SPORT TEAM-CENTERED PROGRAM APPEARS EFFECTIVE IN REDUCING DISORDERED EATING AMONG FEMALE HIGH SCHOOL ATHLETES

CHICAGO—A peer-led, sport team-centered program reduces eating disordered behavior and body-shaping drug use in female high school athletes, according to an article in the November issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to the article, about half of male and female high school students participate in school sports. For young women, pressures to be thin may be compounded by influences of their sport, resulting in more disordered eating behaviors, drug use (tobacco, diet pills, diuretics, laxatives, amphetamines, and anabolic steroids). Athletic teams provide a natural setting for programs to educate about eating disorders and drug use, the article states. The ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives) program is a school-based, team-centered program that focuses on promoting healthy nutrition and effective exercise training as alternatives to harmful behavior in young women.

Diane L. Elliot, M.D., of Oregon Health & Science University, Portland, and colleagues evaluated the ATHENA program's efficacy at 18 high schools among 928 female students (average age, 15.4 years). Schools were randomly assigned to implement the eight-week ATHENA program curriculum (45 minutes per week) incorporated into a team's usual practice activities, or to engage in any of the usual programs for eating disorder prevention offered by the particular school (usual care). Athletes were surveyed on dieting, nutrition, and exercise habits before and after the study. Topics in the ATHENA program were gender specific, were led by the athletes participating, and included information on healthy sport nutrition, effective exercise training, drug use, media images of women and depression prevention.

The researchers found that athletes participating in the ATHENA program reported significantly less ongoing and new use of diet pills, and less use of amphetamines, anabolic steroids, and sport supplements. These athletes also reported more seatbelt use and less new sexual activity. The ATHENA athletes also had positive changes in healthy eating behaviors, and reductions in intent to use diet pills in the future, vomiting to lose weight and tobacco use.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 1, 2004
To contact Erik J. Giltay, M.D., Ph.D., e-mail: giltay{at}dds.nl

OPTIMISM ASSOCIATED WITH LOWERED RISK OF DYING FROM HEART DISEASE

CHICAGO—Patients who described themselves as highly optimistic had lower risks of all-cause death, and lower rates of cardiovascular death than those with high levels of pessimism, according to an article in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, major depression is a known risk factor for cardiovascular death. However, the relationship between optimism and death has not received as much attention.

Erik J. Giltay, M.D., Ph.D., of Psychiatric Center GGZ Delfland, Delft, the Netherlands, and colleagues analyzed data from the Arnhem Elderly Study to test whether participants who are optimistic live longer than patients who are pessimistic.

Participants were aged 65 to 85 years (999 men and women) and completed a 30-item questionnaire on health, self-respect, morale, optimism and relationships. Of the participants, 941 (466 men, 475 women) had complete information on questions regarding optimism, and these patients were divided into four groups based on their level of optimism.

Over the follow up period of 9.1 years (1991 to 2001), there were 397 deaths. Compared to participants who reported a high level of pessimism, participants reporting high levels of optimism had a 55 percent lower risk of death from all causes, and a 23 percent lower risk of cardiovascular death. The researchers also found an inverse relationship between level of optimism and risk of death, with a stronger protective effect of optimism in men than women for all-cause mortality, but not cardiovascular mortality.

"In conclusion, we found that the trait of optimism was an important long-term determinant of all-cause and cardiovascular mortality in elderly subjects independent of sociodemographic characteristics and cardiovascular risk factors," the authors write. "A predisposition toward optimism seemed to provide a survival benefit in elderly subjects with relatively short life expectancies otherwise."

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 1, 2004
To contact Wendy J. Lynch, Ph.D., call Jacqueline Weaver at 203/432-8555.

GAMBLING AMONG ADOLESCENTS AND YOUNG ADULTS ASSOCIATED WITH PSYCHIATRIC PROBLEMS AND SUBSTANCE USE DISORDERS

CHICAGO—Adolescents and young adults who gamble are more likely than nongamblers to have substance use disorders and psychiatric problems, according to an article in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, approximately 68 percent of the U.S. adult population gambled legally in the past year. Although most adults gamble responsibly, about 9 million are classified as problem gamblers and another 3 million as pathological gamblers. Adult pathological gambling is associated with substance use problems, depression, psychiatric treatment, poor health, arrest and incarceration, the article states. Fifty percent to 90 percent of youths aged 12 to 17 years old reported gambling within the past year even though gambling is largely illegal among adolescents. The same problems associated with adult gambling are found in adolescents who gamble heavily, including substance use and depression.

Wendy J. Lynch, Ph.D., of Yale University School of Medicine, New Haven, Conn., and colleagues investigated psychosocial factors associated with gambling in adolescents (aged 16 to 17 years) and young adults (aged 18 to 29 years) who gambled before age 18 (early-onset) or after age 18 (adult-onset).

The researchers used data from adolescent past-year gamblers (who gambled in the past 12 months, n=235), early-onset adult past-year gamblers (n=151), and adult-onset past year gamblers (n=204). They also looked at data from adolescent (n=299) and adult (n=187) nongamblers.

The researchers found: "Adolescent gamblers were more likely than adolescent nongamblers to report alcohol and drug use and abuse/dependence and depression. Elevated rates of alcohol and drug use and abuse/dependence were observed in early-onset adult gamblers vs. adult nongamblers, and only elevated rates of alcohol use were observed in adult-onset gamblers vs. adult nongamblers."

They also found that adolescent gamblers were more likely to report gambling for social reasons rather than to win money, and were less likely to have large wins or losses. Adolescent gamblers were also less likely than early-onset adult gamblers to gamble weekly or daily.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 1, 2004
To contact Bridget F. Grant, Ph.D., Ph.D., call Ann Bradley at 301/443-3860.

MAJORITY OF CIGARETTES IN THE U.S. SMOKED BY NICOTINE-DEPENDENT OR PSYCHIATRICALLY ILL PERSONS

CHICAGO—Psychiatrically ill and nicotine-dependent individuals consume approximately 70 percent of all cigarettes smoked in the United States, according to an article in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Smoking is the leading cause of preventable death in the United States and the single most important avoidable cause of disease and premature death worldwide, according to background information in the article. Among psychiatric outpatients and inpatients, studies have found elevated smoking rates, and a recent national survey discovered higher smoking rates in persons with psychiatric disorders than those without.

Bridget F. Grant, Ph.D., Ph.D., from the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Md., and colleagues used data from interviews with 43,093 adults living both in and out of group homes to examine nicotine and other drug use in conjunction with psychiatric disorders. The interviews were part of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Study participants were assessed for nicotine dependence, alcohol and drug use disorders, mood disorders (e.g. depression, mania), anxiety disorders (e.g. social phobia, generalized anxiety), and personality disorders (e.g. obsessive-compulsive) in face-to-face interviews.

The researchers found that among the total sample, 28.4 percent were current users of any tobacco product, 24.9 percent were current cigarette smokers, and 12.8 percent (n = 4,962) were nicotine dependent. Those who were nicotine-dependent consumed 57.5 percent of all cigarettes smoked in the United States. Among respondents with nicotine dependence, the prevalence of any alcohol use disorder was 22.8 percent, while 21.1 percent had a mood disorder, 22 percent had an anxiety disorder, and 31.7 percent had a personality disorder. Prevalence of drug use disorder among nicotine-dependent persons was 8.2 percent.

Nicotine dependence was most prevalent among persons with an alcohol or drug use disorder (34.5 percent and 52.4 percent, respectively). Among individuals with a mood, anxiety, or personality disorder, nicotine dependence was identified in 29.2 percent, 25.3 percent, and 27.3 percent, respectively.