that meditation reduced anxiety ratings by as much as 39 percent.
“This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety,” Zeidan said.
Researchers discovered that meditation-related anxiety relief is associated with activation of the areas of the brain involved with executive-level function (the anterior cingulate cortex and ventromedial prefrontal cortex).
During meditation, there was more activity in the ventromedial prefrontal cortex, the area of the brain that controls worrying.
In addition, when activity increased in the anterior cingulate cortex – the area that governs thinking and emotion – anxiety decreased.
“Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings,” Zeidan said.
“Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful.”
While meditation is becoming generally accepted as a method to significantly reduce anxiety in patients with generalized anxiety and depression disorder, the current study (using sophisticated neuroimaging experiment technology) is the first to show the brain mechanisms associated with meditation-related anxiety relief in healthy people.
APA Reference Nauert PhD, R. (2013). Meditation That Eases Anxiety? Brain Scans Show Us How. Psych Central. Retrieved on June 6, 2013, from http://psychcentral.com/news/2013/06/05/meditation-that-eases-anxiety-brain-scans-show-us-how/55617.html
More than one-third of American marriages today get their start online — and those marriages are more satisfying and are less likely to end in divorce, according to a new study.
The research, which was funded by the online-dating site eHarmony, was published in the Proceedings of the National Academy of Sciences.
“Meeting online is no longer an anomaly, and the prospects are good,” says lead author John Cacioppo, a professor of social psychology at the University of Chicago. “That was surprising to me. I didn’t expect that.”
The research involved a Harris Poll of nearly 20,000 Americans who got married between 2005 and 2012. It found that 35% of people met online. But while 8% of those who met off-line got separated or divorced, the percentage for those who met online was just 6%. Although these differences narrowed after controlling for factors that affect divorce rates such as income, education and number of years married, they remained significant, Cacioppo says.
Income, however, was a big factor: According to the study, just 3% of people making less than $15,000 annually met online, while a whopping 41% of those making $100,000 or more met partners online. Since greater income is linked with happier marriages and less divorce, controlling for income reduced the differences seen between those who met online and off.
The study also found increased marital satisfaction among people meeting online, compared with off-line venues like at college or in bars.
Eli Finkel, a professor of social psychology at Northwestern University who has published research critical of the online-dating industry, said in e-mail to several journalists that the research is “impressive” with a “large sample” and “fascinating findings.” However, Finkel thinks that the conclusion that online marriages are better is premature.
“The study is a good one,” he says. “It suggests that one can meet a serious romantic partner online. That’s a big deal. But any conclusions that online meeting is better than off-line meeting overstep the evidence.” Finkel explains that the differences between the two venues overall are not large enough to support this claim.
The study does not suggest that meeting online in and of itself actually improves matchmaking or somehow causes marriages to be better. In fact, both online and off, different types of meeting places were linked with different marital prospects.
Not surprisingly, for example, growing up together or meeting at school, through friends or through a religious group were linked with more satisfying marriages than meeting at a bar or club or on a blind date. Oddly, however, meeting at work was just as bad as finding a spouse at a bar or nightclub.
In terms of online venues, marriages begun in chat rooms or online communities were less satisfying than those initiated via online-dating sites, although dating sites themselves varied in terms of the marital satisfaction reported.
“In chat rooms and off-line, you meet only the people who are around and not large numbers of people,” Cacioppo says as a possible explanation for this finding. “If you do online dating, all of sudden, there’s a world of possibilities.”
Another potential explanation for differences between online and off-line marital success has to do with personality. “If you have good impulse control, you may be more likely to meet your spouse [deliberately] online rather than impulsively at a bar,” he says.
Of dating sites, eHarmony fared particularly well — a finding that may raise suspicion because of the funding source. However, the study could not determine whether or not this has anything to do with how it matches people or anything else specific to the site. Because it advertises itself to those who are seeking a spouse, eHarmony may simply attract more people who are ready to settle down. A marriage-focused website, Cacioppo says, “is not appealing if you are just looking for a hookup.”
Cacioppo notes one additional reason why the online world might be conducive to matchmaking — an explanation that might surprise many online daters who have met people whose bodies didn’t exactly match their pictures. “There is some experimental work going back more than 30 years now, which [shows that] meeting [via computer or text] leads people on average to be a little more honest and self-disclosing,” he says.
“When you are face to face, there is face-saving,” he explains. “When you don’t [see each other], you can be more comfortable being yourself.” Being more open, the same studies found, led people to like each other more — something that could obviously influence romantic connections.
When it comes to playing Cupid, it’s still not clear whether online dating ultimately makes better matches. But given the large number of people who meet their mates this way, the good news is that at least it doesn’t seem to make matters any worse.
Future Criminals Can Be Identified as Early as Age 6
Fran Lowry
Mar 22, 2013
Conduct problems and hurtful and uncaring behavior in children as young as 6 years are accurate predictors of violent and nonviolent criminal convictions in young adulthood, new research shows.
Investigators from the Université de Montréal in Canada found that negative behavior at age 6, such as fighting, disobedience, and a lack of empathy, predicted criminal convictions by age 24.
"Most nonviolent and violent crimes are committed by a small group of males and females who display conduct problems that onset in childhood and remain stable across the lifespan," study author Sheilagh Hodgins, PhD, told Medscape Medical News.
"If their conduct problems could be identified and reduced early in life, this would potentially allow these children to alter their developmental trajectories, live healthy and happy lives, and to make positive rather than negative contributions to our society."
The study is published in the March issue of the Canadian Journal of Psychiatry.
Need for Early Intervention
The aim for the study was to further the understanding of how to prevent crime and thereby reduce the human and economic costs associated with criminal activity, she said.
The researchers examined teacher assessments of conduct problems such as fighting, disobedience, school absenteeism, destruction of property, theft, lying, bullying, blaming others, and a lack of empathy among students at age 6 years.
The 1593 boys and 1423 girls were recruited when they were in kindergarten at French-speaking public schools in the province of Quebec from 1986 to 1987.
The same groups of boys and girls were assessed again at age 10 years. They were also assessed for aggressive behavior at age 12.
The researchers later obtained juvenile and adult criminal records and found that teacher ratings of pupils' behaviors at ages 6 and 10 were associated with criminal convictions between the ages of 12 and 24.
Specifically, they found that boys aged 6 who were rated by their teachers as having the highest degree of conduct behavior problems and hurtful and uncaring behaviors were 4 times more likely to be convicted of violent crimes and 5 times more likely to be convicted of nonviolent crimes than boys with lower ratings.
Similarly, girls aged 6 with high ratings for conduct problems and hurtful and uncaring behaviors were 5 times more likely than girls with lower ratings to have a conviction for nonviolent crimes by age 24.
Boys who had high ratings for uncaring and hurtful behaviors but who did not have conduct behavior problems also had an elevated risk for violent and nonviolent crime convictions, and girls with high ratings for uncaring and hurtful behaviors but no conduct behavior problems had a high risk for nonviolent crime convictions.
Such students, Dr. Hodgins added, require "interventions to reduce these behaviors at an early age, which, in turn, will promote better relations with family, peers, and teachers, better academic performance, and the development of prosocial skills."
Pediatricians may be able to identify children who exhibit these behaviors by observing and talking to the children and their parents, she added.
"When these problems are thought to be present, families could be referred to child psychiatric services or other agencies that provide parent training and other interventions aimed at reducing these problems," she said.
Reservations
Commenting on the study for Medscape Medical News, Michael Brody, MD, a child psychiatrist in private practice in Potomac, Maryland, said he has reservations about the study.
Dr. Brody, who was not involved in the research, said he was concerned about "putting a label on a child as young as 6. If you label the child as likely to become a criminal, it could have problems down the road."
Nevertheless, if labeling a child would result in some guarantee of treatment or intervention, it might be worthwhile, Dr. Brody said.
"Often, it does not. In fact, this is a major problem with all of these studies that call for intervention. In our country, there just are no facilities to deal with these children. Even when the kid does something really terrible, who is going to see the child? All the services are overwhelmed. The resources to deal with these problems are nonexistent. Therefore, I have problems about the practicality of this research," he said.
Finally, Dr. Brody questioned the ability of teachers to accurately predict criminality.
"I think teachers are great. What they do is unbelievable, especially in the younger grades, to sit in the classroom for 6 or 7 hours with the kids, but I just wonder about their ability to accurately evaluate them. [The researchers] based their predictions on observations that the child was bullying or hitting or biting and so forth, but I question the reliability of their observations."
The study was supported by the Groupe de Recherche sur L'Inadaptation Psychosociale and the Centre de Recherche at the Institut Philippe Pinel de Montreal. Dr. Hodgins and Dr. Brody report no relevant financial relationships.
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