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 of 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 GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, November 6, 2006)
STRESS, CHILDHOOD TRAUMA LINKED TO CHRONIC FATIGUE SYNDROME IN ADULTS
CHILDREN WITH HIGHER INTELLIGENCE APPEAR TO HAVE REDUCED RISK OF EXPOSURE TO TRAUMATIC EVENTS AND POST-TRAUMATIC STRESS DISORDER
STEROID USERS MAY BE MORE LIKELY TO COMMIT CRIMES INVOLVING WEAPONS, FRAUD
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, November 6, 2006)
MOST U.S. ADULTS IN FAVOR OF MORE BALANCED APPROACH TO SEX EDUCATION IN SCHOOLS
INFANTS WITH IRON DEFICIENCY HAVE LOWER COGNITIVE TEST SCORES IN YOUNG ADULTHOOD, ESPECIALLY THOSE IN LOWER SOCIOECONOMIC LEVELS
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ON-LINE. Go to www.jamamedia.org for more information and to apply for access.
Please Note: The FOR THE MEDIA website now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org
Save the Date: JAMA will present new research from its theme issue on men's health at a media briefing on Tuesday, November 14, at the Millennium Broadway Hotel in New York. Program and registration information will be provided in a future email.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, November 6, 2006
Media Advisory: To contact Christine Heim, Ph.D., call Kathi Baker at 404-727-9371. To contact corresponding author Nancy L. Pedersen, Ph.D., e-mail: nancy.pederson{at}ki.se.
STRESS, CHILDHOOD TRAUMA LINKED TO CHRONIC FATIGUE SYNDROME IN ADULTS
CHICAGO—Traumatic events in childhood and stress or emotional instability at any period in life may be associated with the development of chronic fatigue syndrome (CFS), according to two articles in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals. The findings suggest that CFS and similar illnesses may result from the brain’s inability to cope with challenging experiences.
CFS affects between 400,000 and 900,000 U.S. adults, according to background information in the article. The condition is defined as unexplained fatigue that lasts for at least six months, does not get better with rest and interferes with daily activities. For a formal diagnosis of CFS, fatigue must be accompanied by at least four of eight additional symptoms, including extreme fatigue after exertion, difficulties with memory and concentration, unrefreshing sleep, headaches, muscle pain, joint pain, sore throat and tender lymph nodes. “Despite the substantial public burden of CFS, the causes and pathophysiology [underlying changes] of CFS remain unknown, and effective prevention is elusive,” the authors of the first article write.
Christine Heim, Ph.D., Centers for Disease Control and Prevention and Emory University, Atlanta, and colleagues compared 43 individuals with CFS to 60 controls without CFS who were all part of a large study of Wichita, Kansas, residents. All participants (average age 50.5) underwent a medical examination and provided their medical history, and were interviewed to detect psychiatric disorders. They then responded to a questionnaire that assessed for five types of childhood trauma: emotional, physical and sexual abuse and emotional and physical neglect. Responses to each item were numbered and added to produce a score for each type of trauma and one overall trauma score.
Individuals with CFS had higher overall trauma scores than those without CFS. Exposure to trauma increased the risk of CFS between three and eight times, depending on the type; emotional neglect and sexual abuse during childhood were most strongly associated with CFS. For each additional type of childhood trauma experienced, the risk of having CRS increased by 77 percent; the risk increased by 6 percent for each additional point increase in total trauma score. Not all patients with CFS had experienced childhood trauma, but those who had tended to have worse symptoms than those who had not.
CFS patients were also more likely than controls to have psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. These conditions appeared to be associated with childhood trauma. “In sum, it appears that CFS is part of a spectrum of disorders that are associated with childhood adversity,” the authors write. “In adulthood, these disorders frequently manifest or worsen in relation to an acute stress or challenge. High emotional reactivity is a risk factor for all of these disorders. Thus, enhanced stress and mood reactivity can be assumed to be a central feature common to this spectrum of disorders.
“In fact, these disorders might reflect the brain’s inability to adapt or compensate in response to challenge, leading toward maladaptive responses and ultimately disease,” they conclude.
In the second study, Kenji Kato, Ph.D., Karolinska Institutet, Stockholm, Sweden, and colleagues assessed 19,192 Swedish twins born between 1935 and 1958, 1,570 of whom had chronic fatigue. Of those, 1,120 were impaired by their fatigue and 447 had the necessary four additional symptoms of CFS; these two groups were categorized as having CFS for the purposes of the study. Between 1972 and 1973, all participants answered questions about their personalities—which researchers assessed in terms of emotional stability and extraversion—and one question about stress: “Do you experience your daily existence as being very ‘stress filled’?” Three analyses were performed: One that matched each of the 1,567 individuals with CFS to individuals of the same age and sex without CFS; one that compared those with CFS to their twins without CFS, regardless of whether twins were identical or fraternal; and one that compared only identical twins with CFS to their co-twins without CFS.
In the first two analyses, emotional instability—defined as “an individual’s tendency to experience psychological distress that can be reliably measured by self-report and is relatively stable in an individual over time”—and stress were associated with CFS, while extraversion was not. In the age- and sex-matched comparison, individuals who reported that their life was stressful were 64 to 65 percent more likely to develop CFS; in the analysis comparing twins, the risk increased to 500 percent. “This suggests that some genes may serve as a buffering effect whereas other sensitive individuals are more susceptible to the impact of stress,” the authors write.
When only identical twins were assessed, emotional instability was not linked to risk for CFS, indicating that similar genetic factors underlie both conditions. “In contrast to stress, the association between emotional instability and fatigue is more likely to be endogenous,” or without an external cause, the authors continue. “Because we found considerable influences attributable to genetic and early environmental factors, our results suggest biological mechanisms that mediate the relationship between emotional instability and chronic fatigue. Likely candidates are those genes related to neurotransmission that have been implicated in depression and emotional instability.”
“These findings suggest plausible mechanisms for chronic fatiguing illness,” they conclude.
(Arch Gen Psychiatry. 2006;63:1258-1266 and 1267-1272. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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 6, 2006
Media Advisory: To contact Naomi Breslau, Ph.D., call Tom Oswald at 517-432-0920.
CHILDREN WITH HIGHER INTELLIGENCE APPEAR TO HAVE REDUCED RISK OF EXPOSURE TO TRAUMATIC EVENTS AND POST-TRAUMATIC STRESS DISORDER
CHICAGO—Children who are more intelligent at age 6 may be less likely to experience trauma by age 17 and if they do, may be less likely to develop post-traumatic stress disorder (PTSD), according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In contrast, children who have anxiety disorders and conduct problems at age 6 appear more likely to develop PTSD following exposure to traumatic events.
PTSD is a psychological condition that occurs following exposure to a traumatic event, such as warfare, crime, a natural disaster or a life-threatening illness. Symptoms include sleep problems, depression, flashbacks and anxiety. However, not every individual exposed to such an event will develop PTSD, according to background information in the article. Researchers currently believe that certain factors—such as gender, race and socioeconomic background—predispose individuals to experiencing trauma and also increase their risk of developing PTSD following exposure to trauma. These factors may be more important than the type or severity of the trauma experienced in determining who will develop PTSD.
Naomi Breslau, Ph.D., and colleagues at Michigan State University, East Lansing, studied 713 children (336 boys and 377 girls) born between 1983 and 1985 at two Michigan hospitals, one located in a disadvantaged urban community and one in a middle-class suburban community. At age 6, the children were given intelligence tests. Their teachers rated their behavior at school, and parents reported any symptoms of anxiety disorders, which include phobias (irrational fears), separation anxiety and generalized anxiety disorder. At age 17, the participants completed an interview designed to measure the number and type of traumatic events they had experienced in their lives and also how deeply those events affected them, including whether they had ever experienced symptoms of PTSD.
By age 17, 541 (75.9 percent) of the participants had experienced a traumatic event and 45 (6.3 percent, 8.3 percent of those experiencing trauma) met criteria for PTSD. Those who had an IQ of greater than 115 at age 6 were less likely to be exposed to any type of trauma, especially violent assaults, and were less likely to develop PTSD by age 17 when they did experience a traumatic event. Those whose teachers reported that they had more conduct problems than normal at age 6 had a higher risk of being exposed to violent crime, such as rape, mugging or beating, by age 17. Those children, and also those with anxiety disorders at age 6, were about twice as likely as those who did not have conduct problems or anxiety disorders to develop PTSD by age 17 if they were exposed to a traumatic event.
Sociodemographic factors also influenced the children’s risk for exposure to traumatic events and for PTSD. “We observed in these data the sex-related pattern reported in previous studies, with males more likely to be exposed to trauma, and females more likely to experience PTSD following exposure,” the authors write. “As in previous studies, the cumulative incidence of exposure to traumatic events was higher in inner-city (urban) youth than in suburban youth.”
Individuals with high IQ were less prone to PTSD even if they had other factors, such as anxiety disorders and an urban background, stacked against them. “The ways in which high IQ might protect from the PTSD effects of traumatic exposure are unclear,” the authors conclude. “The findings underscore the importance of investigating cognitive processes in a person’s responses to challenging and potentially traumatic experiences and the involvement of general intelligence in shaping them.”
(Arch Gen Psychiatry. 2006;63:1238-1245. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institutes of Health, Bethesda, Md. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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 6, 2006
Media Advisory: To contact Fia Klötz, M.D., e-mail: fia.klotz{at}surgsci.uu.se.
STEROID USERS MAY BE MORE LIKELY TO COMMIT CRIMES INVOLVING WEAPONS, FRAUD
CHICAGO—The use of anabolic androgenic steroids may be associated with an antisocial lifestyle involving several types of crime, including weapons offenses and fraud, but did not appear to be associated with violent crimes or crimes against property, according to an article in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Non-prescription steroid use has been linked to a number of psychiatric conditions and changes in behavior, according to background information in the article. “Case reports or survey studies of groups using anabolic androgenic steroids (e.g., bodybuilders) have described hypomania or manic episodes, depression or suicide, psychotic episodes and increased aggressiveness and hostility,” the authors write. “This aggressiveness appears to occasionally trigger violent behavior, sometimes even including homicide.”
Fia Klötz, M.D., Uppsala University, Sweden, and colleagues studied the associations between criminality and steroid use in 1,440 Swedish residents tested for the drugs between 1995 and 2001. Individuals were referred for such testing from inpatient and outpatient clinics, including substance abuse facilities, as well as police and customs stations. Of those screened, 241 (average age 20.5) tested positive and 1,199 (average age 20) tested negative and served as controls. Identifying information gathered at the drug-testing laboratory was used to collect criminal records of all the subjects. Offenses for which participants were convicted were divided into five categories: violent crime, including homicide, assault and robbery; weapons offenses; property crimes, including theft and receiving stolen goods; fraud; and sexual offenses.
Those who tested positive for steroid use were about twice as likely to have been convicted of a weapons offense and one and a half times as likely to have been convicted of fraud. There was no difference in the rate of violent crimes, sexual offenses or crimes against property between those who tested positive for steroids and those who tested negative.
When individuals referred to testing from substance abuse centers were excluded, the association between steroid use and weapons offenses remained significant. “One possible explanation for this finding might be that criminals involved in heavy types of crime, such as armed robbery or collection of crime-related debts, derive an advantage from being muscular and/or having a heavy build,” the researchers write. “The well-documented increase in aggressiveness associated with anabolic androgenic steroid use might also be advantageous in carrying out premeditated crimes against people.” Also in this analysis, the association between steroid use and fraud disappeared, and the risk for crimes against property became lower among those testing positive for steroids than among those testing negative.
Although steroids are primarily associated with violent outbursts of anger and impulsive behavior, these results suggest that they may also be linked to crimes involving preparation and advance planning, the authors conclude. However, additional research is required to assess the motives behind and effects of steroid use by criminals.
(Arch Psyc. 2006;63:1274-1279. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Swedish National Drug Policy Coordinator. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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 6, 2006
Media Advisory: To contact Amy Bleakley, Ph.D., M.P.H, call Susan Q. Stranahan at 215-746-3197. To contact editorialist Douglas Kirby, Ph.D., call 831-438-4060.
MOST U.S. ADULTS IN FAVOR OF MORE BALANCED APPROACH TO SEX EDUCATION IN SCHOOLS
CHICAGO—The majority of U.S. adults, regardless of political affiliation, support a more balanced approach to sex education in schools, including teaching children about both abstinence and other methods of preventing pregnancy and sexually transmitted diseases, according to the results of a national survey published in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Young adults age 15 to 24 account for one-fourth of all sexually active individuals, according to background information in the article. However, they acquire about half of the new sexually transmitted disease (STD) infections—a total of 9 million infections, at a cost of $6.5 billion annually. One-fourth of youth have had sex by age 15, 37.5 by age 16 and 46.9 percent by age 17. “These data underscore the relevance of timely and informative sex education in middle and high schools as an important component to the public health goal of promoting safe behaviors and preventing additional infections and unintended pregnancies,” the authors write.
Amy Bleakley, Ph.D., M.P.H., and colleagues at the Annenberg Public Policy Center, Annenberg School for Communication, University of Pennsylvania, Philadelphia, analyzed data from 1,096 adults (average age 46.8, 46 percent men) who participated in the Annenberg National Health Communication Survey between July 2005 and January 2006. Respondents were asked about their support of three different types of sex education: abstinence-only, comprehensive and comprehensive that includes condom instruction. Participants also provided their political ideology on a seven-point scale from “extremely liberal” to “extremely conservative” as well as information about how often they attended religious services. Among the participants, 78.7 percent were white, 9.6 percent were black and 7.6 percent were Hispanic; 39.5 percent identified themselves as politically moderate, 35.5 percent as conservative and 25 percent as liberal.
Overall, 80.4 percent of participants said they believed comprehensive programs were an effective way to prevent unplanned pregnancies, compared with 39 percent who said they believed abstinence-only programs were effective. Eighty-two percent of participants said they supported comprehensive sex education programs and 10 percent opposed them; 68.5 percent supported and 21 percent opposed condom instruction; and 36 percent supported and 50 percent opposed abstinence-only programs. The researchers further broke down results by political affiliation and religious behavior and found the following:
- 91.6 percent of liberals, 86.4 percent of moderates and 70 percent of conservatives supported comprehensive (also known as abstinence plus) programs, while 19 percent of conservatives, 5.3 percent of moderates and 3.7 percent of liberals opposed them
- 47 percent of conservatives supported abstinence-only education, while 67 percent of liberals, 50.4 percent of moderates and 39.9 percent of conservatives opposed it
- 37.5 percent of conservatives, 13.4 percent of moderates and 9.1 percent of liberals opposed condom instruction, while 51.2 percent of conservatives supported it; among all respondents, 57 percent disagreed that condom instruction encourages teens to have sex
- 87.4 percent of those who never attend religious services support comprehensive programs
- Among those who attend religious services more than once per week, 60.3 percent supported abstinence-only and 60.3 percent supported abstinence plus programs; 52.6 percent opposed and 37.9 percent supported condom instruction
- 31.3 percent of those who attend religious services more than once per week and 57.9 percent of those who never attend services oppose abstinence-only education
“The federal government’s support of abstinence-only education is in contrast to the broad public and scientific support for comprehensive sex education demonstrated by our research review and study results. This discrepancy in the realm of sex education highlights a gap between science and policy. Sex education in schools is clearly a politically charged issue, but public opinion in this instance offers an opportunity to diffuse some of the inherent tension between science and policymaking,” the authors conclude. “With such high support for comprehensive sex education among the public from liberals, conservatives and moderates alike, political leaders could capitalize on this rare occasion to enact public policy that is supported by both sound scientific evidence as well as public opinion.”
(Arch Pediatr Adolesc Med. 2006;160:1151-1156. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: CURRENT EVIDENCE SUPPORTS COMPREHENSIVE SEX EDUCATION
Abstinence-only sex education programs have received a large amount of federal funding in recent years, despite the lack of research supporting their effectiveness, writes Douglas Kirby, Ph.D., ETR Associates, Scotts Valley, Calif., in an accompanying editorial.
“To the extent that unproven abstinence-only programs have displaced effective comprehensive programs, the abstinence-only funding may have had much less effect on the behavior of youth than its supporters have hoped,” Dr. Kirby writes. “In fact, it is even possible that by making the funds so restrictive, they had the opposite effect intended.”
That does not mean that abstinence-only programs could not be effective, he continues. Such programs deserve further study, and all forms of sex education that succeed in delaying sex and increasing condom and other contraceptive use among young people should be considered for funding.
(Arch Pediatr Adolesc Med. 2006;160:1182-1184. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
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 6, 2006
Media Advisory: To contact Betsy Lozoff, M.D., call Krista Hopson at 734-764-2220.
INFANTS WITH IRON DEFICIENCY HAVE LOWER COGNITIVE TEST SCORES IN YOUNG ADULTHOOD, ESPECIALLY THOSE IN LOWER SOCIOECONOMIC LEVELS
CHICAGO—Costa Rican teens who were iron-deficient as infants continue to lag behind their peers in cognitive test scores, with a wider gap for children at lower socioeconomic levels, according to study results published in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Several previous studies have shown that children with low levels of iron in their blood do worse than those without an iron deficiency on tests that measure cognitive skills, such as thinking, learning and memory, according to background information in the article. About one-fifth to one-fourth of children around the world have iron deficiency anemia, in which a lack of iron causes problems with hemoglobin—the compound that red blood cells use to transport oxygen through the bloodstream. Many more have low iron without anemia. Children from poor, minority or immigrant backgrounds are more likely to be iron-deficient.
Betsy Lozoff, M.D., University of Michigan, Ann Arbor, and colleagues studied the long-term effects of iron deficiency and socioeconomic status in a group of 185 children from an urban area in Costa Rica. The children, who were an average of 17 months old when the study began in 1983 to 1985, were screened for iron deficiency at their first visit. They were given cognitive tests (on which the index, or overall average score, is 100) then and again at ages 5, 11 to 14, 15 to 18 and 19 years. Those who had low iron levels in infancy even after three months of iron therapy were compared with those who had normal iron levels either without or after treatment.
Of the 185 children, 87 were from middle-class families and 98 were from families with low socioeconomic status. Sixty-two percent of those with chronic iron deficiency and 49 percent of those with good iron status were from families with low socioeconomic status. In middle-class families, initial scores on cognitive tests were eight points apart, 101.2 for those with iron deficiency and 109.3 for those with sufficient iron levels; the gap remained at eight or nine points through 19 years. For those in lower classes, initial scores were also eight points apart: 93.1 for iron-deficient infants and 102.8 for those with normal iron levels. By the time these individuals were 19 years old, the gap in cognitive scores between iron-deficient and non–iron deficient teens had widened to 25 points (70.4 vs. 95.3). “Such a difference is likely to be functionally significant regarding educational attainment and career choices in adulthood,” the authors write.
“The observed pattern appears to make sense in terms of the cumulative and transactional nature of cognitive development,” they continue. “Acquisition of new skills is intimately linked to mastery of skills at an earlier developmental level. If direct and indirect effects of early iron deficiency on the brain disrupted or delayed basic developmental processes, there could be a snowball effect. In an economically stressed family environment, there might not be the resources or capacity to help children compensate.”
The results highlight the need to identify children at risk for iron deficiency and prevent or treat the condition in infancy, the authors conclude.
(Arch Pediatr Adolesc Med. 2006;160:1108-1113. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: All phases of the study were supported by grants from the U.S. National Institute of Child Health and Human Development. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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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