To gather their results, researchers went to the eastern Democratic Republic of Congo, a region routinely called “the worst place in the world” to be a woman, said Darlene A. Kertes, the study’s lead author and an assistant professor in UF’s department of psychology. Women in this unstable region are routinely the target of rape and other war-related traumas.

“Our research shows that stressful life experiences affect our bodies all the way down to our genes,” said Kertes, who also is affiliated with the University of Florida Genetics Institute.

The study was published in the January/February issue of Child Development, the flagship journal for the Society for Research in Child Development. The results showed that mothers’ stressful life experiences were linked with epigenetic markers in key genes that regulate the body’s response to stress, in both mothers and newborns.

“The study is one of the first of its kind to be conducted in a developing country,” Kertes said. “Most information to date about effects of stress and trauma on prenatal development has been gathered in a Western context.”

Samples of umbilical cord blood, placenta and the mothers’ blood were collected at birth and tested for impacts of war trauma and chronic stress. The researchers looked at DNA methylation, an epigenetic process that makes genes more or less able to respond to biochemical signals in the body.

During pregnancy, a mother’s bodily responses to stress are passed onto the fetus, affecting a child’s brain development, birth weight and functioning of the children’s own HPA axis even after they are born.

The researchers looked at the babies’ birth weight as an indicator of children’s overall development. They found that stress-linked DNA methylation differences predicted lower birth weight.

“The stress exposure affected the maternal and fetal tissues differently, which shows that the impact of stress differs depending on an individual’s life phase,” Kertes said, adding that stress experienced at very young ages affects the way the body responds to stress throughout life.

This is the first time researchers have documented stress effects, either pre- or postnatal, on methylation of a gene called CRH in humans. CRH makes a hormone that triggers the body’s stress response. The study also confirmed stress effects on several other genes known to be involved in the stress response.

Kertes and her colleagues have started to examine the longer term effects of stress on child development in conflict-ridden regions. She emphasized that traumatic events can also have cross-generational impacts.

“War and conflict do not just impact the health and well-being for people who experience it directly,” she said. “It can potentially have long-term consequences for future generations.”

This article first appeared on ‘Eurek Alert’ on 2 February 2016.

During Mental Health Week last week, Health Minister Cameron Dick unveiled the Queensland Mental Health Promotion, Prevention and Early Intervention Plan 2015-17, which aims to improve the mental health and wellbeing of Queenslanders by taking early action.

Mr Dick also announced more than $450,000 in funding to improve mental health through greater social inclusion and community participation, particularly in regional areas.

In Parliament yesterday Ms Howard highlighted the government’s commitment to youth mental health, in light of the LNP’s closure of the Barrett Adolescent Centre, which is currently the subject of a commission of inquiry headed by the Hon. Margaret A Wilson QC.

“The Palaszczuk Government values the mental health of our youth and has committed $11.8 million over four years to rebuild mental health care for young people in Queensland after the last three years of neglect,” she said.

Ms Howard also emphasised the importance of working together as a society that values mental health.

“Mental health is an issue that touches all of our lives at some point, either personally or through the experiences of friends and family,” Ms Howard said.

“Most of us can manage these issues and get on with our lives, but others need help.

“Whether as a government, a community or individually, we must do everything we can to assist them.”

Meanwhile the Opposition today sought a bipartisan approach to mental health support services by harmonising two bills currently before Parliament.

Shadow Minister for Health Mark McArdle said it was crucial politics was left at the door when dealing with such an important issue as mental health.

“Currently there are two bills before Parliament, one introduced by the LNP in April and the other introduced by Labor in September,” Mr McArdle said.

“Both bills aim to improve and maintain the health and wellbeing of persons with a mental illness and ensure Queenslanders are supported through evidence based clinical practice.

“In the Minister’s speech introducing the government bill into the house he said, the ‘bills have many reform directions in common’.

“Given the Minister’s comments, it makes sense to present one single Mental Health bill supported by all sides of politics.

“The LNP has written to the Minister for Health and the Chair of the Parliamentary Health and Ambulance Services Committee Leanne Linard calling for one, unified bill on Mental Health.

“In the letter we have requested an extension of the reporting time to allow for this process to occur.

“We are also open to work with the government on any differences within the bills, proposing for any issue to be set aside and worked through individually to form a set of consensus clauses.”

Mr McArdle said one bill, being supported by all sides of politics sends a clear message that mental health is a clinical area where a great deal of bipartisanship exists.

“By working together we can deliver a bill that improves the lives of the nearly 20% of Queenslanders affected by a mental disorder each year,” he said.

The West Moreton Mental Health Collaborative held a number of free community events around the Ipswich region during Mental Health Week last week, including a morning walk, a community showcase at The Park Centre for Mental Health, an information night and a free breakfast in Queens Park and held a silent art auction at the Ipswich Community Art Gallery. Aftercare also hosted an early childhood mental health forum.

This article first appeared on ‘Queensland Times’ on 14 October 2015.

Last year in the Northern Territory, 86% of those in prison and 96% of those in juvenile detention were Indigenous. In Western Australia, Indigenous people account for only 3% of the population, but 40% of prisoners.

It is unacceptable to ignore the intellectual capacity of a person facing the court and it’s vital to ensure that youth put behind bars have been properly assessed before sentencing. This is particularly important for Australians affected by fetal alcohol spectrum disorders (FASD). These occur throughout society and in high levels in some Indigenous communities.

The capacity to screen for prenatal alcohol exposure – as well as to diagnose FASD – must urgently be increased. This echoes recent calls by Perth Children’s Court magistrate Catherine Crawford for clinicians to assess children and youth before sentencing, so the court understands their cognitive limitations.

Cognitive limitations

Fetal alcohol spectrum disorders are a group of preventable conditions resulting from exposure to alcohol in the womb. Alcohol readily crosses the mother’s placenta, entering the circulation of the developing fetus with devastating effects.

Significantly, it can disrupt brain development and that of other organs, causing lifelong problems. These include developmental delay, intellectual and memory impairment, as well as a range of behavioural, emotional and mental health disorders.

People with FASD can suffer from attention-deficit hyperactivity disorders (ADHD), communication disorders, poor impulse control, disobedience and hostility issues, and learning difficulties.

They often struggle to distinguish right from wrong and fail to learn from mistakes. Few with FASD will live and work independently. Many have mental health and substance misuse problems.

It is no surprise that many also come in contact with the law. An adolescent living with a FASD in Canada or the United States, for instance, is estimated to have a 19 times higher risk of incarceration than someone without a FASD.

Despite this, the condition remains poorly recognised and few obtain a diagnosis prior to offending. Offenders with FASD are often poor witnesses and fail to understand why they have been detained. Unable to negotiate the justice system, they are adversely influenced by others and often enter a cycle of re-offending.

FASD and the justice system

Rosie Fulton, a 21-year-old Aboriginal woman with FASD and significant intellectual impairment, was arrested last year after stealing and crashing a car. Declared unfit to stand trial, Rosie was sent to Western Australia’s Kalgoorlie Prison for lack of alternative accommodation.

She stayed in jail for 21 months with no trial or conviction. Only after her story broke, mounting pressure on the health ministers of Western Australia and the Northern Territory led to Rosie being transferred to supervised community accommodation close to her family in Alice Springs.

In Australia, we don’t know how many people deemed “unfit to plead” are in prison and how many have cognitive impairment, as we lack recent data regarding rates of FASD in prisons. US studies suggest up to 60% of young people with FASD will at some time enter the juvenile justice system.

Another study, conducted in a forensic mental health facility in Canada, showed 23% of resident youth had one type of FASD. This figure may be higher in vulnerable Australian populations, particularly in some remote regions where alcohol use in pregnancy is prevalent.

The economic impact of incarcerating people with FASD is huge. In Canada, the direct cost to the correctional system between 2011 and 2012 was CAD$17.5 million for youth and CAD$356.2 million for adults.

Screening for FASD

Diagnosing FASD is a challenge because as children get older, a firm history of prenatal alcohol exposure may be elusive. With age, the characteristic facial features (small eye openings, a thin upper lip and flat philtrum, the area between the upper lip and base of the nose) of fetal alcohol syndrome – a subset of FASD – diminish, and growth deficits correct.

Thorough assessment by a physician, a psychologist and, if necessary, allied health professionals, can identify impairments required for a FASD diagnosis, whether fetal alcohol syndrome or a neuro-developmental disorder associated with prenatal alcohol exposure. Such impairments can be in IQ, communication, memory, motor and executive function, and other areas.

In Canada, youth probation officers are using a tool for screening young offenders for FASD, and identifying the need for referral and assessment.

Another tool for health professionals with accompanying guidelines for assessing and diagnosing people with FASD is being developed in Australia. This will standardise the diagnostic approach.

Tools such as these are necessary to increase screening and diagnostic capacity in the justice and health systems. If a diagnosis is known, the associated behavioural and cognitive deficits can be taken into account when considering the reliability of evidence given by an offender, the supervision required in detention, and the sentence.

Appropriate care

There has been a call for better legal support for people with vulnerabilities in their journey through the criminal justice system. Consideration should be given to the defence of diminished responsibility in conditions such as FASD.

And alternative models of care need to be found to avoid imprisonment of those unable to plead. As identified in the case of Rosie Fulton, this poses a significant challenge, particularly in remote Australia where alternative accommodation is not readily available and would be costly to establish.

But prison is far more costly. In Canada, the justice system accounts for 40% of the total costs of FASD (including health and education). And Australia’s Senate inquiry on justice reinvestment heard that the estimated cost of detaining a juvenile offender in New South Wales in 2010–11 was much higher ($A652 per day) than the cost of supervision in the community ($A16.73 per day).

To end the cycle of re-offending, we urgently need evidence-based strategies to ensure offenders with FASD are recognised early and receive the care they deserve.

This article first appeared on ‘The Conversation’ on 13 October 2015.

Bipolar disorder is a mental illness that causes severe mood swings. The symptoms are often difficult to spot among children and teens because others mistake it for the normal ups and downs that every kid goes through. It is estimated that about 3.4 million American kids and teens experience the early onset of bipolar disorder, according to the American Academy of Child and Adolescent Psychiatry.

Current treatments for bipolar disorder include lithium and psychotherapy. However, lithium medication is often prescribed to adults only as mood stabilizers. While there are many studies on lithium use in adults, only a few tested its effectiveness and safety on children.

The participants were given a standard dose for the first four weeks before gradually increasing it to a maximum dose for the remaining weeks. The researchers assessed the participants’ moods using the standard tools used for bipolar disorder. They also listed the side effects of the drug on the participants.

The analysis showed that those who took lithium showed a significant improvement compared to those who were under the placebo. Almost half of them scored either “very much improved” or “much improved” compared to only 21 percent of those who were under the placebo. Some of the side effects include weight gain and reduced kidney and thyroid function, the authors wrote in a press release.

“Until this study, there was no data to support the use of lithium in the treatment of youth with bipolar disorder,” said Dr. Victor Fornari, director of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., to HealthDay News. “This study provides evidence to support the efficacy and benefit of lithium in the treatment of children with bipolar disorder in a manic state.”

The researchers plan to continue their study to determine whether lithium can be used on children long term.

This article first appeared on ‘HNGN’ on 12 October 2015.

“My baby boy was crying all the time and we weren’t getting much sleep – that’s when things started to go a bit downhill,” Ms Palmbas said.

“I couldn’t sleep even though I was so tired, and I was worrying all the time about every little detail about him; I was stressing over everything.

“It got to the point where I couldn’t cope and I remember ringing up my husband one day at work and said, ‘You have to come home from work’.

“I couldn’t do it anymore. I was crying all the time, I was beside myself and I didn’t want to be alone with the baby. It was horrible.”

Ms Palmbas became incapacitated, unable to live her everyday life and complete simple tasks. Her mind was swarming with negative and terrifying thoughts.

“I was having these horrible thoughts that I was going to hurt my child and that scared the life out of me – I thought I had turned into a monster who wanted to hurt this child she’s longed for,” she said.

“I didn’t know who I was and I didn’t know what was going on. I had these strange thoughts and thought they must be real. I honestly thought I was going crazy.

“I felt terrified all the time and I was in a constant state of panic. It was intense and debilitating.”

When Ms Palmbas attended a mothers’ group, everyone seemed to be coping and having it all together, which made her feel isolated in her experience.

“When it’s not spoken about, you just think that it’s just you,” she said.

“It makes it even harder when you think you’re really alone and no one understands you or is going through anything similar.”

Running away crossed Ms Palmbas’ mind many times.

“I thought I’d just pack my baby up and take him to one of my family members and just drive off, and everyone would live all the better for not having me around,” she said.

“I was just a wreck and absorbed in my thoughts in this deep dark hole. I couldn’t see any way out.”

This article first appeared on ‘ABC’ on 8 October 2015.

The national survey of 5500 children aged 9 to 13 highlighted the significant gap in wellbeing between mainstream kids and those who have a disability, are Indigenous, are young carers or from poor backgrounds.

Thirty per cent of children fall into one or more of these marginalised groups, and they rate their health worse, are less happy at school and have lower levels of family cohesion than their peers. Children with a disability are the worst off overall.

“There is a lot of diversity in wellbeing among young Australian children,” Flinders University associate professor Gerry Redmond, who led the study, said. “We need to focus on why some children are doing a lot less well than others.”

The gap between marginalised and mainstream kids is particularly pronounced by the time they reach year 8.

The Government-funded Australian Child Wellbeing Project surveyed children in years 4, 6 and 8 from 180 schools. Students were asked about their family, living arrangements, school, health, friendship, material wellbeing and bullying. It is the first national survey of children in the middle years, and the findings will be presented at the Australian Social Policy Conference on Monday.

Overall, most children report high life satisfaction and are optimistic about their future. More than 90 per cent of children are in good health. Children nominated family as the most important factor for having a good life, followed by health and friends. Those with a big support network were healthier, more engaged with school and less likely to be bullied.

However, some children are struggling more than their peers. One in five kids report being bullied once a week, with year 4 students experiencing the highest levels of bullying. Bullying included being ignored, being teased, having lies told about them, and people ganging up on them.

Children from marginalised groups were more likely to be bullied, and those with a disability the most bullied of all. The more often children are bullied, the more likely they are to miss school.

“I get the impression, talking to teachers, that this kind of non-physical bullying, like exclusion and telling tales, is extremely difficult to counter,” Professor Redmond said.

Sixty per cent of all children who were bullied reported two or more health issues, including frequent headaches, stomach aches, dizziness, feeling nervous, or having difficulty going to sleep. These complaints are often symptoms of stress.

A quarter of young people have a family member who has a disability, chronic illness, mental illness or drug or alcohol addiction. These young people experience significantly more health complaints than their peers.

“These health problems may be associated with worries about their family, and their direct caring responsibilities,” Professor Redmond said. “They’re worrying about these things that are normally seen as adult issues.”

Mainstream kids score an average life satisfaction of 85/100, while marginalised children score between 64 and 70. Similarly, mainstream children have a health score of 90/100, compared to marginalised kids, who score between 72 and 81.

Professor Redmond said his study provided the hard evidence policy-makers and schools need to act to better help these kids. “Young people in these groups are marginalised, but they actually comprise a large proportion of all young people,” he said.

“This should give policy-makers extra impetus to reduce the disadvantage they experience, and improve their lives.”

This article first appeared on ‘Brisbane Times’ on 25 September 2015.

Children of anxious parents are at an increased risk of developing anxiety, but that doesn’t have to be the case, according to new research by University of Connecticut Health psychiatrist Dr. Golda Ginsburg.

The study, published in The American Journal of Psychiatry, found family-based intervention works. Only nine percent of children who participated in a therapist-directed family intervention developed anxiety after one year, compared to 21 percent in a group that received written instruction, and 31 percent in the group that did not receive any therapy or written instruction.

“The finding underscores the vulnerability of offspring of anxious parents,” Ginsburg said. “If we can identify kids at risk, let’s try and prevent this.”

Anxiety tends to run in families, with up to 50 percent of children of anxious parents growing up to be anxious themselves, she noted.

“Anxiety and fear are protective and adaptive,” Ginsburg said. “But in anxious kids they may not be, because these children have thoughts about danger and threat when there really isn’t one.”

Both inborn temperament and life experiences play a role, she said. The more negative experiences a person has growing up, the greater the likelihood he or she will struggle with anxiety as an adult.

Most of the adults who participated in the study struggled in school and didn’t tell anyone. They didn’t raise their hands, or they got sick before exams. They might not have had any friends. As adults, their anxiety limits their activities and sometimes those of their family members.

During the study, some of the families participated in eight, hour-long sessions with a trained therapist over a period of two months. Others were just given a pamphlet that contained general information about anxiety disorders and treatments. Still others received nothing at all.

The families who participated in therapy were taught to identify the signs of anxiety and how to reduce it. They practiced problem-solving skills, and exercised safe exposures to whatever made their child anxious.

One of the ways to reduce anxiety is a reality check, according to Ginsburg, such as learning to recognize when a fear is healthy and worth paying attention to, like a growling dog, or unhealthy, like  a suspicion that the birthday cake is poisoned.

“We taught the kids how to identify scary thoughts, and how to change them,” Ginsburg said.

For example, if a child is afraid of cats and encounters one in the street, she can first identify the scary thought: “That cat is going to hurt me.” Then she can test that thought: “Is it likely that the cat will hurt me? No, the cat doesn’t look angry. It isn’t baring its teeth or hissing, it’s just sitting there. OK, I can walk past that cat and it won’t do anything.”

The researchers found that, in general, children who participated in the intervention had lower anxiety overall than children who did not participate in the intervention with their families.

The researchers now have received funding from the National Institutes of Health for a follow-up to see whether the effects are maintained over time.

Ginsburg said she wonders whether there would be value in providing regular mental health checkups for families. She added she is considering approaching insurers about offering this to families at risk, to see if it lowers their healthcare costs overall.

“I’d say we need to change our model of mental health to a checkup method — like going to the dentist every six months,” she said.

This article first appeared on ‘Psych Central’ on 28 September 2015.

The university announced Wednesday the arrival of child psychiatrist and researcher Paul Arnold, who specializes in childhood mental illness and childhood obsessive-compulsive disorder (OCD).

As the new director of the Mathison Centre for Mental Health Research & Education, Dr. Arnold’s work will focus on the genetics and neurobiology of childhood OCD and related neuropsychiatric disorders.

His research has the potential to predict risk factors and target treatment for mental illness. He is also establishing the first lab in Alberta to focus on the genetic origins of childhood mental disorders

Studies have indicated that up to 60 per cent of disorders can be attributed to genetic factors, while the remaining 40 per cent are due to a child’s environment or lifestyle, Arnold said.

And while it’s still unclear whether childhood mental illness is on the rise, or just the awareness of it, Arnold says it’s important parents be aware of its prevalence, treatment options and developing better coping strategies for children living in an increasingly stressful world.

“Young children can’t often explain why it is they’re feeling a certain way, or exhibiting certain behaviours,” Arnold said.

“But parents need to know that these conditions are treatable, even at a very young age, and coping strategies can be created in a supportive environment.”

Anxiety can often be identified in children who are exhibiting more fear and stress about certain situations than their peer group, he said. For instance, while it’s completely normal for a young child to feel anxious during the first few days, even weeks, of school, it may not be normal to still feel stressed into October and November.

Stress in children can also be exhibited in obsessive-compulsive disorders. Repetitive habits and obsessions like constant hand-washing or phobias over germs can be seen in young kids in the same way they’re seen in youths and adults.

But OCD may be exhibited differently in younger kids, Arnold added, like repeating a certain task during play or seeking out unreasonable perfection at school, like when drawing a picture, printing a letter or building a block tower.

“Parents need to know that if their child’s anxiety is getting in the way of their everyday life, they can get treatment,” Arnold said.

“There are a number of cognitive behavioural therapies where we can treat these disorders. We may take the child into a stress situation, but we would help them through that with support.”

Arnold will be available to help treat patients at the Alberta Children’s Hospital, with a specialty in the assessment and treatment of children with OCD.

His research program is supported by the seven-year, provincially-funded Alberta Innovates’ Health Solutions Translational Health Chair in Child and Youth Mental Health.

Ed McCauley, vice-president of research at the U of C, said Arnold’s excellence in the field of childhood psychiatric disorders will fortify the strengths of the school’s existing brain and mental health research team.

The Mathison Centre is focused on understanding the causes of mental illness, brain mechanisms, risk factors and treatments of mental disorders, with special emphasis on youth populations.

Researchers from Queen’s University discovered evidence of emotional load-sharing between partners in a close relationship. In the study, Ph.D. candidate Jessica Lougheed, found that a strong relationship with a loved one can help ease stress when placed in difficult situations.

In the study, Lougheed and co-authors measured the stress levels of 66 adolescent girls during a spontaneous speech task. Before the speech performance, the participants and their mothers rated the quality of their relationship.

During the speeches, researchers tracked the participants’ level of stress via galvanic skin response (measuring the level of skin perspiration). To account for the effect of physical rather than purely emotional closeness, the participants’ mothers were instructed either to hold or not hold their daughters’ hand.

The researchers found that physical closeness allowed the participants to manage their stress more efficiently, regardless of how close the mother-daughter pair reported being.

However, when physical contact was removed from the equation, only the participants who reported higher relationship quality showed signs of load-sharing.

“Our results suggest that we are better equipped to overcome challenging situations when we are closer — either physically or in terms of how we feel in our relationships — to people we trust,” said Lougheed.

“We were somewhat surprised to find that mothers’ stress did not vary by physical closeness,” Lougheed said. “After all, it can be stressful for parents to watch their children perform, but being able to offer physical comfort might have lessened the mothers’ stress.

“Thus, emotional load-sharing in this context was not a function of the mothers’ stress level, and we expect that it occurred instead through the daughters’ perceptions of how stressful it was to give a speech. That is, higher physical and/or relationship closeness helped the daughters feel like they could overcome the challenging situation.”

The findings are important as they suggest physical contact can overcome some difficulties associated with relatively low relationship quality, or that being in a high-quality relationship is helpful for managing emotions in the same way as the physical comfort of a loved one.

Researchers warn, however, that the study was a very specific instance with unique characteristics.

Specifically, Lougheed said the general level of relationship quality was relatively high in their sample, and that physical contact may function very differently in distressed families.

She also cautioned against generalizing these results to other partnerships — such as a relationship between romantic partners, platonic friends, and other family members — and suggest that more research be done to determine the effect of socioeconomic status and gender, among other factors.

The study appears in the journal Emotion.

This article first appeared on ‘Psych Central’ on 15 September 2015.