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 PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, January 5, 2009)
TEENS FREQUENTLY MENTION RISKY BEHAVIORS ON SOCIAL NETWORKING SITES
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, January 5, 2009)
CHILDHOOD TRAUMA ASSOCIATED WITH CHRONIC FATIGUE SYNDROME
BRAIN CIRCUIT ABNORMALITIES MAY UNDERLIE BULIMIA NERVOSA IN WOMEN
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 5, 2009
Media Advisory: To contact Megan A. Moreno, M.D., M.S.Ed., M.P.H., call Teri Thomas at 206-987-5213 or e-mail teri.thomas{at}seattlechildrens.org. To contact editorial author Kimberly J. Mitchell, Ph.D., call Lori Wright at 603-862-0574 or e-mail lori.wright{at}unh.edu.
TEENS FREQUENTLY MENTION RISKY BEHAVIORS ON SOCIAL NETWORKING SITES
Single warning e-mail from a physician may decrease references to sex
CHICAGO—About half of teens reference sex, substance use or other risky behaviors on their publicly available online profiles, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. However, a second article reports that a brief e-mail from a physician shows promise in reducing mentions of sex on social networking Web sites.
More than 90 percent of adolescents have Internet access and about half use social networking sites, according to background information in the articles. "MySpace, the most popular social networking site, regularly ranks among the world's 10 most popular Web sites and includes more than 200 million Web profile accounts, of which 25 percent belong to minors," the authors write. "Members of a social networking site create a personal Web profile that may contain images, text and audio. The social networking sites play an important role in adolescents' social lives as a place for identity exploration and peer group interaction."
Despite these potential benefits, risks may be associated with the display of information related to sex, substance use, violence and other health risk behaviors in a public venue. For instance, displaying such information may attract unwanted attention from sexual predators or jeopardize future employment prospects. To determine the prevalence of risky references, Megan A. Moreno, M.D., M.S.Ed., M.P.H., then of the University of Washington and Seattle Children's Hospital Research Institute, Seattle, and now of the University of Wisconsin–Madison, and colleagues analyzed the content of 500 publicly available profiles between July and September 2007. All of the profile owners reported being 18 years old and living in the United States.
A total of 270 (54 percent) of the profiles contained references to risky behaviors, including 120 (24 percent) that mentioned sexual behaviors, 205 (41 percent) referencing substance use, 37 percent mentioning alcohol use and 72 (14.4 percent) referring to violence. Women were less likely than men to display references to violence; reporting a sexual orientation other than "straight" was associated with more references to sexual behavior. Teens whose profiles mentioned church or religious involvement, or indicated active participation in a sport or hobby, were less likely to display any type of risky information.
The findings suggest social networking sites may provide a new way to detect teens at risk for engaging in unhealthy behaviors, the authors note. "Given the popularity of social networking sites among teens and the high prevalence of risk behaviors displayed there, social networking sites can be explored as an innovative venue to identify, screen and ultimately intervene with adolescents who display risk behavior information," they write.
In a second report, Dr. Moreno and colleagues assessed a potential online intervention by creating a MySpace profile with the user name "Dr. Meg," containing information about professional credentials and research interests. They then identified 190 MySpace profiles of 18- to 20-year-olds that contained three or more references to sexual behaviors or substance use, including at least one reference each to alcohol and tobacco use. Half of the profile owners were randomly selected to receive a single e-mail from the Dr. Meg profile, warning them that their profile contained risky information. The e-mail also provided clinical resources, including a link to a Web site with information about sexually transmitted diseases.
Before the e-mail was sent, 54.2 percent of the profiles referred to sex and 85.3 percent mentioned substance use. Three months after the e-mail intervention, 42.1 percent of the profile owners who received an e-mail and 29.5 percent of those who did not made protective changes to their profile. Specifically, references to sex decreased to zero on 13.7 percent of profiles in the group that received the e-mail and 5.3 percent in those that did not, and references to substance use disappeared on 26 percent of the intervention profiles vs. 22 percent of the controls. A total of 10.5 percent of intervention profiles and 7.4 percent of control profiles were set to "private" at the three-month follow-up.
"Our study illustrates that developing online interventions to reduce online risk behaviors is feasible, low-intensity and low-cost," the authors conclude. "Our findings suggest that some teenagers may be open to feedback regarding their Web profiles and subsequently alter online behaviors. Given the hazards associated with displaying risk behavior information, parents and health care providers should recognize the importance of social networking sites in adolescents' social lives, discuss social networking site disclosures with both younger and older adolescents and provide Internet safety resources."
(Arch Pediatr Adoles Med. 2009;163[1]:27-34, 35-41. 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.
EDITORIAL: HEALTH PROFESSIONALS MUST SEEK TO BALANCE BENEFITS, RISKS OF SITES
"As with any new media technology, there are potential benefits and drawbacks to social networking sites," write Kimberly J. Mitchell, Ph.D., and Michele Ybarra, M.P.H., Ph.D., of the Crimes Against Children Research Center, University of New Hampshire, Durham, in an accompanying editorial.
The sites "provide educational benefits to youth; they foster learning and the development of critical thinking skills that complement those taught in classrooms," they continue. "They also provide psychosocial benefits that facilitate identity development, enhance cognitive skills related to perspective taking, allow autonomy and serve as a form of social support, which may prove critical to youth who feel isolated, lonely or ostracized for any number of reasons."
"On the other hand, content on social networking site profiles may increase one's likelihood of being harassed or targeted with unwanted sexual solicitation; it may negatively affect one's future professional opportunities; and its images may portray risky health behaviors as normative. It is our job as professionals to understand these risks and benefits and to identify strategies that help youth reduce the former and increase the latter."
(Arch Pediatr Adoles Med. 2009;163[1]:87-89. 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, January 5, 2009
Media Advisory: To contact Christine Heim, Ph.D., call Kathi Baker at 404-727-9371 or e-mail kobaker{at}emory.edu.
CHILDHOOD TRAUMA ASSOCIATED WITH CHRONIC FATIGUE SYNDROME
CHICAGO—Individuals who experience trauma during childhood appear more likely to develop chronic fatigue syndrome as adults, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In addition, neuroendocrine dysfunction—or abnormalities in the interaction between the nervous system and endocrine system—appears to be associated with childhood trauma in those with chronic fatigue syndrome, suggesting a biological pathway by which early experiences influence adult vulnerability to illness.
Chronic fatigue syndrome affects as many as 2.5 percent of U.S. adults, according to background information in the article. Little is known about the causes and development of the condition. Risk factors include female sex, genetic predisposition, certain personality traits and physical and emotional stress. "Stress in interaction with other risk factors likely triggers chronic fatigue syndrome symptoms through its effects on central nervous, neuroendocrine and immune systems, resulting in functional changes that lead to fatigue and associated symptoms such as sleep disruption, cognitive impairment and pain," the authors write. "However, obviously not every individual exposed to a stressor goes on to develop chronic fatigue syndrome, and it is therefore of critical importance to understand sources of individual differences in vulnerability to the pathogenic effects of stress."
Christine Heim, Ph.D., of Emory University School of Medicine, Atlanta, and colleagues studied 113 patients with chronic fatigue syndrome and 124 healthy individuals who served as controls. Participants—who were drawn from a general sample of 19,381 adults residents of Georgia—reported whether they had experienced childhood trauma, including sexual, physical and emotional abuse or emotional and physical neglect. They also underwent screening for depression, anxiety and post-traumatic stress disorder and were tested for levels of the hormone cortisol in their saliva. Low levels may indicate decreased function of the body's main neuroendocrine stress response system, the authors note.
Individuals with chronic fatigue syndrome reported higher levels of childhood trauma—exposure to trauma was associated with a six-fold increase in the risk of having the condition. Sexual abuse, emotional abuse and emotional neglect were most closely associated with chronic fatigue syndrome. Patients with the syndrome also were more likely than controls to have depression, anxiety and post-traumatic stress disorder.
Cortisol levels were decreased in patients with chronic fatigue syndrome who experienced childhood trauma, but not in those with chronic fatigue syndrome who had not been subjected to trauma. Therefore, stress early in life may cause a biological susceptibility to chronic fatigue syndrome, the authors note.
"Our results confirm childhood trauma as an important risk factor of chronic fatigue syndrome," they write. "In addition, neuroendocrine dysfunction, a hallmark feature of chronic fatigue syndrome, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of chronic fatigue syndrome."
(Arch Gen Psychiatry. 2009;66[1]:72-80. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Centers for Disease Control and Prevention . 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, January 5, 2009
Media Advisory: To contact Rachel Marsh, Ph.D., call Dacia Morris at 212-543-5421 or e-mail morrisd{at}pi.cpmc.columbia.edu.
BRAIN CIRCUIT ABNORMALITIES MAY UNDERLIE BULIMIA NERVOSA IN WOMEN
CHICAGO—Women with bulimia nervosa appear to respond more impulsively during psychological testing than those without eating disorders, and brain scans show differences in areas responsible for regulating behavior, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Bulimia nervosa often begins in the adolescent or young adult years, according to background information in the article. "Primarily affecting girls and women, it is characterized by recurrent episodes of binge eating followed by self-induced vomiting or another compensatory behavior to avoid weight gain," the authors write. "These episodes of binge eating are associated with a severe sense of loss of control."
Certain pathways between nerve cells known as frontostriatal circuits help individuals control their own voluntary behaviors, the authors note. These functions are tested during the performance of the Simon Spatial Incompatibility task, in which participants must indicate the direction an arrow is pointing regardless of where it appears on a screen. The task is easier when the arrow direction matches the side of the screen, but more difficult when, for instance, an arrow that points leftward appears on the right side of the screen. Ignoring the side of the screen to focus on the arrow direction requires regulating behavior by fighting the tendency to respond automatically and resolving conflicting messages.
Rachel Marsh, Ph.D., and colleagues at Columbia University and the New York State Psychiatric Institute, New York, compared the performance on the task of 20 women with bulimia nervosa with that of 20 healthy women who served as controls. Participants performed the task while undergoing functional magnetic resonance imaging (fMRI).
"Patients with bulimia nervosa exhibited greater impulsivity than did control participants, responding faster and making more errors on conflict trials [where the arrow direction and location did not match] that required self-regulatory control to respond correctly," the authors write. "They responded faster on congruent trials following incorrect conflict trials, suggesting impulsive responding even immediately after having committed an error." When patients with bulimia did respond correctly on trials in which the arrow side and direction did not match, their frontostriatal circuits did not activate to the same degree as did those of women in the control group.
"These group differences in performance and patterns of brain activity suggest that individuals with bulimia nervosa do not activate frontostriatal circuits appropriately, perhaps contributing to impulsive responses to conflict stimuli that normally require both frontostriatal activation and the exercise of self-regulatory control to generate a correct response," the authors conclude. "We speculate that this inability to engage frontostriatal systems also contributes to their inability to regulate binge-type eating and other impulsive behaviors."
To expand on this hypothesis, future studies should also include impulsive individuals who have healthy weights and eating behaviors, adolescents close to the time that bulimia nervosa develops and patients with varying severity of symptoms, they note.
(Arch Gen Psychiatry. 2009;66[1]:51-63. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported in part by grants from the National Institute of Mental Health, by a grant from the National Alliance for Research on Schizophrenia and Depression and by funding from the Sackler Institute for Developmental Psychobiology, Columbia University. 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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