Frequent school moves can increase the risk of psychotic symptoms in early adolescence

Researchers at Warwick Medical School have shown that frequently changing schools during childhood can increase the risk of psychotic symptoms in later years.The study, published in American Academy of Child and Adolescent Psychiatry, found that school mobility during childhood heightens the risk of developing psychotic-like symptoms in early adolescence by up to 60%.Suffering from psychotic-like symptoms at young age is strongly associated with mental health problems in adulthood, including psychotic disorders and suicide.Professor Swaran Singh, who led the study, explained, “Changing schools can be very stressful for students. Our study found that the process of moving schools may itself increase the risk of psychotic symptoms — independent of other factors. But additionally, being involved in bullying, sometimes as a consequence of repeated school moves, may exacerbate risk for the individual.”At the age of 12, participants in the study were interviewed to assess for the presence of psychotic-like symptoms including hallucinations, delusions and thought interference in the previous six months. Those that had moved school three or more times were found to be 60% more likely to display at least one definite psychotic symptom.The authors suggested that moving schools often may lead to feelings of low self-esteem and a sense of social defeat. This feeling of being excluded from the majority could also render physiological consequences leading to sensitisation of the mesolimbic dopamine system, heightening the risk of psychotic-like symptoms in vulnerable individuals.Dr Cath Winsper, Senior Research Fellow at Warwick Medical School and part of the study group said, “It’s clear that we need to keep school mobility in mind when clinically assessing young people with psychotic disorders. It should be explored as a matter of course as the impact can be both serious and potentially long lasting. Schools should develop strategies to help these students to establish themselves in their new environment.”Story Source:The above story is based on materials provided by University of Warwick. Note: Materials may be edited for content and length.

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Change in guidelines for type 2 diabetes screening tests may lead to under-diagnosis in children

New American Diabetes Association (ADA) screening guidelines may lead to the missed diagnoses of type 2 diabetes in children, according to a new study by University of Michigan.The research, published in the Journal of Adolescent Health, finds that both pediatric and family medicine providers who care for children are using screening tests for type 2 diabetes that may result in missed diagnoses for children, says lead author Joyce Lee, M.D., M.P.H., associate professor in U-M’s Departments of Pediatrics and Communicable Diseases and Environmental Health Sciences.In 2010, the ADA recommended that physicians use Hemoglobin A1c screening tests, rather than glucose tests for identifying children and adults with pre-diabetes and diabetes. However, this change has been controversial, because of lower test performance of HbA1c in children compared with adults.The study found that when presented with the ADA screening guidelines, 84% of physicians reported that they would switch from using glucose tests to using HbA1c tests.”This potential for increased uptake of HbA1c could lead to missed cases prediabetes and diabetes in children, and increased costs,” says Lee.”A number of studies have shown that HbA1c has lower test performance in pediatric compared with adult populations, and as a result, increased uptake of HbA1c alone or in combination with non-fasting tests could lead to missed diagnoses of type 2 diabetes in the pediatric population.'”Also, a recent analysis of screening strategies found that HbA1c is much less cost-effective than other screening tests, which would result in higher overall costs for screening.”The study was based on a national sample of providers from pediatrics and family practice.”Greater awareness of the 2010 ADA guidelines will likely lead to increased uptake of HbA1c and a shift to use of non-fasting tests to screen for adolescents with type 2 diabetes. This may have implications for detection rates for diabetes and overall costs of screening.”Story Source:The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.

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Sensitive parenting can boost premature children’s school performance

July 31, 2013 — Sensitive parenting helps protect against the negative effects of being born prematurely on children’s school success, a new study has found.Children born prematurely are at risk of a variety of neurological impairments which can mean they are more likely to need special educational support when they reach school age.But a new study led by the University of Warwick shows that parents of very preterm and very low birthweight (VP/VLBW) children can increase their child’s academic achievement through sensitive and cognitively stimulating parenting.Researchers looked at parenting styles of parents of children aged 6 to see what effect they had on those children’s school success when they reached the age of 13.The study found that highly sensitive parenting at age 6 boosted the academic performance of VP/VLBW children when they reached 13 to levels similar to full-term children. A parallel increase was not seen for full-term children.However, the results also showed that more cognitively stimulating early home environments benefit all children’s long-term school success, regardless of whether they were premature or not.Professor Dieter Wolke of University of Warwick said: “By sensitive parenting, we mean adapting one’s parenting to the individual child’s behaviour and responses, while clearly remaining the more competent partner and setting age appropriate limits.””So for example providing gentle feedback and suggesting potential solutions rather than taking over and solving the tasks for the child.”Cognitively stimulating parenting is where parents include activities designed to get children thinking such as reading to them or doing puzzles together.”We found that both these styles of parenting have a positive effect in increasing school performance, with sensitive parenting particularly effective at closing the gap in achievement between preterm and low birth-weight children and their full-term counterparts.”The study, Effects of Sensitive Parenting on the Academic Resilience of Very Preterm and Very Low Birth Weight Adolescents was published in the Journal of Adolescent Health.The researchers sought to clear up uncertainty among the scientific community about whether parenting has an influence on academic achievement of preterm children.They looked at two groups of German children — 314 very preterm/very low birth weight children and a control group of 338 full-term children.They were studied from birth to age 13, with the researchers analysing socioeconomic status, neurological and physical impairment at age 20 months and levels of parental sensitive and cognitive stimulation at age 6 years. School success was measured from six to 13 years of age.The study defined very preterm as babies born at less than 32 weeks gestation or weighing less than 1500g (3lb 5 oz).The researchers found that the 15 per cent of highly sensitive parents within the VP/VLBW group had children whose academic performance at 13 years was similar to the full-term children.In contrast, parents of VP/VLBW children who showed low sensitivity had children who required more special educational help and had more schooling problems.Maternal sensitivity made little difference to the grades or academic performance of full-term children, who were much less susceptible to parenting differences.The research found that cognitively stimulating parenting raised academic performance across both groups of children.Professor Wolke said: “The results suggest that sensitive parenting boosts children’s self-control and attention regulation, which are important for school success.”We would like to see increased investment in programmes that equip parents of VP/VLBW with the skills needed to provide appropriate and sensitive support to their children.”

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Injuries from teen fighting deal a blow to IQ

July 29, 2013 — A new Florida State University study has found that adolescent boys who are hurt in just two physical fights suffer a loss in IQ that is roughly equivalent to missing an entire year of school. Girls experience a similar loss of IQ after only a single fighting-related injury.The findings are significant because decreases in IQ are associated with lower educational achievement and occupational performance, mental disorders, behavioral problems and even longevity, the researchers said.”It’s no surprise that being severely physically injured results in negative repercussions, but the extent to which such injuries affect intelligence was quite surprising,” said Joseph A. Schwartz, a doctoral student who conducted the study with Professor Kevin Beaver in FSU’s College of Criminology and Criminal Justice.Their findings are outlined in the paper, “Serious Fighting-Related Injuries Produce a Significant Reduction in Intelligence,” which was published in the Journal of Adolescent Health. The study is among the first to look at the long-term effects of fighting during adolescence, a critical period of neurological development.About 4 percent of high school students are injured as a result of a physical fight each year, the researchers said.Schwartz and Beaver used data from the National Longitudinal Study of Adolescent Health collected between 1994 and 2002 to examine whether serious fighting-related injuries resulted in significant decreases in IQ over a 5- to 6-year time span. The longitudinal study began with a nationally representative sample of 20,000 middle and high school students who were tracked into adulthood through subsequent waves of data collection. At each wave of data collection, respondents were asked about a wide variety of topics, including personality traits, social relationships and the frequency of specific behaviors.Perhaps not surprisingly, boys experienced a higher number of injuries from fighting than girls; however, the consequences for girls were more severe, a fact the researchers attributed to physiological differences that give males an increased ability to withstand physical trauma.The researchers found that each fighting-related injury resulted in a loss of 1.62 IQ points for boys, while girls lost an average of 3.02 IQ points, even after controlling for changes in socio-economic status, age and race for both genders. Previous studies have indicated that missing a single year of school is associated with a loss of 2 to 4 IQ points.The impact on IQ may be even greater when considering only head injuries, the researchers said. The data they studied took into account all fighting-related physical injuries.The findings highlight the importance of schools and communities developing policies aimed at limiting injuries suffered during adolescence whether through fighting, bullying or contact sports, Schwartz said.”We tend to focus on factors that may result in increases in intelligence over time, but examining the factors that result in decreases may be just as important,” he said. “The first step in correcting a problem is understanding its underlying causes. By knowing that fighting-related injuries result in a significant decrease in intelligence, we can begin to develop programs and protocols aimed at effective intervention.”

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Gynecomastia has psychological impact on adolescent boys, researchers report

Apr. 2, 2013 — Persistent breast enlargement (gynecomastia) negatively affects self-esteem and other areas of mental and emotional health in adolescent males, reports the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Even mild gynecomastia can have adverse psychological effects in boys, according to the study by ASPS Member Surgeon Dr. Brian I. Labow and colleagues of Boston Children’s Hospital. They believe their findings have important implications for early intervention and treatment, including male breast reduction in appropriate cases.

Study Shows Psychological Impact of Gynecomastia in Boys

The researchers administered a series of psychological tests to 47 healthy boys, average age 16.5 years, being evaluated for gynecomastia. The results were compared to those of a group of boys without breast enlargement.

Sixty-two percent of the gynecomastia patients had mild to moderate breast enlargement. As in previous studies, many of the boys with gynecomastia were overweight or obese: 64 percent, compared to 41 percent of the comparison group.

Patients with gynecomastia had lower scores on a standard quality of life assessment, indicating problems in several areas. Even after adjustment for weight and body mass index (BMI), the patients had lower scores for general health, social functioning and mental health. They also had lower scores for physical health, but this was attributed to being overweight.

Breast enlargement was also associated with lower scores for self-esteem. This, along with impairment in emotional areas of quality of life, appeared directly related to gynecomastia, rather than being overweight.

Boys with gynecomastia also scored higher on a test of attitudes toward food and eating. However, there was no difference in the rate of clinical eating disorders between groups.

Psychosocial Effects Independent of Gynecomastia Severity

The negative psychological effects of gynecomastia were similar for boys at different levels of severity. “Merely having gynecomastia was sufficient to cause significant deficits in general health, social functioning, mental health, self-esteem, and eating behaviors and attitudes compared with controls,” Dr. Labow and coauthors write.

Gynecomastia is benign enlargement of male glandular tissue that is very common in adolescent boys. Although breast enlargement usually resolves over time, the problem persists in about eight percent of boys. Typically, boys with gynecomastia who are overweight or obese may simply be advised to lose weight.

However, losing weight won’t correct the problem in patients who have true glandular enlargement, or in those with a large amount of excess skin in the breast area. As shown by the new study, patients with gynecomastia may experience emotional and self-esteem issues regardless of body weight or the severity of breast enlargement.

“As a result, early intervention and treatment for gynecomastia may be necessary to improve the negative physical and emotional symptoms,” Dr. Labow and coauthors state. They note that male breast reduction, performed by a qualified plastic surgeon, is typically a simple and safe procedure.

It may seem self-evident that breast enlargement could have a psychological and emotional impact on teenage boys. However, adolescent gynecomastia has historically been regarded as a “cosmetic” procedure, not reimbursed by most insurance plans. The researchers note that only 35 percent of adolescent boys undergoing surgery for gynecomastia at their hospital were covered by insurance, compared to 85 percent of girls undergoing breast reduction.

“Our results indicate that careful and regular evaluation for gynecomastia may benefit adolescents regardless of BMI status or severity of gynecomastia,” Dr. Labow and colleagues conclude. They call for further studies to evaluate the effects of male breast reduction, including its impact on physical and psychological symptoms.

Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

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