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, June 2, 2008)
LONG-TERM CANNABIS USERS MAY HAVE STRUCTURAL BRAIN ABNORMALITIES
EXPOSURE THERAPY MAY HELP PREVENT POST-TRAUMATIC STRESS DISORDER
PRIVATE FOSTER CARE PROGRAM FOR TEENS ASSOCIATED WITH BETTER MENTAL AND PHYSICAL HEALTH IN YOUNG ADULTHOOD
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, June 2, 2008)
LOW VITAMIN D LEVELS APPEAR COMMON IN HEALTHY CHILDREN
STUDY EXAMINES RISK FACTORS FOR DEVELOPMENT OF EATING DISORDERS
DRINKING JUICE NOT ASSOCIATED WITH BEING OVERWEIGHT IN CHILDREN
Please Note: The above Archives news release has an early embargo because of a Congressional briefing on the topic.
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.
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 2, 2008
Media Advisory: To contact Murat Yücel, Ph.D., M.A.P.S., e-mail: murat{at}unimelb.edu.au.
LONG-TERM CANNABIS USERS MAY HAVE STRUCTURAL BRAIN ABNORMALITIES
CHICAGO— Long-term, heavy cannabis use may be associated with structural abnormalities in areas of the brain known as the hippocampus and amygdala, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Conflicting evidence exists regarding the long-term effects of cannabis use, according to background information in the article. “Although growing literature suggests that long-term cannabis use is associated with a wide range of adverse health consequences, many people in the community, as well as cannabis users themselves, believe that cannabis is relatively harmless and should be legally available,” the authors write. “With nearly 15 million Americans using cannabis in a given month, 3.4 million using cannabis daily for 12 months or more and 2.1 million commencing use every year, there is a clear need to conduct robust investigations that elucidate the long-term sequelae of long-term cannabis use.”
Murat Yücel, Ph.D., M.A.P.S., of ORYGEN Research Centre and the Melbourne Neuropsychiatry Centre at the University of Melbourne, Australia, and colleagues from the University of Wollongong performed high-resolution structural magnetic resonance imaging on 15 men (average age 39.8 years) who smoked more than five joints daily for more than 10 years. Their results were then compared with images from 16 individuals (average age 36.4) who were not cannabis users. All participants also took a verbal memory test and were assessed for subthreshold (below the standard of disease diagnosis) symptoms of psychotic disorders, which include schizophrenia and mania.
The hippocampus, thought to regulate emotion and memory, and the amygdala, involved with fear and aggression, tended to be smaller in cannabis users than in controls (volume was reduced by an average of 12 percent in the hippocampus and 7.1 percent in the amygdala). Cannabis use also was associated with sub-threshold symptoms of psychotic disorders. “Although cannabis users performed significantly worse than controls on verbal learning, this did not correlate with regional brain volumes in either group,” the authors write.
“There is ongoing controversy concerning the long-term effects of cannabis on the brain,” the authors write. “These findings challenge the widespread perception of cannabis as having limited or no neuroanatomical sequelae. Although modest use may not lead to significant neurotoxic effects, these results suggest that heavy daily use might indeed be toxic to human brain tissue. Further prospective, longitudinal research is required to determine the degree and mechanisms of long-term cannabis-related harm and the time course of neuronal recovery after abstinence.”
(Arch Gen Psychiatry. 2008;65[6]:694-701. 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.
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, June 2, 2008
Media Advisory: To contact Richard A. Bryant, Ph.D., e-mail: R.Bryant{at}unsw.edu.au.
EXPOSURE THERAPY MAY HELP PREVENT POST-TRAUMATIC STRESS DISORDER
CHICAGO—Exposure-based therapy, in which recent trauma survivors are instructed to relive the troubling event, may be effective in preventing the progression from acute stress disorder to post-traumatic stress disorder, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Individuals who develop acute stress disorder during or soon after a traumatic event are likely to subsequently develop post-traumatic stress disorder (PTSD), according to background information in the article. PTSD is associated with other mental and physical illnesses, a reduced quality of life and increased health care costs. Both exposure therapy and cognitive restructuring, which focuses on changing maladaptive thoughts and responses to a traumatic event, have been used as early interventions to prevent PTSD in those with acute stress disorder. However, there is evidence that some clinicians do not use exposure therapy because it causes distress for recent trauma survivors.
Richard A. Bryant, Ph.D., of the University of New South Wales, Sydney, Australia, and colleagues conducted a randomized controlled trial involving 90 patients who developed acute stress disorder following a non-sexual assault or motor vehicle crash between March 2002 and June 2006. Thirty participants each were randomly assigned to five weekly 90-minute sessions of exposure therapy or cognitive restructuring, while the remaining 30 were put on a waitlist for treatment. All the patients were assessed at the beginning of the study, after six weeks and six months following treatment.
Sixty-three participants completed the study. After completing treatment, fewer patients in the exposure therapy group (10, or 33 percent) met criteria for PTSD than patients in the cognitive restructuring group (19, or 63 percent) or the wait-list group (23, or 77 percent). At the six-month follow-up, fewer patients in the exposure therapy group (11, or 37 percent) met criteria for PTSD than patients in the cognitive restructuring group (19, or 63 percent), and 14 patients (47 percent) in the exposure group vs. four patients (13 percent) in the cognitive restructuring group achieved full remission.
“Despite some concerns that patients may not be able to manage the distress elicited by prolonged exposure, there was no difference in drop-out rates for the prolonged exposure and cognitive restructuring groups (17 percent vs. 23 percent),” the authors write. In addition, distress ratings were more significantly reduced in the exposure therapy group than the cognitive restructuring group after three sessions.
Exposure therapy may be more effective than cognitive restructuring because it eases the anxiety associated with the traumatic memory and corrects the belief that the memory must be avoided, in addition to encouraging self-control by managing the exposure exercise, the authors note. “The current findings suggest that direct activation of trauma memories is particularly useful for prevention of PTSD symptoms in patients with acute stress disorder,” they conclude. “Exposure should be used in early intervention for people who are at high risk for developing PTSD.”
(Arch Gen Psychiatry. 2008;65[6]:659-667. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This research was supported by a grant from the National Health and Medical Research Council Program, Canberra, Australia. 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, June 2, 2008
Media Advisory: To contact Ronald C. Kessler, Ph.D., call David Cameron at 617-432-0442. To contact editorialist Charles B. Nemeroff, M.D., Ph.D., call Kathi Baker at 404-727-9371.
PRIVATE FOSTER CARE PROGRAM FOR TEENS ASSOCIATED WITH BETTER MENTAL AND PHYSICAL HEALTH IN YOUNG ADULTHOOD
CHICAGO—Adults who were placed in a private, enhanced foster care program as teenagers appear to have significantly fewer mental disorders, ulcers and cardiometabolic problems (diabetes, hypertension or heart disease) but more respiratory disorders than those who were placed in public programs, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Child abuse and neglect have long-term negative effects on both physical and mental health, according to background information in the article. “Although the child welfare system routinely places severely abused and/or neglected children in foster care, no controlled studies exist to determine the effectiveness of this intervention in improving the long-term health of maltreated youth,” the authors write.
Ronald C. Kessler, Ph.D., of Harvard Medical School, Boston, and colleagues assessed 479 adults (average age 23.7 to 25.6) who were placed in foster care between 1989 and 1998, when they were age 14 to 18. Of these, 368 were placed in public foster care programs in Oregon or Washington, and 111 were placed in a model private foster care program. The model program, administered by Casey Family Programs, had caseworkers with higher levels of education, lower caseloads, higher salaries and access to a wider range of services for youth than those in public programs. The private program also offers financial assistance with higher education to alumni.
The adult alumni of the private program, when compared with those of the public program, were less likely to have experienced foster parent neglect, physical abuse or sexual abuse. In addition, over the previous year, they:
- Had 44.7 fewer mental disorders and 20.1 fewer physical disorders per 100 individuals
- Were less likely to report major depression (11.3 percent vs. 24.3 percent), anxiety disorders (28.8 percent vs. 43 percent) and substance abuse disorders (5.1 percent vs. 11.1 percent)
- Were less likely to have had ulcers (7.4 percent vs. 13 percent) and cardiometabolic conditions such as diabetes, hypertension or heart disease (14.9 percent vs. 22.6 percent) but more likely to have had respiratory conditions (28.8 percent vs. 17.9 percent)
“The finding of significantly more respiratory disorders among Casey alumni than public program alumni might reflect the fact that some physical disorders become more prevalent in conjunction with otherwise positive outcomes,” the authors write.
The results suggest that similar analyses should be performed on public and private programs nationwide to pinpoint particular core program components that lead to positive effects. “This information could then be used to develop a blended model program for implementation in demonstration sites and subsequent dissemination to public programs throughout the country if state and federal legislatures could be convinced of the importance of this undertaking,” they conclude. “Although these results constitute only a first step in promoting this envisioned dissemination effort, they clearly document the substantial positive effects of model foster care in the domains of mental and physical health that encourage further exploration in other outcome domains.”
(Arch Gen Psychiatry. 2008;65[6]:625-633. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by an unrestricted grant from the Casey Family Programs (an operating foundation) and in-kind support from the states of Oregon and Washington. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
COMMENTARY: FUTURE STUDIES SHOULD EXAMINE INTERACTION OF FOSTER CARE, GENETICS
“Of the various stressors shown to lower an individual’s threshold for development of a syndromal episode of depression or anxiety disorder, including job loss, marital discord and poverty, few are as robust in their impact as child abuse and neglect,” writes Charles B. Nemeroff, M.D., Ph.D., of Emory University School of Medicine, Atlanta, in an accompanying commentary.
The lower rates of mental health problems for Casey program alumni “have important implications for the pathogenesis and treatment of major psychiatric disorders,” he writes.
“It is now clear that the genetic contribution to vulnerability for mood disorders is at least in part mediated by genetic polymorphic variants of certain critical genes,” Dr. Nemeroff concludes. “Future studies should determine the effects of optimal foster care in individuals genetically at risk for these devastating psychiatric disorders.”
(Arch Gen Psychiatry. 2008;65[6]:623-624. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Dr. Nemeroff is supported by grants form the National Institutes of Health. 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, June 2, 2008
Media Advisory: To contact Catherine M. Gordon, M.D., M.Sc., call James Newton at 617-919-3110. To contact editorialist James A. Taylor, M.D., call Mary Guiden at 206-616-3192.
LOW VITAMIN D LEVELS APPEAR COMMON IN HEALTHY CHILDREN
CHICAGO—Many healthy infants and toddlers may have low levels of vitamin D, and about one-third of those appear to have some evidence of reduced bone mineral content on X-rays, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Reports of a resurgence of vitamin D deficiency and rickets, the resulting bone-weakening disease, have emerged in several states, according to background information in the article. Vitamin D deficiency also appears to be high in other countries, including Greece, China, Canada and England.
Catherine M. Gordon, M.D., M.Sc., and colleagues at Children’s Hospital Boston, studied 380 healthy children ages 8 months to 24 months who visited a primary care center for a physical examination between 2005 and 2007. Parents filled out a questionnaire regarding their nutritional intake and that of their children, and also reported on the use of vitamin D and other supplements, time spent outdoors, socioeconomic status and education level.
Among the 365 children for whom blood samples were available, 12.1 percent (44) had vitamin D deficiency, defined as 20 nanograms per milliliter of blood or less, and 40 percent (146) had levels below the accepted optimal level of 30 nanograms per milliliter. Breastfed infants who did not receive vitamin D and toddlers who drank less milk were at higher risk of deficiency (for each cup of milk toddlers drank per day, blood vitamin D level increased by 2.9 nanograms per milliliter).
Forty children of the 44 with vitamin D deficiency underwent X-rays of the wrist and knee. Thirteen (32.5 percent) had evidence of bone mineral loss, and three (7.5 percent) exhibited changes to their bones suggestive of rickets.
“Only one child had signs of rickets on physical examination,” the authors write. “Thus, these infants and toddlers had a sub-clinical deficiency that could make detection of this issue particularly problematic in routine clinical practice, as a child’s vitamin D status is not typically evaluated as part of routine care.”
The data suggest that infants should receive vitamin D supplements while breastfeeding and raise the question of whether some children, including those with established risk factors for vitamin D deficiency, should receive regular measurements of blood vitamin D levels. “Given the potential benefits of vitamin D on bone and other tissues, and growing data supporting its immunomodulatory and antiproliferative effects, the current findings support recommendations advocating for vitamin D supplementation for all young children,” they conclude.
(Arch Pediatr Adolesc Med. 2008;162[6]:505-512. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by grants from the Allen Foundation Inc. and the McCarthy Family Foundation; a grant from the National Center for Research Resources; and a project of the Maternal and Child Health Bureau, U.S. Health Resources and Services Administration. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: ADDITIONAL INFORMATION NEEDED ABOUT RISKS OF LOW VITAMIN D LEVELS
“The results of this study suggest that a vitamin D level is not a good screening test for rickets in asymptomatic children; 92.5 percent of those with hypovitaminosis [low levels of] D, as defined by Gordon et al, had no evidence of rickets on radiograph [X-ray],” writes James A. Taylor, M.D., of the University of Washington, Seattle, in an accompanying editorial.
“Future research is needed to determine whether infants and toddlers with vitamin D levels of 20 nanograms per milliliter or lower are at significant short- or long-term risk for other bone disease or different conditions,” Dr. Taylor writes. “Pending this research, the recommendations by Gordon et al that all young children should receive vitamin D supplementation and that children with risk factors should have periodic vitamin D levels obtained may be premature.”
(Arch Pediatr Adolesc Med. 2008;162[6]:583-584. 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, June 2, 2008
Media Advisory: To contact Alison E. Field, Sc.D., call James Newton at 617-919-3110.
STUDY EXAMINES RISK FACTORS FOR DEVELOPMENT OF EATING DISORDERS
CHICAGO—Risk factors for binge eating and purging may vary between boys and girls and by age group in girls, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Concerns about weight and body shape are common in pre-adolescents and adolescents and are probably related to the development of unhealthy weight control behaviors and binge eating,” according to background information in the article. Although there have been studies of eating disorders, little is known about the development of binge eating and purging (vomiting or using laxatives to control weight) in teens that are not seeking treatment.
Alison E. Field, Sc.D., of the Children’s Hospital Boston and Harvard Medical School, Boston, and colleagues analyzed data from 1996 to 2003 in 6,916 girls and 5,618 boys (age 9 to 15 at the beginning of the study) to examine the association between various risk factors (such as frequent dieting, trying to look like persons in the media, negative weight comments from fathers or peers and having a mother with history of an eating disorder) and the development of frequent binge eating, purging or both.
During 7 years of follow-up, 10.3 percent of the girls and 3 percent of the boys started to binge eat or purge at least once a week. Slightly more girls started to purge (5.3 percent) than binge eat (4.3 percent), while binge eating was more common than purging (2.1 percent vs. 0.8 percent) among boys. Only a small proportion of boys and girls engaged in both binge eating and purging.
Although girls under age 14 whose mothers had a history of an eating disorder were almost three times as likely than their peers to start purging at least once a week, “maternal history of an eating disorder was unrelated to risk of starting to binge eat or purge in older adolescent females,” the authors write. “Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly.”
“Our results suggest that prevention of disordered eating and eating disorders may need to be age- and sex-specific. Efforts aimed at females should contain media literacy and other approaches to make young persons less susceptible to the media images they see,” the authors conclude. “In addition, programs for females should focus more on becoming more resilient to teasing from males, whereas programs for males should focus on approaches to becoming more resilient to negative comments about weight by fathers.”
(Arch Pediatr Adolesc Med. 2008;162[6]:574-579. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: The analysis was supported by research grants from the National Institutes of Health and support from the Kellogg Company and the Boston Obesity Nutrition Research Center. 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, June 2, 2008
Media Advisory: To contact Theresa A. Nicklas, Dr.P.H., call Dipali Pathak at 713-798-4712.
DRINKING JUICE NOT ASSOCIATED WITH BEING OVERWEIGHT IN CHILDREN
CHICAGO—Children who drink 100-percent juice are no more likely to be overweight and may have a better overall nutrient intake than children who do not drink juice, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Increasing numbers of Americans, including children, are overweight or obese, according to background information in the article. Food-consumption patterns may play a role in children’s weight gain. Drinking juice has been associated with overweight and obesity in some studies but not in others.
Theresa A. Nicklas, Dr.P.H., of Baylor College of Medicine, Houston, and colleagues analyzed data from a group of 3,618 children age 2 to 11 who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. During in-home interviews, the children were weighed and measured, and they or their parents reported the types of foods and drinks they consumed.
On average, the children drank 4.1 fluid ounces of juice per day, which contributed an average of 58 calories to their diet. There was no association between drinking juice and being overweight. Children who drank juice had significantly higher intakes of calories, carbohydrates, vitamins C and B6, potassium, riboflavin, magnesium, iron and folate and significantly lower intakes of total fat, saturated fat, discretionary fat and added sugar.
Children who drank juice also ate more whole fruit than those who did not drink juice. “It is not clear why some children drink more fruit juice and what the association is with increased intake of fruit in these individuals,” the authors write. “Taste and availability are two generally recognized factors in increased intake of fruit and vegetables; usual food intake, subjective norms, parenting style and visual benefits of eating fruit and vegetables are others.”
Overall, children drank less juice than the daily maximum amounts recommended by the American Academy of Pediatrics—4 to 6 ounces for children 1 to 6 years old and 8 to 12 ounces for children and teens 7 to 18 years old. Children age 2 to 3 drank the most juice—an average of 6 ounces per day.
“One-hundred–percent juice consumption was associated with better nutrient intake than in the non-consumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age,” the authors conclude.
(Arch Pediatr Adolesc Med. 2008;162[6]:557-565. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported in part by the USDA Hatch Projects, the Juice Products Association and with federal funds from the USDA/Agricultural Research Service. 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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