JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, November 7, 2005)
PSYCHOLOGICALLY DISTRESSED CHILDREN MORE LIKELY TO BE INVOLVED IN BULLYING
PARENTS' SAFE GUN STORAGE BEHAVIORS IMPROVE AFTER COUNSELING
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, November 7, 2005)
MEDICATION SHOWS PROMISE IN THE TREATMENT OF HYPERACTIVITY ASSOCIATED WITH AUTISM-RELATED DISORDERS
ANTISOCIAL BEHAVIOR IN CHILDREN ASSOCIATED WITH GENE VARIANT AND ENVIRONMENTAL RISK FACTORS
ANXIETY DISORDERS INCREASE RISK OF SUICIDAL THOUGHTS AND ATTEMPTS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 7, 2005
Media Advisory: To contact Gwen M. Glew, M.D., call Clare Hagerty at 206-685-1323.
PSYCHOLOGICALLY DISTRESSED CHILDREN MORE LIKELY TO BE INVOLVED IN BULLYING
CHICAGO—Bullying by elementary school children was associated with increased odds of lacking a feeling of safety while at school, having lower academic achievement, and feeling sad most days, according to an article in the November issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
According to background information in the article, "Bullying is defined as any repeated negative activity or aggression intended to harm or bother someone who is perceived by peers as being less physically or psychologically powerful than the aggressor(s)." In a 2000 survey of more than 15,000 U.S. students, researchers found the prevalence of bullying involvement among teens and preteens was approximately 30 percent. Concerns about the role of bullying in school violence, depression, and health concerns have grown over the past decade.
Gwen M. Glew, M.D., of the University of Washington, Seattle, and colleagues surveyed 3,530 third, fourth, and fifth grade students to determine prevalence of bullying and its association with attendance, academic achievement, suspension or expulsion, and self-reported feelings of sadness, safety and belonging. Students were classified as victims, bullies, bully-victims (those who were both victimized and bullied others), bystanders (children who did not bully others and were not bullied by others) and nonresponders.
Twenty-two percent of the children surveyed reported being involved in bullying, either as a victim, bully, or both. Six percent of the children reported being bullied "always," 14 percent said they bullied others, and two percent said they both bullied and were bullied. All three bullying-involved groups-either as a victim, bully or bully-victim-were significantly more likely than bystanders to feel unsafe at school. Among students who reported feeling as though they did not belong at school, their odds of being a victim were 4.1 times higher than those who felt they belonged at school; their odds of being a bully was 3.1 times higher than those saying they belonged. Bullies and victims were more likely than bystanders to feel sad most days. Both bullies and bully-victims were more likely to be male.
"The prevalence of frequent bullying among elementary school children is substantial. Associations between bullying involvement and school problems indicate this is a serious issue for elementary schools," the authors write. "The take-home message is that elementary school-aged children who are psychologically distressed are more likely to be involved in some form of bullying, and children who struggle academically are more likely to be victims and bully-victims."
(Arch Pediatr Adolesc Med. 2005;159:1026-1031. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study was supported by a National Research Scientist Award Fellowship from the National Institute of Mental Health, Bethesda, Md.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 7, 2005
Media Advisory: To contact Paul S. Carbone, M.D., call Darci Slaten at 520-626-7217. To contact editorialist M. Denise Dowd, M.D., M.P.H., call Jennifer Benz at 816-346-1346.
PARENTS' SAFE GUN STORAGE BEHAVIORS IMPROVE AFTER COUNSELING
CHICAGO—Families who received a brief gun-safety counseling intervention from their pediatrician were more likely to improve their gun storage safety practices, according to a study in the November issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
In 2001, 2,937 children and teenagers died as a result of gun-related injuries, according to background information in the article. Although gun ownership has been identified as a risk factor for homicide and suicide in the home, a significant percentage of gun-owning parents store their guns loaded or unlocked, substantially underestimating the risk of injury to their children.
Paul S. Carbone, M.D., of the Children's Primary Care Medical Group, San Diego, and colleagues identified gun-owning families through a questionnaire in a large, predominately Hispanic pediatric clinic in Tucson, Ariz. Gun-owning families were then assigned to either an intervention group who received gun-safety counseling, a gun-safety brochure and a free gun lock, or a control group. Families were resurveyed one month later to determine changes in gun-ownership and gun storage.
Of the 2,649 parents surveyed on visiting the clinic, 206 (7.8 percent) reported that they kept guns in their homes; 151 completed both the baseline and follow-up questionnaire. "At follow-up, families who received the intervention were more likely to have improved overall gun-safety practices compared with the control group (61.6 percent vs. 26.9 percent)," the researchers report. "In those households still with guns at follow-up, 50.9 percent of the intervention group had some type of improvement in safe gun storage compared with 12.3 percent of the control group. More specifically, 25.0 percent in the intervention group improved the frequency of locked storage of guns compared with 4.8 percent of those in the control group. Twenty-six percent of the intervention group improved the use of locked storage compared with 3.1 percent in the control group."
"This study provides reason to be optimistic about the effectiveness of a brief gun-safety counseling session, reinforced with written material and a gun lock giveaway," the authors write. "Overall, those gun-owning families who received the intervention were more than twice as likely to show some type of improvement in their gun-safety practices. More specifically, although our intervention did not appear to significantly influence the removal of guns from the home, it did significantly improve safe gun storage practices."
"This study provides support to the American Academy of Pediatrics recommendations to discuss gun safety with families and encourages further research in this area," the authors conclude.
(Arch Pediatr Adolesc Med. 2005;159:1049-1054. Available pre-embargo to the media at
www.jamamedia.org.)
Editor's Note: This study was funded by a grant from the American Academy of Pediatrics Research in Pediatric Practice Fund, Elk Grove Village, Ill.
EDITORIAL: FIREARM INJURY PREVENTION - REASONS FOR OPTIMISM
In an accompanying editorial, M. Denise Dowd, M.D., M.P.H., from Children's Mercy Hospital, Kansas City, Mo., writes that although "the American Academy of Pediatrics states that the safest way to prevent gun injury among children is to remove guns from the places children live and play," the reality is that "approximately 35 percent of homes with children younger than 18 years have at least one gun, and of these, 43 percent contain at least one unlocked firearm."
"A major strength of the study by Carbone et al is that families were given a tangible means to risk reduction: a gun lock."
"Pragmatic approaches to risk behavior reduction must take into account current behaviors and realize that education alone is probably not sufficient to alter behavior. Emerging research that incorporates principles of motivational interviewing and brief behavioral change counseling is beginning to find its way to pediatric acute and primary care settings. Although large gaps exist in our knowledge of how to translate these principles into action, studies like that by Carbone et al give us reason to be optimistic."
(Arch Pediatr Adolesc Med. 2005;159:1081-1082. Available pre-embargo to the media at www.jamamedia.org.)
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 7, 2005
Media Advisory: To contact corresponding author David J. Posey, M.D., call Gene Ford at 317-962-4576.
MEDICATION SHOWS PROMISE IN THE TREATMENT OF HYPERACTIVITY ASSOCIATED WITH AUTISM-RELATED DISORDERS
CHICAGO—Medication commonly used to treat attention-deficit hyperactivity disorder (ADHD) may be effective for treatment of hyperactivity symptoms in children with autism and related pervasive developmental disorders, according to a study in the November issue of Archives of General Psychiatry, one of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Children with autism and other pervasive developmental disorders often also have symptoms of hyperactivity, distractibility and impulsiveness requiring treatment, according to background information in the article. Some previous small studies on the use of medications to treat hyperactivity in these children have shown promise, although side effects have been common, including irritability and social withdrawal.
David J. Posey, M.D., Indiana University School of Medicine, Indianapolis, and colleagues in the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network conducted this study. The RUPP Autism Network is funded by the National Institute of Mental Health and is dedicated to the development and testing of treatments for children with autism and related conditions. In this study the investigators conducted a randomized, placebo-controlled crossover trial to determine whether methylphenidate (a medication commonly used in the treatment of ADHD) would be effective in reducing hyperactivity and impulsiveness in children with pervasive developmental disorders. The trial included a one-week phase to test whether the participants could tolerate three different dose levels of the medication. This was followed by a four-week (crossover) phase during which the children were given one of three doses of methylphenidate or placebo in random order to assess effectiveness. Children showing a positive response were treated for an additional eight-week period to ensure that gains were stable. Response to treatment was assessed by parents and teachers using standardized ratings of behavior.
Seventy-two children, aged five to 14 years participated in the study. Six participants (eight percent) had intolerable negative side effects with more than one dosage level and withdrew from the study. Sixteen of the remaining children had intolerable negative side effects at the highest dose and were randomized to a modified crossover phase that omitted the highest dose. Seven participants withdrew due to intolerable negative side effects during the crossover phase, three at the highest dose, three at the medium dose and one while receiving the lowest dose. One child withdrew from the study for unspecified reasons, 58 children completed the crossover phase of the study.
Forty-four (76 percent) of the 58 participants responded during at least one of the four treatment conditions, the researchers report. Methylphenidate was consistently more effective in improving inattention, distractibility, hyperactivity and impulsivity than placebo.
"At present, methylphenidate is a reasonable choice to target hyperactivity in the context of PDDs [pervasive developmental disorders], given modest group effects and a response rate that approaches 50 percent," the authors conclude. "However, caregivers should be cautioned about the strong possibility of adverse effects. In addition, practitioners should be prepared to suspend treatment if considerable adverse effects are reported. Further secondary analyses are planned to better delineate individual responses and other moderators of response, including genotype."
(Arch Gen Psychiatry. 2005;62:1266-1274. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study was supported by funds from the National Institute of Mental Health, Bethesda, Md.; by grants from Indiana University, Indianapolis, Johns Hopkins University, Baltimore, The Ohio State University, Columbus, and Yale University, New Haven, Conn.; from the General Clinical Research Centers, National Center for Research Resources, National Institutes of Health, Bethesda, Md., the National Institute of Mental Health, Bethesda, Md., and the Korczak Foundation, Amsterdam, the Netherlands.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 7, 2005
Media Advisory: To contact Anita Thapar, M.D., e-mail thapar{at}cardiff.ac.uk.
ANTISOCIAL BEHAVIOR IN CHILDREN ASSOCIATED WITH GENE VARIANT AND ENVIRONMENTAL RISK FACTORS
CHICAGO—For children with attention deficit hyperactivity disorder (ADHD), possessing a variant of a gene involved in brain signaling may predict antisocial behavior and increase susceptibility to the effects of lower birth weight, according to a study in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Biological processes play a key role in the genesis of antisocial behavior with specific evidence of brain involvement and contribution of genetic and early environmental risk factors, including prenatal factors, according to background information in the article. Given the links between deficits in a brain region called the prefrontal cortical and antisocial behavior and between the enzyme catechol O-methyltranferase (COMT) and prefrontal cortical functioning, the authors suggest that a variant of the COMT gene might be associated with antisocial behavior.
Anita Thapar, M.D., of Cardiff University, Cardiff, Wales, and colleagues looked for the presence of a variant in the COMT gene in 240 British children, aged five to 14 years with ADHD or hyperkinetic disorder who are at high risk for early-onset antisocial behavior. The researchers used the children's birth weight as a marker for prenatal risk to determine the contribution of the environment to risk of developing symptoms of early-onset antisocial behavior.
The researchers found a significant association between the COMT variant and antisocial behavior; and between low birth weight and antisocial behavior. There was also a significant gene and environment (low birth weight) interaction associated with antisocial behavior.
"Early-onset antisocial behavior in a high-risk clinical group is predicted by a specific COMT gene variant previously linked with prefrontal cortical function and birth weight, and those possessing the val/val genotype are more susceptible to the adverse effects of prenatal risk as indexed by lower birth weight," the authors conclude.
(Arch Gen Psychiatry. 2005;62:1275-1278. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: Project and staff costs were funded by the Department of Health NHS National R&D Programme on Forensic Mental Health, England, and the Wellcome Trust, London.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 7, 2005
Media Advisory: To contact Jitender Sareen, M.D., F.R.C.P.C., call Chris Rutowski at 204-474-9514.
ANXIETY DISORDERS INCREASE RISK OF SUICIDAL THOUGHTS AND ATTEMPTS
CHICAGO—A pre-existing anxiety disorder significantly increases the risk of a subsequent onset of suicidal thoughts and suicide attempts, according to a study in the November issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Suicidal thoughts and suicide attempts are strong risk factors for completed suicides, according to background information in the article. Mood disorders such as depression, substance abuse disorders and schizophrenia are well established risk factors for suicidal thoughts and suicide attempts but, the authors suggest, because anxiety disorders often co-exist with these mental disorders, the impact of anxiety disorders on risk for suicidal thoughts and suicide attempts has been difficult to assess.
Jitender Sareen, M.D., F.R.C.P.C., of the University of Manitoba, Winnipeg, and colleagues analyzed data from interviews of a random sampling of people from the Netherlands to determine whether anxiety disorders are risk factors for subsequent suicidal thoughts or attempts. In two follow up assessments, one year and three years following the baseline interview, the researchers examined whether anxiety disorders at baseline were associated with incidence of suicidal thoughts or suicide attempts.
At the first (one-year) and second (three-year) follow-up periods, there were 41 and 44 new cases of suicidal ideation, respectively (total of 85 new cases at either assessment), and 24 and 15 news cases of suicide attempts, respectively, (total of 39 new cases). After adjusting for other mental disorders and other social factors, the researchers found that presence of anxiety disorder more than doubled the risk of suicidal thoughts or attempts for the 7,076 participants in the baseline interview. For the 4,796 people who participated in all three interviews, the presence of anxiety disorders at baseline more than doubled the risk of subsequent suicidal thoughts and more than tripled the risk of subsequent suicide attempts. "Further analysis demonstrated that the presence of any anxiety disorder in combination with a mood disorder was associated with a higher likelihood of suicide attempts in comparison with a mood disorder alone," the authors report.
"This is the first study to demonstrate that a pre-existing anxiety disorder is an independent risk factor for subsequent onset of suicidal ideation [thoughts] and attempts," the authors conclude. "Moreover, the data clearly demonstrate that co-morbid anxiety disorders amplify the risk of suicide attempts in persons with mood disorders. Clinicians and policymakers need to be aware of these findings, and further research is required to delineate whether treatment of anxiety disorders reduces the risk of subsequent suicidal behavior."
(Arch Gen Psychiatry. 2005;62:1249-1257. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: The Netherlands Ministry of Health, Welfare, and Sports (the Hague) provided financial support to conduct the survey. Preparation of this article was supported by a grants from the Institute of Neurosciences, Mental Health and Addiction, Canadian Institutes of Health Research, Ottawa; the Canadian Institutes of Health Research; and the Manitoba Health Research Council, Winnipeg.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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